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https://www.readbyqxmd.com/read/29052454/surgical-ethics-today-and-tomorrow
#1
Robert M Sade, Minoo N Kavarana
Ethical behavior has always been deeply ingrained in surgical culture, but ethical deliberation has only recently become an important component of cardiac surgical practice. In our earlier review, we covered a range of issues including several related to informed consent, conflict of interest, professional self-regulation and innovation, among many others. This update covers several topics of interest to cardiac surgeons and cardiologists, focusing on controversial issues specific to the practice of cardiothoracic surgery: informed consent, relations with hospitals and euthanasia and physician-assisted suicide...
October 20, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29049754/management-of-retrograde-intraoperative-type-a-aortic-dissection-from-descending-thoracic-aortic-injury
#2
Whitney E Hornsby, William Weir, Minhaj Khaja, Bo Yang
Intraoperative Type A aortic dissection during cardiothoracic surgery is extremely rare, but the consequences can be fatal. We report 2 case summaries of retrograde intraoperative Type A aortic dissection from descending thoracic aortic injury during ascending aortic cannulation and provide a discussion on management.
August 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049538/3d-printed-mitral-valve-models-affordable-simulation-for-robotic-mitral-valve-repair
#3
Ned Premyodhin, Divneet Mandair, Alice S Ferng, Timothy S Leach, Ryan P Palsma, Mohammad Z Albanna, Zain I Khalpey
OBJECTIVES: 3D printed mitral valve (MV) models that capture the suture response of real tissue may be utilized as surgical training tools. Leveraging clinical imaging modalities, 3D computerized modelling and 3D printing technology to produce affordable models complements currently available virtual simulators and paves the way for patient- and pathology-specific preoperative rehearsal. METHODS: We used polyvinyl alcohol, a dissolvable thermoplastic, to 3D print moulds that were casted with liquid platinum-cure silicone yielding flexible, low-cost MV models capable of simulating valvular tissue...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29045643/erratum-to-current-mid-term-outcome-with-an-integrated-surgical-strategy-for-correction-of-d-transposition-of-the-great-arteries-with-ventricular-septal-defect-and-left-ventricular-outflow-tract-obstruction-eur-j-cardiothorac-surg-2016-50-4-617-625-doi-10-1093
#4
Benjamin Bierbach, Claudia Arenz, Phillip Suchowerskyj, Sylvia Schroth, Jadwiga Blaschczok, Boulos Asfour, Martin Schneider, Viktor Hraška
No abstract text is available yet for this article.
October 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29038418/two-reports-of-quadricuspid-aortic-valve-with-aortic-insufficiency
#5
Zahir Satti, Abdalla Ibrahim, Peter Kelly
We report two cases of a quadricuspid aortic valve with severe aortic incompetence. Both patients presented with dyspnea on exertion. Their physical examinations demonstrated wide pulse pressures with diastolic murmurs. Bedside transthoracic Doppler echocardiography revealed preserved left ventricular systolic function and possible quadricuspid aortic valve with severe aortic incompetence in both patients. We proceeded with transesophageal echocardiography that confirmed a quadricuspid aortic valve with severe aortic incompetence in both patients...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29036717/evaluation-of-occupational-radiation-dose-in-transcatheter-aortic-valve-implantation
#6
Anette Aarsnes, Gry Dahle, Erik Fosse, Kjell Arne Rein, Lars Aaberge, Anne Catrine T Martinsen
Occupational doses during fluoroscopy in interventional procedures vary largely (Kim et al. (Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys. 2008;94:211-227)). In transcatheter aortic valve implantation, the operators' positions and use of radiation shielding are particularly related to the entry choice on the patient's heart. This study evaluates how occupational doses depend on operator positioning during transfemoral and transaortal access. Occupational dosimetric readings were collected with electronic dosemeters on two cardiothoracic surgeons and one cardiologist during 31 procedures...
September 23, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29030268/topical-vancomycin-to-reduce-surgical-site-infections-in-neurosurgery-study-protocol-for-a-multi-center-randomized-controlled-trial
#7
Alexander J Jonokuchi, Jared Knopman, Ryan E Radwanski, Moises A Martinez, Blake Eaton Samuel Taylor, Michael Rothbaum, Sean Sullivan, Trae R Robison, Brandon R Christophe, Dimitri Sigounas, Brett Youngerman, Emilia Bagiella, Peter D Angevine, Franklin D Lowy, E Sander Connolly
Surgical-site infections (SSIs) account for 20% of all healthcare-associated infections, are the most common nosocomial infection among surgical patients, and are a focus of quality improvement initiatives. Despite implementation of many quality care measures (e.g. prophylactic antibiotics), SSIs remain a significant cause of morbidity, mortality, and economic burden, particularly in the field of neurosurgery. Topical vancomycin is increasingly utilized in instrumented spinal and cardiothoracic procedures, where it has been shown to reduce the risk of SSIs...
October 10, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29029990/2017-eacts-eacta-guidelines-on-patient-blood-management-for-adult-cardiac-surgery
#8
REVIEW
Christa Boer, Michael I Meesters, Milan Milojevic, Umberto Benedetto, Daniel Bolliger, Christian von Heymann, Anders Jeppsson, Andreas Koster, Ruben L Osnabrugge, Marco Ranucci, Hanne Berg Ravn, Alexander B A Vonk, Alexander Wahba, Domenico Pagano, Moritz W V Wyler von Ballmoos, Mate Petricevic, Arie Pieter Kappetein, Miguel Sousa-Uva, Georg Trummer, Peter M Rosseel, Michael Sander, Pascal Colson, Adrian Bauer
Authors/Task Force Members: Christa Boer (EACTA Chairperson)(Netherlands), Michael I. Meesters (Netherlands), Milan Milojevic (Netherlands), Umberto Benedetto (UK), Daniel Bolliger (Switzerland), Christian von Heymann (Germany), Anders Jeppsson (Sweden), Andreas Koster (Germany), Ruben L. Osnabrugge (Netherlands), Marco Ranucci (Italy), Hanne Berg Ravn (Denmark), Alexander B.A. Vonk (Netherlands), Alexander Wahba (Norway), Domenico Pagano (EACTS Chairperson)(UK), Document Reviewers: Moritz W.V. Wyler von Ballmoos (USA), Mate Petricevic (Croatia), Arie Pieter Kappetein (Netherlands), Miguel Sousa-Uva (Portugal), Georg Trummer (Germany), Peter M...
September 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29029711/surgical-embolectomy-for-massive-and-submassive-pulmonary-embolism-and-pulmonary-thromboendarterectomy-for-chronic-thromboembolic-pulmonary-hypertension
#9
Richard J Shemin
Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029100/2017-eacts-eacta-guidelines-on-patient-blood-management-for-adult-cardiac-surgery-the-task-force-on-patient-blood-management-for-adult-cardiac-surgery-of-the-european-association-for-cardio-thoracic-surgery-eacts-and-the-european-association-of-cardiothoracic
#10
Domenico Pagano, Milan Milojevic, Michael I Meesters, Umberto Benedetto, Daniel Bolliger, Christian von Heymann, Anders Jeppsson, Andreas Koster, Ruben L Osnabrugge, Marco Ranucci, Hanne Berg Ravn, Alexander B A Vonk, Alexander Wahba, Christa Boer, Moritz W V Wyler von Ballmoos, Mate Petricevic, Arie Pieter Kappetein, Miguel Sousa-Uva, Georg Trummer, Peter M Rosseel, Michael Sander, Pascal Colson, Adrian Bauer
No abstract text is available yet for this article.
October 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29029018/corrigendum-to-chewing-50-times-per-bite-could-help-to-resume-oral-feeding-on-the-first-postoperative-day-following-minimally-invasive-oesophagectomy-eur-j-cardiothorac-surg-2017
#11
Zhengshuai Zhu, Yin Li, Yan Zheng, Haibo Sun, Xianben Liu, Ruixiang Zhang, Zongfei Wang, Shilei Liu, Xiankai Chen, Xionghuai Hua, Yongkui Yu, Haomiao Li, Jun Zhang, Qi Liu
No abstract text is available yet for this article.
October 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29028762/intermittent-versus-continuous-and-intermittent-medications-for-pain-and-sedation-after-pediatric-cardiothoracic-surgery-a-randomized-controlled-trial
#12
Jamie S Penk, Cheryl A Lefaiver, Colleen M Brady, Christine M Steffensen, Kimberly Wittmayer
OBJECTIVES: Compare continuous infusions of morphine and midazolam in addition to intermittent doses with an intermittent only strategy for pain and sedation after pediatric cardiac surgery. DESIGN: Randomized controlled trial. SETTING: Advocate Children's Hospital, Oak Lawn, IL. PATIENTS: Sixty patients 3 months to 4 years old with early extubation after pediatric cardiac surgery. INTERVENTIONS: Patients received a continuous infusion of morphine and midazolam or placebo for 24 hours...
October 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29028651/endoscopic-conduit-harvest-in-coronary-artery-bypass-grafting-surgery-an-ismics-systematic-review-and-consensus-conference-statements
#13
Francis D Ferdinand, John K MacDonald, Husam H Balkhy, Gianluigi Bisleri, Ho Young Hwang, Patricia Northrup, Richard H J Trimlett, Lai Wei, Bob B Kiaii
OBJECTIVE: The purpose of this consensus conference was to develop and update evidence-informed consensus statements and recommendations on harvesting saphenous vein and radial artery via an open as compared with endoscopic technique by systematically reviewing and performing a meta-analysis of randomized and nonrandomized clinical trials. METHODS: All randomized controlled trials and nonrandomized controlled trials included in the first the International Society for Minimally Invasive Cardiothoracic Surgery Consensus Conference and Statements, in 2005 up to November 30, 2015, were included in a systematic review and meta-analysis...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29026364/recurrent-pneumothoraces-in-a-patient-with-pulmonary-benign-metastasizing-leiomyoma
#14
Miranda Hann, Rinu Manacheril, Jerry St Pierre, Rajiv Gala
BACKGROUND: Pulmonary benign metastasizing leiomyoma (BML) is a rare disease with a malignant characteristic of spread from the uterus. Most cases are asymptomatic, and only 1% are associated with pneumothorax. CASE REPORT: We present the case of a 42-year-old female with recurrent pneumothoraces leading to an incidental finding of diffuse bilateral pulmonary nodules. The diagnosis of BML was based on the patient's history of uterine leiomyomata and confirmed by a biopsy showing benign smooth muscle staining for desmin and vimentin...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29025110/effect-of-continuous-local-anesthetic-in-post-cardiac-surgery-patients-a-systematic-review
#15
Serena S Hong, Maree A Milross, Jennifer A Alison
Objective: The purpose of this review was to determine the effect of CLA infusion post cardiac surgery on pain, time to ambulation, severe adverse events, patient satisfaction, time to extubation, length of stay in the intensive care unit and in the hospital, total narcotic consumption, and pulmonary function. Design: Systematic review with meta-analysis (PROSPERO CRD42014010188). Methods: We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; Allied and Complementary Medicine (AMED); and PsycINFO; as well as hand-searching cardiothoracic surgery and anesthetic journals and meeting abstracts...
August 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29024879/single-intervention-for-a-reduction-in-portable-chest-radiography-pcxr-in-cardiovascular-and-surgical-trauma-icus-and-associated-outcomes
#16
Joseph E Tonna, Kensaku Kawamoto, Angela P Presson, Chong Zhang, Mary C Mone, Robert E Glasgow, Richard G Barton, John R Hoidal, Yoshimi Anzai
PURPOSE: Studies suggest that "on-demand" radiography is equivalent to daily routine with regard to adverse events. In these studies, provider behavior is controlled. Pragmatic implementation has not been studied. MATERIALS AND METHODS: This was a quasi-experimental, pre-post intervention study. Medical directors of two intervention ICUs requested pCXRs be ordered on an on-demand basis at one time point, without controlling or monitoring behavior or providing follow-up...
October 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29019803/the-spot-gradetm-a-new-method-for-reproducibly-quantifying-surgical-wound-bleeding
#17
William D Spotnitz, Dirk Zielske, Valerie Centis, Rachel Hoffman, Daniel L Gillen, Catherine Wittmann, Vincent Guyot, Doris M Campos, Patricia Forest, Alan Pearson, Paul C McAfee
STUDY DESIGN: Benchtop model with prospective surgeon video testing. OBJECTIVE: To create a surface bleeding severity scale, the SPOT GRADE (SG), for quantitative assessment of target bleeding site (TBS) blood loss. This is of particular interest for spinal surgery due to epidural bleeding and an inability to use diathermy and radiofrequency cautery close to nerve roots. SUMMARY OF BACKGROUND DATA: A novel apparatus perfusable at known flow rates and simulating different sized wounds was used to create movies to educate surgeons on specific degrees of bleeding...
October 10, 2017: Spine
https://www.readbyqxmd.com/read/29017656/-development-and-construction-mode-of-critical-care-medicine-22-years-of-development-and-construction-of-intensive-care-units-of-guizhou-medical-university
#18
Difen Wang, Ying Liu, Jiangquan Fu, Yuanyi Liu, Yumei Cheng, Ying Wang, Liang Li, Ming Liu, Yan Tang, Feng Shen, Xu Liu, Jia Yuan, Xianjun Chen, Hongying Bi, Hongxia Wang, Wei Li, Qimin Chen, Cui Wang
OBJECTIVE: To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU. METHODS: The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28994682/successful-surgical-osteoplasty-of-the-left-main-coronary-artery-with-concomitant-mitral-valve-replacement-and-tricuspid-annuloplasty
#19
Ujjwal Kumar Chowdhury, Abhinav Singh Chauhan, Poonam Malhotra Kapoor, Suruchi Hasija, Priya Jagia, Pradeep Ramakrishnan
A 50-year-old woman with rheumatic heart disease, mitral stenosis, and critical isolated left main ostial stenosis was successfully treated by mitral valve replacement, tricuspid annuloplasty, and surgery of left main osteoplasty and is reported for its rarity. Notable clinical findings included an intermittently irregular pulse, blood pressure of 100/70 mmHg, cardiomegaly, a diastolic precordial thrill, a mid-diastolic murmur without presystolic accentuation that was loudest at the mitral area. Chest radiograph revealed cardiomegaly with a cardiothoracic ratio of 0...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28990396/physicians-perceptions-of-shared-decision-making-in-neonatal-and-pediatric-critical-care
#20
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Ross M Hays, Ardith Z Doorenbos
BACKGROUND: Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. OBJECTIVE: To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments...
January 1, 2017: American Journal of Hospice & Palliative Care
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