Heart Surgery
FDA: Class I recall of Certitude Delivery System
Editor's Note The Food and Drug Administration (FDA) on January 11 classified the recall by Edwards LifeSciences (Irvine, California) of its Certitude Delivery System as Class I, the most serious. The system is used for delivery of the Edwards SAPIEN 3 transcatheter aortic heart valve. The recall was issued because…
Perioperative myocardial injury common after noncardiac surgery
Editor's Note Perioperative myocardial injury (PMI) is a common complication after noncardiac surgery (occurring in 1 of 7 patients), and it is associated with substantial short- and long-term mortality (9% and 22%), this study finds. This analysis included 2,018 patients having 2,546 surgical procedures. PMI occurred after 397 of the…
Postop outcomes in OSA patients having cardiac surgery
Editor's Note Obstructive sleep apnea (OSA) is an important risk factor for postoperative complications in cardiac surgery patients, finds this meta-analysis led by Frances Chung, MD, a noted expert on OSA. After cardiac surgery, major adverse cardiac or cerebrovascular events and newly documented postoperative atrial fibrillation were 33.3% and 18.1%…
CMS finalizes changes to bundled-payment models
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…
Study: Restrictive vs liberal blood transfusion outcomes in cardiac surgery patients
Editor's Note A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this…
Periop nurses key in reducing readmissions after CABG surgery
Editor's Note Perioperative nurses engaging in patient and community education to explain coronary artery bypass grafting (CABG) surgery, reinforcing recommended discharge guidelines, and serving as expert resources are key to positive outcomes and reducing readmissions, finds this review article. In 2016, the Centers for Medicare & Medicaid Services reduced payments…
FDA: Increased rate of major adverse events with Absorb GT1 Bioresorbable Vascular Scaffold
Editor's Note The Food and Drug Administration (FDA) on October 31 issued a Safety Alert saying that interim study results continue to show an increased rate of major adverse cardiac events and Bioresorbable Vascular Scaffold (BVS) thrombosis in patients receiving the Absorb GT1 BVS by Abbott Vascular (Abbott Park, Illinois),…
FDA updates Safety Alert for St Jude defibrillators
Editor's Note The Food and Drug Administration (FDA) on October 19 issued an updated Safety Alert for implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators by St Jude Medical. Because batteries for the devices may fail earlier than expected, St Jude has made available a new battery performance management tool,…
Payment variation in CABG episodes of care can affect bundled payments
Editor's Note Wide variation was found in 90-day coronary artery bypass grafting (CABG) episode payments for Medicare and private payer patients in this study. The differences were driven by increased use of evaluation and management services, higher utilization of inpatient rehabilitation, and patients with multiple readmissions. In the analysis of…
Five-year outcomes of on-pump vs off-pump CABG
Editor's Note In this multicenter study, on-pump coronary artery bypass grafting (CABG) led to significantly higher rates of 5-year survival and event-free survival than off-pump CABG. From 2002 to 2007, a total of 2,203 patients at 18 medical centers were randomly assigned to undergo either on-pump (1,099 patients) or off-…
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