Applying to Integrated Thoracic Surgery Residency: A Survey-Based Cost Analysis.

Background: Application costs are known for other competitive surgical subspecialties but not for integrated thoracic surgery residency (I6). We sought to quantify I6 application costs, assess the value of away rotations and geographic connections, and identify characteristics of matched applicants.

Methods: We retrospectively reviewed the Texas Seeking Transparency in Application to Residency survey-based database for I6 applicants (2019-2022).

The Growing Years: Promoting Yourself in the First 5 Years.

There are several transitions that must be made to define your new role as an attending surgeon. Establishing these transitions can be difficult but trying to promote yourself while undergoing these awkward transitions can be taxing but nevertheless crucial. Whether you are in private practice trying to obtain referrals to build your practice or in an academic setting where you are trying to find your niche, promoting yourself along the way is imperative for your future growth.

Outcome and Cost Comparisons Between Surgical and Transcatheter Aortic Valve Replacements.

Objective: Surgical aortic valve replacement (SAVR) has been the standard of care for severe aortic stenosis. In 2019, annual transcatheter aortic valve replacement (TAVR) implantations surpassed SAVR. We compared in-hospital costs and outcomes between these two procedures.

Monitored Anesthesia Care Versus General Anesthesia for Transcatheter Aortic Valve Replacement.

Objective: Monitored anesthesia care (MAC) has been increasingly used in lieu of general anesthesia (GA) for transcatheter aortic valve replacement (TAVR). We sought to compare outcomes and in-hospital costs between MAC and GA for TAVR at a Veterans Affairs Medical Center.

Methods: A single-center retrospective review was performed of 349 patients who underwent transfemoral TAVR (MAC, = 244 vs GA, = 105) from January 2014 to December 2019.

Patent Ductus Arteriosus Exclusion Technique Using Thoracic Endovascular Aortic Repair.

A large patent ductus arteriosus is an uncommon discovery in an adult. A 2.7-cm patent ductus arteriosus was found in a 31-year-old man with heart failure symptoms.

Spinal Cord Ischemia-Reperfusion Injury Induces Erythropoietin Receptor Expression.

Background: Paraplegia remains a devastating complication of aortic surgery, occurring in up to 20% of complex thoracoabdominal repairs. Erythropoietin (EPO) attenuates this injury in models of spinal cord ischemia. Upregulation of the beta-common receptor (βcR) subunit of the EPO receptor is associated with reduced damage in murine models of neural injury.

Alpha-2 agonist attenuates ischemic injury in spinal cord neurons.

Background: Paraplegia secondary to spinal cord ischemia-reperfusion injury remains a devastating complication of thoracoabdominal aortic intervention. The complex interactions between injured neurons and activated leukocytes have limited the understanding of neuron-specific injury. We hypothesize that spinal cord neuron cell cultures subjected to oxygen-glucose deprivation (OGD) would simulate ischemia-reperfusion injury, which could be attenuated by specific alpha-2a agonism in an Akt-dependent fashion.

Erythropoietin activates the phosporylated cAMP [adenosine 3'5' cyclic monophosphate] response element-binding protein pathway and attenuates delayed paraplegia after ischemia-reperfusion injury.

Objective: Paraplegia remains a devastating complication of complex aortic surgery. Erythropoietin (EPO) has been shown to prevent paraplegia after ischemia reperfusion, but the protective mechanism remains poorly described in the spinal cord. We hypothesized that EPO induces the CREB (cAMP [adenosine 3'5' cyclic monophosphate] response element-binding protein) pathway and neurotrophin production in the murine spinal cord, attenuating functional and cellular injury.

Spinal cord protection via alpha-2 agonist-mediated increase in glial cell-line-derived neurotrophic factor.

Objectives: Delayed paraplegia secondary to ischemia-reperfusion injury is a devastating complication of thoracoabdominal aortic surgery. Alpha-2 agonists have been shown to attenuate ischemia-reperfusion injury, but the mechanism for protection has yet to be elucidated. A growing body of evidence suggests that astrocytes play a critical role in neuroprotection by release of neurotrophins.

Reproducable paraplegia by thoracic aortic occlusion in a murine model of spinal cord ischemia-reperfusion.

Background: Lower extremity paralysis continues to complicate aortic interventions. The lack of understanding of the underlying pathology has hindered advancements to decrease the occurrence this injury. The current model demonstrates reproducible lower extremity paralysis following thoracic aortic occlusion.

Toll-like receptor 4-dependent microglial activation mediates spinal cord ischemia-reperfusion injury.

Background: Paraplegia continues to complicate thoracoabdominal aortic interventions. The elusive mechanism of spinal cord ischemia-reperfusion injury has delayed the development of pharmacological adjuncts. Microglia, the resident macrophages of the central nervous system, can have pathological responses after a variety of insults.

Interruption of spinal cord microglial signaling by alpha-2 agonist dexmedetomidine in a murine model of delayed paraplegia.

Background: Despite investigation into preventable pharmacologic adjuncts, paraplegia continues to complicate thoracoabdominal aortic interventions. The alpha 2a adrenergic receptor agonist, dexmedetomidine, has been shown to preserve neurologic function and neuronal viability in a murine model of spinal cord ischemia reperfusion, although the mechanism remains elusive. We hypothesize that dexmedetomidine will blunt postischemic inflammation in vivo following thoracic aortic occlusion with in vitro demonstration of microglial inhibition following lipopolysaccharide (LPS) stimulation.

Effects of loading on spinal shrinkage in males of different age groups.

A reduction in stature (shrinkage) has been used as a measure of the load on the spine. Musculoskeletal effects of ageing may influence individual responses to compressive loading on the spine and the resultant loss in stature. The aim was to apply the technique of precision stadiometry for assessment of spinal shrinkage in a comparison of responses of two different age groups performing a regimen of circuit weight training.