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Thomas L Spray surgery

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https://www.readbyqxmd.com/read/29601806/remote-ischemic-preconditioning-does-not-prevent-white-matter-injury-in-neonates
#1
J William Gaynor, Susan C Nicolson, Diane M Spray, Nancy B Burnham, Jesse L Chittams, Therese Sammarco, Kevin W Walsh, Thomas L Spray, Daniel J Licht
BACKGROUND: Remote ischemic preconditioning (RIPC) is a mechanism to protect tissues from injury during ischemia and reperfusion. We investigated the neuroprotective effects of RIPC in neonates undergoing cardiac surgery. METHODS: The outcome was white matter injury (WMI), assessed by the change in volume of WMI from preoperative to postoperative brain MRI. Subjects were randomized to RIPC or SHAM. RIPC was induced prior to cardiopulmonary bypass by four 5 minute cycles of blood pressure cuff inflation to produce ischemia of the lower extremity...
March 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452463/autosomal-dominant-mannose-binding-lectin-deficiency-is-associated-with-worse-neurodevelopmental-outcomes-after-cardiac-surgery-in-infants
#2
Daniel Seung Kim, Yatong K Li, Jerry H Kim, Curtis S Bergquist, Marsha Gerdes, Judy C Bernbaum, Nancy Burnham, Donna M McDonald-McGinn, Elaine H Zackai, Susan C Nicolson, Thomas L Spray, Deborah A Nickerson, Hakon Hakonarson, Gail P Jarvik, J William Gaynor
OBJECTIVES: The MBL2 gene is the major genetic determinant of mannose-binding lectin (MBL)-an acute phase reactant. Low MBL levels have been associated with adverse outcomes in preterm infants. The MBL2Gly54Asp missense variant causes autosomal dominant MBL deficiency. We tested the hypothesis that MBL2Gly54Asp is associated with worse neurodevelopmental outcomes after cardiac surgery in neonates. METHODS: This is an analysis of a previously described cohort of patients with nonsyndromic congenital heart disease who underwent cardiac surgery with cardiopulmonary bypass before age 6 months (n = 295)...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29447332/the-impact-of-the-maternal-foetal-environment-on-outcomes-of-surgery-for-congenital-heart-disease-in-neonates
#3
James William Gaynor, Samuel Parry, Julie S Moldenhauer, Rebecca A Simmons, Jack Rychik, Richard F Ittenbach, William W Russell, Erin Zullo, John Laurenson Ward, Susan C Nicolson, Thomas L Spray, Mark P Johnson
OBJECTIVES: Pregnancies with congenital heart disease in the foetus have an increased prevalence of pre-eclampsia, small for gestational age and preterm birth, which are evidence of an impaired maternal-foetal environment (MFE). METHODS: The impact of an impaired MFE, defined as pre-eclampsia, small for gestational age or preterm birth, on outcomes after cardiac surgery was evaluated in neonates (n = 135) enrolled in a study evaluating exposure to environmental toxicants and neuro-developmental outcomes...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29346537/cerebral-mitochondrial-dysfunction-associated-with-deep-hypothermic-circulatory-arrest-in-neonatal-swine
#4
Constantine D Mavroudis, Michael Karlsson, Tiffany Ko, Marco Hefti, Javier I Gentile, Ryan W Morgan, Ross Plyler, Kobina G Mensah-Brown, Timothy W Boorady, Richard W Melchior, Tami M Rosenthal, Brandon C Shade, Kellie L Schiavo, Susan C Nicolson, Thomas L Spray, Robert M Sutton, Robert A Berg, Daniel J Licht, J William Gaynor, Todd J Kilbaugh
OBJECTIVES: Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model. METHODS: Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia...
January 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29246336/hearing-loss-after-cardiac-surgery-in-infancy-an-unintended-consequence-of-life-saving-care
#5
Madison A Grasty, Richard F Ittenbach, Carol Knightly, Cynthia B Solot, Marsha Gerdes, Judy C Bernbaum, Gil Wernovsky, Thomas L Spray, Susan C Nicolson, Robert R Clancy, Daniel J Licht, Elaine Zackai, J William Gaynor, Nancy B Burnham
OBJECTIVES: To investigate the prevalence of hearing loss after cardiac surgery in infancy, patient and operative factors associated with hearing loss, and the relationship of hearing loss to neurodevelopmental outcomes. STUDY DESIGN: Audiologic and neurodevelopmental evaluations were conducted on 348 children who underwent repair of congenital heart disease at the Children's Hospital of Philadelphia as part of a prospective study evaluating neurodevelopmental outcomes at 4 years of age...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29181795/comparison-of-3d-echocardiogram-derived-3d-printed-valve-models-to-molded-models-for-simulated-repair-of-pediatric-atrioventricular-valves
#6
Adam B Scanlan, Alex V Nguyen, Anna Ilina, Andras Lasso, Linnea Cripe, Anusha Jegatheeswaran, Elizabeth Silvestro, Francis X McGowan, Christopher E Mascio, Stephanie Fuller, Thomas L Spray, Meryl S Cohen, Gabor Fichtinger, Matthew A Jolley
Mastering the technical skills required to perform pediatric cardiac valve surgery is challenging in part due to limited opportunity for practice. Transformation of 3D echocardiographic (echo) images of congenitally abnormal heart valves to realistic physical models could allow patient-specific simulation of surgical valve repair. We compared materials, processes, and costs for 3D printing and molding of patient-specific models for visualization and surgical simulation of congenitally abnormal heart valves...
March 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29032297/postoperative-complications-following-primary-penile-inversion-vaginoplasty-among-330-male-to-female-transgender-patients
#7
Thomas W Gaither, Mohannad A Awad, E Charles Osterberg, Gregory P Murphy, Angelita Romero, Marci L Bowers, Benjamin N Breyer
PURPOSE: Studies of surgical complications of penile inversion vaginoplasty are limited due to small sample sizes. We describe postoperative complications after penile inversion vaginoplasty and evaluated age, body mass index and years on hormone replacement therapy as risk factors for complications. MATERIALS AND METHODS: We retrospectively reviewed the records of male to female patients who presented for primary penile inversion vaginoplasty to a high volume surgeon (MLB) from 2011 to 2015...
October 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28927471/a-vascular-endothelial-growth-factor-a-genetic-variant-is-associated-with-improved-ventricular-function-and-transplant-free-survival-after-surgery-for-non-syndromic-chd
#8
Constantine D Mavroudis, Daniel Seung Kim, Nancy Burnham, Alexandra H Morss, Jerry H Kim, Amber A Burt, David R Crosslin, Donna M McDonald-McGinn, Elaine H Zackai, Meryl S Cohen, Susan C Nicolson, Thomas L Spray, Ian B Stanaway, Deborah A Nickerson, Mark W Russell, Hakon Hakonarson, Gail P Jarvik, J William Gaynor
BACKGROUND: We have previously shown that the minor alleles of vascular endothelial growth factor A (VEGFA) single-nucleotide polymorphism rs833069 and superoxide dismutase 2 (SOD2) single-nucleotide polymorphism rs2758331 are both associated with improved transplant-free survival after surgery for CHD in infants, but the underlying mechanisms are unknown. We hypothesised that one or both of these minor alleles are associated with better systemic ventricular function, resulting in improved survival...
January 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/28826991/parents-preferences-regarding-public-reporting-of-outcomes-in-congenital-heart-surgery
#9
Mallory L Irons, J William Gaynor, Thomas L Spray, Chris Feudtner
BACKGROUND: Calls for public reporting of outcomes in congenital heart surgery have led to several different reporting schemes, including a star rating system and benchmark procedure-specific mortality data tables. Important unanswered questions remain about the optimal format and content of public reporting of congenital heart surgery outcomes. METHODS: In conjunction with three parent advocacy groups, we developed a questionnaire to gauge parents' attitudes regarding the format and content of an "optimal" public reporting scheme...
August 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28598945/long-term-outcomes-of-pediatric-cardiac-patients-supported-by-extracorporeal-membrane-oxygenation
#10
Matthew D Elias, Barbara-Jo Achuff, Richard F Ittenbach, Chitra Ravishankar, Thomas L Spray, Stephanie Fuller, Lisa M Montenegro, J William Gaynor, Matthew J O'Connor
OBJECTIVE: Extracorporeal membrane oxygenation is an important form of short-term mechanical support in children with cardiac disease, but information on long-term outcomes and quality of life is limited. The primary objective of this study was to determine the long-term outcomes of children previously supported by extracorporeal membrane oxygenation for cardiac etiologies. DESIGN: A retrospective analysis was performed on patients with cardiac disease managed with extracorporeal membrane oxygenation between January 1, 1995, and December 31, 2012, at the Children's Hospital of Philadelphia...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28320512/effect-of-congenital-heart-disease-on-4-year-neurodevelopment-within-multiple-gestation-births
#11
Amy H Schultz, Richard F Ittenbach, Marsha Gerdes, Gail P Jarvik, Gil Wernovsky, Judy Bernbaum, Cynthia Solot, Robert R Clancy, Susan C Nicolson, Thomas L Spray, Donna McDonald-McGinn, Elaine Zackai, J William Gaynor
OBJECTIVES: We sought to assess the effect of congenital heart disease requiring infant surgery with cardiopulmonary bypass on neurodevelopmental outcomes and growth at 4 years of age, while matching for gestational age, socioeconomic status, maternal gestational conditions, home environment, and parental intelligence by studying multiple-gestation births. METHODS: We performed within-family comparison of 14 multiple-gestation births in which 1 child had congenital heart disease requiring surgery with cardiopulmonary bypass at ≤6 months of age...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28287055/congenital-pulmonary-lymphangiectasia-and-early-mortality-after-stage-1-reconstruction-procedures
#12
Jeremy L Herrmann, Mallory L Irons, Christopher E Mascio, Jack Rychik, Thomas L Spray, J William Gaynor, Jennifer E Pogoriler
OBJECTIVES: Pulmonary lymphangiectasia associated with hypoplastic left heart syndrome with an intact or restrictive atrial septum may result from increased left atrial pressure, and is associated with worse outcomes following staged reconstruction due to lung dysfunction and significant hypoxaemia. Our objective was to characterise the incidence of pulmonary lymphangiectasia in cases of early mortality following stage 1 reconstructions. METHODS: An institutional cardiac surgical database was retrospectively searched for patients who died within 30 days following a stage 1 reconstruction between 1 January, 1984 and 31 December, 2013...
September 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28148316/design-and-initial-results-of-a-programme-for-routine-standardised-longitudinal-follow-up-after-congenital-heart-surgery
#13
Sara K Pasquali, Chitra Ravishankar, Jennifer C Romano, Kristin Kane, Suzanne Viers, Andrea Kennedy, Nancy Burnham, Ray Lowery, Karen Uzark, Lauren Retzloff, Jonathon J Rome, Joseph W Rossano, John R Charpie, Thomas L Spray, Michael G Gaies, Richard G Ohye, J William Gaynor
BACKGROUND: With improvements in early survival following congenital heart surgery, it has become increasingly important to understand longer-term outcomes; however, routine collection of these data is challenging and remains very limited. We describe the development and initial results of a collaborative programme incorporating standardised longitudinal follow-up into usual care at the Children's Hospital of Philadelphia (CHOP) and University of Michigan (UM). METHODS: We included children undergoing benchmark operations of the Society of Thoracic Surgeons...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28007065/a-word-of-caution-in-public-reporting
#14
REVIEW
Thomas L Spray, J William Gaynor
Public reporting in its current form will lead to confusion amongst physicians, administrators, families, and the media. It is unclear that we are giving the families information they really need. At the current time there is no evidence that public reporting really leads to improved outcomes. Rather, it may lead to risk aversion and limit access to care. This is a problem not just for congenital heart surgery but for the entire field of medicine and the care that we provide to our patients. We must be very careful that we don't create a system where we are afraid to take on a patient with increased risk of mortality because it may affect our overall ranking...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27919455/potential-benefits-and-consequences-of-public-reporting-of-pediatric-cardiac-surgery-outcomes
#15
EDITORIAL
J William Gaynor, Sara K Pasquali, Richard G Ohye, Thomas L Spray
No abstract text is available yet for this article.
October 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27449354/historical-perspectives-of-the-american-association-for-thoracic-surgery-thomas-l-spray
#16
EDITORIAL
James S Tweddell
No abstract text is available yet for this article.
October 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27183886/increasing-cumulative-exposure-to-volatile-anesthetic-agents-is-associated-with-poorer-neurodevelopmental-outcomes-in-children-with-hypoplastic-left-heart-syndrome
#17
Laura K Diaz, J William Gaynor, Shannon J Koh, Richard F Ittenbach, Marsha Gerdes, Judy C Bernbaum, Elaine H Zackai, Robert R Clancy, Mohamed A Rehman, Jeffrey W Pennington, Nancy Burnham, Thomas L Spray, Susan C Nicolson
OBJECTIVES: Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy...
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26410159/improving-cardiac-surgical-site-infection-reporting-and-prevention-by-using-registry-data-for-case-ascertainment
#18
Vaidehi Nayar, Andrea Kennedy, Janine Pappas, Krista D Atchley, Cynthia Field, Sarah Smathers, Eva E Teszner, Julia S Sammons, Susan E Coffin, Jeffrey S Gerber, Thomas L Spray, James M Steven, Louis M Bell, Joan Forrer, Fernando Gonzalez, Albert Chi, William J Nieczpiel, John N Martin, J William Gaynor
BACKGROUND: The use of administrative data for surgical site infection (SSI) surveillance leads to inaccurate reporting of SSI rates [1]. A quality improvement (QI) initiative was conducted linking clinical registry and administrative databases to improve reporting and reduce the incidence of SSI [2]. METHODS: At our institution, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and infection surveillance database (ISD) were linked to the enterprise data warehouse containing electronic health record (EHR) billing data...
January 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25957454/subclinical-seizures-identified-by-postoperative-electroencephalographic-monitoring-are-common-after-neonatal-cardiac-surgery
#19
Maryam Y Naim, J William Gaynor, Jodi Chen, Susan C Nicolson, Stephanie Fuller, Thomas L Spray, Dennis J Dlugos, Robert R Clancy, Livia Vianez Costa, Daniel J Licht, Rui Xiao, Heather Meldrum, Nicholas S Abend
OBJECTIVES: The American Clinical Neurophysiology Society recommends continuous electroencephalographic monitoring after neonatal cardiac surgery because seizures are common, often subclinical, and associated with worse neurocognitive outcomes. We performed a quality improvement project to monitor for postoperative seizures in neonates with congenital heart disease after surgery with cardiopulmonary bypass. METHODS: We implemented routine continuous electroencephalographic monitoring and reviewed the results for an 18-month period...
July 2015: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25590308/squeeze-bottle-versus-saline-spray-after-endoscopic-sinus-surgery-for-chronic-rhinosinusitis-a-pilot-multicentre-trial
#20
RANDOMIZED CONTROLLED TRIAL
K I Macdonald, E D Wright, L J Sowerby, B W Rotenberg, C J Chin, L Rudmik, D D Sommer, S Nayan, M DesRosiers, M A Tewfik, C J Valdes, E Massoud, D Thomas, S J Kilty, A Vescan, B Mechor, F Lavigne, M Fandino, A R Javer, I J Witterick
BACKGROUND: There is a need for controlled trials to guide the perioperative management of patients undergoing endoscopic sinus surgery (ESS). The authors performed a pilot multicenter trial to compare two types of saline delivery devices in this population. METHODS: Patients were randomized to high volume saline irrigation with a squeeze bottle and low volume saline spray after ESS in patients with chronic rhinosinusitis (CRS). Surgeons were blinded to treatment, and one-month postoperative scores for sinonasal outcomes [Sinonasal Outcome Test-22 (SNOT-22)] scale, nasal and sinus symptom score (NSS), and perioperative sinus endoscopy (POSE) scale were compared with preoperative scores...
January 2015: American Journal of Rhinology & Allergy
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