Charles Lindberg's place in the annals of aviation history was solidified when he completed the first non-stop solo flight across the Atlantic from New York to Paris in 1927. Instantly, he became an American hero, and the object of incessant media attention. The press dubbed him "Lucky Lindy" or the "Lone Eagle." Although the main focus of his life continued to be dedicated to aeronautics, including the mapping of major air routes around the world, few know that Lindberg was also a biomedical innovator.
The Left Internal Mammary Artery (LIMA), also known as the Left Internal Thoracic Artery (LITA), has been the gold standard conduit of choice for coronary artery bypass grafting (CABG) for several decades.
More than 30 years ago, Boylan et al published a study in the Journal of Thoracic Cardiovascular Surgery in which the long-term results of 200 patients who underwent CABG, 100 of whom received a LIMA — left anterior descending coronary artery (LAD) bypass graft and the second 100 who received a saphenous vein graft (SVG) to LAD bypass graft, were analyzed.
Doctors from Inova Heart & Vascular Institute, Falls Church, Virginia, recently published their findings after comparing the precision of three cardiac surgery risk models used to measure the quality of cardiac surgical care. They compared the Society of Thoracic Surgeons (STS) surgical risk score, primarily used in the United States, with the European System for Cardiac Operative Risk Evaluation (EuroSCORE II, EuroSCORE I).
The original EuroSCORE I was developed between 1995 and 1999 from data of 19,000 patients undergoing cardiac surgery, most of whom had coronary artery bypass grafting (CABG) surgery. About a third underwent valve surgery. The EuroScore I was updated in 2012 to be more user-friendly and applicable to a greater number of procedures.
“Doctors and other health workers pay dearly for the relentless stress of patient care, a plight compounded by mounting bureaucracy and accelerating change in the healthcare industry,” Dr. Mark Greenawald concluded after tragically losing one of his ob-gyn patients during childbirth, and being unable to successfully process the grief from the experience.
Cardiothoracic surgery, Twitter chats and website design may not seem like the perfect combination, but when it comes to accessing the latest journal articles, connecting with patients and expanding your practice, they can be invaluable.
At the 2016 STS Annual Meeting, a panel of cardiothoracic experts shared how these and other internet technology trends are impacting cardiothoracic surgery.
Here are three technology trends impacting cardiothoracic surgery you need to know:
As a surgeon, you're keenly aware of the danger of medical errors and extremely diligent to avoid making them.
Medical errors as a cause of death now rank as the third leading cause of death, behind heart disease and cancer in the United States. Researchers at Johns Hopkins University School of Medicine found that errors result in the deaths of around 250,000 patients per year.
One of the costliest areas in a hospital is the operating room. Despite its high costs, the OR is also one of the top revenue generators, bringing in between $15 - $20 per minute, and that’s just for a basic surgical procedure.
But as budgets become tighter and patients and insurance companies seek a greater value for their money, hospitals are examining ways to increase efficiency in the operating room. Imagine the money and time wasted each time a case is delayed by a search for a piece of missing equipment.
Surgeons at the University of Sapporo Japan analyzed the relationship between intraoperative transit-time flow values and post-op angiographic results of gastroepiploic arterial grafts to the right coronary artery to determine whether the flow values are reliable indicators of early graft patency in gastroepiploic to right coronary artery grafts.
Their study pool included 169 patients who underwent off-pump CABG with GEA-RCA bypass grafts. Eighty-three grafts were anastomosed and flows were measured. An angiogram was taken one week after surgery and the anastomosis of each graft was graded using FitzGibbon grading (Study 1) and graft-flow grading (Study 2).
Topics: CABG Surgery
Clinicians at the University of Calgary, Alberta, Canada sought to evaluate transit-time flow (TTF) as a tool to detect technical errors in arterial bypass grafts intraoperatively and predict outcomes. They measured flow in 336 consecutive patients who had an average of 3.02 grafts each. Ninety-nine percent of these bypass grafts were arterial. Three parameters: pulsatility index (PI), flow (cc/min) and diastolic filling (DF) were measured in 990 of the total 1,000 grafts.
Topics: CABG Surgery
In 2010, the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) Task Force on Myocardial Revascularization released guidelines on myocardial revascularization that state the following with respect to intraoperative graft flow patency assessment following bypass graft construction:
Topics: CABG Surgery