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Addressing COVID-19 in the surgical ICU: Incidence of antibodies in healthcare personnel at a quaternary care center
Alexi Bloom, Isabela Romano, Abdul Kader Natour, Elizabeth Ulrich, Wing Lee Cheung, Lillian Hayes, Zohra Chaudhry, Marcus J. Zervos, Geehan Suleyman, Jeffrey Johnson, Anthony Falvo, Arielle H. Gupta, and Loay S. Kabbani
Background: There is concern that frontline healthcare personnel (HCP) are at increased risk of exposure to COVID-19 compared to the general population. Multiple studies have demonstrated significant seroprevalence of COVID-19 antibodies in HCP. Increased seropositivity has been associated with reduced use of personal protective equipment (PPE) along with reported PPE shortages. This investigation aims to determine the seroprevalence of COVID-19 in frontline HCP working at a quaternary care center... Read More
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Reducing Opioid Induced Respiratory Depression in Post-Operative Arthroplasty Patients
Peter Boateng, Jie Xin Tang, and Anoop Chhina
Pain management in post operative hospitalized patients often involves the use of opioids and other potential sedating medications. However, with an aging population accompanied by increasing co morbidities, there is growing concern for opioid induced respiratory depression (OIRD). Despite this growing concern, there has not been an evidence based method to identify patients at risk for OIRD, nor ways to allocate monitoring modalities appropriately. Our aim is to compare... Read More
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COLECTOMY OUTCOMES IN PATIENTS OVER 65 WITH ULCERATION COLITIS
Kaitlyn Dobesh, Pridvi Kandagatla, Amy Tang, Craig Reickert, and Amalia Stefanou
Introduction: There are limited data regarding surgical outcomes for elderly patients with Ulcerative Colitis, and we sought to examine the post operative outcomes in this population.
Methods: The ACS NSQIP was queried for all patients with a diagnosis of ulcerative colitis and compared elderly patients (those aged 65 and older) to younger patients under age 65. Univariate and multivariate logistic regression was done to evaluate differences in morbidity and... Read More
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Improving Nipple Survival in Large Volume Breast Reduction Using Negative Pressure Wound Therapy
Ricardo Engel, Yitzchok Greenberg, and Aamir Siddiqui
Background: In large volume breast reductions, a primary concern is survival of the nipple areolar complex. Long pedicles can have unreliable vascular supply, leading to nipple ischemia and necrosis. Large volume breast reductions are therefore often managed with free nipple grafting onto a vascularized wound bed. Free nipple grafting presents its own disadvantages of loss of sensation, pilomotor function, and lactation. We present an alternative technique to free nipple... Read More
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Minimally Invasive Mitral Valve Repair Complicated By Intraoperative Right Coronary Artery Occlusion
Rowaa Ibrahim, Larkin Luo, Nicholas S. Yeldo, Trevor Szymanski, Santiago Uribe-Marquez, Derrick V. Williams, Hassan Nemeh, and Khaldoon Alaswad
Introduction: Iatrogenic injury of coronary arteries can complicate mitral valve replacement or repair. Direct injury to the circumflex coronary artery can occur due to the proximity of these vessels to the mitral valve. Acute injury of the right coronary artery on the other hand is seen during tricuspid valve repairs and is almost never seen with mitral valve surgery given its distance from the mitral valve.
Case: We describe... Read More
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Leadless Pacemaker Placement Complicated by Right Ventricular Perforation Requiring Sternotomy
Rowaa Ibrahim, Ajay Singh, and Santiago Uribe-Marquez
Introduction: The implantation of leadless pacemakers has grown substantially. Studies have demonstrated not only their safety, but also lower rates of complications. The incidence of cardiac injury has been found to be 0.1 1.5% with the Micra Transcatheter Pacing System. The need for surgical intervention for cardiac injury is exceptionally rare.
Case: We describe a case of leadless pacemaker placement which was complicated by right ventricle perforation. The patient... Read More
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Staying One Step Ahead: Prophylactic Impella Placement for High Risk CABG
Larkin Luo, Daizo Tanaka, and Joseph A. Sanders
Introduction: Safely separating from cardiopulmonary bypass (CPB) is a difficult task in cardiac surgery with good reason. It is estimated that post cardiotomy cardiogenic shock (PCCS) complicates 0.2% to 6% of cardiac operations and is associated with considerable morbidity and mortality. Early implantation of mechanical circulatory support (MCS) devices before weaning is an attractive strategy and is supported by recent ACC guidelines for technically challenging or prolonged PCI in... Read More
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Kyphoplasty vs Vertebroplasty: A Systematic Review of Height Restoration in Osteoporotic Vertebral Compression Fractures
Nimesh Patel, David Jacobs, Jessin John, Lakshmi Nerusu, Marissa Tandron, William Dailey, Ricardo Ayala, Nabil Sibai, Patrick B. Forrest, Jason M. Schwalb, Markian A. Pahuta, and Rohit Aiyer
Background: Back pain is a leading cause of morbidity in older US adults, especially those with osteoporosis. Osteoporotic vertebral compression fractures (OVCF) commonly occur in people with osteoporosis. ~1/3 of OVCF are symptomatic with acute or chronic low back pain. Annual US cases of osteoporosis with OVCF are ~700,000/year. OVCF and osteoporosis cause high levels of morbidity, decreased functional independence, and chronic pain. Conservative treatment for OVCF is often... Read More
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The effect of oncoplastic reduction on the incidence of post-operative lymphedema in breast cancer patients undergoing lumpectomy
Sanjay Rama, Jenna Luker, Kelley Park, Renee Barry, Saheli Ghosh, Simeng Zhu, Cara E. Cannella, Yalei Chen, Jessica Bensenhaver, Eleanor Walker, Kenneth Levin, Dunya M. Atisha, and Maristella S. Evangelista
Purpose: In breast cancer patients with macromastia, breast conservation surgery (BCS) followed by radiation therapy (RT) may be associated with a different complication profile than those without macromastia. Oncoplastic reduction mammoplasty (ORM) aims to reduce breast volume while excising the tumor bed and its margins. Since breast volume was found to be a risk factor for chronic breast lymphedema, this study was performed to determine the impact of ORM... Read More
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Embolized Transcatheter Mitral Valve: Rare But Devastating Complication
Abhishek Saluja and Jayakar Guruswamy
Introduction: 83 year old female who presents with heart failure exacerbation due to severe bio prosthetic mitral valve dysfunction.
Past Medical History: CHF, paroxysmal atrial fibrillation, CKD Stage III, MVR with St. Jude bio prosthetic valve, Maze procedure, left atrial appendage exclusion, and PFO closure.
Why TMVR: Due to her frailty and co morbidities, she was deemed to not be a surgical candidate. TMVR was attempted.
Case Presentation: General... Read More
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