Journal and News Scan

The PERSEVERE study evaluated one-year outcomes of the AMDS Hybrid Prosthesis for acute DeBakey Type I aortic dissection with malperfusion. This prospective, single-arm trial enrolled 93 patients across 26 US sites between July 2022 and May 2023. Primary endpoints included major adverse events including mortality, stroke, renal failure requiring dialysis, myocardial infarction, and distal anastomotic new entry tears (DANE). Through one-year, mortality was 20.4 percent (compared to 42.7 percent in the reference cohort), with minimal events occurring beyond 30 days and no postoperative DANE tears. Secondary outcomes showed 96 percent freedom from unanticipated aortic reoperation and 100 percent arch patency. Positive aortic remodeling demonstrated total aortic diameter stabilization (100 percent in Zone 1, 98 percent in Zone 2, and 73 percent in Zone 3), true lumen expansion (96 percent, 94 percent, and 70 percent respectively), and false lumen thrombosis (91 percent, 92 percent, and 88 percent respectively). The authors conclude that the AMDS device provides encouraging outcomes with reduced mortality and favorable aortic remodeling in this high-risk population. 

The PROCTOR trial randomized 220 post-coronary artery bypass grafting patients with saphenous vein graft (SVG) failure to native vessel percutaneous coronary intervention (PCI) (n=108) or SVG PCI (n=112). At one-year, major adverse cardiac events occurred in 34 percent with native PCI vs 19 percent with SVG PCI (HR 2.14; P=0.006). Nonfatal target-territory myocardial infarction (MI) was higher with native PCI (HR 2.12; P=0.029), as was repeat revascularization (HR 2.19; P=0.044). PCI-related MI occurred in 13 percent with native PCI and one percent with SVG PCI (HR 14.85; P=0.009). All-cause mortality did not differ (HR 1.59; P=0.472). SVG PCI produced significantly better one-year outcomes. 

Sir Terence English, the pioneering cardiac surgeon who performed the United Kingdom’s first successful heart transplant in 1979, has died at the age of 93. His groundbreaking work helped Royal Papworth Hospital achieve an international reputation for heart transplantation and, later, heart-lung and lung transplants. In 1991, he was knighted for his contributions to surgery and medicine. Sir Terrence will be remembered for his commitment to surgical excellence and mentorship in cardiothoracic surgery, and as somebody who encouraged others to find their own passions.  

The DECAF randomized clinical trial investigated whether caffeinated coffee influences the recurrence of atrial fibrillation (AF) after cardioversion. Two hundred patients with persistent AF were randomized to either continue consuming caffeinated coffee (≥1 cup daily) or abstain entirely for six months. AF or atrial flutter recurred in 47 percent of coffee drinkers compared to 64 percent of abstainers, corresponding to a 39 percent lower recurrence risk (HR 0.61; 95 percent CI 0.42–0.89; P = .01). Secondary analyses showed similar trends for AF alone. No differences were seen in adverse events. Contrary to longstanding assumptions, moderate caffeinated coffee intake was associated with a reduced risk of AF recurrence. Proposed mechanisms for this effect include adenosine receptor antagonism, anti-inflammatory effects, and enhanced physical activity.