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  • Open Access

    ARTICLE

    Minimally Invasive Congenital Cardiac Surgery: A Large Volume European Experience

    Alvise Guariento1,2, Ilias P. Doulamis3, David Blitzer4, Claudia Cattapan2, Massimo A. Padalino2, Vladimiro L. Vida2,*

    Congenital Heart Disease, Vol.15, No.3, pp. 127-139, 2020, DOI:10.32604/CHD.2020.012197 - 15 July 2020

    Abstract Background: In an effort to reduce postoperative trauma and achieve more cosmetic results, minimally invasive approaches to correct congenital heart anomalies have been recently proposed and increasingly adopted. Here we describe our experience for the past 23 years. Methods: Patients who underwent a surgical procedure between February 1996 and March 2019 with a minimally invasive approach for the correction of congenital heart disease in our center were included in this study. A statistical analysis was carried out to compare the results of the different minimally invasive techniques. A meta-analysis was conducted to compare our results in… More >

  • Open Access

    ARTICLE

    Preoperative Risk Assessment and Perioperative Management of Adults with Congenital Heart Disease Undergoing Non-Cardiac Surgery

    Michela Palma, Giancarlo Scognamiglio*, Flavia Fusco, Assunta Merola, Anna Correra, Diego Colonna, Emanuele Romeo, Berardo Sarubbi

    Congenital Heart Disease, Vol.15, No.1, pp. 33-49, 2020, DOI:10.32604/CHD.2020.011523 - 17 June 2020

    Abstract Adults with congenital heart disease (ACHD) constitute a growing population with complex cardiac physiopathology and frequent extra-cardiac involvement. The recent dramatic improvement of their life expectancy has resulted in an increasing proportion of ACHD patients requiring non-cardiac surgery. While a large body of evidence demonstrated the importance of an accurate risk assessment in patients with acquired heart disease before noncardiac surgery in order to reduce perioperative morbidity and mortality and detailed algorithms have been released by international societies, no specific guidelines are available for the perioperative management in this population. Nonetheless, understanding the complex anatomy… More >

  • Open Access

    ARTICLE

    A Patient-Specific Computational Fluid Dynamic Model of Middle Cerebral Artery Aneurysm Before and One Year After Surgery

    Shicheng He1, Juhui Qiu1, Wanling Liu1, Tieying Yin1, Dechuan Zhang2,*, Donghua Liao3,4, Haijun Zhang5, Yuxia Yin5, Guixue Wang1,*

    Molecular & Cellular Biomechanics, Vol.17, No.2, pp. 63-74, 2020, DOI:10.32604/mcb.2020.08750

    Abstract Computational fluid dynamics (CFD) has been widely used for studying intracranial aneurysm hemodynamics, while its use for guiding clinical strategy is still in development. In this study, CFD simulations helped inform treatment decision for a middle cerebral artery (MCA) aneurysm case was investigated. A patient with a 10.4 × 9.8 mm aneurysm attached with a small aneurysm at the edge of the trifurcation in the left MCA was included in this study. For removing the MCA aneurysm, two scenarios were considered: Plan-A involved clipping the small aneurysm and Plan-B involved clipping the whole aneurysm. A… More >

  • Open Access

    ARTICLE

    Extended hospital stay after radical cystectomy with enhanced recovery protocol

    Hatim Thaker, Saum Ghodoussipour, Mateen Saffarian, Akbar Ashrafi, Gus Miranda, Jie Cai, Anne K. Schuckman, Monish Aron, Mihir Desai, Inderbir S. Gill, Siamak Daneshmand, Hooman Djaladat

    Canadian Journal of Urology, Vol.26, No.1, pp. 9654-9659, 2019

    Abstract Introduction: To evaluate the reasons leading to an extended hospital stay (EHS) in patients undergoing radical cystectomy (RC) with postoperative enhanced recovery after surgery (ERAS) protocol.
    Materials and methods: A total of 509 patients underwent RC and urinary diversion with ERAS between May 2012 and March 2017. The protocol includes no bowel preparation, early feeding, predominantly non-narcotic pain control, and μ opioid antagonists. Non-consenting/lost to follow-up patients, and those with non-urothelial carcinoma were excluded. We defined EHS as ≥ 5 postoperative days and compared the cohort to those with a length of stay (LOS) of ≤ 4… More >

  • Open Access

    ARTICLE

    Factors associated with prolonged length of stay following robotic-assisted partial nephrectomy

    Ashley M. Shumate1, Grayson Roth2, Colleen T. Ball2, Kaitlynn Custer2, David D. Thiel1

    Canadian Journal of Urology, Vol.26, No.2, pp. 9726-9732, 2019

    Abstract Introduction: To prospectively analyze the association of clinical and operative variables on patient length of hospital stay (LOS) following robotic-assisted partial nephrectomy (RAPN) and develop an accurate clinical-based scoring system to predict prolonged LOS following RAPN.
    Materials and methods: We analyzed 304 consecutive RAPNs performed by a single surgeon. Prolonged LOS was defined as greater than 3 days of hospitalization postoperatively. Preoperative clinical factors and operative variables were analyzed for association with LOS. After adjusting for multiple testing, p ≤ 0.004 was considered statistically significant.
    Results: LOS was 1 day in 17 (5.6%) patients, 2 days in 136… More >

  • Open Access

    ARTICLE

    Overlapping surgeries: defining the “critical portions” of the procedure

    Joon Yau Leong, Brian Calio, Mihir Shah, Patrick Sullivan, Edouard J. Trabulsi, Leonard G. Gomella, Costas D. Lallas

    Canadian Journal of Urology, Vol.26, No.2, pp. 9694-9698, 2019

    Abstract Introduction: An important aspect of overlapping surgery is to determine the “critical portion” of an operation. Currently, there are no guidelines that standardize the critical portions of common urologic procedures. We sought to determine the relationship between the critical portions of common urologic operations as defined by the primary surgeon compared to the trainee at a single academic medical center.
    Materials and methods: In an open-ended survey of the Urology Department at Thomas Jefferson University, attending surgeons and urology residents were asked to list five of their most commonly performed surgeries and subsequently identify what they defined… More >

  • Open Access

    COMMENTARY

    Intraopertive cystoscopy during AUS surgery – a necessary step?

    Jack M. Zuckerman

    Canadian Journal of Urology, Vol.26, No.4, pp. 9863-9863, 2019

    Abstract This article has no abstract. More >

  • Open Access

    ARTICLE

    Characterization of a learning curve for robotic cystectomy with intracorporeal urinary diversion at two institutions using the cumulative sum (CUSUM) method

    Alexis Wang1, Charles F. Polotti2, Shu Wang1, Sammy Elsamra2,*, Mohummad Minhaj Siddiqui1,*

    Canadian Journal of Urology, Vol.26, No.6, pp. 10033-10038, 2019

    Abstract Introduction: Robotic cystectomy with intracorporeal urinary diversion (RCID) is a technically challenging procedure. It is understood that this approach has a learning curve; however, limited studies have characterized this learning curve. The cumulative sum (CUSUM) method plots the learning curve. The aim of this study was to use the CUSUM approach to investigate the number of cases required to reach a consistent, desired performance level for RCID.
    Materials and methods: A retrospective study of the first 27 and 28 RCID cases performed by two new fellowship-trained faculty at two separate institutions from November 2014 to January 2018… More >

  • Open Access

    ARTICLE

    Surgical treatment of anomalous left main coronary artery with an intraconal course

    Richard D. Mainwaring, Frank L. Hanley

    Congenital Heart Disease, Vol.14, No.4, pp. 504-510, 2019, DOI:10.1111/chd.12826

    Abstract Objective: Anomalous left main coronary artery (LMCA) with an intraconal course is a relatively rare form of anomalous aortic origin of a coronary artery (AAOCA) from the wrong sinus of Valsalva. There is currently a paucity of information regarding this entity. The purpose of this article is to review our surgical experience with repair of anomalous LMCA with an intraconal course.
    Methods: This was a retrospective review of 12 patients with an anomalous LMCA and an intraconal course who underwent surgical repair. The median age at surgery was 15 years (range 2‐47). The seven oldest patients all… More >

  • Open Access

    ARTICLE

    Pacemaker treatment after Fontan surgery—A Swedish national study

    Jenny Alenius Dahlqvist1, Jan Sunnegårdh2, Katarina Hanséus3, Eva Strömvall Larsson2, Anders Nygren2, Magnus Dalén4,5, Håkan Berggren6, Jens Johansson Ramgren7, Urban Wiklund8, Annika Rydberg1

    Congenital Heart Disease, Vol.14, No.4, pp. 582-589, 2019, DOI:10.1111/chd.12766

    Abstract Objective: Fontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indica‐ tions in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden.
    Methods: We retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n = 599).
    Results: After a mean follow‐up of 12.2 years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total… More >

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