Operative techniques for improving surgical exposure in basic cardiac surgery.

Operative exposure is key to ensuring surgical efficiency and patient safety in cardiac surgery. As the population ages and the prevalence of obesity increases, cardiac surgeons will be challenged to consider obese patient physiology and body habitus, surgical exposure and sternotomy closure techniques, and postoperative medical management to ensure optimal outcomes. In this article, we describe techniques to improve operative exposure in both obese and non-obese patients undergoing basic cardiac surgery and highlight the roles of surgical team members to ensure patient safety and provide optimal anesthetic management.

Quantifying prognostic impact of prescription opioid use before kidney transplantation through linked registry and pharmaceutical claims data.

Background: Limited data are available on the outcome implications of prescription narcotic use before kidney transplantation.

Methods: We examined a novel database wherein national transplant registry identifiers for kidney transplant recipients were linked to records from a large U.S.

Prognostic impact of mechanical ventilation after liver transplantation: a national database study.

Background: The impact of mechanical ventilatory support (MCVS) on mortality and graft loss after liver transplantation (LT) is not well described.

Methods: Multivariate analysis of a novel database linking national transplant registry and Medicare claims data was used to assess the impact of early MCVS on mortality and graft survival following LTs performed between 2002 and 2008.

Results: Among 10,517 LT recipients, 6.