Episode 146: Critical Care Ultrasound with Lee Goeddel

In this 146th episode I welcome back Dr. Lee Goeddel to the show to discuss critical care ultrasound including how it differs from POCUS and how people can prepare for the new certification exam.

References:

Pears and Pitfalls in Critical Care Ultrasonography: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693549/

Episode 140: Transfusion Triggers and The TRICS 3 Trial with David Mazer

In this 140th episode I welcome Dr. David Mazer to the show. Dr. Mazer was the PI and first author on the TRICS 3 trial looking at liberal versus restrictive transfusion strategies in moderate to high risk cardiac surgery patients published in the NEJM in 2017.

Dr. Mazer would like to add the following random recommendation: For a great combination of live jazz and good food and drinks in Toronto, check out the Jazz Bistro just up the street from St. Michael’s Hospital.

Reference: https://www.nejm.org/doi/full/10.1056/NEJMoa1711818

Dr. Mazer can be reached at David.Mazer@UnityHealth.To

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