Surviving the Struggle of COVID-19: Practical Recommendations for Pediatric/Adult Cardiology and Cardiac Surgical Programs in Resource-Limited Settings: a Review.

Introduction: The primary aim of this systematic review is to provide perioperative strategies to help restore or preserve cardiovascular services under threat from financial and personnel constraints imposed by the coronavirus disease 2019 (COVID-19) pandemic.

Methods: The Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials/CCTR, and Google Scholar were systematically searched using the search terms "(cardiac OR cardiology OR cardiothoracic OR surgery) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)". Additionally, the webpages of relevant medical societies, including the World Federation Society of Anesthesiologists, the Cardiothoracic Surgery Network, and the Society of Thoracic Surgeons, were screened for relevant information.

Cardiac surgeons' concerns, perceptions, and responses during the COVID-19 pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on health care and cardiac surgery. We report cardiac surgeons' concerns, perceptions, and responses during the COVID-19 pandemic.

Methods: A detailed survey was sent to recruit participating adult cardiac surgery centers in North America.

Emotional quality-of-life and patient-reported limitation in sports participation in children with uncorrected congenital and acquired heart disease in healthcare-restricted settings in low- and middle-income countries.

Background: Little is known about emotional quality-of-life in paediatric heart disease in low- and middle-income countries where the prevalence of uncorrected lesions is high. Research on emotional quality-of-life and its predictors in these settings is key to planning interventions.

Methods: Ten-year retrospective cross-sectional study of children aged 6-17 years with uncorrected congenital or acquired heart disease in 12 low- and middle-income countries was conducted.

The Disparity Between Public Utilization and Surgeon Awareness of the STS Patient Education Website.

Background: Many online resources currently provide healthcare information to the public. In 2015, the Society of Thoracic Surgeons (STS) created a multimedia web portal (ctsurgerypatients.org) to educate the public regarding cardiothoracic surgery and provide an informative tool to which cardiothoracic surgeons could refer patients.

Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability.

Noncommunicable diseases account for 38 million deaths each year, and approximately 75% of these deaths occur in the developing world. The most common causes include cardiovascular diseases, cancer, respiratory diseases, and diabetes mellitus. Many adults with acquired cardiothoracic disease around the world have limited access to health care.

Conduits for coronary bypass: vein grafts.

The saphenous vein has been the principal conduit for coronary bypass grafting from the beginning, circa 1970. This report briefly traces this history and concomitantly presents one surgeons experience and personal views on use of the vein graft. As such it is not exhaustive but meant to be practical with a modest number of references.

Are thromboembolic and bleeding complications a drawback for composite aortic root replacement?

Background: Valve-preserving aortic root reconstruction is being performed with increasing frequency. Independent of durability concerns, enthusiasm for retaining the native valve is often championed on the presumption that composite graft replacement of the aorta will be complicated by thromboembolism and bleeding. Our goal in this late follow-up study is to determine if thromboembolism or bleeding, or both, are indeed problematic after composite aortic root replacement.

Intracoronary fiducial embolization after percutaneous placement for stereotactic radiosurgery.

Although well established for the treatment of intracranial and prostatic pathology, stereotactic radiosurgery has only recently emerged as a modality for the treatment of malignant lung lesions. Utilization of radio-opaque markers, called fiducials, facilitate dose-intensive radiation focused on the tumor with sparing of surrounding normal tissue. There is a paucity of literature regarding complications that occur secondary to placement of these fiducials.

Biomarkers for diagnosis in thoracic aortic disease: CON.

The fundamental requirements for a meaningful biomarker have not been met in the prediction of the aneurysm trait, the progression of the aneurysm disease state, or the prevention of catastrophic aortic complications. Aortic aneurysm is a worthy opponent on all fronts, and clinicians should continue actively to evaluate all potential diagnostic and therapeutic adjuncts with high levels of scientific scrutiny and rigor, so that the understanding and management of this disease process evolves in a complementary, rather than duplicative, manner. In the meantime, proteomics, genomics, and metabolomics continue to represent a muse of sorts in scientific circles, but clinicians are responsible for verifying the relevance and meaningful application of its postulates as they apply to individual patients within the context of efficient and effective global health care delivery.

Thoracic aortic aneurysm clinically pertinent controversies and uncertainties.

This paper addresses clinical controversies and uncertainties regarding thoracic aortic aneurysm and its treatment. 1) Estimating true aortic size is confounded by obliquity, asymmetry, and noncorresponding sites: both echocardiography and computed tomography/magnetic resonance imaging are necessary for complete assessment. 2) Epidemiology of thoracic aortic aneurysm.

Assisted circulation: experience with the Novacor Left Ventricular Assist System.

Surgical therapy for the treatment of heart failure is a relatively young solution to a problem that has overwhelmed civilizations dating back to the First Dynasty. Despite centuries of enormous multidisciplinary medical and technological advance, nearly 2000 people in the USA died of cardiovascular disease every day in 2006, averaging one death every 35 seconds, and claiming more lives than the next four leading causes of death combined. In 2007, one in 30 female deaths will be from breast cancer, while one in 2.

Straight deep hypothermic arrest: experience in 394 patients supports its effectiveness as a sole means of brain preservation.

Background: The three methods of brain preservation for aortic arch surgery--straight deep hypothermic circulatory arrest (DHCA) without perfusion adjuncts, retrograde cerebral perfusion, and antegrade cerebral perfusion--remain controversial. Patients in this report underwent surgery solely with DHCA.

Methods: Straight DHCA at 19 degrees C was used in 394 patients (267 males, 127 females) during a 10-year period.

Airway complications after pulmonary resection.

Airway complications following pulmonary resection remain a challenging problem. A high degree of clinical suspicion, contrasted CT imaging, and early reoperation are crucial in preserving viable lung parenchyma following the anatomic compromise of lobar torsion. Likewise, early recognition and expeditious drainage of the pleural space in the setting of bronchial dehiscence may help prevent the aspiration pneumonia and consequent respiratory failure that is the leading cause of death in this patient population; A variety of interventions to manage stump dehiscence are possible, but successful management still remains difficult and requires an individualized approach.

A comparison of total thyroidectomy and lobectomy in the treatment of dominant thyroid nodules.

Patients with a clinically concerning dominant thyroid nodule have been managed by lobectomy or total thyroidectomy at our institution. We determined the complications associated with both approaches and the ability of thyroid lobectomy to avoid the need for thyroid hormone replacement therapy. Records of all patients with a dominant thyroid nodule managed with surgery from August 1993 through December 2000 were reviewed for demographics, history of head and neck radiation, indication for surgery, preoperative fine-needle aspirate results, final pathologic evaluation, perioperative complications, determinations of need for subsequent thyroid surgery after lobectomy, and need for thyroid hormone replacement therapy after surgery.