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Surgical aortic valve replacement generally improves patients’ symptoms and prolongs survival. However, the perceived risk of surgical aortic valve replacement in patients over 80 may result in surgery being denied or a recommendation for alternative therapy. Investigators at the Mayo Clinic challenge the way these patients have been managed. They report that repeat sternotomy in patients over 80 who have previously had coronary bypass graft surgery can be done with low risk. Their findings are published in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

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Reports of the two earliest tissue-engineered whole organ transplants using a windpipe, or trachea, created using the patient's own stem cells, were hailed as a breakthrough for regenerative medicine and widely publicized in the press. However, two leading transplant surgeons in Belgium warn of the dangers of media attention, and urge that tracheal bioengineering be demonstrated as both effective and safe before further transplants take place. Their views are published in an Editorial in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

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Long-term survivors after esophagectomy with gastric pull-up can enjoy a satisfying meal and good quality of life according to a new study from a team of researchers at the University of Southern California Keck School of Medicine, Los Angeles. This study concluded that pessimism about the long-term quality of life after an esophagectomy on the part of treating physicians and patients is unwarranted. It is published in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

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Surgeons in France have successfully replaced the aortic valve in two patients without opening the chest during surgery. The procedure, using totally endoscopic aortic valve replacement (TEAVR), shows potential for improving quality of life of heart patients by offering significantly reduced chest trauma. It is described in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

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AATS and three cardiovascular professional societies today released an overview of transcatheter therapies for mitral regurgitation. Intended to “help frame subsequent discussions” among the field’s various stakeholders, the document highlights critical issues that should be considered as the technologies are integrated into clinical practice.

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The American Association for Thoracic Surgery (AATS), a professional organization of surgeons dedicated to the diagnosis, treatment, and cure of diseases of the chest, strongly supports the United States Preventive Services Task Force (USPSTF) draft recommendation for lung cancer screening of asymptomatic smokers.

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Tumors have the potential to grow locally and invade neighboring organs. Some chest tumors may invade one of the great vessels of the body, the aorta. Surgical removal of these tumors is very challenging and necessitates the support of a heart-lung machine. Therefore there is an increased risk of complication and death. In a small series of patients, placing a stent within the aorta facilitated the subsequent removal of tumor and eliminated the need for heart-lung bypass. A report of these results is presented by Stéphane Collaud, MD, MSc, at the Emerging Technology and Techniques Forum of the 93rd AATS Annual Meeting in Minneapolis on May 8, 2013.

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Inherited ventricular arrhythmias are an important cause of morbidity and sudden cardiac death in children who have structurally normal hearts. Despite conventional medical therapy, some of these children remain symptomatic with recurrent life-threatening arrhythmias, syncope, or frequent discharges from implantable cardioverter defibrillators (ICDs). Video-assisted thoracoscopic left cardiac sympathetic denervation (VATS-LCSD) is a minimally invasive procedure that can help many of these children with refractory cardiac arrhythmias. The results of a single-center experience with VATS-LCSD will be presented during the Congenital Heart Disease Session of the 93rd AATS Annual Meeting in Minneapolis by Dr. Sophie C. Hofferberth, MBBS.

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Adults with end-stage respiratory failure and pulmonary hypertension requiring ECMO (extracorporeal membrane oxygenation) have been “bridged” toward lung transplantation with novel lung assist devices such as the Novalung. This and related devices work based on pumpless application of oxygenators. A presentation by David M. Hoganson, MD, and colleagues from Washington University School of Medicine in St. Louis at the Congenital Heart Disease Session of the 93rd AATS Annual Meeting describes the first time application of this technology to newborns and small children.

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When a biologic aortic valve prosthesis fails, the patient often faces a high risk valve replacement through repeat open heart surgery. A new technique, known as Valve-in-Valve, uses minimally invasive techniques to introduce a collapsible aortic heart valve into the damaged valve in order to restore function. This procedure avoids the need to open the chest or use cardiopulmonary bypass (heart-lung machine), according to Leo Ihlberg, MD, PhD, a cardiothoracic surgeon at the Heart and Lung Center of Helsinki University Hospital, Finland, who will be presenting the results of a new study at the 93rd AATS Annual Meeting in Minneapolis on May 6, 2013.

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The American Association for Thoracic Surgery Annual Meeting is the oldest and largest cardiothoracic surgery meeting in North America. The 93rd will be held at the Minneapolis Convention Center, Minneapolis, MN, USA, on May 4-8, 2013. Approximately 2500 professionals are expected to attend.

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Anemia increases operative mortality and morbidity in non-cardiac and cardiac surgical procedures. Anemic surgical patients may require more blood transfusions, raising the risk of transfusion-related complications and increasing costs. For those reasons, optimizing patient readiness by correcting anemia prior to surgery is an important clinical goal. A simple new protocol has been proposed that helps correcting anemia using a single, high dose of recombinant human erythropoietin (HRE) administered only two days prior to surgery. The results of a randomized study will be presented by Luca Weltert, MD, Cardiac Surgery Department of the European Hospital in Rome, during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis.

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Lung cancer is associated with very high mortality, in part because it is hard to detect at early stages, but also because it can recur frequently after surgical removal. The question arises as to what is the best way to follow lung cancer patients after surgery in order to spot problems early enough, before symptoms become obvious, so that patients may still be eligible for new interventions. In this study presented at the 93rd AATS Annual Meeting, investigators from the University of Toronto departments of Thoracic Surgery and Diagnostic Radiology show that minimal dose computed tomography (MnDCT) of the thorax offers much greater sensitivity at detecting new or recurrent lung cancer, with equivalent amount of radiation, compared to conventional chest x-rays.

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For more than 40 years, patients under 65 years of age requiring heart valve replacement have had to choose between a mechanical valve that offers life-long durability but requires aggressive warfarin anticoagulation or a biological (cow or pig) valve that will wear out in 10-20 years but does not require anticoagulation. Aggressive warfarin anticoagulation is accompanied by significant annual risk of bleeding, while inadequate anticoagulation of a mechanical artificial valve has been associated with high risk of clotting problems that can cause strokes.