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Cardiothoracic AND surgery

Roberta E Redfern, Kevin Fleming, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
BACKGROUND: Transfusion of allogenic blood products is associated with significant morbidity and increased risk of mortality. Thrombelastography (TEG) to direct transfusion management during and immediately following cardiothoracic surgery reduced blood product usage in our institution. The goal of this study was to quantify the impact of TEG on postoperative outcomes. METHODS: All patients who underwent cardiac surgery before and after implementation of TEG were retrospectively analyzed...
February 12, 2019: Annals of Thoracic Surgery
Joost Hopman, Corianne Meijer, Nikki Kenters, Jordy P M Coolen, Mohammad R Ghamati, Shaheen Mehtar, Reinout van Crevel, Wim J Morshuis, Ad F T M Verhagen, Michel M van den Heuvel, Andreas Voss, Heiman F L Wertheim
Importance: Resistance of gram-negative bacilli to carbapenems is rapidly emerging worldwide. In 2016, the World Health Organization defined the hospital-built environment as a core component of infection prevention and control programs. The hospital-built environment has recently been reported as a source for outbreaks and sporadic transmission events of carbapenemase-producing gram-negative bacilli from the environment to patients. Objective: To assess risk after the identification of an unexpected, severe, and lethal hospital-acquired infection caused by carbapenemase-producing Pseudomonas aeruginosa in a carbapenemase-low endemic setting...
February 1, 2019: JAMA network open
Michael P DeWane, Daniel C Thomas, Walter E Longo, Peter S Yoo
The pursuit of dedicated research time during surgical residency prolongs training and delays entry into practice. Currently, there is a lack of research quantifying the financial implication of this delay and trainees' understanding of its impact on career earnings. An opportunity cost analysis was performed regarding the impact of delay due to training within general surgery and selected subspecialties. An anonymous survey was distributed to general surgery categorical junior trainees in 2017 at a large academic hospital in the Northeast to determine understanding and beliefs regarding dedicated training on career earnings...
November 1, 2018: American Surgeon
Ahmed Latif, Luke Hopkins, David Robinson, Christopher Brown, Tarig Abdelrahman, Richard Egan, Awen Iorwerth, John Pollitt, Wyn G Lewis
OBJECTIVE: Performance assessment is challenging to administer and validate, yet remains central to patient safety and quality of care. The aim of this study was to evaluate Consultant Surgeon trainer performance with respect to Workplace Based Assessment (WBA) completion. DESIGN: All WBAs for 60 Core Surgical Trainees (n = 2932) recorded in one academic year were analyzed using the Intercollegiate Surgical Curriculum Progamme. Primary outcome measures were numbers of WBAs performed related to trainer role (Assigned Educational Supervisor vs...
February 8, 2019: Journal of Surgical Education
Jamie Penk, Katja M Gist, Eric L Wald, Laura Kitzmiller, Tennille N Webb, Yi Li, David S Cooper, Stuart L Goldstein, Rajit K Basu
OBJECTIVE: A standardized assessment of response to furosemide is predictive of acute kidney injury progression in adults, but a paucity of data exists in pediatric patients. We evaluate furosemide responsiveness in a multicenter cohort of pediatric patients after cardiac surgery. METHODS: Children who underwent cardiac surgery with a Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery score of 3 or greater were retrospectively identified...
January 11, 2019: Journal of Thoracic and Cardiovascular Surgery
Justin G Wilkes, Jessica L Evans, B Stephen Prato, Steven A Hess, Dougald C MacGillivary, Timothy L Fitzgerald
BACKGROUND: Frailty in the surgical patient has been associated with increased morbidity, mortality, and failure-to-rescue. However, there is little understanding of the economic impact of frailty. STUDY DESIGN: A prospective database of elective surgery patients at an academic medical center was utilized to create a modified version of the Risk Analysis Index, a validated frailty index. This included 10,257 patients undergoing elective surgery from 2016-2017. Patients were classified as not frail (RAI = 0), somewhat frail (RAI = 1-10), or significantly frail (RAI > 10)...
February 8, 2019: Journal of the American College of Surgeons
Brian E Kogon, Matthew E Oster, Amelia Wallace, Karen Chiswell, Kevin D Hill, Morgan L Cox, Jeffrey P Jacobs, Sara Pasquali, Tara Karamlou, Marshall L Jacobs
BACKGROUND: Hospital readmission after pediatric cardiac surgery is incompletely understood. We analyzed data from the STS Congenital Heart Surgery database (STS-CHSD) to determine prevalence, to describe patient characteristics, and to evaluate risk factors for readmission. METHODS: Readmission was defined by the "readmission within 30 days after discharge" field. Routine variables were summarized. Regression analysis was used to identify factors associated with readmission...
February 8, 2019: Annals of Thoracic Surgery
Noor Sameh Darwich, Robert L Tyrrell
Bilateral pneumothoraces following unilateral subclavian vein cannulation is a rare complication. It is usually associated with an intrapleural communication which can be congenital or formed following cardiothoracic and mediastinal surgeries, or trauma. The term Buffalo chest was used to define a single chest cavity with no anatomic separation of the two hemithoraces. It is called Buffalo chest because this unique chest anatomy of the American buffalo, or bison, helped hunters to kill them with a single arrow to the chest because the resultant pneumothorax could collapse both lungs...
2019: Respiratory Medicine Case Reports
Nikki L Stamp, Jessica G Y Luc, Maral Ouzounian, Farah Bhatti, Tamara Ni Hici, Mara B Antonoff
To deliver the best possible care, the global surgical workforce should mirror the diverse society it is entrusted to serve. Cardiothoracic surgery remains amongst the most under-represented of the surgical specialties for women. Herein, we describe the role of social media in the cardiothoracic surgery community and its potential to rewrite the narrative for women in cardiothoracic surgery.
January 31, 2019: Interactive Cardiovascular and Thoracic Surgery
J Jiménez Gómez, M Gómez Cervantes, V Núñez Cerezo, V Amesty Morello, M D Ponce Dorrego, F B Nava Hurtado de Saracho, L Martínez Martínez, J C López Gutiérrez
INTRODUCTION: High morbidity has been described in secondary chylothorax. Thoracic duct embolization (TDE) after intranodal lymphangiography (IL) is one of the treatments in adults but there is poor experience in children. We aim to describe our experience with this technique for refractory pediatric chylothorax. METHODS: A retrospective study of patients with refractory chylothorax treated with thoracic duct embolization at our Institution in the last 4 years was performed...
January 21, 2019: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Yi Hao, Yueling Chen
BACKGROUND: Vitamin D is an indispensable molecule for human health. Wide ranges of diseases are linked with vitamin D deficiencies. Role of vitamin D in chronic heart failure has been demonstrated in different populations; however, reports are limited in Chinese population. Vitamin D exerts its effect through vitamin D receptor and variants in vitamin D receptor (VDR) gene are shown to affect vitamin D signaling. In the present study, we hypothesized that both vitamin D levels and VDR variants could be associated with the development of chronic heart failure...
February 4, 2019: Journal of Clinical Laboratory Analysis
Trevor A Davis, Pooja S Yesantharao, Stephen C Yang
BACKGROUND: With the impending shortage of cardiothoracic surgeons, much focus has been on increasing trainee interest, particularly at the medical student level. We aimed to determine the impact of participation in our Cardiothoracic Surgery Interest Group (CTSIG) on medical student attitudes regarding surgery, and especially CT surgery. METHODS: An anonymous survey was administered at two time points to the current member list of our 2015-16 CTSIG, and repeated for the 2016-17 academic year...
January 30, 2019: Annals of Thoracic Surgery
Ganqiong Xu, Jiawei Zhou, Shi Zeng, Ming Zhang, Zhu Ouyang, Yili Zhao, Hongxia Yuan, Lili Tong, Chan Yin, Qichang Zhou
To provide useful information for diagnosing and predicting fetal intraabdominal extralobar pulmonary sequestration (IEPS), a retrospective review of diagnostic approaches was conducted. Ultrasonography was performed serially in 21 fetuses with IEPS from 2005 to 2017. Prenatal sonographic features, treatment, and outcomes of each case were evaluated and collected. These cases of IEPS were also compared to 43 cases previously reported by other researchers from 1986 to 2017. Of the 21 sonographic features, 14 (67%) were hyperechoic, 21 (100%) were well circumscribed, and 17 (81%) depicted a mass that shifted with fetal breaths/hiccups non-synchronized with adjacent organs (sliding sign)...
January 30, 2019: Scientific Reports
Adela Arapović, Sandra Prgomet, Marijan Saraga, Tanja Kovačević, Zoltán Prohászka, Ranka Despot, Eugenija Marušić, Josipa Radić
BACKGROUND Thrombotic thrombocytopenic purpura (TTP) in children is a rare life-threatening syndrome, characterized by microangiopathic hemolytic anemia, thrombocytopenia with renal dysfunction, neurologic symptoms, and fever. TTP is usually caused by deficient activity of von Willebrand factor cleaving protease (ADAMTS13), due to either gene mutations or acquired via anti-ADAMTS13 autoantibodies. It can be triggered by bone marrow or solid organ transplantation, cardiothoracic-, abdominal-, and orthopedic surgeries, infections including very rarely Helicobacter pylori infection...
January 31, 2019: American Journal of Case Reports
Thorir E Long, Solveig Helgadottir, Dadi Helgason, Gisli H Sigurdsson, Tomas Gudbjartsson, Runolfur Palsson, Olafur S Indridason, Martin I Sigurdsson
BACKGROUND: The aim of this study was to examine different definitions of renal recovery following postoperative acute kidney injury (AKI) and how these definitions associate with survival and the development and progression of chronic kidney disease (CKD). METHODS: This was a retrospective study of all patients who underwent abdominal, cardiothoracic, vascular, or orthopedic surgery at a single university hospital between 1998 and 2015. Recovery of renal function following postoperative AKI was assessed comparing 4 different definitions: serum creatinine (SCr) (i) < 1...
January 30, 2019: American Journal of Nephrology
Paul M Thein, Julia Ong, Tim M Crozier, Arthur Nasis, Sam Mirzaee, Sean X Tan, Ralph Junckerstorff
BACKGROUND: Atrial fibrillation(AF) occurs frequently following cardiothoracic surgery and treatment decisions are informed by evidence-based clinical guidelines. Outside this setting there is little data to guide clinical management. Our aim was to describe the characteristics, management and outcomes of hospitalised adult patients with new-onset AF. METHODS: The medical emergency team(MET) database was utilised to identify patients who had a 'MET call' activated for tachycardia between 2015 and 2016...
January 28, 2019: Internal Medicine Journal
Faheem Sheriff, Joshua Hirsch, Kenneth Shelton, David D'Alessandro, Chris Stapleton, Matthew Koch, James Rabinov, Arminder Jassar, Aman Patel, Thabele Leslie-Mazwi
OBJECTIVES: Ischemic stroke due to large-vessel occlusion (LVO) is a complication after cardiothoracic surgery (CTS). Recently published endovascular stroke trials have major implications for treating LVO strokes; we evaluated our experience in patients undergoing CTS. METHODS: Our prospective institutional CTS database was reviewed between July 2013 and April 2018 for ischemic strokes. Patients with LVO were identified and their course and outcomes analyzed. RESULTS: A total of 5947 patients were reviewed; 148 (2...
December 11, 2018: Journal of Thoracic and Cardiovascular Surgery
Megan F Hunt, Xun Zhou, Cecillia Lui, Stephen C Yang
No abstract text is available yet for this article.
December 19, 2018: Journal of Thoracic and Cardiovascular Surgery
Joshua A Gabel, Roger T Tomihama, Ahmed M Abou-Zamzam, Victor Nekrasov, Udochukwu E Oyoyo, Christian Bianchi, Theodore H Teruya, Sharon C Kiang
OBJECTIVE: The natural history of penetrating aortic ulcer (PAU) has been variably described and clear guidelines are lacking. We reviewed our experience with penetrating aortic ulcers in a tertiary referral center. METHODS: Imaging reports from January 2010 - December 2017 were retrospectively searched for the diagnosis of "penetrating aortic ulcer." Diagnosis was confirmed by review of imaging studies. Patient demographics, presenting symptoms, and anatomic characteristics were collected and analyzed for associations with need for surgical intervention, aortic complication, and overall survival...
January 23, 2019: Annals of Vascular Surgery
Abdullah Abdulfattah Mashat, Ahmed Hussein Subki, Moaz Abdulrahman Bakhaider, Wejdan Mohammad Baabdullah, Jawaher Badr Walid, Abdulrahman Hatim Alobudi, Maged Mazen Fakeeh, Anas Jamal Algethmi, Wesam Awad Alhejily
Introduction: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia worldwide and carries significant risk of morbidity and mortality. The prevalence of AF is high in significant parts of the world, but not much is known from countries, such as Saudi Arabia. Aims: To study the risk factors, etiologies, comorbidities, and outcome of AF in Saudi Arabia. Patients and methods: A retrospective study was conducted in King Abdul-Aziz Hospital in Jeddah during the period 2010-2017...
2019: International Journal of General Medicine
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