The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. John Forrest, a cardiologist and Director of both Interventional Cardiology and the Structural Heart Disease Program at Yale Medicine, New Haven, CT, USA, about a paper he authored titled “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis,” published by the Journal of the American College of Cardiology. Chapters 00:00 Intro  02:38 TAVR vs SAVR Context  03:54 CDC WONDER Data, TAVR SAVR  05:37 JANS 1, TAVR vs SAVR 5-Year Outcomes  07:31 JANS 2, Temporary MCS Devices Landscape  09:17 JANS 3, Pulm Resection Post-CABG  10:23 JANS 4, PRE-HIIT Randomized Trial  12:36 Career Center  13:10 Video 1, Redo MVR After VIV TAVR  15:37 Video 2, Repair After Acute Intramural Hematoma  18:01 Video 3, Acute Severe MR Repair  19:36 Dr. Forrest, 6-Year TAVR vs SAVR  44:49 Upcoming Events  45:33 The Lifeline Podcast  They explored other randomized trials involving high-risk and intermediate-risk patients with aortic stenosis and examined the specific goals of this low-risk trial. The discussion then delved into the trial’s results, highlighting that there was no significant difference in the composite endpoint of all-cause mortality or disabling stroke. However, a noteworthy finding was that the transcatheter aortic valve replacement (TAVR) arm experienced a higher reintervention rate compared to surgery, primarily due to an increased incidence of aortic regurgitation. They also addressed factors such as valve dilation, stents, and various reasons for surgical valve failure. Additionally, they examined the similarities between this trial and other partner trials and the future for low-risk patients with aortic stenosis.   Joel also highlights recent JANS articles on the updated five-year outcomes of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at low- to intermediate-surgical risk, a United States nationwide analysis on the changing landscape of temporary mechanical circulatory support devices in the new heart allocation system, pulmonary resection post-coronary artery bypass grafting, and a randomized controlled trial on the preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or esophagus (PRE-HIIT).  In addition, Joel explores redo mitral valve replacement after previous valve-in-valve mitral TAVR, aortic repair after acute intramural hematoma, and repair of acute severe mitral regurgitation due to iatrogenic papillary muscle rupture. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk  2.) The Changing Landscape of Temporary Mechanical Circulatory Support Devices in the New Heart Allocation System—A United States Nationwide Analysis  3.) Pulmonary Resection Post-Coronary Artery Bypass Grafting: Feasible, but Right-Sided Procedures Demand Caution  4.) Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Esophagus (PRE-HIIT): A Randomized Controlled Trial  CTSNet Content Mentioned  1.) Redo Mitral Valve Replacement After Previous Valve-in-Valve Mitral TAVR  2.) Aortic Repair After Acute Intramural Hematoma   3.) Repair of Acute Severe Mitral Regurgitation Due to Iatrogenic Papillary Muscle Rupture  Other Items Mentioned  1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  2.) The Lifeline: End-Tidal Carbon Dioxide Monitoring in Cardiac Surgical Emergencies  3.) Instructional Video Competition     4.) Career Center   5.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Mateo Marin-Cuartas, CTSNet JANS Editor and cardiac surgeon at the University Department of Cardiac Surgery at Leipzig Heart Centre University Hospital in Leipzig, SN, Germany; and Samuel Heuts, a cardiothoracic surgeon in the Department of Cardiothoracic Surgery at Maastricht University Medical Center in Maastricht, LI, about a paper they authored titled “Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk,” published in Heart, a journal produced by the British Medical Journal. Chapters 00:00 Intro 01:51 JANS 1, 6-Year Outcomes TAVR vs SAVR 06:45 JANS 2, Evolut THV Postdilation 09:22 Video 2, TAVI in SAVR Explantation 11:10 JANS 3, High Risk Increasing Adoption of DCD 13:17 JANS 4, Lobar Quantitation for Assessment 15:16 Video 1, Narayana Robotic AVR 17:23 Video 3, Extended Resections Podcast 18:30 Dr. Marin-Cuartas & Heuts, TAVR vs SAVR 36:42 Upcoming Events 37:32 Instructional Video Competition 38:55 Career Center They discussed the motivations behind the creation of this paper and provided insights into its Bayesian hierarchical design. Key findings included the five-year all-cause mortality rates and the risk of stroke associated with the procedures. They also referenced other studies with similar findings, such as a recently published paper from the Journal of the American College of Cardiology on the “Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.” Finally, they explored the future of transcatheter aortic valve implantation and surgical aortic valve replacement.   Joel also highlights recent JANS articles on the six-year outcomes after transcatheter vs surgical aortic valve replacement in low-risk patients with aortic stenosis, postdilation of Evolut transcatheter heart valves, insights into current practices in the United States regarding increasing adoption of donation after circulatory death in high-risk heart transplant recipients, and the value of V/Q SPECT/CT lobar quantitation for pre-treatment assessment of lung malignancy.  In addition, Joel explores robotic-assisted aortic valve replacement, TAVI in SAVR explantation, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Maninder Kalkat about extended resections. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis  2.) Postdilation of Evolut Transcatheter Heart Valves: Insights From Bench Testing  3.) Increasing Adoption of Donation After Circulatory Death in High Risk Heart Transplant Recipients: Insights Into Current Practices in the United States  4.) The Value of V/Q SPECT/CT Lobar Quantitation for Pre-Treatment Assessment of Lung Malignancy  CTSNet Content Mentioned  1.) Robotic-Assisted Aortic Valve Replacement   2.) TAVI in SAVR Explantation: A Two-Step Technique for Successful Removal   3.) The Atrium: Extended Resections   Other Items Mentioned  1.) Updated 5-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Low- to Intermediate-Surgical Risk  2.) The Lifeline  3.) Instructional Video Competition     4.) Career Center   5.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this first edition of the new CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Barbara McLean, a Critical Care Clinical Nurse Specialist at Grady Memorial Hospital in Atlanta, GA, USA. They discuss end-tidal carbon dioxide (EtCO2) monitoring in cardiac surgical emergencies.  Chapters 00:00 Intro 01:30 End-Tidal CO2 Monitoring Overview 09:16 Case 1 13:52 Case 2 19:57 Outlier Cases 21:01 Global Application Mclean began by providing an overview of EtCO2, including bedside interpretation, values for rapid non-invasive cardiopulmonary evaluation during acute decompensation, critical values that warrant intervention, and how to differentiate ventilation and perfusion abnormalities, metabolic acidosis, hypoventilation, hyperventilation, and arterial CO2. They then discuss various case studies outlining postoperative outcomes and the symptoms patients were experiencing emphasizing this important monitoring modality to aid in accurate and timely clinical assessment during complex emergencies.  Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don’t miss next month’s episode!  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Niv Ad, Editor-in-Chief of the journal Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery and professor of surgery at Johns Hopkins University School of Medicine in Baltimore, Maryland, USA, about the journal. Chapters 00:00 Intro 02:04 JANS 1, Adverse Effects Statin Therapy 06:21 JANS 2, Mortality & Reintervention, Robotic MR 09:15 JANS 3, Balloon vs Self Expanding Transcath Valves 11:41 JANS 4, Transcath Aortic Valve in MV Replacement 13:54 Career Center 14:33 Video 1, Endo Cone Repair w Ebstein Anomaly 16:26 Video 2, Retrograde Cardioplegia Cath Placement 17:19 Video 3, Standardized Strategy, Rheumatic MV Disease 20:31 Dr. Ad, Innovations Journal 31:05 Upcoming Events 31:38 New Podcast, The Lifeline 32:15 Closing They discussed the main topics and procedures covered by Innovations, highlighting its double-blind peer-review process and the special feature section. Additionally, they provided tips for those interested in submitting to the journal.   Joel also highlights recent JANS articles on a meta-analysis of double-blind randomized controlled trials for the assessment of adverse effects attributed to statin therapy in product labels, mortality and reintervention after robotic mitral repair in the United States, the three-year results of the LYTEN trial on balloon- vs self-expanding transcatheter valves for failed small surgical aortic, and the first-in-human study on transcatheter aortic valve-in-mechanical valve replacement.  In addition, Joel explores an endoscopic cone repair in an adult patient with Ebstein anomaly, an alternative cannulation site for the placement of a retrograde cardioplegia catheter, and a standardized surgical management strategy for rheumatic mitral valve disease. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Assessment of Adverse Effects Attributed to Statin Therapy in Product Labels: A Meta-Analysis of Double-Blind Randomised Controlled Trials  2.) Mortality and Reintervention After Robotic Mitral Repair in the United States  3.) Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial  4.) Transcatheter Aortic Valve-in-Mechanical Valve Replacement: A First-in-Human Study   CTSNet Content Mentioned  1.) Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly   2.) Placement of a Retrograde Cardioplegia Catheter: An Alternative Cannulation Site  3.) Standardized Surgical Management Strategy for Rheumatic Mitral Valve Disease  Other Items Mentioned  1.) Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery  2.) The Lifeline  3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Maninder Kalkat, a consultant cardiothoracic surgeon in the Regional Department of Thoracic Surgery at University Hospital Birmingham, about extended resections.   Chapters 00:00 Intro  01:07 Inspiration & Areas of Interest  03:23 Definition & Classification  09:28 History  10:16 Preop Considerations  19:07 Operating Team Plan  22:23 Fitness for Surgery  23:55 Airway Resections  31:33 Chest Wall Resections  36:17 Reconstructive Material  38:43 Vascular Resections  43:53 Postoperative Care  47:59 Future of Extended Resections  50:15 Summary  50:48 Surgery Training Tips They provided an overview of extended resections, including the definition, indications, and examples, as well as the history of extended resections. They also discussed preoperative considerations and examined airway resections, detailing what it is, indications, and the technical principles of the operation. Additionally, they explored chest wall resections, including the definition, indications, and technical principles. Drs. Copperwheat and Kalkat also examined vascular resections, highlighting what they are, indications, and the technical aspects involved. They also reviewed postoperative considerations, complications, and outcomes. Finally, they shared training tips, future directions, and key principles in extended resections.   The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out for next month’s episode.   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Puja Khaitan, thoracic consultant at Sheikh Shakhbout Medical City, Abu Dhabi, UAE, and Founder and Congress Chair of the Emirates International Thoracic Surgery Congress, about thoracic surgery in the United Arab Emirates (UAE). Chapters 00:00 Intro 02:35 JANS 1, Therapy & Risk in Idiopathic Pulm Fibrosis 04:18 JANS 2, Sex-Related Treatment Effects 06:03 JANS 3, Endoscopic vs Open RAH in CABG 08:14 JANS 4, Textbook Outcome in MV Surgery 11:16 Career Center 12:08 Video 1, AMDS to FET Conversion 13:13 Video 2, Constrictive Pericarditis & Pericardiectomy 14:42 Video 3, Right Axillary Thoracotomy 16:17 Dr. Khaitan, Thoracic Surgery in the UAE 23:46 Upcoming Events 24:46 Instructional Video Competition They discussed her professional background and training, as well as the differences in cases between the UAE and United States. They also delved into research in the UAE, the state of thoracic hospitals, general surgical residency programs, and the future of fellowships in the country.   Joel also highlights recent JANS articles on a large retrospective propensity-weighted cohort study on antifibrotic therapy and lung cancer risk in patients with idiopathic pulmonary fibrosis, sample size considerations to assess sex-related treatment effects, endoscopic or open radial artery harvest in coronary artery bypass surgery, and results from the Netherlands Heart Registration on mitral valve surgery.  In addition, Joel explores a safe and reproducible redo aortic surgery approach on AMDS to frozen elephant trunk conversion, an approach to constrictive pericarditis and pericardiectomy from diagnosis to definitive surgical, and right axillary thoracotomy. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Antifibrotic Therapy and Lung Cancer Risk in Patients With Idiopathic Pulmonary Fibrosis: A Large Retrospective Propensity-Weighted Cohort Study  2.) Sample Size Considerations to Assess Sex-Related Treatment Effects  3.) Endoscopic or Open Radial Artery Harvest in Coronary Artery Bypass Surgery  4.) Textbook Outcome in Mitral Valve Surgery—Results from the Netherlands Heart Registration  CTSNet Content Mentioned  1.) AMDS to Frozen Elephant Trunk Conversion: A Safe and Reproducible Redo Aortic Surgery Approach    2.) From Diagnosis to Definitive Surgical Therapy: An Approach to Constrictive Pericarditis and Pericardiectomy  3.) Right Axillary Thoracotomy: A Minimally Invasive Gateway to Multiple Defects  Other Items Mentioned  1.) Emirates International Thoracic Surgery Congress  2.) Instructional Video Competition   3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

In this episode of The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society; and co-moderator Dr. Kevin Lobdell, Professor and Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health spoke with Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center and Dr. Serdar Gunaydin, Head of Department at the University of Health Sciences in Turkey, about patient blood management.   Chapters  00:00 Intro  01:14 Transfusion as a Risk Factor  07:08 Hemoglobin Drugs  08:24 Pillars of Blood Management  09:56 Anesthesia  12:30 Transfusion Triggers  17:33 O2 Delivery, Hemoglobin Number  22:20 Non-Transfusion Patients  23:22 Anemic Level Bottom Number  25:06 Bleeding Checklist  29:41 Anemia Tolerance  They discussed independent risk factors for blood transfusion, the role of hemoglobin as a predictor for blood transfusion, and considerations related to anemic patients and hemoglobin levels. Additionally, they explored the key pillars of blood management, treating preoperative anemia, and anesthesia. They examined transfusion triggers, oxygen delivery, and the care of non-transfusion patients. Finally, they emphasized the importance of a bleeding checklist and anemia tolerance.   The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Hani Shennib, a Clinical Professor of Vascular and Cardiothoracic Surgery at the University of Arizona College of Medicine, Phoenix, USA, about catheters as a language. Chapters 00:00 Intro 02:48 UK Thoracic Forum 06:11 JANS 1, Detecting AF Using Watch 07:44 JANS 2, End-to-End Anastomotic Stapler 09:24 JANS 3, Improving Patient Selection NSCLC 12:05 JANS 4, 5-Year Women Outcomes TAVR vs SAVR 13:30 Video 1, MVR Tips & Tricks 14:43 Video 2, Ruptured SVA w Hemi-Yacoub Remodeling 16:32 Video 3, Modified Inclusion, Autograft in a Vest 18:04 Dr. Shennib, Catheters as a Language 48:25 Upcoming Events 48:52 Career Center They explore the importance of making catheters a language by learning, speaking, and practicing it daily. They also discuss how cardiac surgeons have lost the role of “gatekeepers,” with cardiologists now controlling more of the decision-making process. Dr. Shennib emphasizes the need for surgeons to be involved in decision-making from diagnosis to treatment and highlights the significance of patient-centered decision-making and the human aspect of these choices. They also compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), examining which procedure is more appropriate in different circumstances. Furthermore, they explore the reasons behind the shrinking cardiac specialty and discuss how to save it. Finally, they discuss the future of cardiac surgery.   Joel also highlights recent JANS articles on a randomized controlled trial on the enhanced detection and prompt diagnosis of atrial fibrillation using an Apple watch, the results of a human cadaver study on a novel aortic end-to-end anastomotic stapler device, improving patient selection for minimally invasive lobectomy or stereotactic ablative radiotherapy based on clinical characteristics, and a systematic review and meta-analysis on the five-year outcomes of transcatheter versus surgical aortic valve replacement in women.  In addition, Joel explores tips and tricks for mitral valve repair from a Brussels experience, treatment of ruptured sinus valsalva aneurysm with hemi-Yacoub remodeling technique, and a Ross procedure with modified inclusion technique. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial  2.) A Novel Aortic End-to-End Anastomotic Stapler Device—Results of a Human Cadaver Study  3.) Stage I Non-Small Cell Lung Cancer: Improving Patient Selection for Minimally Invasive Lobectomy or Stereotactic Ablative Radiotherapy Based on Clinical Characteristics  4.) Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Women: A Systematic Review and Meta-Analysis   CTSNet Content Mentioned  1.) Mitral Valve Repair—Tips and Tricks From Brussels Experience: 2025 London Core Review Cardiothoracic Surgery Course   2.) Treatment of Ruptured Sinus Valsalva Aneurysm With Hemi-Yacoub Remodeling Technique   3.) Ross Procedure With Modified Inclusion Technique: An Autograft in a Vest  Other Items Mentioned  1.) Instructional Video Competition   2.) Career Center   3.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Louise Kenny, a consultant pediatric and adult congenital cardiothoracic and transplant surgeon at Freeman Hospital in Newcastle upon Tyne, England, about congenital heart transplants. Chapters 00:00 Intro 02:24 JANS 1, VECTOR Procedure 07:38 JANS 2, Combined Inflation & Cooling 08:26 JANS 3, Caring for VIP Patients 11:43 JANS 4, Country Wealth & Min Inv Correlation 12:57 Career Center 13:37 Video 1, Debranching AAV Step-by-Step 15:14 Video 2, Abramson Technique 16:59 Video 3, Min Inv Cardiac w Dr. Chitwood 18:54 Dr. Kenny, DCD-HOPE Congenital Transplant 31:58 CKD & CSA-AKI Podcast Episode 34:12 Upcoming Events 35:13 Closing They discussed the complexities surrounding congenital heart transplants, donation after brain death (DBD), and donation after circulatory death (DCD). They also explored the benefits of hypothermic oxygenated perfusion (HOPE) for children, particularly in DCD pediatrics patients, and highlighted the first case where this model was used. Additionally, they examined the future of HOPE and its potential for more complex procedures. Moreover, they discussed implanting ventricular assist devices (VAD) in children, along with what other countries are doing regarding congenital heart transplants, including ongoing studies in this field.    Joel also highlights recent JANS articles on the first human VECTOR procedure for percutaneous aorto-coronary bypass graft to prevent coronary obstruction following TAVR, combined inflation and cooling method improves lung function in uncontrolled donation after circulatory death, caring for VIP patients in cardiothoracic surgery, and the national wealth and the global spread of minimally invasive thoracic surgery.  In addition, Joel explores a step-by-step guide for debranching of aortic arch vessels through a cervical approach for aortic arch aneurysm, a master class with Horacio Abramson on the Abramson technique, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Randolph Chitwood about the future of minimally invasive cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure  2.) Combined Inflation and Cooling Method Improves Lung Function in Uncontrolled Donation After Circulatory Death  3.) Caring for VIP Patients in Cardiothoracic Surgery: Navigating Bias, Pressure, and Protocol  4.) National Wealth and the Global Spread of Minimally Invasive Thoracic Surgery: Insights From the European Society of Thoracic Surgeons Database  CTSNet Content Mentioned  1.) Debranching of Aortic Arch Vessels Through a Cervical Approach for Aortic Arch Aneurysm: A Step-by-Step Guide  2.) Master Class: The Abramson Technique With Horacio Abramson and Joel Dunning  3.) The Atrium: The Future of Minimally Invasive Cardiac Surgery  Other Items Mentioned  1.) HOPE for Children: Successful Pediatric DCD Heart Transplantation Using Hypothermic Oxygenated Perfusion  2.) Instructional Video Competition   3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Drs. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, and Marlies Ostermann, consultant in critical care and nephrology at Guy's and St. Thomas Foundation Trust and a Director of Research for the Intensive Care Society, about chronic kidney disease (CKD) and cardiac surgery-associated acute kidney injury (CSA-AKI). Chapters 00:00 Intro 02:11 Definition & Background 10:55 Burden of CSA-AKI 12:58 Unmet Medical Need 19:47 Identification & Collaboration 26:07 KDIGO, O2 Delivery 32:15 CKD CSA-AKI Final Remarks 35:10 JANS, Success in African CT Surgery 38:49 Video, Modified Root Inclusion Technique 40:53 Closing They delve into the complexities of CSA-AKI, exploring the percentage of patients affected, defining the condition, and highlighting the overall significance of this issue. They also address creatinine as a late marker for AKI, the long-term scarring that can occur from AKI, and the critical need for thorough preoperative assessments to identify high-risk patients. Additionally, they emphasize the importance of a complete health assessment before surgery. Furthermore, they discuss the dangers of reaching stage 3 AKI, the increased costs of care once that point is reached, and what actions to take if a patient has a positive marker but appears stable. They also highlight the premature use of diuretics contributing to AKI and hyperbilirubinemia. Moreover, they consider how CKD along elevates mortality risk and the importance of developing targeted therapies in the future. Finally, they discuss approaches to reduce ischemia-reperfusion (IR) AKI and the optimization of hemodynamics, as well as potential drugs for treating AKI effectively.   Joel also highlights a recent JANS article on aligning training, patient profiles, and outcomes to redefine success in cardiac surgery in Africa. In addition, he explores the modified root inclusion technique for a fourth sternotomy with Ross/Konno after previous mechanical aortic valve replacement.   Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Redefining Success in Cardiac Surgery in Africa: Aligning Training, Patient Profiles, and Outcomes  CTSNet Content Mentioned  1.) Fourth Sternotomy With Ross/Konno After Previous Mechanical Aortic Valve Replacement: The Modified Root Inclusion Technique  Other Items Mentioned  1.) Career Center   2.) CTSNet Events Calendar  3.) Instructional Video Competition   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.