Perfusion and aortic surgery: patient directed cardiopulmonary bypass and quality improvement.

Aortic surgery frequently extends the boundaries of perfusion knowledge learned from non aortic cardiac surgery.This is due to the extremes of temperature, prolonged bypass times, hypothermic arrest, and selective organ(s) perfusion. Suboptimal perfusion can potentially affect outcomes even after technically successful aortic surgery.

Has Microsoft left behind risk modeling in cardiac and thoracic surgery?

This concept paper examines a number of key areas central to quality and risk assessment in cardiac surgery. The effect of surgeon and institutional factors with regard to outcomes in cardiac surgery is utilized to demonstrate the need to sub analyze cardiac surgeons performance in a more sophisticated manner than just operation type and patient risk factors, as in current risk models. By utilizing the mathematical/engineering concept of Fourier analysis in the breakdown of cardiac surgical results the effects of each of the core components that makes up the care package of a patient's experiences are examined.

Introducing change (science into the operating room): quality improvement versus experimentation.

Introducing change is sometimes vital on an individual, departmental, and institutional level to improve the quality of care of patients undergoing cardiopulmonary bypass. This review discussed the following areas: cost of poor quality, variation, knowledge, Deming's red bead experiments and his conclusions, how do you try to improve, measurement, statistics, and quality improvement verses research. Successes and failures with regard to the introduction of change, and strategies to introduce change without creating conflict are discussed with reference to the hospital in which the author works.

"First-hit" heart attack risk calculators on the world wide web: implications for laypersons and healthcare practitioners.

Background: Heart attack risk calculators are readily accessible on the world wide web, offering potentially powerful means of health education and risk awareness. Laypersons may be unaware of differences in applicability, risk calculation algorithms and output formats among such calculators. This study assesses the impact of basic web searching terms on type of calculator accessed and on the resulting risk score.

Transulnar access for coronary angiography and intervention: an early review to guide research and clinical practice.

Access for coronary angiography and intervention is increasingly achieved via the radial artery due to the significant risks of femoral access. However, anatomical and size variation mean the radial artery is not always suitable. The ulnar artery is occasionally used as an alternative in such cases, and while ulnar artery puncture may be relatively easy, there are anatomical particulars that could lead to complications following this access route.