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Cardiothoracic surgery

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https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#1
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#2
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
February 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436152/multispecialty-involvement-in-the-management-of-type-b-aortic-dissections-in-the-endovascular-era-implications-for-training-cardiothoracic-residents
#3
Corbin Muetterties, Rohan Menon, William Moser, Nels Carroll, Kathleen Marulanda, Myunghan Choi, Grayson H Wheatley
PURPOSE: Involvement of qualified specialists with proficiency in endovascular therapies has created flux regarding the role of cardiothoracic surgeons, vascular surgeons, and other catheter-skilled specialists in the management of type B aortic dissections. We used manuscript authorship trends and recent match data in order to study how multi-specialty involvement in treating aortic dissections has changed in the endovascular era. METHODS: A PubMed review of published literature between 1998 and 2015 was performed with "aortic dissection" in the title...
April 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28424290/skin-derived-precursors-from-human-subjects-with-type-2-diabetes-yield-dysfunctional-vascular-smooth-muscle-cells
#4
Sarah Katherina Steinbach, Terrence M Yau, Maral Ouzounian, Husam Abdel-Qadir, Mark Chandy, Thomas Waddell, Mansoor Husain
Objective: Few methods enable molecular and cellular studies of vascular aging or type-2 diabetes (T2D). Here we report a new approach to studying human vascular smooth muscle cell (VSMC) pathophysiology by examining VSMCs differentiated from progenitors found in skin. Approach and Results: Skin-derived precursors (SKPs) were cultured from biopsies (N=164, ~1 cm(2)) taken from the edges of surgical incisions of older adults (N=158; males 72%; mean age 62.7±13 years) undergoing cardiothoracic surgery, and differentiated into VSMCs at high efficiency (>80% yield)...
April 19, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28423132/repair-of-penetrating-pericardial-and-diaphragmatic-injury-with-cormatrix%C3%A2-patch-in-a-case-of-suicide-attempt
#5
Federica Jiritano, Carlo Garrasi, Lucia Cristodoro, Egidio Bevacqua, Pasquale Mastroroberto
The authors report the case of a suicide attempt. A 59-year-old man with self-inflicted penetrating chest trauma underwent emergency cardiothoracic surgery. Pre-operative computed tomography scan showed critical proximity between the blade and the right ventricle. Intraoperative findings showed a pericardial laceration and a huge diaphragmatic lesion with heart and abdominal organs integrity. The diaphragm muscle was repaired with a CorMatrix® patch, an acceptable alternative to the traditional synthetic mesh avoiding infection and repeated herniation...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28418290/invasive-nontuberculous-mycobacterial-infections-among-cardiothoracic-surgical-patients-exposed-to-heater-cooler-devices-1
#6
Meghan M Lyman, Cheri Grigg, Cara Bicking Kinsey, M Shannon Keckler, Heather Moulton-Meissner, Emily Cooper, Minn M Soe, Judith Noble-Wang, Allison Longenberger, Shane R Walker, Jeffrey R Miller, Joseph F Perz, Kiran M Perkins
Invasive nontuberculous mycobacteria (NTM) infections may result from a previously unrecognized source of transmission, heater-cooler devices (HCDs) used during cardiac surgery. In July 2015, the Pennsylvania Department of Health notified the Centers for Disease Control and Prevention (CDC) about a cluster of NTM infections among cardiothoracic surgical patients at 1 hospital. We conducted a case-control study to identify exposures causing infection, examining 11 case-patients and 48 control-patients. Eight (73%) case-patients had a clinical specimen identified as Mycobacterium avium complex (MAC)...
May 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28414673/purulent-pericarditis-due-to-an-infected-pacemaker-lead
#7
Teresa Backes
INTRODUCTION: Intravenous drug users have a substantially increased risk of infective endocarditis, especially in the setting of implanted cardiac devices. Purulent pericarditis is a rare occurrence that can occur iatrogenically or through direct or hematogenous spread. CASE DESCRIPTION: A 75 year old man with a past medical history significant for hepatitis C, IV drug abuse, and sick sinus syndrome status post pacemaker was brought in by EMS with a chief complaint of diaphoresis and chest pain...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414671/three-s-a-crowd-an-extremely-rare-case-of-cor-triatriatum-dexter
#8
A Elagizi, R Marvin, G O'Bryan, V Vyas, L Arcement
INTRODUCTION: Cor triatriatum is a congenital cardiac anomaly in which the left (sinister) or right (dexter) atrium is divided into two compartments by residual embryonic tissue, resulting in a tri-atrial heart. As cor triatriatum dextrum can present clinically in various ways and have multiple associated cardiac anomalies, this report attempts to contribute to what is known about this exceedingly rare disorder. CASE: A 40 year old Hispanic man with a medical history of gastritis presented with complaints of palpitations, dizziness and bilateral lower extremity edema...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414667/the-mysterious-case-of-dyspnea
#9
S Saad, N Turaga, J Grant, N Jain
INTRODUCTION: Dehiscence of a mitral valve annuloplasty ring is a rare occurrence that often manifests as mitral regurgitation and heart failure. We present a case of mitral ring dehiscence which was initially unrecognized by standard 2-dimensional transthoracic echocardiography (2D TTE); and 2-dimensional transesophageal echocardiography (2D TEE);. CASE: A 65-year-old woman was referred to Cardiology clinic for evaluation of dyspnea. Her history included tobacco abuse, atrial fibrillation status post pulmonary vein isolation, nonischemic cardiomyopathy, and prior mitral valve repair with annuloplasty ring for rheumatic valvular disease...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#10
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28408203/surgeon-involvement-in-transcatheter-aortic-valve-replacement-in-the-united-states-a-2016-society-of-thoracic-surgeons-survey
#11
Joseph E Bavaria, Richard L Prager, Keith S Naunheim, Mark S Allen, Robert S D Higgins, Vinod H Thourani, Thomas E MacGillivray, Natalie Boden, Joseph F Sabik
BACKGROUND: The Society of Thoracic Surgeons (STS) surveyed cardiothoracic surgeon participants in its Adult Cardiac Surgery Database (ACSD) to learn the extent of surgeon involvement in transcatheter aortic valve replacement (TAVR) procedures. METHODS: An electronic survey was delivered to 2,594 surgeons in June 2016. When the survey closed 2 weeks later, 487 completed surveys had been submitted for a response rate of 18.8%. RESULTS: Among the 487 participants in the ACSD who responded to the survey, 410 (84...
April 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#12
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28386460/reversal-of-abnormal-cardiac-parameters-following-mitral-valve-replacement-for-severe-mitral-stenosis-in-relation-to-pulmonary-artery-pressure-a-retrospective-study-of-noninvasive-parameters-early-and-late-pattern
#13
REVIEW
Usha T Parvathy, Rajesh Rajan, Alexander Georgevich Faybushevich
BACKGROUND AND OBJECTIVES: Although the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods. METHODS: The preoperative, early, and 1-year postoperative data - functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) - of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson's), and their change (t-test), in relation to that in PAP...
June 1, 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28379438/does-the-fissureless-technique-decrease-the-incidence-of-prolonged-air-leak-after-pulmonary-lobectomy
#14
Shuangjiang Li, Wenyu Lv, Kun Zhou, Guowei Che
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether the fissureless technique can reduce the incidence of prolonged air leak (PAL) after pulmonary lobectomy. Altogether 18 papers were found using the reported search, of which 1 prospective randomized study and 4 retrospective cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
March 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28363674/assessment-of-female-medical-students-interest-in-careers-in-cardiothoracic-surgery
#15
Darci C Foote, James M Meza, Vikram Sood, Rishindra M Reddy
OBJECTIVE: Although over half of medical students are females, women comprise only 21% of cardiothoracic (CT) surgery residency applicants and 5% of the CT workforce. We sought to gain insight into female medical students' perceptions of CT surgery and identify targets to increase interest. DESIGN: A 33-question survey queried career selection factors, perceptions of CT surgery, and ways to increase interest in the field. Responses were stratified by sex and preclinical versus clinical years...
March 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28359460/teamwork-and-communication-skills-in-cardiothoracic-surgery
#16
Jennifer L Wilson, Richard I Whyte, Sidhu P Gangadharan, Michael S Kent
Teamwork and communication skills are essential for the safe practice of cardiothoracic surgery. In this article, we will summarize the literature on teamwork and the culture of safety, and discuss how surgeons may directly improve the outcomes of their patients by addressing these factors.
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28347662/an-assessment-of-the-frequency-of-palliative-procedures-in-thoracic-surgery
#17
Richard K Freeman, Gabriel Arevalo, Anthony J Ascioti, Megan Dake, Raja S Mahidhara
OBJECTIVES: Palliative care is a medical specialty focused on improving the quality of life of patients and their families with life threatening illness by preventing or relieving suffering. An assessment of a thoracic surgery service was performed to identify the scope and frequency of care that was considered palliative and any implications the findings might have on the current thoracic surgery residency curriculum. METHODS: A retrospective review of a prospectively collected database of general thoracic surgery procedures performed over a 5-year period at a single institution was performed...
March 24, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28343700/fostering-a-culture-of-innovation-in-academic-surgery
#18
Daniel P McCarthy
Dr McCarthy is a fellow in cardiothoracic surgery at the University of Washington. During his general surgery training at Northwestern University, he completed a research fellowship in surgical innovation and obtained masters' degrees with a focus on health enterprise management, entrepreneurship, and innovation.
April 2017: Surgery
https://www.readbyqxmd.com/read/28341473/pneumonia-after-cardiac-surgery-experience-of-the-national-institutes-of-health-canadian-institutes-of-health-research-cardiothoracic-surgical-trials-network
#19
Gorav Ailawadi, Helena L Chang, Patrick T O'Gara, Karen O'Sullivan, Y Joseph Woo, Joseph J DeRose, Michael K Parides, Vinod H Thourani, Sophie Robichaud, A Marc Gillinov, Wendy C Taddei-Peters, Marissa A Miller, Louis P Perrault, Robert L Smith, Lyn Goldsmith, Keith A Horvath, Kristen Doud, Kim Baio, Annetine C Gelijns, Alan J Moskowitz, Emilia Bagiella, John H Alexander, Alexander Iribarne
RATIONALE: Pneumonia remains the most common major infection after cardiac surgery despite numerous preventive measures. OBJECTIVES: To prospectively examine the timing, pathogens, and risk factors, including modifiable management practices, for postoperative pneumonia and estimate its impact on clinical outcomes. METHODS: A total of 5158 adult cardiac surgery patients were enrolled prospectively in a cohort study across 10 centers. All infections were adjudicated by an independent committee...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28325567/microvascular-surgery-in-the-congenital-cardiac-patient-a-case-series-exploring-feasibility-and-practical-applications
#20
John A LoGiudice, Karri Adamson, Nancy Ghanayem, Ronald K Woods, Michael E Mitchell
BACKGROUND: Pediatric congenital heart disease patients are at risk for vascular injuries during surgical procedures or when the arterial system is accessed for monitoring or diagnostic studies. Our treatment of emergent situations in this patient population using microvascular techniques shows the feasibility of such techniques. METHODS: A retrospective chart review of patients aged 0-18 years with congenital heart disease identified six patients who underwent microvascular surgery by the senior surgeon from June 2007 to May 2015...
February 17, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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