NeuroNews’ Post

BTB🔙 To this amazing article 🔊🔊 "Multinational and Cross-Sectional Survey on Valve-Sparing Aortic Replacement Controversies" in collaboration with Tirone David, C. Feindel (Toronto General Hospital), Martins Misfelds, Michael Borger (Heart Center Leipzig), Hans-Joachim Schäfers(Saarland University Medical Center, Homburg/Saar), J. Coselli (Michael E. DeBakey Department of Surgery), et al. at Sociedad Argentina de Cardiología ➡️ A literature review was performed regarding the most frequent debates and controversies in Valve-sparing aortic root replacement (VSAR). A survey was developed and sent to surgeons with known expertise in VSAR regarding their opinion on patient-related factors, technical aspects, echocardiography, research, training, and the future of VSAR. (46 topics) ✅ 20 most renamed surgeons in the field completed the survey ✅ Severity of aortic regurgitation was not considered a limitation for the VSAR ✅ All of them felt that VSAR is safe for the Marfan´s syndrome population and bicuspid valves ✅ Surgeons reported a 7% failure rate, leading to conversion to Bentall surgery, and a 26% change of strategy intraoperatively. ✅ A minimally invasive approach was not considered to improve results ✅ Most of the surgeons agreed that VSAR should be performed by highly experienced surgeons. ✅ 16 out of 20 considered that the intention to repair the aortic valve should be the standard for all candidates for a VSAR Read the full article -->chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://lnkd.in/dCEqhXdb

Research from our unit on the effect of operative time on adverse postoperative outcomes in DIEP flap UCLRoyal Free London NHS Foundation Trust. We confirmed OT was an independent predictor for postoperative complications in the DIEP flap, and demonstrated this in unilateral reconstructions. A clinical maximum threshold of 7 hours was derived based on this cohort to help guide future surgical practice. Efficiency can be achieved by meticulous preoperative planning and process standardisation, multiple senior surgeons working per flap and smooth team-work between specialties and intraoperative staff. Dual Plastic Consultants, Team work between Breast and Plastic Surgeons, and Process standardisation are key for better outcomes. #Diepflap #breastcancerawareness #microsurgery #Londonmicrosurgerygroup #londonbreastmeeting#rflppu

Experts gathered at the Society for Vascular Surgery’s 2023 Vascular Annual Meeting (VAM) in National Harbor, Maryland (June 14–17) to discuss the latest innovation from Shockwave Medical—the Shockwave L6 Peripheral Intravascular Lithotripsy (IVL) catheter (available in 8-12 mm diameter sizes), for use in calcified large-vessel interventions. Karan Garg, MD (New York City, USA) was joined by Misty Humphries, MD (Sacramento, USA) and Mathew Wooster, MD (Charleston, USA) to explore how the new device has changed their practice and treatment approach in larger vessels. According to Humphries, the larger Shockwave L6 catheter “opens up the ability to do thoracic endografting and aortic endografting for patients with calcified vessels”. Wooster added that, while the Shockwave M5+, worked and was a “great” device, the L6 simplifies certain procedures. He explained: “Instead of having to use a small Shockwave balloon that’s truly undersized and then come back with a standard balloon in order to get up to a large enough diameter for our large-bore device, you do it in one step, and it just makes things much more efficient.” To demonstrate the benefits of the new L6 in clinical practice, Wooster shared with the group a case that showed “how the L6 can really impact our care, and change the pathways that we have available to us”. The case involved a 70-year-old man with a 5cm juxtarenal aneurysm, subacute ischemia, and a nearly occluded common femoral artery. Sharing the outcomes, Wooster detailed that the L6 device ensured the common femoral artery was “almost pristine” following treatment. Commenting on the case, which Wooster said he was “fully expecting to fail,” Humphries highlighted the impressive trackability of the L6, with Garg remarking on the “well-executed” nature of the treatment. The Shockwave L6 catheter is available in the US-only. This video is sponsored by Shockwave Medical. https://lnkd.in/eygf6TgB #ShockwaveIVL #ShockwaveL6 #vascular

Expert Insights: Choosing the Best Laparoscopic Surgeon in Kandivali When faced with the need for surgery, particularly minimally invasive procedures, choosing the right surgeon is paramount for a successful outcome. https://lnkd.in/gMwCV5_g

Experts gathered at the Society for Vascular Surgery’s 2023 Vascular Annual Meeting (VAM) in National Harbor, Maryland (June 14–17) to discuss the latest innovation from Shockwave Medical—the Shockwave L6 Peripheral Intravascular Lithotripsy (IVL) catheter (available in 8-12 mm diameter sizes), for use in calcified large-vessel interventions. Karan Garg, MD (New York City, USA) was joined by Misty Humphries, MD (Sacramento, USA) and Mathew Wooster, MD (Charleston, USA) to explore how the new device has changed their practice and treatment approach in larger vessels. According to Humphries, the larger Shockwave L6 catheter “opens up the ability to do thoracic endografting and aortic endografting for patients with calcified vessels”. Wooster added that, while the Shockwave M5+, worked and was a “great” device, the L6 simplifies certain procedures. He explained: “Instead of having to use a small Shockwave balloon that’s truly undersized and then come back with a standard balloon in order to get up to a large enough diameter for our large-bore device, you do it in one step, and it just makes things much more efficient.” To demonstrate the benefits of the new L6 in clinical practice, Wooster shared with the group a case that showed “how the L6 can really impact our care, and change the pathways that we have available to us”. The case involved a 70-year-old man with a 5cm juxtarenal aneurysm, subacute ischemia, and a nearly occluded common femoral artery. Sharing the outcomes, Wooster detailed that the L6 device ensured the common femoral artery was “almost pristine” following treatment. Commenting on the case, which Wooster said he was “fully expecting to fail,” Humphries highlighted the impressive trackability of the L6, with Garg remarking on the “well-executed” nature of the treatment. The Shockwave L6 catheter is available in the US-only. This video is sponsored by Shockwave Medical. #ShockwaveIVL #ShockwaveL6 #vascular https://lnkd.in/eKNXnb-z

Good to know

ERAS and STS recommendations for perioperative care after cardiac surgery. Nothing groundbreaking here as a lot of these are cornerstones of good ICU care, but good to be familiar with. https://lnkd.in/gGmWxZ93

I agree female surgeons take more time to complete a surgical procedure with more favorable results. The word is "patience" #thoracic #surgeons #neurosurgeon #orthopedicsurgeon #hospitals #medical #cardiovascular

I am glad to share my article About Off pump CABG... 1. **Definition:** Off-pump coronary artery bypass grafting (OPCABG) is a surgical technique used in cardiac surgery where the heart is not stopped during the procedure. Instead of using a heart-lung machine, the surgeon performs the grafts on the beating heart. 2. **Advantages:** One major advantage is the avoidance of cardiopulmonary bypass-related complications, such as systemic inflammatory response syndrome. OPCABG may reduce the risk of neurological complications and bleeding. Additionally, it can be beneficial for patients with certain coexisting conditions. 3. **Procedure:** During OPCABG, the surgeon stabilizes the area of the heart where the graft is needed using specialized devices. This allows the surgeon to perform the grafts while the heart continues to beat. Multiple grafts can be done without stopping the heart, potentially reducing the overall duration of the surgery. 4. **Patient Selection:** Not all patients are suitable candidates for OPCABG. Patient selection is crucial, and factors such as the complexity of coronary artery disease, patient age, and overall health need to be considered. High-risk patients may benefit more from traditional on-pump CABG. 5. **Outcomes:** While OPCABG offers certain advantages, studies have shown comparable long-term outcomes between OPCABG and on-pump CABG in terms of mortality and major adverse cardiac events. The choice between the two techniques often depends on individual patient characteristics and surgeon expertise.

Harmonizing Practices: WSES' abdominal wall closure guidelines echo American and European Hernia Societies' strategies In 2022, the World Society of Emergency Surgery (WSES), uniting global trauma and emergency surgeons, identified a critical gap: the absence of guidelines for abdominal wall closure in the emergency setting. In a remarkable turnaround, the WSES has published a guideline in 2023 named ECLAPTE: Effective Closure of LAParoTomy in Emergency. ECLAPTE pinpoints six crucial actions to reduce complications in relation to abdominal wall closure and recommends closing the abdominal wall with a suture-to-wound-length ratio of 4:1, using the small bites technique. This guideline, designed to mitigate complications such as incisional hernias, demonstrates that WSES shares the same vision as the American and European hernia societies. This alignment marks a significant step towards the implementation of this technique. Link to the guidlines: https://lnkd.in/eUBNdZbw #WSES #Suturion #smallbitestechnique #guidelines #abdominalwallclosure