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https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#1
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27865060/reducing-variation-in-feeding-newborns-with-congenital-heart-disease
#2
Janet M Simsic, Kirby-Rose Carpenito, Kristin Kirchner, Stephanie Peters, Holly Miller-Tate, Brian Joy, Mark Galantowicz
OBJECTIVE: Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience-based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit. DESIGN: This is a retrospective analysis of a quality improvement project...
November 16, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27847658/direct-acting-antivirals-in-patients-with-chronic-hepatitis-c-and-down-syndrome
#3
Eric R Yoo, Ryan B Perumpail, George Cholankeril, Aijaz Ahmed
Patients with Down syndrome who received blood transfusions, likely in conjunction with cardiothoracic surgery for congenital heart disease and prior to the implementation of blood-donor screening for hepatitis C virus infection, face a substantial risk of acquiring the infection. In the past, interferon-based therapy for chronic hepatitis C infection in patients with Down syndrome was noted to have lower efficacy and potentially higher risk of adverse effects. Recently, the treatment for chronic hepatitis C has been revolutionized with the introduction of interferon-free direct acting antivirals with favorable safety, tolerability, and efficacy profile...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27789191/winning-hearts-and-minds-inspiring-medical-students-into-cardiothoracic-surgery-through-highly-interactive-workshops
#4
Joseph George, Tom Combellack, Ana Lopez-Marco, Umair Aslam, Yasir Ahmed, Prakash Nanjaiah, Aprim Youhana, Pankaj Kumar
BACKGROUND: The cardiothoracic surgical (CTS) specialty has witnessed a decline in the applicant pool. Early exposure, positive experiences, inspiring role models, and career insight are key in the decision-making process for specialty choice. Our objective was to assess the effect of high tutor:student ratio interactive CTS workshops in influencing the career choice of UK undergraduate medical students. METHODS: Medical students attended a workshop comprising (1) guided dissection of fresh animal hearts, (2) surgical skills practice on models and fresh hearts, (3) operative videos (adult, congenital, transplant, and aortic) with interactive commentary, and (4) careers seminar...
October 24, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27637287/the-society-of-thoracic-surgeons-thoracic-surgery-practice-and-access-task-force-2014-workforce-report
#5
John S Ikonomidis
BACKGROUND: The Society of Thoracic Surgeons (STS) has intermittently surveyed its workforce, providing isolated accounts of the current state of thoracic surgical practice. METHODS: The 63-question survey instrument was received by 4,343 surgeon members of the STS, and responses were gathered between October 1 and November 5, 2014. The return rate was 29.1%. RESULTS: The median age of the active United States thoracic surgeons is 54 years...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27621900/giant-bronchogenic-cyst-with-pericardial-defect-a-case-report-literature-review-in-japan
#6
Toshiko Kamata, Shigetoshi Yoshida, Takekazu Iwata, Yukio Nakatani, Ichiro Yoshino
Congenital pericardial defects are a rare anomaly, found during autopsy and cardiothoracic surgery. We describe a case of a 69-year-old female, with a right-sided congenital pericardial defect associated with a giant bronchogenic cyst (BC) found during surgery. The cyst was resected and the patient developed arrhythmia following surgery. A review of the literature in Japan was performed, focusing on congenital anomalies associated with pericardial defects and its pathogenesis. We paid particular attention to complications following thoracic surgery in patients with pericardial defects and indications of pericardial reconstruction in such patients...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27444317/patent-foramen-ovale-diagnosis-the-importance-of-provocative-maneuvers
#7
Silvia Mongodi, Gabriele Via, Mariachiara Riccardi, Guido Tavazzi, Andrea Maria D'Armini, Marco Maurelli, Antonio Braschi, Francesco Mojoli
Patent foramen ovale (PFO) is a frequent congenital anomaly, but massive right-to-left shunt (RTLS) is normally prevented by higher pressures in left heart chambers. However, mechanical ventilation with positive end-expiratory pressure (PEEP) can significantly increase right atrial pressure, accentuating the RTLS, mainly after major cardiothoracic surgery. We report a patient admitted to the intensive care unit after cardiac surgery. Pre- and intraoperative transesophageal echocardiography only described an aneurysmal interatrial septum with no shunt...
July 22, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27375053/vitamin-d-kinetics-and-parathyroid-gland-function-in-patients-with-congenital-heart-disease
#8
Gaku Izumi, Kei Inai, Eriko Shimada, Toshio Nakanishi
OBJECTIVE: It has been recently reported that vitamin D deficiency may contribute to systemic illnesses that accompany chronic heart failure. These reports also suggest the serum levels of parathormone, which activates vitamin D in the liver, can be a useful marker of heart failure. This study was designed to evaluate the clinical implications of vitamin D and parathormone levels in patients with congenital heart diseases and chronic heart failure. DESIGN: We measured 25-hydroxyvitamin D and parathormone serum levels in 103 adult patients with congenital heart diseases (age range 20-89 years)...
December 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27359082/prenatal-detection-of-major-congenital-heart-disease-optimising-resources-to-improve-outcomes
#9
Siobhan Corcoran, Kaleigh Briggs, Hugh O' Connor, Sieglinde Mullers, Cathy Monteith, Jennifer Donnelly, Patrick Dicker, Orla Franklin, Fergal D Malone, Fionnuala M Breathnach
INTRODUCTION: Congenital heart disease (CHD) is the most common major structural fetal abnormality and the benefits of prenatal detection are well described. The objective of this study was to evaluate the precision of prenatal diagnosis at a single tertiary referral unit over two three year periods (2006, 2007, 2008 and 2010, 2011, 2012), before and after a prenatal screening protocol for CHD was developed to include extended cardiac views, mandatory recall for suboptimal views, and a multidisciplinary Fetal Cardiac clinic was established...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27358296/mortality-following-congenital-heart-surgery-in-adults-can-be-predicted-accurately-by-combining-expert-based-and-evidence-based-pediatric-risk-scores
#10
Jürgen Hörer, Jelena Kasnar-Samprec, Julie Cleuziou, Martina Strbad, Michael Wottke, Harald Kaemmerer, Christian Schreiber, Rüdiger Lange
OBJECTIVES: Currently, there are few specific risk stratification models available to predict mortality following congenital heart surgery in adults. We sought to evaluate whether the predictive power of the common pediatric scores is applicable for adults. In addition, we evaluated a new grown-ups with congenital heart disease (GUCH) score specifically designed for adults undergoing congenital heart surgery. METHODS AND RESULTS: Data of all consecutive patients aged 18 years or more, who underwent surgery for congenital heart disease (CHD) between 2004 and 2013 at our institution, were collected...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27319988/humanitarian-outreach-in-cardiothoracic-surgery-from-setup-to-sustainability
#11
REVIEW
Joseph A Dearani, Jeffrey P Jacobs, R Morton Bolman, JaBaris D Swain, Luca A Vricella, Samuel Weinstein, Emily A Farkas, John H Calhoon
Noncommunicable diseases account for 38 million deaths each year, and approximately 75% of these deaths occur in the developing world. The most common causes include cardiovascular diseases, cancer, respiratory diseases, and diabetes mellitus. Many adults with acquired cardiothoracic disease around the world have limited access to health care. In addition, congenital heart disease is present in approximately 1% of live births and is therefore the most common congenital abnormality. More than one million children in the world are born with congenital heart disease each year, and approximately 90% of these children receive suboptimal care or have no access to care...
September 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27306543/frequency-of-mammary-artery-coiling-in-single-ventricle-patients-and-future-coronary-artery-grafting
#12
Khaled Abdelhady, Anas Taqatqa, Carlos Miranda, Sawsan Awad
Pre-Fontan coil closure of aorto-pulmonary collaterals decreases single-ventricle volume load and improves outcome. Coiling of right and left internal mammary arteries may present a challenge to cardiothoracic surgery teams caring for these patients when future coronary artery bypass grafting is needed for SV patients. The goal of this study was to determine the frequency of internal mammary artery coil closure in SV patients in a single tertiary care center. A retrospective review of all pediatric single-ventricle patients who underwent cardiac catheterization between March 2009 and October 2015 at Rush Center for Congenital Heart Disease was performed...
October 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27220370/feasibility-of-a-team-approach-to-complex-congenital-heart-defect-neurodevelopmental-follow-up-early-experience-of-a-combined-cardiology-neonatal-intensive-care-unit-follow-up-program
#13
Olena Chorna, H Scott Baldwin, Jamie Neumaier, Shirley Gogliotti, Deborah Powers, Amanda Mouvery, David Bichell, Nathalie L Maitre
Infants with complex congenital heart disease are at high risk for poor neurodevelopmental outcomes. However, implementation of dedicated congenital heart disease follow-up programs presents important infrastructure, personnel, and resource challenges. We present the development, implementation, and retrospective review of 1- and 2-year outcomes of a Complex Congenital Heart Defect Neurodevelopmental Follow-Up program. This program was a synergistic approach between the Pediatric Cardiology, Cardiothoracic Surgery, Pediatric Intensive Care, and Neonatal Intensive Care Unit Follow-Up teams to provide a feasible and responsible utilization of existing infrastructure and personnel, to develop and implement a program dedicated to children with congenital heart disease...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27167006/learning-from-experience-improving-early-tracheal-extubation-success-after-congenital-cardiac-surgery
#14
Peter D Winch, Anna M Staudt, Roby Sebastian, Marco Corridore, Dmitry Tumin, Janet Simsic, Mark Galantowicz, Aymen Naguib, Joseph D Tobias
OBJECTIVES: The many advantages of early tracheal extubation following congenital cardiac surgery in young infants and children are now widely recognized. Benefits include avoiding the morbidity associated with prolonged intubation and the consequences of sedation and positive pressure ventilation in the setting of altered cardiopulmonary physiology. Our practice of tracheal extubation of young infants in the operating room following cardiac surgery has evolved and new challenges in the arena of postoperative sedation and pain management have appeared...
July 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27149367/cardiothoracic-applications-of-3-dimensional-printing
#15
Andreas A Giannopoulos, Michael L Steigner, Elizabeth George, Maria Barile, Andetta R Hunsaker, Frank J Rybicki, Dimitris Mitsouras
Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides...
September 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27131899/the-future-of-the-academic-cardiothoracic-surgeon-results-of-the-tsra-tsda-in-training-examination-survey
#16
Elizabeth H Stephens, Asad A Shah, Michael P Robich, Dustin M Walters, Walter F DeNino, Muhammad Aftab, Vakhtang Tchantchaleishvili, Amanda L Eilers, Robert D Rice, Andrew B Goldstone, Ryan C Shelstad, Tarek Malas, Marisa Cevasco, Erin A Gillaspie, Damien J LaPar
BACKGROUND: Traditionally cardiothoracic residents spent dedicated research time during general surgery equipping them for a potential academic career. Recent changes in training paradigms, including integrated programs that may not include research time, could affect the development of future academic cardiothoracic surgeons. METHODS: Responses to the 2015 Thoracic Surgery Directors' Association/Thoracic Surgery Residents' Association survey accompanying the in-training examination taken by current cardiothoracic surgery residents were analyzed...
August 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27131412/ct-measurement-of-central-pulmonary-arteries-to-diagnose-pulmonary-hypertension-phtn-more-reliable-than-valid
#17
Silanath Terpenning, Matthew Deng, Susie N Hong-Zohlman, Cheng Ting Lin, Seth J Kligerman, Jean Jeudy, Loren H Ketai
UNLABELLED: The association between main pulmonary artery (MPA) size and pulmonary arterial hypertension (PAHTN) is well established; however, the clinical utility of routine measurement of MPA is uncertain due to considerable overlap between normal patients and those with pulmonary hypertension. The lack of diagnostic accuracy could be further degraded by variability among the radiologists. It is unknown whether the addition of right and left pulmonary artery measurements would improve accuracy or further impair it...
July 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27085196/are-there-gaps-in-current-thoracic-surgery-residency-training-programs
#18
Danny Chu, Ara A Vaporciyan, Mark D Iannettoni, John S Ikonomidis, David D Odell, Richard J Shemin, Sandra L Starnes, William Stein, Vinay Badhwar
BACKGROUND: Cardiothoracic surgery is rapidly evolving to adapt to a changing health care environment and a wider application of innovative techniques. The Society of Thoracic Surgeons Workforce on Thoracic Surgery Resident Issues Transition to Practice Task Force sought to identify new or existing gaps of training in contemporary thoracic surgery residency training programs. METHODS: A voluntary survey consisting of 24 questions was distributed to recent graduates of thoracic surgery residency programs in the United States during the 2014 American Board of Thoracic Surgery oral examination application process...
June 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27083964/challenges-with-the-establishment-of-congenital-cardiac-surgery-centers-in-nigeria-survey-of-cardiothoracic-surgeons-and-residents
#19
Kelechi E Okonta, Charles I Tobin-West
BACKGROUND: There are gaps in understanding the challenges with the establishment of pediatric cardiac surgical practices in Nigeria. The aim of this study was to examine the prospects and challenges limiting the establishment of pediatric cardiac surgical practices in Nigeria from the perspectives of cardiothoracic surgeons and resident doctors. METHODS: A descriptive study was carried out to articulate the views of the cardiothoracic surgeons and cardiothoracic resident doctors in Nigeria...
May 1, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27072399/integration-of-computed-tomography-and-three-dimensional-echocardiography-for-hybrid-three-dimensional-printing-in-congenital-heart-disease
#20
Jordan Gosnell, Todd Pietila, Bennett P Samuel, Harikrishnan K N Kurup, Marcus P Haw, Joseph J Vettukattil
Three-dimensional (3D) printing is an emerging technology aiding diagnostics, education, and interventional, and surgical planning in congenital heart disease (CHD). Three-dimensional printing has been derived from computed tomography, cardiac magnetic resonance, and 3D echocardiography. However, individually the imaging modalities may not provide adequate visualization of complex CHD. The integration of the strengths of two or more imaging modalities has the potential to enhance visualization of cardiac pathomorphology...
December 2016: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
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