Replacement of extended aortic arch aneurysm using partial sternotomy under beating heart and continuous cardiac perfusion.

We report the case of a 72-year-old male patient who presented with a progressive aortic arch aneurysm. To reduce surgical trauma, we planned the procedure using an upper partial sternotomy with continuous cardiac perfusion and moderate hypothermia. Two vents were inserted to provide sufficient relief to the heart during perfusion.

Applying the Andersen behavioral model to the medication therapy management program: an approach for improving medication safety in older adults.

Medication therapy problems (MTPs) are common among older adults and are associated with considerable morbidity, mortality, and healthcare costs. The Medicare Part D Medication Therapy Management (MTM) program, which includes Comprehensive Medication Reviews (CMRs), Targeted Medication Reviews (TMRs), and guidance on safe medication disposal, is designed to optimize therapeutic outcomes and reduce adverse events by addressing MTPs. Although this program has demonstrated success in reducing MTPs, its utilization remains low, with ongoing concerns about service access disparities, patient satisfaction, and long-term health outcomes.