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Endoscopic Studies II: Thoracocentesis

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Noteworthy in Cardiothoracic Surgery 2023.

Jessica Y Rove1, Michael T Cain1, Jordan R Hoffman1

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Summary

Donation after circulatory death (DCD) organ transplantation is rising. Key trials in extracorporeal life support (ECLS), aortic surgery cooling strategies, and updated atrial fibrillation guidelines are reviewed for cardiothoracic surgery advancements.

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cardiac surgerycardiopulmonary bypasscirculatory arrestheart failurethoracic surgery

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Area of Science:

  • Cardiothoracic Surgery
  • Transplantation
  • Cardiovascular Research

Background:

  • Donation after circulatory death (DCD) organ transplantation is increasing.
  • Extracorporeal life support (ECLS) use has grown, especially post-COVID-19.
  • Optimizing cognitive outcomes in complex aortic surgery requires better evidence on cooling and perfusion strategies.

Purpose of the Study:

  • To summarize high-impact trials and trends in cardiothoracic surgery and transplantation from the past year.
  • To review the impact of DCD on heart and lung transplantation.
  • To discuss recent guideline updates relevant to cardiothoracic surgery.

Main Methods:

  • Review of data on DCD transplantation outcomes.
  • Analysis of the ECLS-SHOCK trial results for cardiogenic shock patients.
  • Examination of the GOT ICE trial evaluating hypothermic circulatory arrest temperatures and cognitive outcomes.
  • Summary of surgically relevant updates from 2023 STS and ACC/AHA/ACCP/HRS atrial fibrillation guidelines.

Main Results:

  • DCD transplantation continues to rise, with new best practice recommendations.
  • The ECLS-SHOCK trial compared ECLS to usual care in cardiogenic shock.
  • The GOT ICE trial assessed cognitive effects of different cooling temperatures during hypothermic circulatory arrest.
  • Updated guidelines from STS and ACC/AHA/ACCP/HRS offer new recommendations for atrial fibrillation management.

Conclusions:

  • Significant advancements and ongoing research in DCD transplantation, ECLS, and aortic surgery cooling strategies are shaping cardiothoracic surgery.
  • Recent guideline updates provide crucial information for managing atrial fibrillation in cardiothoracic patients.
  • The reviewed studies highlight key areas of progress and future directions in the field.