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Gupta AK, Bacchi S, Kovoor JG, Jiang M, Stretton B, Zaka A, He C, Vallely MP, Kovoor P, Bennetts JS, Maddern GJ. Re: "Rates and risk factors for persistent opioid use after cardiothoracic surgery: A cohort study". Surgery 2024; 176:984-985. [PMID: 38760233 DOI: 10.1016/j.surg.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Aashray K Gupta
- University of Adelaide, Adelaide, Australia; Gold Coast University Hospital, Southport, Australia.
| | - Stephen Bacchi
- University of Adelaide, Adelaide, Australia; Flinders University, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | - Joshua G Kovoor
- University of Adelaide, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | | | | | - Ammar Zaka
- Gold Coast University Hospital, Southport, Australia
| | - Cheng He
- Gold Coast University Hospital, Southport, Australia
| | | | - Pramesh Kovoor
- Department of Cardiology, Westmead Hospital, Westmead, Australia
| | - Jayme S Bennetts
- Flinders University, Adelaide, Australia; Flinders Medical Centre, Adelaide, Australia
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2
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Daniel J, Glynatsis JM, Kovoor JG, Stretton B, Bacchi S, Ovenden CD, To MS, Goh R, Hewitt JN, Sahota RS, Chan JCY, Ramponi F, Krishnan G, Gupta AK. Sensorineural hearing loss after cardiac surgery: a systematic review. ANZ J Surg 2024; 94:536-544. [PMID: 37872745 DOI: 10.1111/ans.18742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/19/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Sensorineural hearing loss (SNHL) may occur following cardiac surgery. Although preventing post-operative complications is vitally important in cardiac surgery, there are few guidelines regarding this issue. This review aimed to characterize SNHL after cardiac surgery. METHOD This systematic review was registered on PROSPERO and conducted in accordance with PRISMA guidelines. A systematic search of the PubMed, Embase and Cochrane Library were conducted from inception. Eligibility determination, data extraction and methodological quality analysis were conducted in duplicate. RESULTS There were 23 studies included in the review. In the adult population, there were six cohort studies, which included 36 cases of hearing loss in a total of 7135 patients (5.05 cases per 1000 operations). In seven cohort studies including paediatric patients, there were 88 cases of hearing loss in a total of 1342 operations. The majority of cases of hearing loss were mild in the adult population (56.6%). In the paediatric population 59.2% of hearing loss cases had moderate or worse hearing loss. The hearing loss most often affected the higher frequencies, over 6000 Hz. There have been studies indicating an association between hearing loss and extracorporeal circulation, but cases have also occurred without this intervention. CONCLUSION SNHL is a rare but potentially serious complication after cardiac surgery. This hearing loss affects both paediatric and adult populations and may have significant long-term impacts. Further research is required, particularly with respect to the consideration of screening for SNHL in children after cardiac surgery.
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Affiliation(s)
- Jonathan Daniel
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John M Glynatsis
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Joshua G Kovoor
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Brandon Stretton
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Christopher D Ovenden
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Minh-Son To
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Rudy Goh
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Joseph N Hewitt
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Justin C Y Chan
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- NYU Langone, New York City, New York, USA
| | - Fabio Ramponi
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Giri Krishnan
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Southport, Queensland, Australia
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Singh A, Nanda C, Mehta Y, Bhan A. Successful Extracorporeal Cytokine Hemoadsorption in a Marfan Syndrome Patient with COVID-19 Undergoing Redo Bentall Procedure. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e940383. [PMID: 37749880 PMCID: PMC10542413 DOI: 10.12659/ajcr.940383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/26/2023] [Accepted: 06/08/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Patients with COVID-19 undergoing emergency or complex surgical procedures are at increased risk of developing perioperative complications. CytoSorb is a blood purification therapy used to remove circulating cytokines in conditions of hyperinflammation. This report is of a patient with COVID-19 requiring redo replacement of the aortic valve and aorta due to aortic aneurysm of the ascending aorta (Bentall procedure) associated with Marfan syndrome. The patient was successfully treated with extracorporeal cytokine hemoadsorption. CASE REPORT A 34-year-old man with Marfan syndrome, who had undergone a Bentall procedure in 2018, was admitted with symptoms of worsening dyspnea, tachycardia, fever, and confirmed COVID-19. Further diagnostic workup revealed dehiscence of the aortic root as well as moderate aortic regurgitation, in the context of a hyperinflammatory state. Anti-infective treatment was initiated. Given the severity of symptoms, COVID-19, echocardiography findings, and risk of aortic rupture, urgent Bentall surgery was performed. Additionally, a CytoSorb hemoadsorber was integrated into the cardiopulmonary bypass circuit to attenuate the anticipated systemic hyperinflammation. Intraoperatively, several blood products were administered due to excessive bleeding from the friable tissues and the pre-existing anemia and thrombocytopenia. Treatment was associated with marked improvements in vital parameters and inflammatory markers, and weaning from the ventilator and inotropes was possible after 48 hours. The remaining time in hospital was uneventful. CONCLUSIONS This report supports the findings from recent studies and reports that extracorporeal cytokine hemoadsorption has a role to play in reducing the systemic effects of cytokine storm associated with complex surgery involving cardiopulmonary bypass alongside severe infections, including COVID-19.
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Affiliation(s)
- Ajmer Singh
- Department of Cardiac Anesthesia, Medanta The Medicity, Gurgaon, Haryana, India
| | - Chinmaya Nanda
- Department of Cardiac Anesthesia, Medanta The Medicity, Gurgaon, Haryana, India
| | - Yatin Mehta
- Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Anil Bhan
- Department of Cardiac Surgery, Medanta The Medicity, Gurgaon, Haryana, India
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Agarwal R, Mudgal S, Arnav A, Ranjan N. Coronary artery bypass grafting in active or recent COVID-19 infection: a systematic review. Indian J Thorac Cardiovasc Surg 2023; 39:350-358. [PMID: 37342488 PMCID: PMC9995725 DOI: 10.1007/s12055-023-01495-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction Even though there have been few studies on coronary artery bypass grafting (CABG), data on patients with coronavirus disease-2019 (COVID-19) infection show that cardiac surgery has poor outcomes in this subset. From the available studies in the literature, we conducted a systematic review with the aim of determining the outcome of COVID-19 patients who underwent CABG. Methods Between December 2019 and October 2022, searches were conducted in PubMed, the Directory of Open Access Journals, and Google Scholar to find studies reporting results of COVID-19 patients undergoing CABG. We extracted data on the clinical profile and outcomes of the patients from the eligible studies. The quality of the studies was assessed using a standardised tool. Results The total sample size across the 12 included studies was 99 patients who underwent CABG in active disease or within 30 days of COVID-19 infection. The median and interquartile range (IQR) for the length of time spent on a mechanical ventilator, stay in the intensive care unit (ICU), and the total hospital stay were 0.9 (0.47-2), 4.5 (2.5-8), and 12.5 (8.5-22.5) days respectively. Seventy-six patients developed postoperative complications, and there were eleven deaths. Conclusion The findings of the present study indicate that mortality risk goes down when the time between COVID-19 diagnosis and surgery increases. When compared to data from other high-risk urgent or emergent CABG patients around the world who were not infected with COVID-19, patients who underwent CABG in the COVID-19 subgroup had similar postoperative outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s12055-023-01495-7.
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Affiliation(s)
- Rajat Agarwal
- Department of Cardiothoracic Surgery, All India Institute of Medical Sciences (AIIMS) Deoghar, PTI Campus, Jasidih, Deoghar, 814142 Jharkhand India
| | - Shiv Mudgal
- College of Nursing, All India Institute of Medical Sciences (AIIMS) Deoghar, Deoghar, Jharkhand 814142 India
| | - Amiy Arnav
- Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS) Deoghar, Deoghar, Jharkhand 814142 India
| | - Nishit Ranjan
- Department of General Surgery, All India Institute of Medical Sciences (AIIMS) Deoghar, Deoghar, Jharkhand 814142 India
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Baş T, Çevirme D, Zengin A, Baltacı H, Aksoy R, Kırali K. Cardiovascular surgery during the first wave of COVID-19 pandemic. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2023; 31:309-316. [PMID: 37664763 PMCID: PMC10472468 DOI: 10.5606/tgkdc.dergisi.2023.23909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/06/2023] [Indexed: 09/05/2023]
Abstract
Background In this study, we aimed to evaluate primary outcomes and main characteristics of emergency and elective/urgent cardiovascular surgeries which were performed in the first three months of the novel coronavirus disease 2019 (COVID-19) pandemic in our center. Methods Between March 11th, 2020 and June 11th, 2020, a total of 209 patients (44 males, 165 females; mean age: 57.3±12.8 years; range, 20 to 80 years) who underwent emergency or elective/urgent surgery with cardiovascular pathologies were retrospectively analyzed. The patients were classified as emergency and elective/urgent according to the level of necessity of the surgical procedure at the time of hospital admission. Pre-, intra-, and postoperative data of the patients were recorded. Results During the study period, 156 elective/urgent and 74 emergency cardiovascular surgeries were performed. Six COVID-19 (+) patients were operated emergently. The number of acute aortic dissection and peripheral vascular surgery was higher in the emergency group (p<0.05). Two patients who were COVID-19 (-) preoperatively became COVID-19 (+) in the postoperative period. In these patients, acute respiratory distress syndrome developed, and extracorporeal membrane oxygenation support was needed. Four patients who needed post-cardiotomy extracorporeal membrane oxygenation support due to low cardiac output were COVID-19 (-) both in the pre- and postoperative periods. The overall in-hospital mortality rate was 9.1%. Conclusion Even during pandemic such as COVID-19, referral centers with experienced personnel can provide non-pandemic healthcare with a quality close to the daily routine.
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Affiliation(s)
- Tolga Baş
- Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialized Training and Research Hospital, Istanbul, Türkiye
| | - Deniz Çevirme
- Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialized Training and Research Hospital, Istanbul, Türkiye
| | - Ahmet Zengin
- Department of Cardiovascular Surgery, Hakkari Yüksekova State Hospital, Hakkari, Türkiye
| | - Hakan Baltacı
- Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialized Training and Research Hospital, Istanbul, Türkiye
| | - Rezan Aksoy
- Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialized Training and Research Hospital, Istanbul, Türkiye
| | - Kaan Kırali
- Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialized Training and Research Hospital, Istanbul, Türkiye
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Gupta AK, Kleinig O, Tan S, Nagarathinam B, Kovoor JG, Bacchi S, Zaka A, He C, Stroebel A, Beltrame JF, Vallely MP, Bennetts JS, Maddern GJ. Lost in Translation: The Impact of Language Barriers on the Outcomes of Patients Receiving Coronary Artery Revascularization. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 52:94-98. [PMID: 36990850 DOI: 10.1016/j.carrev.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023]
Abstract
INTRODUCTION Clear and effective communication is vital in discussions regarding coronary revascularization. Language barriers may limit communication in healthcare settings. Previous studies on the influence of language barriers on the outcomes of patients receiving coronary revascularization have produced conflicting results. The aim of this systematic review was to evaluate and synthesise the existing evidence regarding the effects of language barrier on the outcomes of patients receiving coronary revascularization. METHODS A systematic review was conducted, including a search of the PubMed, EMBASE, Cochrane, and Google Scholar databases on 01/10/2022. The review was conducted in accordance with PRISMA guidelines. This review was also prospectively registered on PROSPERO. RESULTS Searches identified 3983 articles of which a total 12 studies were included in the review. Most studies describe that language barriers result in delayed presentation, but not delays in treatment following hospital arrival with respect to coronary revascularization. The findings with respect to the likelihood of receiving revascularization have varied significantly; however, some studies have indicated that those with language barriers may be less likely to receive revascularization. There have been some conflicting results with respect to the association between language barrier and mortality. However, most studies suggest that there is no association with increased mortality. In studies that evaluated length of stay variable results have been reported based on geographical location. Namely Australian studies have suggested no association between language barrier and length of stay, but Canadian studies support an association. Language barriers may also be associated with readmissions following discharge, and major adverse cardiovascular and cerebrovascular events (MACCE). CONCLUSION This study demonstrates that patients with language barriers may have poorer outcomes from coronary revascularization. Future interventional studies will be required to consider the sociocultural context of patients with language barriers, and may be targeted at timepoints including prior to, during, or after hospitalisation for coronary revascularization. Further examination of the adverse health outcomes of those with language barriers in fields outside of coronary revascularization are required in view of the stark inequities identified in this field.
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Affiliation(s)
- Aashray K Gupta
- University of Adelaide, Adelaide, Australia; Gold Coast University Hospital, Southport, Australia.
| | | | - Sheryn Tan
- University of Adelaide, Adelaide, Australia
| | | | - Joshua G Kovoor
- University of Adelaide, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | - Stephen Bacchi
- University of Adelaide, Adelaide, Australia; Flinders University, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | - Ammar Zaka
- Gold Coast University Hospital, Southport, Australia
| | - Cheng He
- Gold Coast University Hospital, Southport, Australia
| | | | - John F Beltrame
- University of Adelaide, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia
| | | | - Jayme S Bennetts
- Flinders University, Adelaide, Australia; Flinders Medical Centre, Adelaide, Australia
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Gupta AK, Ovenden CD, Nathin K, Aujayeb N, Hewitt JN, Kovoor JG, Chan JCY, Wells A. Geographical distribution of authorship for leading cardiothoracic surgery journals. J Card Surg 2022; 37:4465-4473. [PMID: 36229966 PMCID: PMC10092000 DOI: 10.1111/jocs.17022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/28/2022] [Accepted: 09/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Evolution of surgical practice is influenced by publications in the leading journals of that field. If the authorship of a publication lacks geographical diversity, this could create bias and limit generalizability of the evidence. Accordingly, we conducted a geographical analysis of the leading Cardiothoracic Surgery journals worldwide. METHODS Using 2020 Impact Factor, we searched the leading Cardiothoracic Surgery journals over the past decade. Only original articles were included. Data regarding first, second and last authors were extracted from every article. From this, we analysed country of affiliation, highest academic degree obtained and author location by metropolitan or rural setting. RESULTS A total of 12,706 original articles were published in the top 5 ranked Cardiothoracic journals between 2011 and 2020. Authors originated from 69 countries, with the majority being from North America and Western Europe. The United States was the most common country of affiliation (42.8%) in all five journals, with New York City the most prominent city. A total of 63.7% of the authorship originated from large metropolitan areas (estimated as population greater than 500,000 residents), and the most common degrees obtained by authors were MD and PhD. CONCLUSION The prominent Cardiothoracic authorship is predominantly located in Western countries, most commonly large metropolitan centers in the United States. This raises questions as to whether the literature adequately reflects populations in other geographical areas such as the continents of South America and Africa and rural settings. Leading journals should consider policies which encourage publication by authors from geographical locations that are underrepresented globally.
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Affiliation(s)
- Aashray K Gupta
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Kayla Nathin
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Nidhi Aujayeb
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Joseph N Hewitt
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Joshua G Kovoor
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Justin C Y Chan
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia.,Department of Cardiothoracic Surgery, New York University Langone Health, New York, USA
| | - Adam Wells
- Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
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Gupta AK, Sabab A, Goh R, Ovenden CD, Kovoor JG, Ramponi F, Chan JCY, Reddi BAJ, Bennetts JS, Maddern GJ, Kleinig TJ. Endovascular thrombectomy for large vessel occlusion acute ischemic stroke after cardiac surgery. J Card Surg 2022; 37:4562-4570. [PMID: 36335602 PMCID: PMC10100038 DOI: 10.1111/jocs.17082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/28/2022] [Accepted: 09/24/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Acute ischemic stroke (AIS) can be a catastrophic complication of cardiac surgery previously without effective treatment. Endovascular thrombectomy (EVT) is a potentially life-saving intervention. We examined patients at our institution who had EVT to treat AIS post cardiac surgery. METHODS We retrospectively reviewed a stroke database from January 1, 2016 to October 31, 2021 to identify patients who had undergone EVT to treat AIS following cardiac surgery. Demographic data, operation type, stroke severity, imaging features, management and outcomes (mortality and modified Rankin Score (mRS)) were assessed. RESULTS Of 5022 consecutive patients with AIS, 870 underwent EVT. Seven patients (0.8%) had EVT following cardiac surgery. Operations varied: two coronary artery bypass grafting (CABG), two transcatheter AVR, one redo surgical aortic valve replacement (AVR), one mitral valve repair and one patient with combined aortic and mitral valve replacements and CABG. Meantime postsurgery to stroke symptoms onset was 3 days (range 0-9 days). Median NIHSS was 26 (range 10-32). Five patients had middle cerebral artery occlusion and two internal carotid artery (n = 2). Median time between onset of symptoms and recanalization was 157 min (range 97-263). Two patients received Intra-arterial Thrombolysis. All patients survived and were discharged to another hospital (n = 3), home (n = 2), or rehabilitation facility (n = 2). Median 3-month mRS was 3 (range 0-6). CONCLUSION We report the largest case series of EVT after cardiac surgery. EVT can be associated with excellent outcomes in these patients. Close neurological monitoring postoperatively to identify patients who may benefit from intervention is key.
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Affiliation(s)
- Aashray K. Gupta
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Ahad Sabab
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Rudy Goh
- Stroke UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Christopher D. Ovenden
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Joshua G. Kovoor
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Australian Safety and Efficacy Register of New Interventional Procedures–SurgicalRoyal Australasian College of SurgeonsAdelaideSouth AustraliaAustralia
| | - Fabio Ramponi
- Department of Cardiothoracic SurgeryRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Justin C. Y. Chan
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | | | - Jayme S. Bennetts
- Cardiothoracic Surgical UnitFlinders Medical CentreAdelaideSouth AustraliaAustralia
| | - Guy J. Maddern
- Discipline of Surgery, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Australian Safety and Efficacy Register of New Interventional Procedures–SurgicalRoyal Australasian College of SurgeonsAdelaideSouth AustraliaAustralia
- Research, Audit and Academic SurgeryRoyal Australasian College of SurgeonsAdelaideSouth AustraliaAustralia
| | - Timothy J. Kleinig
- Stroke UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- Discipline of Medicine, Royal Adelaide HospitalUniversity of AdelaideAdelaideSouth AustraliaAustralia
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Girgin S, Aksun M, Tüzen AS, Gürbüz A, Karahan N. A Case Series of Problems That Can Occur During Open Heart Surgery in Patients With COVID-19 Infection. Cureus 2022; 14:e27488. [PMID: 36060354 PMCID: PMC9421346 DOI: 10.7759/cureus.27488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 12/04/2022] Open
Abstract
The utilization of open cardiac surgery on patients infected with coronavirus disease 2019 (COVID-19) has resulted in a very challenging perioperative management method. High rates of morbidity and mortality have been documented in the literature for patients who have undergone open heart surgery while infected with COVID-19; however, data on complications that may occur during and after surgery in patients with COVID-19 infection are limited. In this article, we aimed to present the clinical course and perioperative consequences of three patients with preoperative COVID-19 infection.
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de Miguel-Diez J, Jimenez-Garcia R, de Miguel-Yanes JM, Hernández-Barrera V, Carabantes-Alarcon D, Zamorano-Leon JJ, Noriega C, Lopez-de-Andres A. Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients. J Clin Med 2022; 11:3924. [PMID: 35807209 PMCID: PMC9267656 DOI: 10.3390/jcm11133924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; p = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; p = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for "any cardiac procedure" (1.18, 95% CI 1.03-1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD.
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Affiliation(s)
- Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain;
| | - Rodrigo Jimenez-Garcia
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Jose M. de Miguel-Yanes
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain;
| | - Valentin Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - David Carabantes-Alarcon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Jose J. Zamorano-Leon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain;
| | - Ana Lopez-de-Andres
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
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Gupta AK, Kovoor JG, Ovenden CD, Cullen HC. RE: Using YouTube analytics to improve videos for cardiac surgery patients. J Card Surg 2022; 37:3445. [DOI: 10.1111/jocs.16739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Aashray K. Gupta
- Department of Cardiothoracic Surgery Royal Adelaide Hospital Adelaide South Australia Australia
- Adelaide Medical School Adelaide Australia
| | | | | | - Hugh C. Cullen
- Department of Cardiothoracic Surgery Royal Adelaide Hospital Adelaide South Australia Australia
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12
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Gupta AK, Kovoor JG, Ovenden CD, Cullen HC. Paradigm shift: Beyond the COVID-19 era, is YouTube the future of education for CABG patients? J Card Surg 2022; 37:2292-2296. [PMID: 35578374 PMCID: PMC9322273 DOI: 10.1111/jocs.16617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/02/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients commonly use YouTube for education, and this may have increased due to COVID-19 related restrictions on access to healthcare professionals. However, YouTube videos lack peer review and regulation. To assess patient education in the COVID-19 era, we analyzed the quality of YouTube videos on coronary artery bypass graft (CABG) surgery. METHODS We searched YouTube using the phrase "coronary artery bypass graft." Two authors individually used the Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems, to rate the first 50 videos retrieved. Data collected for each video included; number of views, duration since upload, percentage positivity (proportion of likes relative to total likes plus dislikes), number of comments, and video author. Interobserver reliability was assessed using an intraclass correlation coefficient (ICC). Associations between video characteristics and quality were tested using linear regression or t-tests. RESULTS The average number of views was 575,571. Average quality was poor, with mean scores of 1.93/4 (ICC 0.54) for JAMA criteria, 2.52/5 (ICC 0.78) for DISCERN criteria, and 4.04/8 (ICC 0.66) for HON criteria. Videos uploaded by surgeons scored highest overall (p < .05). No other factors demonstrated significant association with video quality. CONCLUSION YouTube videos on CABG surgery are of poor quality and may be inadequate for patient education. Given the complexity of the procedure and that beyond the COVID-19 era, patients are more likely to seek education from digital sources, treating surgeons should advise of YouTube's limitations and direct patients to reliable sources of information.
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Affiliation(s)
- Aashray K Gupta
- Department of Cardiothoracic Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Surgery, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Joshua G Kovoor
- Discipline of Surgery, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Christopher D Ovenden
- Discipline of Surgery, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Hugh C Cullen
- Department of Cardiothoracic Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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