Episode 130: Adults with Congenital Heart Disease with Jochen Steppan

In this 130th episode I welcome back Dr. Jochen Steppan to discuss the perioperative care of adults with congenital heart disease. We discuss the incidence, evaluation and management including the different types of physiology that a provider might see and how to manage each one.

References:

http://www.pted.org/ For pictures of the lesions

Stoelting’s Anesthesia and Co-Existing Disease, 7th EditionChapter 7 “Congenital Heart Disease” by Jochen Steppan and Bryan Maxwell 

Int Anesthesiol Clin. 2018 Fall;56(4):3-20. “When Your 35-Year-Old Patient has a Sternotomy Scar: Anesthesia for Adult Patients with Congenital Heart Disease Presenting for Noncardiac Surgery” By Cheema A, Ibekwe S, Nyhan D, Steppan J.

Episode 105: Blood Management Part 1 With Drs. Frank & Cha

In this 105th episode, which will be the first part in a series on blood management, I turn over the mic to Dr. Stephanie Cha who interviews Dr. Steve Frank about blood management in cardiac surgery and how to do “bloodless” surgery for patients who refuse blood transfusions.

References:

1.         Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussieres JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S, Network AIotACT. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med 2017;376:136-48.
2.         Frank SM, Wick EC, Dezern AE, Ness PM, Wasey JO, Pippa AC, Dackiw E, Resar LM. Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion 2014;54:2668-77.
3.         Cho BC, DeMario VM, Grant MC, Hensley NB, Brown CHt, Hebbar S, Mandal K, Whitman GJ, Frank SM. Discharge hemoglobin level and 30-day readmission rates after coronary artery bypass surgery. Anesth Analg 2018.
4.         Pattakos G, Koch CG, Brizzio ME, Batizy LH, Sabik JF, 3rd, Blackstone EH, Lauer MS. Outcome of patients who refuse transfusion after cardiac surgery: A natural experiment with severe blood conservation. Arch Intern Med 2012;172:1154-60.
5.         Frank SM, Scott AV, Resar LM. Bloodless medicine and surgery: Top 10 things to consider.Anesthesiology News 2016.

Episode 101: Coming off Bypass with Stephen Freiberg

In this 101st episode I welcome back Dr. Stephen Freiberg to the show to discuss how to successfully come off bypass when doing cardiac surgery with cardiopulmonary bypass.

References:

-Barash Anesthesia for Cardiac Surgery
-Barry AE, Chaney MA, London MJ. Anesthetic management during cardiopulmonary bypass: a systematic review. Anesth Analg 2015; 120:749.
-Denault AY, Tardif JC, Mazer CD, et al. Difficult and complex separation from cardiopulmonary bypass in high-risk cardiac surgical patients: a multicenter study. J Cardiothorac Vasc Anesth 2012; 26:608.
-Lomivorotov VV, Efremov SM, Kirov MY, et al. Low-Cardiac-Output Syndrome After Cardiac Surgery. J Cardiothorac Vasc Anesth 2017; 31:291.
-McKinlay KH1, Schinderle DB, Swaminathan M, Podgoreanu MV, Milano CA, Messier RH, El-Moalem H, Newman MF, Clements FM, Mathew JP.JPredictors of inotrope use during separation from cardiopulmonary bypass.  Cardiothorac Vasc Anesth. 2004 Aug;18(4):404-8.

Episode 93: CABG with Tom Metkus

In the episode, episode 93, I welcome Dr. Tom Metkus back to the show to discuss perioperative considerations for CABG surgery.

References:

Syntax Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0804626

STICH Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1100356

ROOBY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa0902905

CORONARY Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1200388

PREVENT IV Trial: https://www.ncbi.nlm.nih.gov/pubmed/16287955

ART Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1610021

Episode 91: Perioperative evaluation for non-cardiac surgery with Tom Metkus

In this episode, episode 91, I welcome Dr. Tom Metkus back to the show to discuss how we risk-stratify patients for non-cardiac surgery.

References:

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000104

http://www.onlinejacc.org/content/64/22/e77

https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-ESA-Guidelines-on-non-cardiac-surgery-cardiovascular-assessment-and-managemhttp://

www.onlinejacc.org/content/accj/69/14/1861.full.pdf

Episode 88: ERAS for Cardiac Surgery with Mike Grant

In this episode, episode 88, I welcome Dr. Mike Grant to the show to discuss Enhanced Recovery After Surgery (ERAS) protocols for cardiac surgery.

References:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Enhanced+recovery+after+surgery+pathway+for+patients+undergoing+cardiac+surgery%3A+a+randomized+clinical+trial

https://www.ncbi.nlm.nih.gov/pubmed/?term=Enhanced+Recovery+for+Cardiac+Surgery+Noss

https://www.ncbi.nlm.nih.gov/pubmed/27321791

https://www.ncbi.nlm.nih.gov/pubmed/?term=27832832

Episode 87: Aortic Dissection with Tom Metkus

In this episode, episode 87, I welcome Dr. Tom Metkus to the show.  Dr. Metkus is a cardiologist and intensivist and we discuss the etiology, presentation, management and outcomes of acute aortic dissections.

Outline by Brian Park: Aortic Dissection Outline

Episode 83: AICDs and Pacemakers with Jared Miller

In this episode, episode 83, I welcome Dr. Jared Miller to the show.  Dr. Miller is finishing his electrophysiology fellowship and we discuss the preoperative management of pacemakers and AICDs.

Outline by Brian Park: AICD Outline

Reference:

https://www.ncbi.nlm.nih.gov/pubmed/24182719

Episode 79: Pediatric Cardiothoracic Anesthesia with Dheeraj Goswami

In this episode, episode 79, I welcome Dr. Dheeraj Goswami to the show to discuss pediatric cardiothoracic anesthesiology.  We discuss the training required to do these cases, the most common cases and concerns, and how it differs from other forms of anesthesia.

Episode 59: Pulmonary HTN with Jochen Steppan

In this episode, episode 59, I welcome international pulmonary hypertension expert Dr. Jochen Steppan to the show to discuss pulmonary hypertension and how to manage the preoperative care of patients with this disease.

Outline by Brian Park: Outline