1
|
Yin C, Muller Moran HR, Arora RC. Commentary: In it for the long haul: Posthospital recovery after venovenous extracorporeal membrane oxygenation for coronavirus disease 2019-related acute respiratory distress syndrome. J Thorac Cardiovasc Surg 2023; 166:854-855. [PMID: 34998585 PMCID: PMC8683378 DOI: 10.1016/j.jtcvs.2021.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Charles Yin
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hellmuth R Muller Moran
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
| |
Collapse
|
2
|
Muller Moran HR, Spooner AJ, Yamashita MH. Commentary: An all-access pass to transcatheter aortic valve replacement. J Thorac Cardiovasc Surg 2023; 165:1372-1373. [PMID: 34049710 DOI: 10.1016/j.jtcvs.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Hellmuth R Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Aaron J Spooner
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Michael H Yamashita
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.
| |
Collapse
|
3
|
Muller Moran HR, Arora RC. Commentary: How soon is now? Semin Thorac Cardiovasc Surg 2023:S1043-0679(23)00043-6. [PMID: 37001594 DOI: 10.1053/j.semtcvs.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023]
|
4
|
Muller Moran HR, Alakhtar AM, Al-Atassi T, Rubens FD, Arora RC, Lachapelle KJ. Cardiac Surgery Training in the Transcatheter Era. Can J Cardiol 2022; 38:1736-1738. [PMID: 35940455 DOI: 10.1016/j.cjca.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
| | - Ali M Alakhtar
- Department of Surgery, McGill University, Montreal, Quebec, Canada; Department of Surgery, Qassim University, Oassim, Saudi Arabia
| | - Talal Al-Atassi
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Fraser D Rubens
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Rakesh C Arora
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | | |
Collapse
|
5
|
Muller Moran HR, Yamashita MH, Arora RC. Reply: Right, wrong, or somewhere in between? JTCVS Open 2022; 11:153. [PMID: 36172407 PMCID: PMC9510788 DOI: 10.1016/j.xjon.2022.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
6
|
White A, Muller Moran HR, Ryan J, Mador B, Campbell S, Turner SR. Validity Evidence for Procedure-Specific Competency Assessment Tools in Cardiovascular and Thoracic Surgery: A Scoping Review. J Surg Educ 2022; 79:1016-1023. [PMID: 35491353 DOI: 10.1016/j.jsurg.2022.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Surgical education has shifted from a time-based approach to the achievement and demonstration of procedural competency. High quality, objective assessment instruments are required to support this new approach. This study comprehensively reviewed the literature to identify and evaluate available procedure-specific assessment instruments in cardiothoracic and vascular surgery. DESIGN A systematic search of 8 databases identified studies containing procedure-specific operative assessment instruments in cardiothoracic and vascular surgery. Generic global rating scales were excluded, unless modified to be procedure-specific. Two reviewers independently evaluated the validity evidence, methodological rigour and educational utility of each instrument using objective scoring criteria. Validity evidence was evaluated with a scoring tool aligned with the contemporary framework of validity. Methodological rigour was evaluated using the Medical Education Research Study Quality Instrument. Educational utility was evaluated according to the Accreditation Council for Graduate Medical Education (ACGME) framework. RESULTS There were 2130 unique studies describing procedure-specific assessment in surgery. Of these, 9 studies evaluating 8 procedure-specific assessment instruments met inclusion criteria for cardiothoracic and vascular surgery. Four instruments were identified in thoracic surgery, 2 in cardiac surgery, and 2 in vascular surgery. Only 1 instrument was designed to evaluate surgeon performance, with the remainder designed to evaluate residents. No single instrument scored the maximum score of 15 for validity evidence. The highest score was 11, with 62.5% (n = 5) of instruments scoring greater than 10. All tools attained high scores in content validity, with minimal evidence generally presented regarding the consequences of assessment using a particular instrument. All but 1 instrument scored greater than 11 out of a maximum 16.5 points for methodological rigour. Very few studies reported on the ACGME domains of educational utility. CONCLUSIONS In an era where surgical education is shifting towards the demonstration of procedural competency, objective procedure-specific assessment is critical. This review identified that few procedure-specific assessment instruments in cardiothoracic and vascular surgery exist, emphasizing the need for such instruments to ensure the success of competency-based education models.
Collapse
Affiliation(s)
- Abigail White
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | | | - Joanna Ryan
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Brett Mador
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | | | - Simon R Turner
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
7
|
Ahmed Z, Lau CH, Poole M, Arshinoff D, El-Andari R, White A, Johnson G, Doucet VM, Yilmaz R, Shi G, Natheir S, Hampshire J, Fazlollahi AM, Ramazani F, Elfaki L, Wang L, Desrosiers T, Lee M, Nisar M, Parapini ML, Larrivée S, White A, Dhillon J, Deng SX, Balamane S, Lee-Wing V, White A, Lee D, Gibert Y, Gervais V, Daniel R, Minor S, Ko G, Nguyen MA, Zablotny S, Lemieux V, Roach E, Ho J, Aggarwal I, Solish M, Lee JM, Rajendran L, Datta S, Gariscsak P, Johnson G, Del Fernandes R, Daud A, Fahey B, Zafar A, Worrall AP, Kheirelseid E, McHugh S, Moneley D, Naughton P, Fazlollahi AM, Bakhaidar M, Alsayegh A, Yilmaz R, Del Maestro RF, Harley JM, Ungi T, Fichtinger G, Zevin B, Stolz E, Bozso SJ, Kang JJ, Adams C, Nagendran J, Li D, Turner SR, Moon MC, Zheng B, Vergis A, Unger B, Park J, Gillman L, Petropolis CJ, Winkler-Schwartz A, Mirchi N, Fazlollahi A, Natheir S, Del Maestro R, Wang E, Waterman R, Kokavec A, Ho E, Harnden K, Nayak R, Malthaner R, Qiabi M, Christie S, Yilmaz R, Winkler-Schwarz A, Bajunaid K, Sabbagh AJ, Werthner P, Del Maestro R, Bratu I, Noga M, Bakhaidar M, Alsayegh A, Winkler-Schwartz A, Harley JM, Del Maestro RF, Côté D, Mortensen-Truscott L, McKellar S, Budiansky D, Lee M, Henley J, Philteos J, Gabinet-Equihua A, Horton G, Levin M, Saleem A, Monteiro E, Lin V, Chan Y, Campisi P, Meloche-Dumas L, Patocskai E, Dubrowski A, Beniey M, Bélanger P, Khondker A, Kangasjarvi E, Simpson J, Behzadi A, Kuluski K, Scott TM, Sidhu R, Karimuddin AA, Beaudoin A, McRae S, Leiter J, Stranges G, O’Brien D, Singh G, Zheng B, Moon MC, Turner SR, Salimi A, Zhu A, Tsang M, Greene B, Jayaraman S, Brown P, Zelt D, Yacob M, Keijzer R, Shawyer AC, Muller Moran HR, Ryan J, Mador B, Campbell S, Turner S, Ng K, Behzadi A, Benaskeur YI, Kasasni SM, Ammari N, Chiarella F, Lavallée J, Lê AS, Rosca MA, Semsar-Kazerooni K, Vallipuram T, Grabs D, Bougie É, Salib GE, Bortoluzzi P, Tremblay D, Kruse CC, McKechnie T, Eskicioglu C, Posel N, Fleiszer D, Berger-Richardson D, Brar S, Lim DW, Cil TD, Castelo M, Greene B, Lu J, Brar S, Reel E, Cil T, Diebel S, Nolan M, Bartolucci D, Rheault-Henry M, Abara E, Doyon J, Lee JM, Archibald D, Wadey V, Maeda A, Jackson T, Okrainec A, Leclair R, Braund H, Bunn J, Kouzmina E, Bruzzese S, Awad S, Mann S, Appireddy R, Zevin B, Gariscsak P, Liblik K, Winthrop A, Mann S, Abankwah B, Weinberg M, Cherry A, Lemieux V, Doyon J, Hamstra S, Nousiainen M, Wadey V, Marini W, Nadler A, Khoja W, Stoehr J, Aggarwal I, Liblik K, Mann S, Winthrop A, Lowy B, Vergis A, Relke N, Soleas E, Lui J, Zevin B, Nousiainen M, Simpson J, Musgrave M, Stewart R, Hall J. Canadian Conference for the Advancement of Surgical Education (C-CASE) 2021: Post-Pandemic and Beyond Virtual Conference AbstractsBlended learning using augmented reality glasses during the COVID-19 pandemic: the present and the futureActivating emotions enhance surgical simulation performance: a cluster analysisTraining in soft-tissue resection using real-time visual computer navigation feedback from the Surgery Tutor: a randomized controlled trialSonoGames: delivering a point of care ultrasound curriculum through gamificationTeaching heart valve surgery techniques using simulators: a reviewPortable, adjustable simulator for cardiac surgical skillsDesign and validity evidence for a unique endoscopy simulator using a commercial video gameComparison of a novel silicone flexor tendon repair model to a porcine tendon repair modelAssessment system using deep learningChallenges addressed with solutions, simulation in undergraduate and postgraduate surgical education, innovative education or research in surgical educationMachine learning distinguishes between skilled and less-skilled psychological performance in virtual neurosurgical performanceA powerful new tool for learning anatomy as a medical studentDevelopment and effectiveness of a telementoring approach for neurosurgical simulation training of medical studentsA team based learning approach to general otolaryngology in undergraduate medical educationStudent-led surgery interest group outreach for high school mentorship: a diversity driven initiativeRetrospective evaluation of novel case-based teaching series for first year otolaryngology residentsHarassment in surgery: assessing differences in perceptionFactors associated with medical student interest in pursuing a surgical residency: a cross-sectional survey studyUnderstanding surgical education experiences: an examination of 2 mentorship modelsLeadership development programs for surgical residents: a narrative review of the literatureValidation of knee arthroscopy simulator scoring system against subjective video analysis scoringCharacterizing the level of autonomy in Canadian cardiac surgery residentsMentorship patterns among medical students successfully matched to a surgical specialityStaying safe with laparoscopic cholecystectomy: the use of landmarking and intraoperative time-outsEndovascular aneurysm repair has changed the training paradigm of vascular residentsImplementation of a standardized handover in pediatric surgeryProcedure-specific assessment in cardiothoracic and vascular surgery: a scoping reviewLongitudinal mentorship-based programs for junior medical students increases exposure, confidence, and interest in surgeryCreating a green-shift in surgical education: a scoping review of initiatives and methods to make perioperative care more sustainableA novel plastic surgery residency bootcamp: structure and utilityVideo-based coaching for surgical residents: a systematic review and meta-analysisVirtual patient cases aligned with EPAs provide innovative e-learning strategiesAchieving competency in the CanMEDS roles for surgical trainees in the COVID-19 era: What have we learned and where do we go?Profiles of burnout and response to the COVID-19 pandemic among general surgery residents at a large academic training programLearner-driven telemedicine curriculum during the COVID-19 pandemicCentralized basic orthopaedic surgery virtual examinations — assessment of examination environmentEffects of the COVID-19 pandemic on surgical resident training: a nationwide survey of Canadian program directorsExploring the transition to virtual care in surgery and its impact on clinical exposure, teaching, and assessment during the COVID-19 pandemiecImpact of COVID-19 on procedural skills training and career preparation of medical studentsVirtual surgical shadowing for undergraduate medical students amidst the COVID-19 pandemicEducational impact of the COVID-19 third wave on a competency-based orthopedic surgery programVirtualization of postgraduate residency interviews: a ransforming practice in health care educationAn informational podcast about Canadian plastic surgery training programs: “Doctority Canada: Plastic Surgery.”Virtual versus in-person suture training: an evaluation of synchronous and asynchronous teaching paradigmsMerged virtual reality teaching of the fundamentals of laparoscopic surgery: a randomized controlled trialShould surgical skills be evaluated during virtual CaRMS residency interviews? A Canadian survey of CaRMS applicants and selection committee members during the COVID-19 pandemicImpact of the COVID-19 pandemic on surgical education for medical students: perspectives from Canada’s largest faculty of medicine. Can J Surg 2021. [PMCID: PMC8628843 DOI: 10.1503/cjs.018821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
8
|
Muller Moran HR, Arora RC. Fighting against 'cancel culture' in cardiac surgery. Eur J Cardiothorac Surg 2021; 61:233-234. [PMID: 34179959 DOI: 10.1093/ejcts/ezab304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hellmuth R Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, MB, Canada
| | - Rakesh C Arora
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, MB, Canada
| |
Collapse
|
9
|
Moran HRM, Arora RC, Manji RA. Commentary: The A-B-C's of H-I-T. Semin Thorac Cardiovasc Surg 2021; 34:581-582. [PMID: 34098116 DOI: 10.1053/j.semtcvs.2021.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023]
Affiliation(s)
- Hellmuth R Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rizwan A Manji
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada.
| |
Collapse
|
10
|
Muller Moran HR, Arora RC. Commentary: Searching for liquid gold. JTCVS Open 2021; 6:198-199. [PMID: 36003571 PMCID: PMC9390354 DOI: 10.1016/j.xjon.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
|
11
|
Muller Moran HR, Maurice-Ventouris M, Alharbi M, Harley JM, Lachapelle KJ. A scoping review to identify competencies for transcatheter cardiovascular procedures. J Thorac Cardiovasc Surg 2020; 164:e457-e469. [PMID: 33485666 DOI: 10.1016/j.jtcvs.2020.11.096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/21/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Transcatheter procedures are increasingly being recognized as a priority for cardiac surgeons and cardiac surgery trainees. The optimal method of teaching these procedures during residency training has not been established. We used an evidence-based approach to systematically review the literature and identify competencies to inform future paradigms of transcatheter training in cardiac surgery. METHODS A scoping review was conducted to retrieve relevant literature on the performance of transcatheter cardiovascular procedures, identify competencies required by surgical residents learning to perform these procedures, and develop a preliminary list of competencies for consideration during transcatheter training. MEDLINE, Scopus, and ERIC were queried until April 1, 2020, using a systematic search strategy. No limitations were placed on publication date or type. RESULTS A total of 1456 sources of evidence were retrieved. After deduplication and screening, there remained 33 that were included in the scoping review, published between 2006 and 2020. The distribution of publication types included 10 comparative studies (30.3% of total), 8 societal statements (24.2% of total), 5 surveys and 5 opinion articles (each 15.2% of total), 2 editorials and 2 descriptions of a simulator (each 6.1% of total), and 1 narrative review (3.0% of total). From these, a total of 400 items were identified and organized into 97 competencies. CONCLUSIONS Evidence on the competencies required to perform transcatheter cardiovascular procedures is available from a variety of sources. The identified competencies may be a useful resource for developing curricula and teaching transcatheter procedures to cardiac surgery residents.
Collapse
Affiliation(s)
- Hellmuth R Muller Moran
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Surgery, McGill University, Montreal, Quebec, Canada
| | | | - Mohammed Alharbi
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Jason M Harley
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | | |
Collapse
|
12
|
Muller Moran HR, Yamashita MH, Arora RC. Commentary: Vita ex machina-life from the machine. J Thorac Cardiovasc Surg 2020; 161:1333-1334. [PMID: 33494916 DOI: 10.1016/j.jtcvs.2020.11.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Hellmuth R Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Michael H Yamashita
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.
| |
Collapse
|
13
|
Muller Moran HR, Yamashita MH. Commentary: Preaching to the wire. JTCVS Tech 2020; 4:150-151. [PMID: 34317993 PMCID: PMC8307788 DOI: 10.1016/j.xjtc.2020.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/13/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hellmuth R. Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Michael H. Yamashita
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
- Address for reprints: Michael H. Yamashita, MDCM, MPH, FRCSC, St Boniface Hospital, Y3519—409 Tache Ave, Winnipeg, Manitoba, Canada R2H 2A6.
| |
Collapse
|
14
|
Muller Moran HR, Arora RC. Commentary: Thrombosis and hemorrhage, yin and yang. JTCVS Tech 2020; 4:156-157. [PMID: 34317995 PMCID: PMC8303075 DOI: 10.1016/j.xjtc.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hellmuth R Muller Moran
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba.,Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Division of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba.,Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| |
Collapse
|
15
|
Muller Moran HR, Maguire D, Maguire D, Kowalski S, Jacobsohn E, Mackenzie S, Grocott H, Arora RC. Association of earlier extubation and postoperative delirium after coronary artery bypass grafting. J Thorac Cardiovasc Surg 2019; 159:182-190.e7. [PMID: 31076177 DOI: 10.1016/j.jtcvs.2019.03.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Earlier extubation after cardiac surgery is reported to have benefits on length of stay and complication rates, but the influence on postoperative delirium remains unclear. We sought to determine the effect of earlier extubation on delirium after coronary artery bypass grafting. METHODS A single-center retrospective review of consecutive isolated coronary artery bypass grafting patients from January 1, 2010, to December 31, 2015, was conducted. Baseline demographic characteristics, preoperative comorbidities, intraoperative data, and postoperative data were collected. A multivariable logistic regression was performed with analysis limited to extubation within the first 24 hours postoperatively. RESULTS We identified 2561 eligible patients. Delirium occurred in 13.9% (n = 357). Duration of postoperative mechanical ventilation was associated with higher delirium rates following adjustment, particularly after 12 to 24 hours (hourly odds ratio, 1.12; 95% confidence interval, 1.05-1.19; P < .001). No association was observed during the time period from 0 to 12 hours (hourly odds ratio, 1.02; 95% confidence interval, 0.99-1.06; P = .218). Major adverse events were associated with duration of ventilation after 0 to 12 hours (hourly odds ratio, 1.08; 95% confidence interval, 1.03-1.14; P < .002) but not after 12 to 24 hours (hourly odds ratio, 1.04; 95% CI, 0.96-1.14; P = .316). The overall rate of reintubation was 2.9% (n = 73). CONCLUSIONS Our findings suggest that delirium rates increase with lengthier postoperative ventilation times. This study provides the basis for consideration of the appropriate selection of earlier extubation to minimize delirium in patients undergoing cardiac surgery.
Collapse
Affiliation(s)
- Hellmuth R Muller Moran
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Duncan Maguire
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Doug Maguire
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephen Kowalski
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Eric Jacobsohn
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Scott Mackenzie
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hilary Grocott
- Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada; Department of Anesthesia, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.
| |
Collapse
|
16
|
Muller Moran HR, Dutta V, Yan W, Ghorpade NN, Arora RC, Singal RK, Strumpher J. Extracorporeal membrane oxygenation before surgical repair of a postinfarction ventricular septal defect. J Thorac Cardiovasc Surg 2017; 155:e121-e123. [PMID: 29338861 DOI: 10.1016/j.jtcvs.2017.11.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/07/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Hellmuth R Muller Moran
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Vikas Dutta
- Department of Anesthesia & Perioperative Care, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Weiang Yan
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Nitin N Ghorpade
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Rohit K Singal
- Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Johann Strumpher
- Department of Anesthesia & Perioperative Care, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Winnipeg Regional Health Authority Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.
| |
Collapse
|
17
|
Muller Moran HR, Kass M, Ravandi A, Zieroth S, Schaffer SA, Cordova FJ, Pozeg ZI, Arora RC, Singal RK. Diagnosis of Left Ventricular Assist Device Outflow Graft Obstruction Using Intravascular Ultrasound. Circ Heart Fail 2016; 9:CIRCHEARTFAILURE.116.003472. [DOI: 10.1161/circheartfailure.116.003472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hellmuth R. Muller Moran
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Malek Kass
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Amir Ravandi
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Shelley Zieroth
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - S. Allan Schaffer
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Francisco J. Cordova
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Zlatko I. Pozeg
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Rakesh C. Arora
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| | - Rohit K. Singal
- From the Department of Surgery (H.R.M.M., Z.I.P., R.C.A., R.K.S.) and Department of Medicine (M.K., A.R., S.Z., S.A.S., F.J.C.), Max Rady College of Medicine, University of Manitoba, Canada; and Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada (H.R.M.M., M.K., A.R., S.Z., S.A.S., F.J.C., Z.I.P., R.C.A., R.K.S.)
| |
Collapse
|