Cardiovascular Surgery - Science topic

We prefer Bivalirudin. Please send me your experiences and dosage regimes.

I am a cardiovascular surgery resident, i am looking for a topic to investigate and it will be my research thesis. Any suggestions?

There is no powerful evidence to support any specific threshold. The study reported by the Yale group reported an increase in complications at sizes of 70mm (Davies 2002), but most consensus guidelines suggested repairing them at 55mm. Given the lack of natural history data, what are the arguments for and against this aggressive threshold?

Most consensus lines suggest you to repair them at 55mm. What are the arguments for and against this aggressive threshold and which percentage of patients don't need surgery since during the follow up the aneurysm diameter doesn't increase significantly?

Hi,

I need to open aorta en face for O red oil staining purpose. Does anyone know any tips on how to do this. My problem is more to technical part which I really don't know how to get a nice longitudinal incision / enface opening of aorta. I have tried multiple times but the aorta tear throughout its length. Should I open the aorta enface while it still attached to vertebrae? And should I open aorta en face first, pin it to dish / wax, then only after that do ORO staining.? Is there any video guide about how to open this aorta. 

thank you very much.

Help is much appreciated.

Would it be bispectral index or exhausted anaesthetic gas from CPB circuit (analogue to end tidal anaesthetic gas)?

Many thanks for your time and atttention,

Ka

Some changes following administration of Histidine-Tryptophan-Ketoglutarate (HTK) Custodiol including Anemia and hyponatremia are not uncommon in our cardiac patients. However we have noticed degrees of hematuria in our patients who have received Custodiol Bretschneider solution). Although wasting of the cardioplegic solution was effective in some patients, my last patient had hematuria on the contrary to the wasting of the solution. I didn't find any report in the literature. Please share your ideas about the reason and possible solutions.

cardiovascular surgery

cardiology

Actually, I am concerned with the association between the use of contrast agents and rupture of thoracic aortic dissection (Stanford A type).

Here is the case I experienced recently. A 57-year-old male with a history of hypertension and atrial fibrillation visited our department with a complaint of chest pain. His consciousness was clear and his systolic blood pressure was 100 mmHg. TTE revealed dilated ascending aorta along with moderate aortic regurgitation. Immediately, contrast-CT was performed. Contrast enhanced CT revealed Stanford A type aortic dissection. There was no retention of pericardial effusion. Within a few minutes after that, he fell into CPA. TEE revealed massive retention of pericardial effusion. PCPS was introduced. However, PCPS did not work efficiently probably because of collapse in the right heart. Immediately, pericardial drainage was performed; drainage was not effective because of coagulated blood.

In this case,

Should we have performed pericardiotomy to save this patient?

May contrast agents trigger the rupture of thoracic aortic dissection (Stanford A type)? Actually, I know several cases that thoracic aortic dissection ruptured immediately after contrast CT. I want a paper discussing this point.  

Does anybody know how to implant stent model into virtual vessel vessel model for CFD studies ? Maybe someone know special software or method how to deform a straight pipe model of a stent to fit a vessel geometry. I need to deform it something like the image in attachements

We operated a case of a women with a debut of giant cell arteritis with an acute ascending aorta dissection and I don't find many series with this kind of presentation of aortitis.

revascularisation options in egg shell aorta

Viability scan, assessment of angina and dyspnea and fractional flow reserve are some of the tools. A very important paper by John Elefteriades (Circulation 1999) says that revascularizing even scarred myocardium benefits the patients in terms of symptomatic and survival improvement.

On pump versus off pump CABG what are your reasons?

What is an acceptable ACT for you (PERFUSIONIST) to start the pump (cardiopulmonary bypass)?

Patient is currently under antibiotic therapy for prosthetic (bovine) valve endocarditis, CRP is almost negative, there are no vegetations and no insufficiency of the valve. Therapy will last for two more weeks. Knee replacement surgery is scheduled in four weeks. Should we wait longer? How Long?

Dobutamine is considered as the first line inotrope for perioperative hemodynamic support in cardiac surgery by some of the classic references. What is your inotrope of choice? Have you stopped dobutamine due to adverse effects?

Could you recommend the best device for A-fib surgery?