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Cardiothoracic AND surgery

Constantine Mavroudis, James K Kirklin, William M DeCampli
The history of the first 41 years of the Congenital Heart Surgeons Society (CHSS) was recorded in 2015 which chronicled the metamorphosis of a small informal meeting into a mature organization with bylaws, officers, committees, funded research, the Kirklin-Ashburn Fellowship, and a vision to become the premier organization of congenital heart surgery in North America. Chief among these transformations was the implementation and development of the CHSS Data Center. Member participation, fellowship education, and significant outcomes research have been the hallmark of the CHSS...
November 2018: World Journal for Pediatric & Congenital Heart Surgery
Carlos Domínguez-Massa, Félix Serrano-Martínez, Óscar R Blanco-Herrera, Alberto Berbel-Bonillo, Fernando Hornero-Sos, José A Montero-Argudo
Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided. The hepatic tumor resection was the first procedure to be performed. One week later, under cardiopulmonary bypass, deep hypothermia, and circulatory arrest, thrombectomy of the inferior vena cava and right atrium was accomplished, plus thromboendarterectomy of the right pulmonary artery...
October 14, 2018: World Journal for Pediatric & Congenital Heart Surgery
Bernd Saugel, Maurizio Cecconi, Ludhmila Abrahao Hajjar
The monitoring and optimization of cardiac output (CO) are central components of perioperative hemodynamic management in patients undergoing cardiothoracic surgery. Until recently, echocardiography and invasive indicator dilution methods have been the mainstays of CO monitoring in these patients. However, completely noninvasive methods to estimate CO have become available during recent years. In this review, the physical measurement principles, limitations, and measurement performance of the different techniques for continuous noninvasive CO estimation in the setting of cardiothoracic surgery are described...
June 27, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Myriam Amsallem, Olaf Mercier, Yukari Kobayashi, Kegan Moneghetti, Francois Haddad
In the last decade, there has been renewed interest in the study of the right ventricle. It is now well established that right ventricular function is a strong predictor of mortality, not only in heart failure but also in pulmonary hypertension, congenital heart disease, and cardiothoracic surgery. The right ventricle is part of a cardiopulmonary unit with connections to the pulmonary circulation, venous return, atria, and left ventricle. In this context, ventriculoarterial coupling, interventricular interactions, and pericardial constraint become important to understand right ventricular adaptation to injury or abnormal loading conditions...
October 4, 2018: JACC. Heart Failure
Xiu Wu, Wei Cao, Bin Zhang, Shengyu Wang
INTRODUCTION: The effect of high-flow nasal cannula (HFNC) on adult post cardiothoracic operation remains controversial. We conducted a meta-analysis of randomized controlled trials to evaluate the effect of HFNC and conventional oxygen therapy (COT) on postcardiothoracic surgery. METHODS: A search was conducted in Embase, MEDLINE, Ovid, and Cochrane databases until December, 2017 for all the controlled study to compare HFNC with COT in adult postcardiothoracic surgery...
October 2018: Medicine (Baltimore)
David Blitzer, Elizabeth H Stephens, Vakhtang Tchantchaleishvili, Xiaoying Lou, Peter Chen, Greg Pattakos, Panos N Vardas
BACKGROUND: Changes in healthcare have led to increasing utilization of Advanced Practice Providers (APPs), but their role in Cardiothoracic Surgery (CTS) education remains undefined. This study aimed to analyze the extent of APP utilization on the CTS team, their role within the hierarchy of clinical care, and the impact of PEs on CTS training from the resident perspective. METHODS: CTS residents' responses to the 2017 Thoracic Surgery Residents Association (TSRA)/Thoracic Surgery Directors Association (TSDA) In-Service Training Examination (ITE) survey regarding the role of APPs in specific clinical scenarios, and perception of APP contribution to residents' educational environment were analyzed...
October 9, 2018: Annals of Thoracic Surgery
Shunsuke Kawamoto
In this review article, the latest monitoring systems for vital signs in cardiothoracic surgery, including a multi-wavelength pulse oximeter, a transcutaneous blood gas monitoring system, a modified pulmonary artery catheter, and modern less-invasive cardiac output measurement systems are introduced. These less-invasive and real-time/continuous monitoring technologies would provide useful information for perioperative care after cardiothoracic surgeries, and improve the outcomes of surgeries.
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kento Fukumoto, Masaki Anraku
Extracorporeal membrane oxygenation (ECMO) is a temporary mode of providing life support by totally/partially augmenting heart and lung function over a few days to weeks. More than 30,000 cases involving ECMO usage in adults have been reported worldwide since the introduction of this unique therapy, and its applications continue to evolve rapidly. In recent times, ECMO plays a key role not only in the domain of critical care in intensive care units, but is also useful in the field of cardiothoracic surgery;it provides cardiopulmonary support intra- and post-operatively, respiratory support for primary graft dysfunction after lung transplantation and serves as a bridge to lung transplantation...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Lara Hessels, Annemieke Oude Lansink-Hartgring, Miriam Zeillemaker-Hoekstra, Maarten W Nijsten
BACKGROUND: Nonosmotic sodium storage has been reported in animals, healthy individuals and patients with hypertension, hyperaldosteronism and end-stage kidney disease. Sodium storage has not been studied in ICU patients, who frequently receive large amounts of sodium chloride-containing fluids. The objective of our study was to estimate sodium that cannot be accounted for by balance studies in critically ill patients. Chloride was also studied. We used multiple scenarios and assumptions for estimating sodium and chloride balances...
October 11, 2018: Annals of Intensive Care
Paul E Rothenberg, Byron D Hughes, Farshad Amirkhosravi, Bless P Onaiwu, Ikenna C Okereke
Background: While minimally invasive thoracic surgery (MIS) has increased nationwide over the years, most patients undergoing lung and esophageal resections still undergo an open approach. We performed a national survey to analyze factors associated with a propensity to perform MIS after completing a cardiothoracic training program. Materials and methods: Cardiothoracic surgery trainees in 2 or 3-year programs from 2010 to 2016 were sent an online survey regarding the numbers and types of cases performed during training and current practice patterns as attending surgeons...
November 2018: Annals of Medicine and Surgery
Elaine Yang, Bradley W Frazee
Infective endocarditis (IE) is an uncommon infection of cardiac valves associated with bacteremia. It increasingly affects elderly patients with chronic disease and artificial cardiac devices. The presentation, however, remains subtle and varied, with nonspecific symptoms ranging from those resembling a mild viral infection to septic shock and multiorgan failure. IE carries potential to cause significant morbidity and mortality through its impact on cardiac function and from embolic complications. Blood cultures prior to antibiotics and obtaining prompt echocardiography are key diagnostic steps, followed by proper selection of empiric antibiotics and, in many cases, collaboration with infectious disease, cardiology, and cardiothoracic surgery specialists...
November 2018: Emergency Medicine Clinics of North America
Ashley B Hodge, Brian F Joy, Virginia K Cox, Aymen N Naguib, Dmitry Tumin, Mark E Galantowicz
Introduction: Waiting while a loved one is in surgery can be a very stressful time. Current processes for updating families vary from institution to institution. Providing timely and relevant updates, while important to the family, may strain a surgical team's operational system. In our initial experience with the Electronic Access for Surgical Events (EASE) application (app), we tested the extent to which its implementation improved communication with patient families. Methods: We compared compliance data collected pre-EASE (December 2013 through September 2014) and post-EASE implementation (October 2014 until December 2015)...
March 2018: Pediatric Quality & Safety
Ashwin K Thiagaraj, Richard Bloomingdale, Tesfaye Telila, Luis C Afonso
The HELEX septal occluder (W.L. Gore & Associates, Newark, DE, USA) is a popular closure device for patent foramen ovale (PFO) and secundum atrial septal defect (ASD). Composed of a versatile polymer and a wire frame, it has been used for nearly a decade. A 50-year-old African American man with a PFO repaired 5 years previously with the HELEX was admitted to our hospital with methicillin-resistant Staphylococcus aureus bacteremia. A transesophageal echocardiogram demonstrated large mobile vegetations on the left and right atrial aspects of the occluder...
December 2017: Journal of Cardiology Cases
D J Gross, E H Chang, P L Rosen, V Roudnitsky, M Muthusamy, G Sugiyama, P J Chung
BACKGROUND: Most thoracic surgical procedures in the United States are being performed by general surgeons (GSs) without any advanced training. With the recent approval of computed tomography screening for lung malignancy in high-risk populations, the number of thoracic oncologic resections is expected to rise. Previous literature has demonstrated consistently worsened outcomes for patients undergoing thoracic surgical procedure when done by nonthoracic fellowship-trained surgeons. Using the American College of Surgeons National Surgical Quality Improvement Project database, we examined short-term outcomes in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for malignancy...
November 2018: Journal of Surgical Research
Alexander Meyer, Dina Zverinski, Boris Pfahringer, Jörg Kempfert, Titus Kuehne, Simon H Sündermann, Christof Stamm, Thomas Hofmann, Volkmar Falk, Carsten Eickhoff
BACKGROUND: The large amount of clinical signals in intensive care units can easily overwhelm health-care personnel and can lead to treatment delays, suboptimal care, or clinical errors. The aim of this study was to apply deep machine learning methods to predict severe complications during critical care in real time after cardiothoracic surgery. METHODS: We used deep learning methods (recurrent neural networks) to predict several severe complications (mortality, renal failure with a need for renal replacement therapy, and postoperative bleeding leading to operative revision) in post cardiosurgical care in real time...
September 28, 2018: Lancet Respiratory Medicine
G Erdoes, B Martinez Lopez De Arroyabe, D Bolliger, A B Ahmed, A Koster, S Agarwal, C Boer, C von Heymann
Despite current recommendations on the management of severe peri-operative bleeding, there is no pragmatic guidance for the peri-operative monitoring and management of cardiac surgical patients taking direct oral anticoagulants. Members of the Transfusion and Haemostasis Subcommittee of the European Association of Cardiothoracic Anaesthesiology, of their own volition, performed an independent systematic review of peer-reviewed original research, review articles and case reports and developed the following consensus statement...
September 27, 2018: Anaesthesia
Valérie Lafrenière-Bessi, Frédéric Jacques, Richard Baillot, Jean Bussières, Paola A Ugalde, Stephan Langevin
BACKGROUND: Diaphragmatic plication to help ventilation weaning of an adult obese patient after cardiac surgery is very uncommon. Diaphragm paralysis is usually treated with conservative measures and ventilator support, after which surgical management is considered after months of medical monitoring. CASE PRESENTATION: We report the case of a morbidly obese patient to whom ventilation weaning was unsuccessful following coronary artery bypass graft operation with mitral valve replacement...
September 26, 2018: Journal of Cardiothoracic Surgery
Joseph E Bavaria
No abstract text is available yet for this article.
September 22, 2018: Annals of Thoracic Surgery
Michael A Fierro, Raquel R Bartz, Elliott Bennett-Guerrero
No abstract text is available yet for this article.
October 2018: Journal of Cardiothoracic and Vascular Anesthesia
Mara B Antonoff, Jessica G Y Luc, G Alexander Patterson, Bryan F Meyers, Ralph J Damiano, Marc R Moon
BACKGROUND: Recent initiatives in cardiothoracic (CT) surgery education have been aimed at early tracking, emphasizing specialization during the final years of residency. This study was performed to examine the impact of subspecialization on graduate assessment of quality of training and to identify educational gaps. METHODS: Surveys were sent to 119 surgeons who completed thoracic surgery residency at Washington University between 1958-2017. Surveys evaluated transition-to-practice preparedness in patient care, technical skills, and qualifying and certifying examinations...
September 18, 2018: Annals of Thoracic Surgery
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