Best practices for preventing hospital-acquired pressure injuries in surgical patients.

Hospital-acquired pressure ulcers (HAPUs) and deep tissue injuries (DTIs), while considered to be preventable in most cases continue to affect many patients in acute care facilities. Surgical patients have an especially high risk of developing HAPUs for several reasons, including immobility during the intraoperative and immediate postoperative periods. HAPUs are responsible for significant patient harm in the form of pain, increased susceptibility to infection, and delayed recovery.

Surgical resection of atrial myxomas.

Myxomas are the most common form of benign cardiac tumors; these tumors occur primarily in the atria. Most myxomas are idiopathic in origin, but in rare cases, patients have a family history of myxomas. Although these tumors are benign, myxomas have the potential to cause serious complications, including embolic events and partial or complete obstruction of intracardiac blood flow.

Ebstein's anomaly: a complex congenital heart defect.

Ebstein's anomaly is a complex, congenital heart defect characterized by a malformation of the tricuspid valve and right side of the heart. A variety of cardiac abnormalities are associated with Ebstein's anomaly, including atrial septal defect, conduction system abnormalities, patent foramen ovale, pulmonary stenosis or atresia, and ventricular septal defect.The clinical course of a patient with Ebstein's anomaly depends on the severity of the abnormalities present.

The arterial switch procedure for transposition of the great arteries.

Transposition of the great arteries is the most common congenital heart defect among the birth defects that present with cyanosis during the early neonatal period. Infants with this cardiac birth defect, in which the aorta originates from the right ventricle and the pulmonary artery originates from the left ventricle, usually do not survive without surgical intervention in the first few days of life. The arterial switch procedure, performed via a median sternotomy incision during cardiopulmonary bypass, restores the aorta and pulmonary artery to their normal anatomic positions.

The modified Bentall procedure for aortic root replacement.

The Bentall procedure is a surgical repair of an ascending aortic or aortic root aneurysm in combination with aortic valve disease. Less commonly, it is used to repair aortic dissection affecting the aortic root and valve. During the procedure, a composite aortic valve graft is used to replace the proximal ascending aorta and aortic valve.

Pulmonary thromboendarterectomy for thromboembolic pulmonary hypertension.

Pulmonary artery thromboendarterectomy (PTE) is a surgical procedure that offers the only cure for chronic thromboembolic pulmonary hypertension (TPH), a progressive form of secondary pulmonary hypertension. Current estimates indicate that 1% to 5% of patients who survive a pulmonary embolus will develop chronic TPH with progressively worsening pulmonary hypertension and right-sided heart failure. This bilateral procedure is performed through a sternotomy incision using cardiopulmonary bypass, profound hypothermia, and intermittent circulatory arrest with antegrade cerebral perfusion.

Anterior cervical discectomy and fusion for cervical disc disease.

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure proven successful in the treatment of symptoms caused by cervical degenerative disc disease that is unresponsive to conservative therapy. Retrospective studies of patients who have undergone ACDF indicate that this procedure has a high rate of success for relieving symptoms and a low rate of associated complications. This article discusses normal cervical spine anatomy, the pathology of degenerative cervical disc disease, and perioperative nursing care for patients undergoing ACDF.