Redo Cardiac Surgery After Personalized External Aortic Root Support Operation.

A 36-year-old man with Marfan syndrome underwent mitral surgery after personalized external aortic root support operation. Redo surgery was performed without aortic cannulation (with right axillary cannulation and retrograde cardioplegia). Surgical findings revealed unique aortic changes with adventitial growth and vasa vasorum, without visible mesh.

Could Blockchain Help With COVID-19 Crisis?

The novel coronavirus that causes the Coronavirus Disease 2019 (COVID-19) has spread all over the world at an unprecedented rate. With growing recognition of the distributed nature of health services, the technology of blockchain has recently reached the impetus of the healthcare domain. This article provides: 1) a panoramic overview of existing solutions and scenarios incorporating blockchain to combat COVID-19 in the healthcare domain along with their benefits and challenges; as well as 2) a framework that will facilitate new research activities on this subject.

Early to midterm survival of patients with deep sternal wound infection managed with laparoscopically harvested omentum.

Objective: The optimal management of deep sternal wound infection (DWSI) remains controversial. Our objective was to evaluate outcomes of patients with DSWI managed with transposition of laparoscopically harvested omentum (LHO).

Methods: Between 2000 and 2020, a total of 38,623 adult patients who underwent full median sternotomy for cardiac surgery were analyzed retrospectively at our institution.

Ramping Up the Delivery of Cardiac Surgery During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons.

The coronavirus disease 2019 (COVID-19) has had a profound global effect. Its rapid transmissibility has forced whole countries to adopt strict measures to contain its spread. As part of necessary pandemic planning, most Canadian cardiac surgical programs have prioritized and delayed elective procedures in an effort to reduce the burden on the health care system and to mobilize resources in the event of a pandemic surge.

Cardiac Surgery in Canada During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons.

On March 11, 2020, the World Health Organization declared that COVID-19 was a pandemic. At that time, only 118,000 cases had been reported globally, 90% of which had occurred in 4 countries. Since then, the world landscape has changed dramatically.

Five Maneuvers to Facilitate Faster Robotic Mitral Valve Repair.

Robotically assisted mitral valve reconstruction has become a cornerstone in the management of degenerative mitral valve regurgitation. High-volume centers report exceptional outcomes with minimal morbidity and mortality in select patient populations. As compared to conventional sternotomy, robotically assisted surgery has yielded comparable efficacy and safety, with potential benefits of improved cosmesis and a faster recovery period.

Impact of visualization on simulation training for vascular anastomosis.

Objective: There is mounting evidence supporting the benefit of surgical simulation on the learning of skills independently and in a patient-safe environment. The objective of this study was to examine the effect of visualization of surgical steps via instructional media on performance of an end-to-side microvascular anastomosis.

Methods: Thirty-two first- and second-year surgical trainees from the University of Ottawa received an expert-guided, didactic lecture on vascular anastomosis and performed an end-to-side anastomosis on a procedural model to assess baseline skills.

Gender and Cardiothoracic Surgery Training: Specialty Interests, Satisfaction, and Career Pathways.

Background: The cardiothoracic surgical workforce is changing. Although 5% of practicing surgeons are women, 20% of current cardiothoracic surgery residents are women. The purpose of this study was to evaluate the influence of gender on specialty interest, satisfaction, and career pathways of current residents.

The Future of the Academic Cardiothoracic Surgeon: Results of the TSRA/TSDA In-Training Examination Survey.

Background: Traditionally cardiothoracic residents spent dedicated research time during general surgery equipping them for a potential academic career. Recent changes in training paradigms, including integrated programs that may not include research time, could affect the development of future academic cardiothoracic surgeons.

Methods: Responses to the 2015 Thoracic Surgery Directors' Association/Thoracic Surgery Residents' Association survey accompanying the in-training examination taken by current cardiothoracic surgery residents were analyzed.

Characterizing the Operative Experience of Cardiac Surgical Trainees: What Are Residents Really Doing in the Operating Room?

Background: The present study aimed to describe and compare the operative experience of cardiothoracic surgical residents for basic and advanced cardiac surgical procedures.

Methods: Data were obtained from the 2015 Thoracic Surgery Directors Association Survey administered to all thoracic surgical residents taking the yearly In-Service Training Examination (n = 356). Residents were asked whether they routinely served as the operative surgeon on various cardiac operations and operative tasks.

Is Aortic Valve Repair Reproducible? Analysis of the Learning Curve for Aortic Valve Repair.

Background: Aortic valve (AV) preservation and repair, although effective, is performed in a limited number of centres. Lack of wider application might be due to challenges in dissemination of tacit surgical knowledge. We examined the learning curve in 2 centres that initiated dedicated programs in AV repair.

Severe tracheobronchial compression in a patient with Turner's syndrome undergoing repair of a complex aorto-subclavian aneurysm: anesthesia perspectives.

We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner's syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful preoperative preparation, maintenance of spontaneous breathing when possible, and consideration of having an alternative source of oxygenation and circulation established prior to induction of general anesthesia. Cardiopulmonary monitoring is essential for safe general anesthesia and diagnosis of unexpected intraoperative events.

Mapping and ablation of autonomic ganglia in prevention of postoperative atrial fibrillation in coronary surgery: MAAPPAFS atrial fibrillation randomized controlled pilot study.

Background: Postoperative atrial fibrillation (POAF) remains common after coronary artery bypass grafting (CABG). Limited efforts to intervene on cardiac autonomic ganglionic plexi (AGP) during surgery show mixed results. In this pilot study, we evaluated the safety and feasibility of map-guided ablation of AGPs during isolated CABG in the prevention of POAF.

Aortic valve preservation and repair in acute Type A aortic dissection.

Objectives: Repair and preservation of the aortic valve in Type A aortic dissection (AAD) remains controversial. We performed a meta-analysis of outcomes for aortic valve (AV) repair and preservation in AAD focusing on long-term valve-related events.

Methods: Structured searches were performed in Embase (1980-2013) and PubMed (1966-2013) for studies reporting AV repair or preservation in AAD.

Mitral valve interventions in heart failure.

Purpose Of Review: This review describes new developments in mitral valve interventions for patients with heart failure. The review also discusses innovative therapies in the treatment of mitral regurgitation in patients with heart failure and describes novel risk factors of recurrent mitral regurgitation following repair in this population.

Recent Findings: Percutaneous strategies are rapidly emerging as an important adjunct to conventional mitral surgery, specially for patients with functional mitral regurgitation and heart failure.

Systematic review of aortic valve preservation and repair.

Background: Aortic valve repair has emerged as a feasible alternative to replacement in the surgical treatment of selected patients with aortic valve (AV) pathology. In order to provide a synopsis of the current literature, we preformed a systematic review with a focus on valve-related events following AV repair.

Methods: Structured keyword searches of Embase and PubMed were performed in January 2012.

Repair of quadricuspid aortic valve associated with ascending aorta dilatation.

Quadricuspid aortic valve is a rare congenital anomaly that may require surgical intervention because of valvular dysfunction. Rarely, it may be associated with enlargement of the ascending aorta. Here, the case is presented of a quadricuspid aortic valve-associated enlargement of the ascending aorta and functional aortic annulus dilatation in a 36-year-old patient.

Reoperation of left heart valve bioprostheses according to age at implantation.

Background: Evidence supporting the use of bioprostheses for heart valve replacement in young adults is accumulating. However, reoperation data, which may help guide clinical decision making in young patients, remains poorly defined in the literature.

Methods And Results: We examined the need for reoperation in 3975 patients who underwent first-time bioprosthetic aortic valve replacement (AVR) (n=3152) or mitral valve replacement (MVR) (n=823).

The role of pulmonary embolectomy in the treatment of acute pulmonary embolism: a literature review from 1968 to 2008.

Acute massive or submassive pulmonary embolism (PE) requires prompt diagnosis, risk-stratification and aggressive treatment. Mortality rates can rise up to 70% within the first hour of presentation and are strongly correlated with the degree of right ventricular (RV) dysfunction, cardiac arrest, and consequential congestive heart failure. While anticoagulation is universally employed, there are inadequate data to establish definitive guidelines for the management of massive PE despite the availability of multiple treatment modalities.

The use of the Impella LP 2.5 percutaneous microaxial ventricular assist device as hemodynamic support during high-risk abdominal surgery.

Physiologic changes associated with anesthesia and technical aspects of noncardiac surgical procedure expose patients with severely depressed myocardial function to an enormous risk of perioperative complications and morbidity. In cases when these patients require mechanical circulatory support while undergoing emergent or elective operations, perioparative monitoring becomes of paramount importance.