The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Reverse cannulation method as a strategy for aortic aneurysm surgery: A computational fluid dynamics study on minimizing neurological risks.
To evaluate the blood flow velocity and wall shear stress in total arch replacement with a "shaggy" aorta, using computational fluid dynamics, and determine the optimal cannulation method. ⋯ Our simulations indicate that, irrespective of the cannula type or orientation, directing the cannula tip toward the aortic root (reversed direction) prevents accelerated blood flow in critical areas, suggesting its potential as an optimal approach for aortic arch surgery in "shaggy" aorta cases.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
A Novel, Multi-Modal, Intraoperative Cognitive Workload Assessment of Cardiac Surgery Team Members.
To characterize cognitive workload (CWL) of cardiac surgery team members in a real-world setting during coronary artery bypass grafting (CABG) surgery using providers' heart rate variability (HRV) data as a surrogate measure of CWL. ⋯ Our innovative analysis demonstrates that CWL fluctuates across surgical procedures by role and phase, which may reflect the distribution of primary tasks. This corroborates earlier findings from self-report measures. The data suggest that team-wide, peak CWL during a phase decreases from early phases of surgery through initiation of cardiopumonary bypass (CPB), rises during anastomosis, and decreases after termination of CPB. Knowledge of these trends could encourage the adoption of behaviors to enhance team dynamics and performance.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Aortic Valve Degeneration After Valve-Sparing Root Replacement in Patients with Bicuspid Aortopathy or Connective Tissue Disorder.
We sought to evaluate outcomes of valve-sparing root replacement (VSRR) in patients with bicuspid aortopathy (BAV) versus other connective tissue disorder (CTD). ⋯ Patients with BAV and CTD have excellent operative outcomes, no mortality, and minimal residual AI after VSRR. Although the incidence of recurrent AI was similar, patients with BAV are at risk for AS.