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Cardiothoracic AND surgery

Mohammad Irfan Akhtar, Mona Momeni, Andrea Szekely, Mohammad Hamid, Mohamed R El Tahan, Steffen Rex
OBJECTIVE: To describe global practices for on-table extubation (OTE) in pediatric cardiac anesthesia in European and non-European countries. DESIGN: Multiple-choice, web-based survey with 34 questions addressing organizational data, existence of OTE programs, inclusion and exclusion criteria for OTE, and intraoperative and immediate postoperative management. SETTING: Online survey endorsed by the European Association of Cardiothoracic Anesthesiologists...
July 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Ghulam Jalani, Vivienne Tam, Fiorenzo Vetrone, Marta Cerruti
Efficient control over drug release is critical to increasing drug efficacy and avoiding side effects. An ideal drug delivery system would deliver drugs in the right amount, at the right location and at the right time noninvasively. This can be achieved using light-triggered delivery: light is noninvasive, spatially precise and safe if appropriate wavelengths are chosen. However, the use of light-controlled delivery systems has been limited to areas that are not too deep inside the body because ultraviolet (UV) or visible (Vis) light, the typical wavelengths used for photoreactions, have limited penetration and are toxic to biological tissues...
August 16, 2018: Journal of the American Chemical Society
D Yap, M Ng, N Mbakada
Small bowel obstruction is the most common surgical emergency after a patient has had abdominal surgery. However, Boerhaave syndrome secondary to an ileostomy obstruction has not been reported in current literature. We present a rare case of two concurrent surgical emergencies in a patient with Boerhaave syndrome and small bowel obstruction. A 38-year-old woman presented with sudden onset severe central chest pain associated with breathlessness. She had a history of Crohn's disease, which had been treated with pancolectomy and ileostomy...
August 16, 2018: Annals of the Royal College of Surgeons of England
Seok Mei Lim, Beatrix Wong, Gail Brenda Cross, Reshma Merchant
An 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquaculture pathogen which typically affects elderly and immunocompromised patients...
2018: IDCases
Antonia F Chen, Andrew Fleischman, Matthew S Austin
Intrawound antibiotics have been used in orthopaedic surgery procedures to prevent the development of surgical site infections. Local delivery of antibiotic powder has demonstrated a notable reduction in surgical site infection in rabbit and rodent in vivo models, as well as in other surgical fields, including vascular, colorectal, cardiothoracic, and dermatologic surgery. Intrawound antibiotic powder has been used in many orthopaedic applications, including spine surgery, total joint arthroplasty, trauma, foot and ankle reconstruction, and elbow surgery...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
Nicola Moran, Gobnait Byrne
AIMS: to explore cardiothoracic nurses' knowledge and self-reported competence of wound care following cardiac surgery and to ascertain if there were any differences in knowledge between nurses working in public and private hospitals. BACKGROUND: cardiothoracic nurses are the main providers of wound care for patients post cardiac surgery, however, there is a lack of research about their knowledge of wound care. DESIGN: a descriptive, quantitative design was used in the form of a cross-sectional, self-reported questionnaire...
August 9, 2018: British Journal of Nursing: BJN
Preston Hood, Maharshi Patel, Amanda Johnson, John Pirris, Jerry Matteo
Conventional repair of aortic pathology such as thoracic aortic aneurysms (TAA), aortic dissections, and intramural hematomas (IMH) involves major cardiothoracic surgery. Complication rates can be as high as 30%, therefore percutaneous endograft placement has become the new gold standard. However, not every patient is a suitable candidate for endovascular repair of a thoracic aneurysm, especially, patients with a very short proximal landing zone neck or a difficult type II or type III configuration of the aortic arch...
June 3, 2018: Curēus
Mark B Orringer
Dr. Gordon F. Murray was the 44th president of the Society of Thoracic Surgeons and a distinguished member of this profession. He had a major influence on surgery as both Chief of the Division of Cardiothoracic Surgery and Chairman of the Department of Surgery at West Virginia University. An advocate of resident education, he served on the American Board of Thoracic Surgery and the Residency Review Committee, and was President of the Thoracic Surgery Directors Association. He was a tireless worker and leader in our specialty...
August 3, 2018: Annals of Thoracic Surgery
J Truijen, B E Westerhof, Y-S Kim, W J Stok, B A de Mol, B Preckel, M W Hollmann, J J van Lieshout
While haemodynamic variability interferes with the assumption of constant flow underlying thermodilution cardiac output calculation, variability in (peripheral) arterial vascular physiology may affect pulse contour cardiac output methods. We compared non-invasive finger arterial pressure-derived continuous cardiac output measurements (Nexfin® ) with cardiac output measured using thermodilution during cardiothoracic surgery and determined the impact of cardiovascular variability on either method. We compared cardiac output derived from non-invasive finger arterial pressure with cardiac output measured by thermodilution at four grades (A-D) of cardiovascular variability...
August 3, 2018: Anaesthesia
Abdul K R Purba, Didik Setiawan, Erik Bathoorn, Maarten J Postma, Jan-Willem H Dik, Alex W Friedrich
Introduction: The preoperative phase is an important period in which to prevent surgical site infections (SSIs). Prophylactic antibiotic use helps to reduce SSI rates, leading to reductions in hospitalization time and cost. In clinical practice, besides effectiveness and safety, the selection of prophylactic antibiotic agents should also consider the evidence with regard to costs and microbiological results. This review assessed the current research related to the use of antibiotics for SSI prophylaxis from an economic perspective and the underlying epidemiology of microbiological findings...
2018: Frontiers in Pharmacology
Himani V Bhatt, John Spivack, Pritul R Patel, Ahmed El-Eshmawi, Yasmin Amir, David H Adams, Gregory W Fischer
OBJECTIVE: This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements. DESIGN: Prospective study. SETTING: The cardiothoracic operating rooms (ORs) at Mount Sinai Medical Center in New York, NY. PARTICIPANTS: Fifty-nine patients over 18 years of age underwent elective mitral valve surgery for severe mitral regurgitation from 2014 to 2015...
June 2, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Lloyd Edward Kwanten, Ben O'Brien, Sibtain Anwar
Opioids have played in a key role in cardiac anesthesia and analgesia since the early years of cardiac surgery. Today, opioids continue to be the primary mode for analgesia in cardiac surgery, yet there is considerable variability in the choice, dose and route of used. A history of the use of opioids in cardiothoracic anesthesia is presented, followed by an examination of the differences among current opioids in use and of outcome variables important in cardiac anesthesia, such as postoperative analgesia, extubation times, fast-track cardiac anesthesia, chronic neuropathic pain, and cardioprotection...
June 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Jessica G Y Luc, Nikki L Stamp, Mara B Antonoff
OBJECTIVE: As women represent <5% of practicing cardiothoracic (CT) surgeons, networking and mentorship is pivotal to support the growth of women in this field. With widespread use of social media in the health care domain, its role in enhancing mentorship for CT surgeons lacking access to same-sex mentors remains unknown. METHODS: A 35-item survey investigating CT trainee and surgeon social media use was designed using online survey software and distributed via social media and email...
July 28, 2018: Seminars in Thoracic and Cardiovascular Surgery
Stephanie Wu, Audrey Chai, Sandra Arimie, Anilkumar Mehra, Leonardo Clavijo, Ray V Matthews, David M Shavelle
BACKGROUND: Mitral regurgitation (MR) is a common valvular disorder, occurring in up to 10% of the general population. Although surgery is the established treatment for primary MR, many patients do not receive appropriate therapy. The objective of this study was to determine the incidence and treatment pattern of patients with severe MR evaluated at a tertiary medical center and determine factors associated with receiving surgery. METHODS: All patients with moderate-severe and severe MR undergoing transthoracic echocardiography from 2011 to 2016 were identified...
July 24, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
E Wierda, D C Eindhoven, M J Schalij, C J W Borleffs, G Amoroso, D van Veghel, C R Mitchell, B A J M de Mol, A Hirsch, M C Ploem
Context: Quality-of-care registries have been shown to improve quality of healthcare and should be facilitated and encouraged. The data of these registries are also very valuable for medical data research.<b >While fully acknowledging the importance of re-using already available data for research purposes, there are concerns about how the applicable privacy legislation is dealt with. These concerns are also articulated in the new European law on privacy, the 'General Data Protection Regulation' (GDPR) which has come into force on May 25th 2018...
July 30, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Carlos Santiago Restrepo, Daniel Vargas, Santiago Martinez-Jimenez, Daniel Ocazionez
Complications following cardiothoracic surgery are responsible for prolonged hospital stay, increase cost in patient care and increased morbidity and mortality. Vascular complications in particular are significant contributors to poor patient outcome due to either hemorrhage or thrombosis and ischemia. Evaluation of vascular complications in the postoperative patient requires a rapid and reliable imaging approach. Vascular complications after cardiothoracic surgery include pulmonary artery thrombosis, pseudoaneurysm, pulmonary vein thrombosis, vascular fistulas, stenosis and infarction...
June 2018: Cardiovascular Diagnosis and Therapy
Murali Chakravarthy
No abstract text is available yet for this article.
July 2018: Annals of Cardiac Anaesthesia
Brenton Robinson
Subcutaneous emphysema (SE) is often seen as a sequela of chest tube placement, cardiothoracic surgery, trauma, pneumothorax, infection or malignancy. In most cases SE is self-limited and requires no intervention. Rarely, air can rapidly dissect into subcutaneous tissue planes leading to respiratory distress, patient discomfort and airway compromise. This is a case of a 75-year-old woman that developed massive SE and impending respiratory failure with rapid progression of air into her subcutaneous tissue. In an effort to rapidly stabilize the patient we placed multiple percutaneous angiocatheters into the subfascial space with complete resolution in <24 h...
July 2018: Journal of Surgical Case Reports
Ikechukwu A Nwafor, John C Eze
BACKGROUND: The clinical effects of CHD can occur during the neonatal period, childhood, adolescent, and even adulthood. Some CHD in the adult population have indications for surgical management. OBJECTIVE: The objective of this study was to review the role of humanitarian cardiac surgery missions in the surgical management of CHD in the adult population in a developing country.Materials and methodOver a 5.5-year period - June, 2003, February, 2013-October, 2017 - five different humanitarian cardiac surgery teams visited National Cardiothoracic Center of Excellence, Nigeria...
July 23, 2018: Cardiology in the Young
Joshua L Hermsen, Roderick Yang, Thomas M Burke, Todd Dardas, L Myria Jacobs, Edward D Verrier, Nahush A Mokadam
OBJECTIVE: We sought to develop a 3-D printing-based simulator for teaching extended septal myectomy to trainees in cardiothoracic surgery (clinical postgraduate year 4-7). This procedure is difficult to teach because of generally unfamiliar and highly variable anatomy, limited visibility for the assistant, and significant potential complications. METHODS: A curriculum using multimedia didactics and 3-D print-based patient-specific surgical simulation was implemented...
November 6, 2017: Journal of Thoracic and Cardiovascular Surgery
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