Impella flow pump reinsertion after axillary graft thrombectomy: Technical points in replacing axillary Impella.

Axillary Impella devices are increasingly employed for long-term support of patients with systolic heart failure and shock. Axillary access allows for awake support and ambulation, which carries an inherent risk of disconnection or malposition. We report a series of two cases where device replacement due to dysfunction and malposition can be completed safely through the original axillary graft using axillary graft thrombectomy, given that the clot burden could be a major source of morbidity to the patient.

Reducing unnecessary testing: an intervention to improve resident ordering practices.

Purpose Of The Study: To reduce the number of unnecessary laboratory tests ordered through a measurement of effects of education and cost awareness on laboratory ordering behaviour by internal medicine residents for common tests, including complete blood cell count (CBC) and renal profile (RP), and to evaluate effects of cost awareness on hospitalisation, 30-day readmission rate and mortality rate.

Study Design: 567 patients admitted during February, March and April 2014 were reviewed as the control group. Total CBC, CBC with differential and RP tests were counted, along with readmission and mortality rates.

Age is not a contraindication for orthotopic liver transplantation: a single institution experience with recipients older than 75 years.

Introduction: Transplant community has arbitrary age limit for liver transplantation based on the increased comorbidities in aging population. There has been an increased demand to consider older patients to have access to liver transplantation as the US population continues to live longer with better health.

Methods: This is a single institution, retrospective review of patients, who were age 75 or over underwent liver transplantation.