Introduction: Engaging patients living with or at risk of aortic dissection via the Aortic Dissection Collaborative, physician education in vascular genetics was identified as a research priority. We surveyed vascular surgeons to characterize practice patterns, motivations, and barriers regarding aortopathy genetic testing.
Methods: An anonymous 27-question survey was distributed on social media platforms between November and December 2022. Domains included demographics, vascular genetic education, testing attitudes and utilization, and experience in treating patients with genetic vascular aortopathies. The analysis included summary statistics and unpaired t-test to compare responses by interest in incorporating testing and practice type.
Results: A total of 171 vascular surgeons from 15 countries responded to the survey (23% trainees). Over half received vascular genetics education during training (59%), and most (86%) were interested in incorporating genetic testing into their practice. Academic surgeons were more likely to have cared for a patient with a known genetic aortopathy over the past year than surgeons in hospital-based and private practices (83% vs. 56% vs. 27%; P < 0.01), to have ever made a referral to a medical geneticist (78% vs. 51% vs. 9%; P < 0.01), and have access to genetic counselors or geneticists (66% vs. 46% vs. 0%; P < 0.01). Barriers to genetic testing were rated as more significant by surgeons in nonacademic practices, with top barriers being insurance coverage of testing, cost of genetic testing, and access to genetic counselors. Evidence-based professional society guidelines were the strongest rated motivating factor for testing incorporation among respondents.
Conclusions: Vascular surgeon attitudes are not major barriers to incorporating genetic testing for patients with aortopathies; however, practical challenges regarding genetic testing and counseling are barriers to implementation especially for vascular surgeons in nonacademic practices. Future efforts should focus on evidence-based society guidelines, continuing medical education to increase adoption, and facilitating access to genetic counseling.
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http://dx.doi.org/10.1016/j.avsg.2024.01.032 | DOI Listing |
Cochrane Database Syst Rev
January 2025
Neonatal Intensive Care Unit, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Background: Esophageal atresia is one of the most common life-threatening congenital malformations and is defined as an interruption in the continuity of the esophagus with or without fistula to the trachea or bronchi. Definitive treatment is surgical ligation of the fistula if present and esophageal end-to-end anastomosis of the two pouches, thereby reconstructing the continuity of the esophagus. During this procedure, the surgeon may choose to either ligate or preserve the azygos vein, a major draining vein for the esophagus and surrounding structures, but no definitive consensus on the matter exists.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Harrington Heart and Vascular Institute, University Hospital - Cleveland/Case Western Reserve University, Cleveland, Ohio.
Background: Low oxygen delivery (DO2) on cardiopulmonary bypass has been associated with acute kidney injury. We sought to determine the association of intraoperative DO2, postoperative length of stay, and major postoperative events.
Methods: DO2 values were calculated in 845 patients after initiation, and every 30 minutes on bypass.
Ann Thorac Surg Short Rep
December 2024
Sanger Heart & Vascular Institute, Charlotte, North Carolina.
Background: Our remote patient monitoring (RPM) program for adult cardiac surgery patients aims to remove barriers to access, provide continuity of expert care, and increase their time-at-home. The RPM program integrates novel biosensors, an application for audiovisual visits, messaging, biometric data tracking, patient-reported outcomes, and scheduling with the aim of reducing postoperative length of stay and 30-day readmissions, while simultaneously increasing the rate of patients discharged to home.
Methods: Our institutional database was utilized for this retrospective review of 1000 consecutive RPM patients who underwent coronary artery bypass, valve, and coronary artery bypass + valve, at 3 hospitals from July 2019 through April 2023.
Phlebology
January 2025
Research Department, The Whiteley Clinic, Guildford, UK.
Background: Pelvic venous disorders (PeVD), previously "Pelvic congestion syndrome (PCS)" is usually defined as a female health problem. However, it is our impression that gynaecologists rarely recognise this condition, and most of the research interest appears to be by vascular and venous surgeons, and radiologists. The aim of this study was to investigate if there was evidence to support this view.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
January 2025
Academic Department of Otolaryngology-Head and Neck Surgery, Royal College of Surgeons Ireland, 123 St. Stephen's Green, Dublin 2, D02 YN77, Ireland.
Purpose: This meta-analysis sought to compare knot tying against other methods of haemostasis in terms of post-operative haemorrhage, intraoperative blood loss and tonsillectomy time.
Methods: Two independent reviewers performed a literature search according to PRISMA guidelines. Three databases were consulted, Pubmed, Google Scholar and Embase.
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