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| The Monthly Pulse |
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| CABG bests PCI for multivessel CAD, large new study confirms
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| The Story |
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| According to data from more than 100,000 patients with multivessel coronary disease, coronary artery bypass grafting (CABG) is associated with higher survival rates than percutaneous coronary intervention (PCI). The findings, which were shared at the 59th Annual Meeting of the Society of Thoracic Surgeons (STS), show that not only was long-term survival improved among patients who received CABG, but the risk for complications was also lower. Patients were also less likely to need additional stenting procedures or related interventions within three years. |
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| What You Should Know |
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| The new research on CABG versus PCI was a response to the coronary artery revascularization guidelines released in 2021 by the American College of Cardiology, American Heart Association, and Society for Cardiovascular Angiography and Interventions. Within these updates, CABG was downgraded from its previous class 1 recommendation to class 2B. Many cardiac surgeons were shocked by this change, but note that it was made based on limited data including the ISCHEMIA trial. Because this trial failed to accurately represent average patients eligible for CABG, researchers sought to analyze a broader data set, which led to these findings.
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| FDA warns that early deterioration is possible with Abbott’s Trifecta heart valves
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| The Story |
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| Recently, Abbott and the FDA announced that the company’s line of Trifecta bioprosthetic heart valves may be at risk for early structural valve deterioration (SVD). Both the original Trifecta valve and the Trifecta GT, which are designed to treat damaged or diseased aortic heart valves, may be affected. A series of reports of deterioration have been issued, especially three to four years following implantation.
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| What You Should Know |
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| According to the FDA’s advisory, published literature on the durability of the Trifecta valve shows that other commercial valves are less likely to experience early SVD. While the Trifecta valves have not been formally recalled, the FDA encourages healthcare providers to monitor the issue closely. Abbott, too, has encouraged providers to report any adverse reactions or quality issues related to the valves.
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| Pericardial tamponade, a diagnostic chameleon: from the historical perspectives to contemporary management |
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| The Story |
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| Pericardial tamponade after cardiac surgery is sometimes misrecognized and often gets diagnosed late in its course. In a recent case study, surgeons share the ways in which the condition was diagnosed and promptly treated in a 74-year-old woman ten days after receiving elective biological aortic valve replacement and aorto-coronary-bypass grafting. |
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| What You Should Know |
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| According to the case study, the patient deteriorated unexpectedly and rapidly, developing radiating epigastric pain and features of low peripheral perfusion and shock. A contrast-enhanced CT scan was performed to rule out abdominal pathology, but bleeding from the right coronary anastomosis was discovered. The bleeding was located and treated successfully, but surgeons are sharing the incident as a reminder to expect the occurrence of life-threatening situations such as cardiac tamponade in the days after cardiac surgery, even in the case of atypical symptoms.
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| Leadership Reflections |
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In Person
I’m more of an introvert than extrovert, more task oriented than people oriented. It’s easy for me to sit at my desk, dig into my work, and rely on well thought out and scripted emails for communication with our team and clients. It feels risky for me to get out and be with people in person where things can sometimes feel awkward or messy. This has been exacerbated by the pandemic - I can’t remember the last time I was with people for an entire workday without a screen between us.
I had the privilege of attending the Association for Advancing Physician and Provider Recruitment’s Annual Conference last month. I don’t normally attend conferences as an exhibitor but took advantage of the opportunity to meet with our clients and conference attendees face to face. I also had the chance to spend time with some of our newer team members, learning about the challenges of their roles and mentoring along the way. What a gift!
I am committed to being more present, in person, with our team and our clients, and I welcome the opportunity to visit with you and your team. I have seen great mutual benefits come out of these visits. I also encourage you to step away from your screen when you are able to spend time in person with members of your team you don’t see on a regular basis. In spite of being out of practice, I believe everyone is craving more in-person human connection!
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| 15th annual Mid-Atlantic VAD and ECMO Symposium (MAVES) |
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| Sanibel Symposium |
| Wed. May 10 - Sat. May 13 |
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| Hoosier Extracorporeal Science Conference |
| Fri. May 26 - Sat. May 27 |
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| AAPA 2023 |
| Sat., May 20 - Wed., May 24 |
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| AACN NTI 2023 |
| Mon., Jun. 12 - Wed., Jun. 14 |
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