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Journal and News Scan
A brief and readable editorial on the United Kingdom prespective on the global impact of the pandemic to the delivery of cardiovascular care, attempting a semi-quantitative economic appraisal of the problem.
A large RCT with results somewhat supportive of considering a NOAC in the place of warfarin for post operative surgical patients. The study will be weighed against healthcare economical aspects. One question will arise: Why, if there was a subgroup ( the cohort had an average age below 60 years) eceiving lifelong warfarin or equivalent anticoagulation prior to surgery, they did not have a mechanical prosthesis? It is of course possible that local financial constrains impede access to such devices, and bioprostheses were more affordable.
A relatively recent, open-access, brief viewpoint on the utility of screening for thoracic aortic pathologies. Although the negative opinion expressed by the author may not be universally accepted, a debate fuelled by data and especially patient-centered cerebrospinal outcomes will certainly be of benefit; evem more so with the spreading of metrics for prediction of acute complications of aortic disease.
This is a comprehensive review of current strategies for monitoring and protection of the brain during aortic arch surgery under hypothermic circulatory arrest.
Hoyos Mejia et al. present a single center report regarding the outcome of thoracic surgery during the COVID-19 pandemic. They recorded a significant reduction in thoracic surgical cases. They observed five cases of coronarvirus infection in 101 surgical patients within 14 days after surgery. Two of these patients needed inpatient treatment and none died due to the infection. They conclude that it is safe to perform selected surgical procedures during the pandemic if managed properly.
This study evaluated preoperative cerebrospinal fluid drainage (CSFD) In patients undergoing isolated descending TEVAR with or without arch involvement (+/− arch TEVAR).
A scholarly and sober narrative review on , as the authors state, a ' hot topic' that is already being debated in Multidisciplinary Meetings and Lung Cnacer Boards.
Philipp Angleitner et al. present a retrospective study regarding incidence and outcome of bloodstream infections in LVAD patients. The incidence of bloodstream infections is 32.1% within the first year. This event was associated with increased risk of death and stroke. Risk factors of bloodstream infections were identified as lower albumin and ECMO/IABP prior to LVAD implantation.
The authors used The Society of Thoracic Surgeons Database to evaluate cerebral perfusion strategies for type A aortic dissection.
A latge RCT of the first myosin inhibitor in severe chronic heart failure: somewhat difficult to interpret results, as deaths were slightly higher in the intervention group while there was no 'significant' benefit in cardiovascular deaths. The authors discuss the possibility of benefit in lower ejection fractions and proceed to discuss and present subgroups in an effort to glean some granularity in indications for omecamtiv mecarbil.