Sahel Kargar’s Post

🔥 Just publihed! 🔥 "Early chest tube removal on the first postoperative day protocol of an enhanced recovery after cardiac surgery programme is safe" in European Journal of Cardio-Thoracic Surgery 2024. 🔍 Our findings reveal that the CTR on POD1 protocol can be safely incorporated into a standardized systematic Enhanced Recovery After Surgery programme. This approach not only enables early mobilization but also significantly contributes to the improvement of postoperative outcomes, setting a new benchmark in patient care. 📖 https://lnkd.in/exxG62J8 We extend our heartfelt thanks to all our team members and collaborators for their hard work and dedication. This achievement is a testament to the collective effort and passion for excellence in the field of ERAS programme in cardiac surgery. EACTS - European Association for Cardio-Thoracic Surgery SFCTCV Société Savante SFAR - Société française d'anesthésie et de réanimation SFC - Société Française de Cardiologie CHRU de Strasbourg - Hôpitaux Universitaires de Strasbourg American Association for Thoracic Surgery (AATS) #CardiacSurgery #ERAS #PatientCare #MedicalResearch #Publication #EuropeanJournalOfCardioThoracicSurgery

CARDIAC SURGERY Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis.It also includes heart transplantation.The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero (1801) in the city of Almería (Spain), Dominique Jean Larrey (1810), Henry Dalton (1891), and Daniel Hale Williams (1893).The first surgery on the heart itself was performed by Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo. Cappelen ligated a bleeding coronary artery in a 24-year-old man who had been stabbed in the left axilla and was in deep shock upon arrival. Access was through a left thoracotomy. The patient awoke and seemed fine for 24 hours but became ill with a fever and died three days after the surgery from mediastinitis.Open-heart surgery is any kind of surgery in which a surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart. "Open" refers to the chest, not the heart. Depending on the type of surgery, the surgeon also may open the heart. Dr. Wilfred G. Bigelow of the University of Toronto found that procedures involving opening the patient's heart could be performed better in a bloodless and motionless environment. Therefore, during such surgery, the heart is temporarily stopped, and the patient is placed on cardiopulmonary bypass, meaning a machine pumps their blood and oxygen. Because the machine cannot function the same way as the heart, surgeons try to minimize the time a patient spends on it #snsinstitutions #snsdesignthinkers #designthinking

Incidence of re-intubation in post cardiac surgery patient is low. < 3% for CABG only. Higher with concomitant valve replacement. www.inspire-rt.com A couple of questions for those of you who manage these patients. 1) Do you do formal SBTs on these patients? 2) If you do formal SBTs, how do you do them? What level of support? 3) If you know the numbers, what is your re-intubation rate of these patients? 4) Do you ever extubate in the OR? 5) Do you meet the STS benchmark of extubation in < 6 hours post-op? Thank you for your input. Akram M. Zaaqoq, MD, MPH thoughts? https://lnkd.in/evtidZXM

Nice new paper about the benefits of surgical ablation for atrial fibrillation compared to no therapy during other cardiac surgery (see link below). Over 30,000 patients reviewed in the paper, and like many others before, shows improved survival if AF is treated during other cardiac surgery. Unfortunately 80% of patients received no surgical AF therapy - a trend the CT surgical community must improve. As I’ve said for a while regarding surgical AF therapy: some things are better than other things, but something is better than nothing. At the very least do an excellent LAA exclusion. If you’d like to gain some more insight: Armin Kiankhooy has a great video on CTSNet / Cardiothoracic Surgery Network describing AF team building plus a great baseball analogy for growing your surgical AF therapy skills. Waikato Cardiothoracic Unit #atrialfibrillation #cardiacsurgery #cardiothoracicsurgery #ablation

This study assessed the safety of an early chest tube removal (CTR) protocol on the first postoperative day in an enhanced recovery after surgery (ERAS) program, focusing on patients undergoing elective coronary revascularization and/or valve surgery from 2015 to 2021. #CardiacSurgery #ChestTubeRemoval #EnhancedRecovery #PostoperativeCare

🔍 Comparison of Multidimensional Frailty Instruments for Estimation of Long-term Patient-Centered Outcomes After Cardiac Surgery 📚 Earn 1.0 CME Credit 👨⚕️ Authors: Louise Sun, Habib Jabagi MD, BSC, MSc, MLP, FRCSC, Jiming Fang, Douglas Lee 🧑🔬 Key Findings: Significant variations in frailty assessment across different instruments. HFRS showed highest accuracy for short-term, while PFI excelled in long-term predictions. 💡 Clinical Relevance: This study emphasizes the importance of selecting appropriate frailty assessment tools for predicting patient outcomes post-cardiac surgery. It offers insights into optimizing preoperative risk stratification and health resource planning, enhancing patient-centered care. 📖 Read the full article for in-depth analysis and implications for clinical practice. ➡️ https://ow.ly/T7Ga50QlHsq #CardiacSurgery #FrailtyAssessment #PatientCare #MedicalResearch #PhysicianInsights #CME

Nighttime dexmedetomidine for delirium prevention in non-mechanically ventilated patients after cardiac surgery in elderly cardiac surgery patients with a low baseline risk of postoperative delirium and extubated within 12 h of ICU admission, a short nighttime dose of dexmedetomidine decreased the incidence of delirium on postoperative day one. https://lnkd.in/dsjPr28E #dexmedetomidine #delirium #cardiacsurgery

The study aimed to investigate the role of cold-induced RNA-binding protein (CIRP) in the development of acute kidney injury (AKI) following cardiac surgery. Elevated extracellular CIRP levels, particularly associated with prolonged cardiopulmonary bypass (CPB) #CardiacSurgery #CIRP #Kidney

Cardiopulmonary bypass (CPB) ensures tissue oxygenation during cardiac surgery. New technology allows continuous registration of CPB variables during the operation. The aim of the present investigation was to study the association between CPB management and the risk of postoperative acute kidney injury (AKI). #AKI #Blood #Kidney

Cardiac Surgery Chief Tsuyoshi Kaneko, MD, recently took the main stage at the New York Valves 2024 to showcase the midterm results of his team's registry analysis. Dr. Kaneko, the Shoenberg Chair in Cardiovascular Surgery, showed that transcatheter aortic valve-in-valve (ViV) replacement for a failed surgical valve is a safe procedure associated with lower risks of death and stroke than native transcatheter aortic valve implantation. According to the team, the results suggest that the procedure should be made available to more patients, noting that the current US Food and Drug Administration only allows for aortic ViV for patients deemed at high risk for surgery. Read the full story in TCTMD: https://lnkd.in/gJq-a2G7