Surgery and Surgeons

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    Heart-Valve Patients Should Have Earlier Surgery, Study Suggests

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    The results of a new clinical trial have overturned the “wait and see” approach that cardiologists have long favored for symptom-free patients.For decades, people with failing heart valves who nevertheless felt all right would walk out of the cardiologist’s office with the same “wait and see” treatment plan: Come back in six or 12 months. No reason to go under the knife just yet.A new clinical trial has overturned that thinking, suggesting that those patients would be much better off having their valves replaced right away with a minimally invasive procedure.The trial, whose results were published this week in The New England Journal of Medicine, could change the way doctors treat severe aortic stenosis, a narrowing of the valve that controls blood flow from the heart. The disease, which has a prognosis worse than that of most cancers, afflicts more than 3 percent of people ages 65 and older. It is expected to become more common as people live longer.Replacing people’s heart valves, even if they were not yet experiencing any ill effects, appeared to roughly halve their risk of being unexpectedly hospitalized for heart problems over at least two years, the trial found.Patients who were put on the more conservative treatment plan overwhelmingly ended up needing surgery anyway: Roughly 70 percent of them developed symptoms and needed to have their valves replaced within two years, suggesting that the disease worsens more quickly than previously understood.“You may be able to at least prevent that progression and perhaps improve patient outcomes by treating earlier,” said Dr. Gregg Stone, a professor of medicine at the Icahn School of Medicine at Mount Sinai, describing the implications of the trial. The findings, he said, “will have a major effect on practice.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Louisiana Passes Surgical Castration Bill for Child Molesters

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      The bill, if signed by the governor, would be the first to allow a judge to order surgical procedures for those who commit sex crimes against children.Judges in Louisiana could order people who are convicted of sex crimes against children to undergo surgical castration under a bill that state lawmakers passed overwhelmingly on Monday.While Louisiana and a few other states, including California, Texas and Florida, have long allowed chemical castration, the option to punish sex offenders via surgical castration — which is far more intrusive — appears to be the first in the country, according to the National Conference of State Legislatures and prisoners’ advocacy groups.The bill now awaits the signature of Gov. Jeff Landry, a Republican who took office in January vowing a tough-on-crime approach. And while the bill easily passed the Republican-dominated Legislature, it was a Democrat from Baton Rouge, Senator Regina Barrow, who introduced the measure.“We are talking about babies who are being violated by somebody,” Ms. Barrow told lawmakers during an April committee meeting. “That is inexcusable.”The bill allows for the procedure to be ordered for either men or women.Some legislators expressed concerns about Louisiana’s record of wrongful convictions and the prospect of racial bias.“Who does this affect most?” Representative Edmond Jordan, a Baton Rouge Democrat who is Black, said during a legislative hearing. “I know it’s race neutral. I know we say it can apply to anybody, but we all know who it affects.” More

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      First Official Photo of Princess Catherine Since Surgery Is Released by Royal Palace

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      Amid rampant rumors on social media about the condition of the princess, Kensington Palace issued the picture to mark Mother’s Day in Britain but provided no details on her condition.Nearly two months after undergoing abdominal surgery, Catherine, the princess of Wales, appeared in an official photograph, released on Sunday by Kensington Palace to mark Mother’s Day in Britain.Catherine, who posed with her three children, George, Charlotte and Louis, has not been seen in public since before she entered the hospital on Jan. 16, provoking a swirl of increasingly far-fetched rumors on social media about her condition.The image of a smiling Catherine, surrounded by her family, will most likely quiet what had become an extraordinary distraction for the British royal family, which is also dealing with a cancer diagnosis for King Charles III. But it did not completely dispel the questions about the 42-year-old princess.Kensington Palace, where Catherine and her husband, Prince William, have their offices, did not release any new details on her condition or convalescence. It said the photograph was taken by William this past week in Windsor, where the family lives in Adelaide Cottage, on the grounds of Windsor Castle.In a post on social media accompanying the photograph, Catherine said, “Thank you for your kind wishes and continued support over the last two months. Wishing everyone a Happy Mother’s Day.”Last week, a grainy paparazzi shot of Catherine, riding in a car driven by her mother, was posted on the American celebrity gossip site TMZ. British newspapers and broadcasters reported widely on the photograph, but did not publish it, honoring the palace’s appeal that she be allowed to recuperate in private.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      King Charles Released From Hospital After Prostate Procedure

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      Charles was released on Monday hours after Catherine, Princess of Wales, left the same hospital following abdominal surgery.King Charles III was released from a London hospital on Monday after undergoing a procedure to treat an enlarged prostate, Buckingham Palace officials said.Charles was seen waving as he exited The London Clinic, a private hospital, hours after his daughter-in-law Catherine, Princess of Wales, left the same hospital following an abdominal operation she had earlier this month.In a statement on Monday, the palace said Charles, 75, had “rescheduled forthcoming public engagements to allow for a period of private recuperation.” The king was admitted to the hospital Friday morning for what Buckingham Palace described as “scheduled treatment.” Benign prostate enlargement is common in men over 50 and can be found in up to 90 percent of men over 70. Treatment can include medication and changes to diet and lifestyle, as well as surgical procedures in more severe cases to remove excess tissue from the prostate gland.Medical experts said that the most common treatment was a transurethral resection of the prostate, in which a surgeon scrapes out the inside of the prostate gland, giving the urethra more space.Buckingham Palace did not specify which procedure Charles underwent.Queen Camilla was with Charles when he was admitted last week, and she was photographed arriving at and leaving the hospital multiple times over the weekend.January has brought troubling health news for the British royal family. Not only did announcements of Charles and Catherine’s procedures catch supporters and the public off guard, so did news that Sarah Ferguson, Duchess of York and ex-wife of the king’s younger brother, Prince Andrew, had been diagnosed with melanoma, a serious type of skin cancer.It was Ms. Ferguson’s second cancer diagnosis within a year. Last summer she spoke publicly about her decision to undergo a mastectomy and reconstructive surgery after a breast cancer diagnosis. More