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Myocardiial Protection Strategy Utilizing Retrograde Cardioplegia
Myocardial Protection Strategy Utilizing Retrograde Cardioplegia Item Type text; Electronic Thesis Authors Karbasi, Michael Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 25/09/2021 11:23:01 Link to Item http://hdl.handle.net/10150/281195 Myocardial Protection Strategy Utilizing Retrograde Cardioplegia for Neonatal Arterial Switch Operations Michael Karbasi1, John Nigro, M.D.2,3, Bradford Sanders, CCP,, MS2,3, Cyrus Kosar, MS4, Brigham C. Willis, M.D.1,2,3 1 University of Arizona, College of Medicine-Phoenix; 2Children’s Heart Center, Phoenix Children’s Hospital, Phoenix, AZ; 3Eller Congenital Heart Center at St. Joseph’s Hospital and Medical Center, Phoenix, AZ; and 4Institute for Aging Research in Affiliation with Harvard Medical School ABSTRACT RESULTS 30.0 Introduction: Myocardial protection strategies are a central component of neonatal arterial switch operations. Traditionally antegrade cardioplegia 25.0 through the aortic root has been the method of delivery, but use of retrograde cardioplegia via the coronary sinus has become the standard 20.0 of practice by many in the field. Methods: After obtaining IRB approval 15.0 Retrograde and informed consent, a retrospective chart review was done to assess Days Antegrade outcomes between 48 patients receiving antegrade (n= 5) and retrograde 10.0 (n= 43) cardioplegia during neonatal switch operations. Preoperative demographics and postoperative outcomes were compared between the 5.0 two groups and compared with historical studies. -
Ilizarov Method for Wound Closure and Bony Union of an Open Grade IIIB
WWW.CRCPR-ONLINE.COM Case Rep Clin Pract Rev, 2004; 5(1): xxx-xxx Case Report Received: 2003.01.10 Accepted: 2003.05.22 Ilizarov method for wound closure and bony union of Published: 2004.00.00 an open grade IIIB tibia fracture John E. Mullen, M.D., S. Robert Rozbruch, M.D., Arkady Blyakher, M.D., David L. Helfet, M.D. Limb Lengthening Service, Orthopedic Trauma Service, Hospital for Special Surgery, New York, New York Summary Background: The treatment of tibia fractures with a critical sized wound is complicated. When primary closure is not possible, the classic options are rotational or free flap coverage. Soft-tissue coverage is critical to avoid infection. There are instances when flap coverage is not an option. We present an alternative technique for simultaneous bone healing and soft tissue closure using the Ilizarov method. Case report: A grade IIIB open tibia fracture was treated with an Ilizarov external fixator. Wound debridement, removal of loose bone fragments and gradual compression across the fracture site led to bony shortening and union. Soft tissue transport led to secondary wound closure. An excellent anatomic and functional outcome resulted. Conclusions: This technique of bone and soft-tissue transport may prove useful in the treatment of tibia fractures with difficult to close wounds or for patients who are not candidates for flap coverage. Key words: Ilizarov•tibia•wound Full-text PDF: http://www.crcpr-online.com/pub/vol_5/no_1/3389.pdf Word count: 1506 Tables: - Figures: 8 References: 19 Author’s address: GS. Robert Rozbruch, M.D., Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, phone: (212) 606-1415, fax: (212) 774-2744, e-mail: [email protected] 1 Case Report BACKGROUND Open fractures of the tibial shaft are both common and may be fraught with complications. -
Comparison of Del Nido Cardioplegia
ORIGINAL ARTICLE Braz J Cardiovasc Surg 2021;36(2):158-64 Comparison of Del Nido Cardioplegia and Blood Cardioplegia in Terms of Development of Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting Umut Serhat Sanrı1, MD; Kadir Kaan Özsin1, MD; Faruk Toktaş1, MD; Şenol Yavuz1, MD DOI: 10.21470/1678-9741-2020-0047 Abstract length of hospital stay remain significantly higher in the BC group Objective: Del Nido cardioplegia (DNC) has been used in (P=0.044, P<0.001, respectively). In addition, the aortic cross-clamp pediatric cardiac surgery for many years with a single dose time and the cardioplegia volume delivered were significantly application and its usage in adult cardiac surgery has been lower in the DNC group (P=0.042, P<0.001, respectively). In increasing in recent years, with results being published. In multivariate logistic regression analysis, only higher cardioplegia this study, we aimed to investigate the effect of DNC on the volume was determined as an independent predictor for PoAF development of postoperative atrial fibrillation (PoAF). development (OR 1.001; 95% CI 1.000-1.001; P=0.033). We did not Methods: In this retrospective observational comparative found difference between groups in terms of troponin T, inotropic study, 255 patients who underwent isolated on-pump coronary drug support, need for intraaortic balloon pump and mortality. artery bypass grafting, between January 2019 and November Conclusion: This study showed that DNC can be used safely 2019, were enrolled. The patients were divided into two groups: in adult coronary bypass surgery and PoAF development effect DNC (n=132) and blood cardioplegia (BC) (n=123). -
ICD~10~PCS Complete Code Set Procedural Coding System Sample
ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00 -
External Fixation
External Fixation. Basic principles. Biomechanics Dynamization Selected constructs External Fixation Frame biomechanics The required strength of an external frame depends on the intended function of the fixator and the degree of fracture instability. With any frame, following the basic biomechanical principles helps to ensure a stable fixation.1 a b Options to increase frame stability a. Increase the distance between the two outermost Schanz screws in each fragment. c Note: Innermost Schanz screws should be at least 2 cm from the fracture line. b b. Increase the number of Schanz screws in each fragment. c. Reduce the distance between the rod and bone. d. Add a second rod or tube in the same plane, with the clamps in close contact (i.e., double-stacking). e. Use a larger diameter Schanz screw. Increasing the diameter by 1 mm more than doubles the stiffness and nearly doubles the strength. In the tibia, since sagittal bending moments are approximately d two to five times greater than those in the coronal plane, placing the frame in the sagittal plane will increase frame stability. To be mechanically effective, the stiffness of the external fixation frame should match the forces and moments at the fracture site. This sagittal-to-coronal stiffness ratio can be achieved if the Schanz screws are oriented in the AP direction.2 Note: The same factors that increase frame stability for unilateral frames apply to modular frames. e 1. F. Behrens and K. Searls. “External Fixation of the Tibia.” Journal of Bone and Joint Surgery. 68 (1986): 246–254. 2. Ibid. Synthes External Fixation Increase load-sharing to stimulate callus formation When the external fixation frame is used as definitive treatment for a fracture, the surgeon may wish to increase load-sharing. -
A Common Occurrence After Coronary Bypass Surgery
CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector lACC Vol. 15, No.6 1261 May 1990:1261-9 Acute Myocardial Dysfunction and Recovery: A Common Occurrence After Coronary Bypass Surgery WARREN M. BREISBLATT, MD, FACC, KEITH L. STEIN, MD, CYNTHIA J. WOLFE, RN, WILLIAM P. FOLLANSBEE, MD, FACC, JOHN CAPOZZI, CNMT, JOHN M. ARMITAGE, MD, ROBERT L. HARDESTY, MD, FACC Pittsburgh, Pennsylvania To evaluate whether acute myocardial dysfunction was min after coronary bypass and showed complete recovery common in the early postoperative period, serial hemody• within 48 h. Left ventricular end-systolic and end-diastolic namic measurements and radionuclide evaluation of ven• volume index increased significantly postoperatively, but tricular function were performed before and after opera• recovery in left ventricular ejection fraction was mostly due tion in 24 patients undergoing elective coronary bypass to decreases in end-systolic volume index (50 ± 22 ml at surgery. All patients had uncomplicated surgery, and no trough and 32 ± 16 ml at recovery). Depressed myocardial patient sustained an intraoperative infarction. In 96% of function was independent of bypass time, number of grafts patients, significant depression in right and left ventricular placed, preoperative medications or core temperatures ejection fraction was seen postoperatively, reaching a nadir postoperatively. Postoperative therapy with pressors or at 262 ± 116 min after coronary bypass. Left ventricular inotropic agents delayed but did -
Assessment of Bronchiectasis by Computed Tomography
Thorax: first published as 10.1136/thx.40.12.920 on 1 December 1985. Downloaded from Thorax 1985;40:920-924 Assessment of bronchiectasis by computed tomography IM MOOTOOSAMY, RH REZNEK, J OSMAN, RSO REES, MALCOLM GREEN From the Departments of Diagnostic Radiology and Chest Medicine, St Bartholomew's Hospital, London ABSTRACT Computed tomography and bronchography were used to assess the distribution of bronchiectasis in 15 lungs from eight patients with clinical features of the disease. Of the 36 lobes adequately displayed by bronchography, 22 were found to have bronchiectasis and 14 were found to be normal by both techniques. Cystic disease was readily identified by computed tomography but the cylindrical and varicose types of bronchiectasis could not be distinguished. Segmental local- isation was less accurate, with agreement between computed tomography and bronchography in 116 out of 130 segments. It is concluded that with a modern high resolution scanner computed tom- ography provides a useful method of assessing lobar distribution in bronchiectasis. The incidence of bronchiectasis in the United King- placing bronchography in a substantial number, dom has decreased since the advent ofantibiotic treat- Muller et al found correspondence in only about half ment and the decline in severe respiratory disease in the lungs studied. childhood. Nevertheless, it still occurs as the result of The purpose of this study is to assess the place of severe pulmonary infections and in association with modern high resolution computed tomography scan-copyright. immune deficiency, cystic fibrosis, and other condi- ners in the clinical management ofpatients with bron- tions. chiectasis and to investigate the accuracy with which The disease is defined as irreversible abnormal di- lobar and segmental disease and the type of disease latation of the bronchi and has been classified by present can be predicted. -
Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log
Clinical Policy: Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log Description Services for gender confirmation most often include hormone treatment, counseling, psychotherapy, complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation as appropriate, genital reconstruction, facial hair removal, and certain facial plastic reconstruction. Not every individual will require each intervention so necessity needs to be considered on an individualized basis. This criteria outlines medical necessity criteria for gender confirmation surgery when such services are included under the members’ benefit plan contract provisions. Policy/Criteria It is the policy of Pennsylvania Health and Wellness® (PHW) that the gender confirmation surgeries listed in section III are considered medically necessary for members when diagnosed with gender dysphoria per criteria in section I and when meeting eligibility criteria in section II. I. Gender Dysphoria Criteria, meets A and B A. Marked incongruence between the member’s experienced/expressed gender and assigned gender, of at least 6 month’s duration, as indicated by two or more of the following: 1. Marked incongruence between the member’s experienced/expressed gender and primary and/or secondary sex characteristics; 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender; 3. A strong desire for the primary and/or secondary sex characteristics of the other gender; 4. A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender); 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender); 6. -
Knee Arthrodesis After Failed Total Knee Arthroplasty
650 COPYRIGHT Ó 2019 BY THE JOURNAL OF BONE AND JOINT SURGERY,INCORPORATED Current Concepts Review Knee Arthrodesis After Failed Total 04/12/2019 on 1mhtSo9F6TkBmpGAR5GLp6FT3v73JgoS8Zn360/N4fAEQXu6c15Knc+cXP2J5+wvbQY2nVcoOF2DIk3Zd0BSqmOXRD8WUDFCPOJ9CnEHMNOmtIbs3S0ykA== by http://journals.lww.com/jbjsjournal from Downloaded Knee Arthroplasty Downloaded Asim M. Makhdom, MD, MSc, FRCSC, Austin Fragomen, MD, and S. Robert Rozbruch, MD from http://journals.lww.com/jbjsjournal Investigation performed at the Hospital for Special Surgery, Weill Cornell Medicine, Cornell University, New York, NY ä Knee arthrodesis after failure of a total knee arthroplasty (TKA) because of periprosthetic joint infection (PJI) may provide superior functional outcome and ambulatory status compared with above-the-knee amputation. by 1mhtSo9F6TkBmpGAR5GLp6FT3v73JgoS8Zn360/N4fAEQXu6c15Knc+cXP2J5+wvbQY2nVcoOF2DIk3Zd0BSqmOXRD8WUDFCPOJ9CnEHMNOmtIbs3S0ykA== ä The use of an intramedullary nail (IMN) for knee arthrodesis following removal of TKA components because of a PJI may result in higher fusion rates compared with external fixation devices. ä The emerging role of the antibiotic cement-coated interlocking IMN may expand the indications to achieve knee fusion in a single-stage intervention. ä Massive bone defects after failure of an infected TKA can be managed with various surgical strategies in a single- stage intervention to preserve leg length and function. Primary total knee arthroplasty (TKA) is a common procedure suppressive antibiotics for recurrent PJIs are generally reserved with a reported increase of 162% from 1991 to 2010 in the for patients with more severe preoperative disability and United States1,2. From 2005 to 2030, it is projected that the medical comorbidity and those who are not candidates to number of TKA procedures will grow by 673% or 3.5 million. -
Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy, -
Modern Techniques in Knee Arthrodesis
International Journal of Orthopaedics Online Submissions: http: //www. ghrnet. org/index. php/ijo Int. J. of Orth 2016 February 23 3(1): 487-496 doi: 10. 17554/j. issn. 2311-5106.2016 03.119 ISSN 2311-5106 EDITORIAL Modern Techniques in Knee Arthrodesis Kelvin Kim, Nimrod Snir, Ran Schwarzkopf Kelvin Kim, Penn State College of Medicine, Hershey, PA, United Kim K, Snir N, Schwarzkopf R. Modern Techniques in Knee States Arthrodesis. International Journal of Orthopaedics 2016; 3(1): 487- Nimrod Snir, Division of Orthopaedic Surgery, Tel-Aviv Sourasky 496 Available from: URL: http: //www. ghrnet. org/index. php/ijo/ Medical Center, Tel-Aviv University, Tel-Aviv, Israel article/view/1620 Ran Schwarzkopf, Department of Orthopaedic Surgery, Division of Adult Reconstruction, NYU Hospital for Joint Diseases, NYU Lan- INTRODUCTION gon Medical Center, New York, NY, United States Correspondence to: Ran Schwarzkopf, Assistant Professor, Di- In the circumstances that revision arthroplasty can no longer serve vision of Adult Reconstruction, NYU Hospital for Joint Diseases, as a viable option to treat complications of total knee arthroplasty NYU Langon Medical Center, New York, NY, 212-5987200, United (TKA), knee arthrodesis serves as an acceptable option for salvage States treatment. Once used as the main option for treatment of septic Email: [email protected] arthritis, tuberculosis, and poliomyelitis back when the procedure was th th [1,2] Telephone: +1-212-513-7711 Fax: + 1-212-598-6000 introduced in the late 19 and early 20 century , today, the most Received: July 16, 2015 Revised: January 1, 2016 common indications for knee arthrodesis are failed TKAs - mainly Accepted: January 9, 2016 in cases of knee extensor mechanism loss, persistent infection, an Published online: February 23, 2016 immune compromised patient, poor soft tissue coverage of the knee, or severe bone loss and instability[1,3-5]. -
Role of High-Resolution CT in Diagnosis, Regional Distribution and Characterize Bronchiectasis Morphologically
International Journal of Radiology and Diagnostic Imaging 2021; 4(1): 166-170 E-ISSN: 2664-4444 P-ISSN: 2664-4436 www.radiologypaper.com Role of high-resolution CT in diagnosis, regional IJRDI 2021; 4(1): 166-170 Received: 30-11-2020 distribution and characterize bronchiectasis Accepted: 05-01-2021 morphologically Priyanka Patil Specialist Radiologist, Department of Radiology, Priyanka Patil, Gururaj Bangari, Veeresh Hanchinal and Rahul Shirol Gadag Institute of Medical Sciences, Malasamudra, Karnataka, India DOI: http://dx.doi.org/10.33545/26644436.2021.v4.i1c.180 Gururaj Bangari Abstract Assistant Professor, Background: Bronchiectasis causes physical, social, and financial strain on affected patients and Department of Radiology, results in a significant negative effect on the quality of life of the patient. SDM College of Medical Objectives: This study was undertaken to find the role of HRCT in diagnosis, regional distribution and Sciences and Hospital, characterize bronchiectasis morphologically. Dharwad, Karnataka, India Method: A prospective study of sixty patients was done in whom clinically bronchiectasis was Veeresh Hanchinal suspected and were subjected to HRCT examination. Bronchiectasis was assessed in terms of Associate Professor, localization, regional distribution and morphological forms. Department of Radiology, Results: The mean age for all patients included in the study was 50.7 ± 12.09. The mean age of the Gadag Institute of Medical male patients was 51.56 ± 12.09 and the mean age of the female patients was 50.16 ± 12.23Out of a Sciences, Malasamudra, total of 60 patients there were 23 (38%) males and 37 (62%) females. 18 patients (30%) had unilateral Karnataka, India disease & 42 (70%) had disease in both lungs.