Understanding the Effect of Bias on the Experience of Women Surgeons: A Qualitative Study.

Background: Exploring the lived experiences of surgeons is necessary to understand the changing culture of surgery and the unique challenges of being a woman in surgery. Surgeons have significant experiences and observations best discovered through qualitative study. The purpose of this study is to identify the similarities and differences between the experiences of men and women surgeons after initiation of mandatory microaggression training.

Outcomes of carotid endarterectomy in the Vascular Quality Initiative based on patch type.

Objective: The Vascular Quality Initiative (VQI) is the largest registry of vascular surgical procedures and as such is capable of distinguishing small but important differences in outcomes. The goal of this study was to determine the outcomes of carotid endarterectomy (CEA) based on patch type, including bovine pericardium, autogenous vein, polytetrafluoroethylene (PTFE), and Dacron.

Methods: All primary CEAs performed with primary repair and patching (n = 70,987) within the VQI were retrospectively analyzed.

Long-term impact of the Vascular Study Group of New England carotid patch quality initiative.

Objective: Patch angioplasty has been shown to decrease rates of restenosis after carotid endarterectomy (CEA). In 2003, the Vascular Study Group of New England (VSGNE) implemented its first quality initiative aimed at increasing the rates of patch closure after CEA. This study reports the effects of that initiative on the rate of patch closure in the VSGNE and also postoperative and 1-year CEA outcomes.

Comparison of major adverse event rates after elective endovascular aneurysm repair in New England using a novel measure of complication severity.

Objective: Major adverse event (MAE) rates are used as an outcome measure after surgical procedures. Although MAE rates summarize the occurrences of adverse events, they do not reflect differences in severity of these events. We propose that a measure of complication severity could provide a more accurate assessment about the quality of care.

Patients with end-stage renal disease have poor outcomes after endovascular abdominal aortic aneurysm repair.

Objective: Although endovascular repair of abdominal aortic aneurysms (AAAs) has been demonstrated to have favorable outcomes, not all cohorts of patients with AAA fare equally well. Our goal was to investigate perioperative and 1-year outcomes in patients with end-stage renal disease (ESRD) on dialysis, who have traditionally fared worse after vascular interventions, to assess how ESRD affects outcomes in a large modern cohort of endovascular aneurysm repair (EVAR) patients.

Methods: The Vascular Quality Initiative database was queried for all patients undergoing EVAR from 2010 to 2017.

Current management of traumatic thoracic aortic injury.

Traumatic aortic rupture is a devastating injury that is difficult to manage because of the need to approach aortic repair, often in concert with management of complex associated injuries to nonvascular organ systems. Traditional open repair, while effective in the long-term, is associated with a periprocedural mortality between 10% and 20%, along with a 5% risk of stroke and up to a 5% risk of spinal chord ischemia. The advent of endovascular stent graft repair has allowed single centers to cut periprocedural mortality in half and decrease the risk of major neurologic events to <2%.

A novel stentless mitral valve.

Stentless mitral valves have found little clinical utility to date due to difficulty in insertion. A new design for a stentless mitral valve, a modification of an existing aortic stentless prosthesis, is described. The new design mimics the native mitral physiology, and its insertion is easier than with existing stentless mitral valves.

Routine evaluation for aspiration after thoracotomy for pulmonary resection.

Background: The purpose of this study was to evaluate the role of a routine protocol for evaluation of oropharyngeal aspiration after thoracotomy for pulmonary resection.

Methods: Demographic, operative, and outcomes data were collected prospectively for consecutive patients undergoing thoracotomy for pulmonary resection starting in April 2005. Starting on postoperative day one, patients underwent evaluation by a licensed speech therapist before per os intake.

Increasing endovascular intervention for claudication: impact on vascular surgery resident training.

Purpose: To audit the caseloads of vascular surgery residents in the management of disabling claudication and assess the influence of endovascular procedures on overall operative experience.

Methods: A retrospective review was conducted of vascular surgery resident experience in the open and endovascular management of lower limb claudication during two 3-year periods (January 2000 to December 2002 and January 2003 to December 2005). The time periods differed with regard to number of surgical faculty with advanced endovascular skills (3 in the first period and 4 in the second) and the availability of portable operating room angiography equipment.

Bedside modified Clagett procedure for empyema after pulmonary resection.

The objective of this study is to demonstrate the effectiveness and feasibility in treating empyema after pulmonary resection with a modified Clagett procedure performed at the bedside (BMCP). A retrospective review of a single surgeon's experience at a single institution was undertaken. All operative, postoperative, and outcome data were analyzed.

Pseudoaneurysm of the superficial femoral artery associated with osteochondroma--a case report.

Osteochondromas, the most common benign bone tumor, often go undetected and seldom cause significant clinical sequelae. Rarely they present as an arterial pseudoaneurysm, usually of the popliteal or superficial femoral artery. The authors present the case of a 14-year-old male with a distal superficial femoral artery pseudoaneurysm accompanied by distal embolization from a femoral exostosis.