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Cardiothoracics

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https://www.readbyqxmd.com/read/28632654/an-overview-of-cardiac-computed-tomography-in-adults-with-congenital-heart-disease
#1
Pal Suranyi, Akos Varga-Szemes, Anthony M Hlavacek
Familiarity with congenital heart disease (CHD) and its manifestations in adults is becoming increasingly important for the practicing cardiothoracic imager. The use of computed tomographic angiography is becoming commonplace not only in adults with a history and subsequent interventions for CHD as a child but also in de novo detection of-typically-milder, survivable forms of CHD, which are clinically suspected because of declining cardiac performance, cardiac events, or murmurs. Occasionally, adult CHD (ACHD) is found incidentally on scans performed for other indications (eg, trauma or neoplasm staging) because of improvements in computed tomographic technology and advanced visualization...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28624014/can-routine-chest-radiography-be-used-to-diagnose-mild-copd-a-nested-case-control-study
#2
A M den Harder, A M Snoek, T Leiner, W J Suyker, L M de Heer, R P J Budde, J W J Lammers, P A de Jong, M J A Gondrie
OBJECTIVES: To determine whether mild stage chronic obstructive pulmonary disease (COPD) can be detected on chest radiography without substantial overdiagnosis. METHODS: A retrospective nested case-control study (case:control, 1:1) was performed in 783 patients scheduled for cardiothoracic surgery who underwent both spirometry and a chest radiograph preoperative. Diagnostic accuracy of chest radiography for diagnosing mild COPD was investigated using objective measurements and overall appearance specific for COPD on chest radiography...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28616278/management-of-the-vertebral-artery-during-thoracic-endovascular-aortic-repair-with-coverage-of-the-left-subclavian-artery
#3
Jian Zhu, Er-Ping Xi, Shui-Bo Zhu, Gui-Lin Yin, Rong-Ping Wang, Yu Zhang
BACKGROUND: The application of thoracic endovascular aortic repair (TEVAR), a minimally invasive operation, in the aortic arch has been a challenge of cardiovascular surgery in recent years. This study aimed to investigate management of the vertebral artery with coverage of the left subclavian artery (LSA) during TEVAR. METHODS: From January 2007 to September 2014 in the Department of Cardiothoracic Surgery at Wuhan General Hospital of Guangzhou Military Region, 160 patients underwent LSA closure or partial coverage during TEVAR of an aortic lesion near the LSA...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612281/perioperative-management-of-antiplatelet-treatment-in-patients-undergoing-isolated-coronary-artery-bypass-grafting-in-dutch-cardiothoracic-centres
#4
P W A Janssen, D M F Claassens, L M Willemsen, T O Bergmeijer, P Klein, J M Ten Berg
BACKGROUND: International guidelines do not provide uniform recommendations regarding the use of antiplatelet treatment in the perioperative period in patients undergoing coronary artery bypass grafting (CABG). METHODS: A questionnaire was sent to all 16 cardiothoracic centres in the Netherlands to determine which antiplatelet treatment is used in the perioperative setting. Furthermore, a single-centre prospective observational cohort study was performed which included all patients undergoing isolated CABG in July 2014...
June 13, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28609315/the-role-of-extracorporeal-membrane-oxygenation-simulation-training-at-extracorporeal-life-support-organization-centers-in-the-united-states
#5
Mark F Weems, Philippe S Friedlich, Lara P Nelson, Alyssa J Rake, Laura Klee, James E Stein, Theodora A Stavroudis
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) requires a multidisciplinary healthcare team. The Extracorporeal Life Support Organization publishes training guidelines but leaves specific requirements up to each institution. Simulation training has shown promise, but it is unclear how many institutions have incorporated simulation techniques into ECMO training to date. METHODS: We sent an electronic survey to ECMO coordinators at Extracorporeal Life Support Organization sites in the United States...
June 12, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28607827/discrimination-against-female-surgeons-is-still-alive-where-are-the-full-professorships-and-chairs-of-departments
#6
EDITORIAL
Nancy E Epstein
BACKGROUND: Although half of all medical students are now and women are increasingly filling surgical residency positions, few ascend the academic ladder to become chairman of their departments, much less full academic professors. METHODS: We queried PubMed to search for the number of women surgeons in different subspecialties, and asked how many were chairman or full academic professors? RESULTS: Data coming out of largely general or cardiothoracic surgery departments cited no substantial gains for women surgeons over the years; there were few chairmanships or full professorships...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28603837/the-added-value-of-f-tapse-in-the-surveillance-of-pregnancies-complicated-by-fetal-and-placental-tumors
#7
Sharon Perlman, Baruch Messing, Yishay Salem, Shiran Porat, Reuven Achiron, Yinon Gilboa
INTRODUCTION: Fetal and placental tumors are associated with high prevalence of obstetrical complications and poor fetal outcome. The aim of our study was to assess the added value of serial fetal Tricuspid Annular Plane Systolic Excursion (f-TAPSE) measurements for monitoring cardiac function in cases of fetal and placental tumors. METHODS: Serial measurements of f-TAPSE were performed prospectively in fetuses referred for fetal and placental tumors. The patients were followed longitudinally every 2 weeks...
June 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28600373/evaluation-of-a-physiatrist-directed-prehabilitation-intervention-in-frail-patients-with-colorectal-cancer-a-randomised-pilot-study-protocol
#8
Sherman G Wong, Eugene Maida, David Harvey, Natalie Wagner, Ranil Sonnadara, Nalin Amin
INTRODUCTION: Prehabilitation interventions have shown efficacy in the orthopaedic and cardiothoracic surgical populations, but there has been limited evidence for general surgical patients. We present the protocol for a pilot trial of a novel prehabilitation intervention, consisting of a physiatrist-directed preoperative assessment and treatment programme. METHODS AND ANALYSIS: This is a single-centre pilot randomised controlled trial investigating physiatrist-directed prehabilitation for a 4 to 6-week preoperative period...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28594583/impact-of-surgeon-specialty-on-perioperative-outcomes-of-surgery-for-benign-esophageal-diseases-a-nsqip-analysis
#9
Zeyad Khoshhal, Joseph Canner, Eric Schneider, Miloslawa Stem, Elliott Haut, Francisco Schlottmann, Arianna Barbetta, Benedetto Mungo, Anne Lidor, Daniela Molena
BACKGROUND: Surgery for benign esophageal disease is mostly performed either by general surgeons (GS) or cardiothoracic surgeons (CTS) in the United States. The purpose of this study was to evaluate the effect of surgeon specialty on perioperative outcomes of surgery for benign esophageal diseases. MATERIALS AND METHODS: We have conducted a retrospective analysis using the ACS-NSQIP during the period of 2006-2013. Patients who underwent paraesophageal hernia (PEH) repair, gastric fundoplication, or Heller esophagomyotomy were divided into two groups according to the specialty of the surgeon (GS or CTS)...
June 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28592842/the-effects-of-e-interventions-on-the-medical-outcomes-of-hemodialysis-patients-a-retrospective-matched-patient-cohort-study
#10
Chang-Chyi Jenq, Cheng-Chieh Hung, Kuo-Chang Juan, Kuang-Hung Hsu
Aggressively applying e-interventions in the health care industry has become a global trend to improve the quality of medical care. The present retrospective study evaluated the effect of electronic information systems on the quality of medical care provide to hemodialysis (HD) patients. In total, 600 patients (300 patients each in the e-intervention and non-e-intervention groups, were matched for sex, age, HD duration, diabetes, and hypertension) receiving HD at the study institute for four years were included in this study...
June 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28587877/cardiothoracic-surgical-training-in-canada-and-the-united-states-divergent-paths-converging-goals
#11
EDITORIAL
Corey A Kalbaugh, John S Ikonomidis
No abstract text is available yet for this article.
May 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28583680/comparison-of-frequency-of-referral-to-cardiothoracic-surgery-for-aortic-valve-disease-in-blacks-hispanics-and-whites
#12
Benjamin Cruz Rodriguez, Priyanka Acharya, Christopher Salazar-Fields, Aaron Horne
Racial differences in prevalence and in intervention rate of those with severe aortic stenosis have been reported. Our objective was to evaluate health disparities in referral to cardiothoracic surgery (CTS) for aortic stenosis in black and Hispanic compared with white patients before the transcatheter aortic valve replacement program was started in our community. Using a retrospective cohort design, we identified all patients >40 years, who had been captured with aortic valve disease from January 2011 to June 2016...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28583423/postoperative-bleeding-after-change-in-heparin-supplier-a-cardiothoracic-center-experience
#13
Mirela Bojan, Andreas Fischer, Ashok Narayanasamy, Paul Yea, Eleanor Dunnett, Andrea Kelleher
OBJECTIVE: Unfractionated heparin is a mixture of glycosaminoglycans with different pharmacologic and pharmacokinetic properties. The literature suggests that blood loss after cardiac surgery is related to both elevated postoperative heparin concentrations and the potency of different heparin brands. DESIGN: An audit of the observed increase in the incidence of cardiac surgery-related bleeding after change in heparin supplier. Patient characteristics were compared between groups before and after a change in heparin brands...
February 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28582520/rapid-resolution-of-ortner-s-syndrome-with-giant-left-atrium-after-double-valve-replacement-surgery
#14
Metesh Nalin Acharya, Toufan Bahrami, Aron-Frederik Popov, Sunil Kishore Bhudia
Hoarseness of voice due to recurrent laryngeal nerve palsy is an uncommon manifestation of cardiothoracic disease. Ortner's syndrome is hoarseness attributed to mechanical compression of the left recurrent laryngeal nerve in association with several cardiopulmonary disease states. We here describe a rare case of Ortner's syndrome developing in a 60-year-old woman with a giant left atrium in the context of rheumatic mitral valve stenosis. The remarkable resolution of her voice hoarseness within 1 week of valve replacement surgery has not been reported in similar cases to date...
June 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28575906/-preoperative-evaluation-of-adult-patients-before-elective-non-cardiothoracic-surgery
#15
(no author information available yet)
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anaesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28575079/comparison-of-forced-air-and-water-circulating-warming-for-prevention-of-hypothermia-during-transcatheter-aortic-valve-replacement
#16
Benjamin Rohrer, Emily Penick, Farhad Zahedi, Hocine Tighiouart, Brian Kelly, Frederick Cobey, Stefan Ianchulev
INTRODUCTION: Transcatheter Aortic Valve Replacement (TAVR) procedures at our institution were complicated by perioperative hypothermia despite use of the standard of care forced-air convective warming device (the BairHugger, Augustine Medical Inc, Eden Prairie, MN, USA). To remedy this problem, we initiated a quality improvement process that investigated the use of a conductive warm water-circulating device (the Allon ThermoWrap, Menen Medical Corporation, Trevose, PA, USA), and hypothesized that it would decrease the incidence of perioperative hypothermia...
2017: PloS One
https://www.readbyqxmd.com/read/28572111/patients-hand-washing-and-reducing-hospital-acquired-infection
#17
Stacy Haverstick, Cara Goodrich, Regi Freeman, Shandra James, Rajkiran Kullar, Melissa Ahrens
BACKGROUND: Hand hygiene is important to prevent hospital-acquired infections. Patients' hand hygiene is just as important as hospital workers' hand hygiene. Hospital-acquired infection rates remain a concern across health centers. OBJECTIVES: To improve patients' hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients' education to reduce hospital-acquired infections. METHODS: In August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28570451/the-cardioplastic-approach-to-the-treatment-of-infected-aortic-grafts
#18
Russell S Frautschi, Bahar Bassiri Gharb, Mindy M Duong, Raffi Gurunluoglu, Francis Papay, James E Zins, Antonio Rampazzo
BACKGROUND: Aortic graft infection (AGI) is a rare complication following reconstructive aortic surgery, yet it represents a significant source of morbidity and mortality. There is no consensus regarding the optimal surgical management, due in part to the small cohorts of patient reports. Pedicled muscle or omental flap coverage of AGI has been shown to improve outcomes, making them a valuable consideration in the treatment algorithm. Thus, we aim to compile and evaluate cases of autologous vascularized tissue (AVT) in the treatment of infected aortic grafts, summarizing location specific trends, treatments, and outcomes...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28540614/a-comparison-of-volume-clamp-method-based-continuous-noninvasive-cardiac-output-cnco-measurement-versus-intermittent-pulmonary-artery-thermodilution-in-postoperative-cardiothoracic-surgery-patients
#19
Julia Y Wagner, Annmarie Körner, Leonie Schulte-Uentrop, Mathias Kubik, Hermann Reichenspurner, Stefan Kluge, Daniel A Reuter, Bernd Saugel
The CNAP technology (CNSystems Medizintechnik AG, Graz, Austria) allows continuous noninvasive arterial pressure waveform recording based on the volume clamp method and estimation of cardiac output (CO) by pulse contour analysis. We compared CNAP-derived CO measurements (CNCO) with intermittent invasive CO measurements (pulmonary artery catheter; PAC-CO) in postoperative cardiothoracic surgery patients. In 51 intensive care unit patients after cardiothoracic surgery, we measured PAC-CO (criterion standard) and CNCO at three different time points...
May 24, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#20
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
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