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Pediatric cardiothoracic

Mark K Ferguson
The world of cardiothoracic surgery lost a friend and remarkable colleague on May 9, 2016. Robert L. Replogle, the 31st President of The Society of Thoracic Surgeons, died at the University of Chicago Medical Center after a brief illness, surrounded by his loving family. Known to his friends as "Rep," he will be remembered as an excellent pediatric and adult cardiac surgeon and as a visionary leader.
October 2016: Annals of Thoracic Surgery
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Nakul P Valsangkar, Tiffany W Liang, Paul J Martin, John S Mayo, Carlo Maria Rosati, David V Feliciano, Teresa A Zimmers, Leonidas G Koniaris
BACKGROUND: Research and innovation are crucial to advancements in medicine and improvements in patient care. The contribution of surgical fellowships to scholarly productivity is unclear. The objective of this study was to determine the impact of subspecialty fellowships on academic output in departments of surgery. METHODS: This cross-sectional study examined fellowships offered at the top 50 university-based National Institutes of Health-funded and top 5 academically prolific hospital-based departments of surgery...
August 11, 2016: Surgery
Kathleen M Tibbetts, Derek Wu, Jeffrey V Hsu, William B Burton, Michel Nassar, Melin Tan
OBJECTIVE: Unilateral vocal fold immobility (UVFI) results in deficits in phonatory, respiratory, and swallow function of the pediatric patient. Little is known about long-term functional swallow outcomes. METHODS: Medical records of children diagnosed with UVFI between 2005 and 2014 at a tertiary children's hospital were retrospectively reviewed. Etiology, laryngoscopy findings, and swallow status at diagnosis and follow-up were recorded. Swallow outcomes were compared by etiology using Fisher's exact test...
September 2016: International Journal of Pediatric Otorhinolaryngology
Nowell M Fine, Sudhir S Kushwaha
The mammalian target of rapamycin (mTOR) inhibitors sirolimus and everolimus are increasingly utilized in cardiothoracic transplantation. Several recent clinical trials have demonstrated their efficacy in combination with reduced cyclosporine dosing in de novo heart transplant recipients, in particular with everolimus. A number of other studies have demonstrated their efficacy for improving renal function and reducing calcineurin inhibitor use, attenuating cardiac allograft vasculopathy progression and reducing cytomegalovirus infections in maintenance heart transplant populations...
August 5, 2016: Transplantation
Corinna Clio Zygourakis, Victoria Valencia, Chris Moriates, Christy Boscardin, Sereina Catschegn, Andrew Goldberg, Kevin Bozic, Kent Soo Hoo, Rosanna Wustrack, Lawrence H Pitts, Adams Dudley, Ralph Gonzales, Michael T Lawton
INTRODUCTION: Despite the large contribution of surgical expenses to rising health care costs, many surgeons have little knowledge of their operating room (OR) costs. The goal of OR SCORE (OR Surgical Cost Reduction) is to determine whether providing surgeons with cost feedback reduces OR costs. METHODS: We performed a prospective controlled trial from January to December 2015 at University of California San Francisco (UCSF). Each surgeon in the orthopedic, ear, nose, and throat, and neurosurgery departments received standardized scorecards on a monthly basis in 2015...
August 2016: Neurosurgery
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
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
Qalab Abbas, Anwar Ul Haq, Raman Kumar, Syed Asad Ali, Kashif Hussain, Sadia Shakoor
BACKGROUND: Pediatric Intensive Care Unit (PICU) patients are often prescribed antibiotics with a low threshold in comparison to patients elsewhere. Irrational antibiotics use can lead to rapid emergence of drug resistance, so surveillance of their use is important. OBJECTIVES: To evaluate the use of antibiotics in relation to bacteriological findings in PICU of a Tertiary Hospital. METHODS: Retrospective review of medical records of all children (age 1 month-16 years) admitted in our closed multidisciplinary-cardiothoracic PICU from January to June 2013 was performed, after approval from Ethical Review Committee...
May 2016: Indian Journal of Critical Care Medicine
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
Brent B Pickrell, Jeffrey S Coursen, Jose Ruben Rodriguez, Laura A Monson
Sternal wound infections remain a significant cause of morbidity and mortality in patients undergoing complex cardiothoracic surgery. Heart and lung transplant patients presumably face additional risk secondary to their underlying morbidity, postoperative immunosuppression, and difficulty with primary wound closure over large graft size. These patients present a unique challenge to the reconstructive surgeon, as many have a significant past surgical history, which can limit or alter treatment options. This study reports 2 pediatric transplant patients who underwent use of omental flap for sternal wound reconstruction in the context of significant past abdominal surgery...
June 2016: Journal of Craniofacial Surgery
Elizabeth A Krupinski, Alex Chung, Kimberly Applegate, Ariadne K DeSimone, Srini Tridandapani
RATIONALE AND OBJECTIVES: To increase detection of mislabeled medical imaging studies, evidence shows it may be useful to include patient photographs during interpretation. This study examined how inclusion of photographs impacts visual search. MATERIALS AND METHODS: Ten radiologists participated. Average age was 43.00 years and average years Board-certified was 9.70, with 2 residents, 1 general, 2 abdominal, 4 cardiothoracic, and 1 pediatric radiologist. They viewed 21 portable chest radiographs with and without a simultaneously acquired photograph of the patient while visual search was recorded...
August 2016: Academic Radiology
Nancy Blake, Nida Sulit Oriza, Victoria Winter, Flerida Imperial-Perez
No abstract text is available yet for this article.
April 2016: AACN Advanced Critical Care
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
Nathaniel R Sznycer-Taub, Ray Lowery, Sunkyung Yu, Sonal T Owens, Jennifer C Hirsch-Romano, Gabe E Owens
OBJECTIVES: Patients who require venoarterial extracorporeal membrane oxygenation because of cardiac failure frequently have supranormal blood oxygen tensions (hyperoxia). Recent studies have suggested worse outcomes in patients with hyperoxia after resuscitation from cardiac or respiratory arrests, presumably because of oxidative stress. There are limited data regarding the effect of hyperoxia on outcomes in pediatric patients on venoarterial extracorporeal membrane oxygenation. DESIGN: Retrospective chart review...
April 2016: Pediatric Critical Care Medicine
O N Ekeke, K E Okonta, P O Igwe
BACKGROUND: There is paucity of literatures on audit of mortality in the surgical units of tertiary hospitals in the country. This has made the spectrum of mortality not to been known in some of the centers and therefore, there is a great disparity and dearth in apportioning health care services appropriately. AIM: The determination of the pattern of mortality in a surgical unit helps in planning, provision of quality surgical care and prioritizing of limited resources in developing countries...
May 2016: Nigerian Journal of Clinical Practice
Cornelius Piros Kulandasamy Pillai, Yoshitoku Yoshida, Patrick Justin Lawrence, Eiko Yamamoto, Joshua A Reyer, Nobuyuki Hamajima1
Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH...
February 2016: Nagoya Journal of Medical Science
Emily C Benefield, Tracy M Hagemann, H Christine Allen, Kevin Farmer, Michael E Burton, Susana Chavez-Bueno, Peter N Johnson
OBJECTIVES: This study compared vancomycin trough concentrations and pharmacokinetic parameters in pediatric cardiothoracic surgery (CTS) patients versus those in controls receiving 20 mg/kg/dose, intravenously, every 8 hours. METHODS: A retrospective study was conducted in children <18 years of age, following CTS, versus an age-and sex-matched control group. The primary objective was to determine differences in trough concentrations between groups. Secondary objectives included comparisons of pharmacokinetics between groups and development of vancomycin-associated acute kidney injury (AKI), defined as a doubling in serum creatinine from baseline...
January 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Branislava Medić, Branislav Rovcanin, Katarina Savic Vujovic, Danilo Obradovic, Dusan Duric, Milica Prostran
Despite the recent findings concerning pathogenesis and novel therapeutic strategies, the mortality rate in patients with acute kidney injury (AKI) remains very high. Early detection of patients with impaired renal function may help to ensure more aggresive treatment and to improve clinical outcome. Serum creatinine is still gold standard of kidney injury, although it is well known as an insensitive and unreliable biomarker (for example, its concentration does not increase significantly until about half of the kidney function is lost)...
2016: Current Medicinal Chemistry
David S Mulder
Anthony R. C. Dobell died on June 17, 2015, at the age of 88. Dobell was the first Canadian president of the Society of Thoracic Surgeons. He was a pioneer in the development of pediatric and adult cardiac surgery at McGill University. He was inspired by Dr John Gibbon during his residency training at Jefferson Medical College in Philadelphia. He developed a McGill-based residency in Cardiothoracic Surgery and always took pride in the legacy of more than 40 residents scattered throughout North America.
December 2015: Annals of Thoracic Surgery
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