10/07/2016

STAT Categories: Procedure-specific Mortality Risk Categories

Based on JTCVS 2009;138:1139
(Click on the image to enlarge)












10/05/2016

Radial Artery Access - Vasodilator Cocktail

Vasodilator Cocktail for radial artery access:

Nicardipine 200 mcg in 2 ml
1% Lidocaine 1 ml
3-5K of Heparin
+ patient's blood

Infuse slowly as soon as access is obtained.

(Do some folks add Nitroglycerin to this cocktail?)

Terumo sheath - hydrophilic coating helps.
Propafol can be used as a lubricant.
Sterile mineral oil - if the pharmacy has it - can also be used as lubricant.

Radial Artery Access - Vasodilator Cocktail

Vasodilator Cocktail for radial artery access:

Nicardipine 200 mcg in 2 ml
1% Lidocaine 1 ml
3-5K of Heparin
+ patient's blood

Infuse slowly as soon as access is obtained.

(Do some folks add Nitroglycerin to this cocktail?)

Terumo sheath - hydrophilic coating helps.
Propafol can be used as a lubricant.
Sterile mineral oil - if the pharmacy has it - can also be used as lubricant.

9/10/2016

Blalock-Hanlon Atrial Septectomy (d-Transposition of Great Arteries)

This is performed without cardiopulmonary bypass.
(Click on the image to enlarge)
From Clinical Aspects of Operable Heart Surgery 1968. Donald Kahn, Ruth Strang and William Wilson. Appleton-Century-Crofts (Meredith Corporation), New York. 1968.

Mustard Operation for d-Transposition of Great Arteries

(Click on the image to enlarge)
From Clinical Aspects of Operable Heart Surgery 1968. Donald Kahn, Ruth Strang and William Wilson. Appleton-Century-Crofts (Meredith Corporation), New York. 1968.

8/06/2016

Pericardiocentesis - Using EKG via needle as guide

From Page 7.8 in Atlas of the Heart. Ed. J Willis Hurst, Robert H Anderson, Anton E Becker and Benson R Wilcox. Grower Medical Publishing, New York. 1988.

7/11/2016

Early Repolarization Patterns

From Abdi Ali, et al. World Journal of Cardiology 2015;7:466-75.

Other related references:
Perez MV, Friday K, Froelicher V. Semantic confusion: the case of early repolarization and the J point. Am J Med. 2012;125:843-844.

aïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008;358:2016-2023.

5/28/2016

New Food Label Design (to be implemented before July 2018)

Most important change: "Added Sugar" information.
Removal of "Calories from fat"
Inclusion of Vitamin D and Pottasium.
Few revisions to daily requirements calculation (Sodium chloride requirement was reduced from 2400 mg/day to 2300 mg/day)

3/31/2016

How to identify pacemaker?

From Heart Rhythm 2011;8:915-922.

(Click on the image to enlarge)

Telephone numbers for manufacturers to identify the pacemaker:
Medtronic: 1-800-Medtronic (1-800-633-8766)
St Jude Medical: 1-800-PaceICD (1-800-722-3774)
Boston Scientific: 1-800-Cardiac (1-800-227-3422)
Sorin Gp (ELA): 1-800-352-6466
Biotronik: 1-800-547-0394
Note: The telephone numbers are different, to call the representative to come and interrogate the pacemakers.

3/29/2016

3/27/2016

Anomalous origin of Vertebral Artery

(click on the image to enlarge)

 
                          (Netter)                                                        (Am J Neuroradiol 1998;20:1318-1321)

Netter diagram: Top - Normal, Middle - "Bovine" arch (common origin for innominate and LCC arteries) and Botton - Right vertebral artery from innominate artery & Left vertebral artery from aortic arch.

AJNR cartoon: Possible anomalous vertebral artery origins


2/18/2016

Prevalence of late hypertension after coarctation repair - Age at operation

n=176 consecutive patients
Median f-up = 7.5 yrs.
Mortality - 0% for isolated coarctation (n=116), 7.4% for coarctation associated with other anomalies.
Seirafi et al.Ann Thoracic Surg 1998;66:1378-82.

Age at repair was not significant risk factor in another study: Hager et al. JTCVS 2007;134:738-45. n=405, Surgical era 1974-2000.