GIA-Aneurysmorrhaphy and Dermal Detachment: A Novel Technique to Repair Arteriovenous Fistula Aneurysms.

This report describes a simplified technique for management of aneurysmal arteriovenous fistulas along with results of initial clinical experience in 12 patients. Various techniques have been described which seek to repair the arteriovenous fistula and lengthen its duration of use. Here, we introduce the GIA-aneurysmorrhaphy and dermal detachment (GADD) procedure, a novel technique which requires minimal dissection to decompress tension on the overlying skin.

Conversation and the Jehovah's Witness dying from blood loss.

Religious belief can complicate the usual management of seriously ill patients when the patient is a Jehovah's Witness and the treatment is a blood transfusion. This narrative highlights critical points in a discussion of two cases wherein the process to promote an exercise of free will also becomes an exercise for the ethics consultant and healthcare team. Despite a medical care program's carefully considered additions to an electronic healthcare record, additional conversation, investigation, preparation, and an open mind are required.

Screening carotid artery duplex in patients undergoing cardiac surgery.

Background: We sought to determine the prevalence of carotid artery stenosis (CAS)>50% in a large, multi-institutional health maintenance organization found during duplex ultrasonography screening before cardiac surgery and to identify risk factors to increase the yield of a preoperative screening program.

Methods: This retrospective review study was conducted on 722 patients who had undergone duplex ultrasonography screening of the carotid artery before cardiac surgery between June 2008 and February 2011. The primary outcome was CAS>50% detected on duplex ultrasonography screening.

Total laparorobotic repair of abdominal aortic aneurysm with sac exclusion obliteration and aortobifemoral bypass.

A 65-year-old man with coronary artery disease, hypertension, and peripheral vascular disease was found to have an asymptomatic abdominal aortic aneurysm (AAA) of 5.5 cm on surveillance for his peripheral vascular disease. Cardiac stress testing demonstrated no evidence of myocardial ischemia, and he opted to undergo open repair of his aneurysm.