Surgical Repair of Atrial-Esophageal Fistula Following Catheter Ablation.

Left atrial-esophageal fistula after radiofrequency ablation for atrial fibrillation is a rare and potentially lethal complication. Although surgical management is associated with improved outcomes, the optimal approach remains to be elucidated. We describe a case of atrial-esophageal fistula treated with a simultaneous repair of the atrium and esophagus via a right thoracotomy with an extrapericardial off-pump approach.

Radical nephrectomy with resection of vena cava thrombus using extracorporeal circulation and deep hypothermic circulatory arrest.

Introduction: Patients with renal cell carcinoma (RCC) with level 3 or 4 caval thrombus have a poor prognosis, with reported five-year survival rates of 30-40%. The aim of this study was to assess the perioperative morbidity and long-term oncological outcomes for radical nephrectomy with resection of vena cava thrombus using a combined surgical approach, including extracorporeal circulation and deep hypothermic circulatory arrest.

Methods: A retrospective review was performed of the institutional case log to identify all radical nephrectomies with caval thrombus performed from January 2006 to May 2020.

Development of a cumulative teaching score for tracking surgeon performance in undergraduate medical education.

Background: Surgeon educators are important in undergraduate medical education (UME). However, teaching activities are undervalued and under-recognized compared with research, resulting in poorer quantity and quality of surgeon teaching. The purpose of this study was to investigate teaching roles available to surgeons and the amount of effort involved.

Perceval Sutureless Valve - are Sutureless Valves Here?

With the advent of transcatheter aortic valve implantation (TAVI) techniques, a renewed interest has developed in sutureless aortic valve concepts in the last decade. The main feature of sutureless aortic valve implantation is the speed of insertion, thus making implantation easier for the surgeon. As a result, cross clamp times and myocardial ischemia may be reduced.

Planting the 'SEAD': early comprehensive exposure to surgery for medical students.

Introduction: The popularity of surgical specialties is declining amongst Canadian medical students. Limited early exposure of students to surgery and minor involvement of surgeons in preclerkship education are barriers to creating interest in the field. Although many informal observerships and interest groups exist, there are no structured programs in Canada that offer preclerkship medical students a comprehensive exposure to surgery.

Cut-off values for transit time flowmetry: are the revision criteria appropriate?

Background: Graft Imaging to Improve Patency (GRIIP), a single-center, randomized blinded clinical trial, reported that intraoperative graft assessment with graft revision according to a priori criteria of transit time flowmetry (TTF) and intraoperative fluorescent angiography did not improve graft patency at one year after coronary artery bypass grafting (CABG) when compared with standard intraoperative management. The objective of this study is to investigate whether other TTF values are more predictive of the saphenous vein graft (SVG) failure and/or clinical outcomes.

Methods: This is a case control retrospective study of 65 SVGs from 44 patients from GRIIP.

Mitroflow pericardial bioprosthesis: structured failure at 4.5 years.

Background: Prosthetic heart valves are commonly used in the management of significant valvular disease. Although bioprostheses are increasingly popular, structural deterioration with cusp tears and calcification persists.

Methods: We present a case of a Mitroflow pericardial bioprosthesis (Sorin Group Inc.

Technique of harvesting an internal thoracic artery densely adherent to the periosteum.

The internal thoracic artery (ITA) has been universally accepted as a superior conduit for patients undergoing coronary artery bypass operations. The harvesting of the ITA is a routine procedure. Rarely, one encounters an ITA densely adherent to the overlying periosteum.

Are stentless valves hemodynamically superior to stented valves? Long-term follow-up of a randomized trial comparing Carpentier-Edwards pericardial valve with the Toronto Stentless Porcine Valve.

Objective: The benefit of stentless valves remains in question. In 1999, a randomized trial comparing stentless and stented valves was unable to demonstrate any hemodynamic or clinical benefits at 1 year after implantation. This study reviews long-term outcomes of patients randomized in the aforementioned trial.

The Graft Imaging to Improve Patency (GRIIP) clinical trial results.

Objective: This trial aimed to determine whether intraoperative graft assessment with criteria for graft revision would decrease the proportion of patients with 1 or more graft occlusions or stenoses or major adverse cardiac events 1 year after coronary artery bypass grafting.

Methods: A single-center, randomized, single-blinded, controlled clinical trial was designed. Patients were randomized to either of 2 groups: intraoperative graft patency assessment using indocyanine-green fluorescent angiography and transit-time flowmetry, with graft revision according to a priori criteria (imaging group), or standard intraoperative management (control group).

Troponin after cardiac surgery: a predictor or a phenomenon?

Background: Increased cardiac troponin is observed after virtually every cardiac operation, indicating perioperative myocardial injury. The clinical significance of this elevation is controversial. This study aimed to correlate postoperative troponin levels with major adverse cardiac events (MACE).

Bacteremia caused by Pantoea agglomerans and Enterococcus faecalis in a patient with colon cancer.

A case of bacteremia caused by Pantoea agglomerans (P. agglomerans) and Enterococcus faecalis in a male patient with colon cancer is reported. He was successfully treated with vancomycin and meropenem.

Primary bacteraemia caused by Rhizobium radiobacter in a patient with solid tumours.

A case of Rhizobium radiobacter primary bacteraemia in a patient with solid tumours is reported. Corticosteroid therapy and diabetes mellitus were the predisposing factors. The patient was treated successfully with amikacin and piperacillin/tazobactam.

A randomized comparison of intraoperative indocyanine green angiography and transit-time flow measurement to detect technical errors in coronary bypass grafts.

Background: Early coronary bypass graft failures may be preventable if identified intraoperatively. The purpose of this investigation was to compare the diagnostic accuracy of two intraoperative graft assessment techniques, transit-time ultrasound flow measurement and indocyanine green fluorescent-dye graft angiography.

Methods: Patents undergoing isolated coronary artery bypass grafting with no contraindications for postoperative angiography were enrolled in the study.

Central line-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myeloid leukaemia in Piraeus, Greece.

A case of central venous catheter-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myelogenous leukaemia is reported. The patient was successfully treated with amikacin and piperacillin-tazobactam. The clinical isolate was identified as R.

Age-dependent changes in body size of Greek boys from 1982 to 2002.

Objective: The prevalence of childhood obesity has been rising during the past decades in many parts of the world, including Greece. The dispersion of these trends across age, however, is less clear. The aim of this study was to examine the relationship between age and 20-year changes in anthropometric characteristics of Greek boys.

Changing relationships of obesity and dyslipidemia in Greek children: 1982-2002.

Background: The prevalence of childhood overweight and obesity has been increasing rapidly during the past decades in many parts of the world. Less is known with respect to the effects of increasing adiposity on blood lipid profile. The present study was designed to examine the influence of adiposity on secular trends in anthropometric characteristics and plasma lipids of Greek children.

Improving the quality of coronary bypass surgery with intraoperative angiography: validation of a new technique.

Objectives: We report a comprehensive assessment and validation of a new intraoperative angiography technique.

Background: Technical problems at the site of the distal anastomosis compromise an underappreciated proportion of coronary bypass grafts. The absence of a systematic, validated technique to verify graft patency in the operating room represents a significant breach in quality assurance.

Twenty-year dynamics in adiposity and blood lipids of Greek children: regional differences in Crete persist.

Aim: To examine whether secular trends in adiposity and blood lipid profile of Greek children manifested equally among individuals from urban and rural provinces.

Methods: Cretan boys (aged 12.1+/-2.

Determinants of incomplete left ventricular mass regression following aortic valve replacement for aortic stenosis.

Objective: Incomplete regression of left ventricular hypertrophy (Abn-LVMI) following AVR for aortic stenosis (AS) may decrease long-term survival. In this prospective study, we identified the predictors of Abn-LVMI.

Methods: Between 1990 and 2000, 529 patients undergoing AVR for AS had clinical and hemodynamic data collected prospectively.

Fatal Blastoschizomyces capitatus sepsis in a neutropenic patient with acute myeloid leukemia: first documented case from Greece.

Blastoschizomyces capitatus (formerly known as Geotrichum capitatum and Trichosporon capitatum) is a rare, yet an emerging, cause of invasive infections in immunosuppressed patients. Profound and prolonged neutropenia is the crucial predisposing factor for this yeast infection. Blastoschizomyces capitatus was isolated from peripheral blood cultures of a profoundly neutropenic patient with acute myeloid leukemia (M2 FAB).

Chryseobacterium indologenes non-catheter-related bacteremia in a patient with a solid tumor.

A case of non-catheter-related bacteremia caused by Chryseobacterium indologenes in a nonneutropenic man with a solid tumor is described. The patient was successfully treated with piperacillin-tazobactam.

Long-term results of aortic valve replacement with the St. Jude Toronto stentless porcine valve.

Background: Long-term survival and freedom from valve-related events of the St. Jude Toronto stentless porcine valve (SPV) are unknown. The aim of this study was to investigate late clinical outcomes after aortic valve replacement with the Toronto SPV.

Secular trends in cardiovascular risk factors among school-aged boys from Crete, Greece, 1982-2002.

Objective: The aim of the present study was to examine secular trends in major cardiovascular disease (CVD) risk factors, that is, obesity and dyslipidaemia, among Cretan children during 1982-2002.

Design: Epidemiological survey.

Setting And Subjects: A total of 528 boys in 1982 and 620 boys in 2002, aged 12.