Great news from the
#Covid_19
front. Admissions and hospital census down dramatically in greater Phila and most of the world. Let’s be
#data
driven. Need cardiac surgery resurgence now to decrease excess deaths. It’s time to treat cardiac disease!
@STS_CTsurgery
Cover picture on the Thoracic Surgery Foundation (TSF) Annual report. What can I say?The tape is a retro fashion statement! Thanks to all who have given and will give to the
@CTSurgeryFdn
the Charitable Arm of the
@STS_CTsurgery
Distributed a record $1.14 mil to 109 CT Surgeons.
With Sookyeon Kim, owner of our local dry cleaner. PA Gov. Wolf delayed enforcement of order closing 'non-life-sustaining' businesses enabling her to open today. As I entered her store, I noticed that she was wearing an
#N95
mask.
She is aware that I am a cardiac surgeon and immediately offered me a mask. I gratefully accepted because I don’t have one and I’m on call this weekend! Tragically, I had to get my first
#N95
from my dry cleaner because
#Hospitals
don’t have enough of them!
Registration is open for the 4th North American Aortic Valve Repair Symposium! Hope to see my friends and colleagues in Philadelphia in September!
#avrs
#aorta
#HeartSurgery
@pennsurgery
@EACTS
Session in Lisbon on Data integrity, clinical trials, and honest reporting of important trial results was provocative, scientific, contentious, passionate yet civil and full of robust discussion. Great job by
@dompagano
for organizing!
When I asked where she obtained the mask, she stated that her husband purchased them months ago after hearing of the epidemic in their native
#SouthKorea
. Sookyeon previously had thymectomy via sternotomy. (she granted permission to share)
@dompagano
Domenico. The world is with you as we all tackle this terrible virus. I loved the scene in your post: Hope, Beauty, and Action all depicted in one video. I’m so proud of all our Physicians and Nurses. Worldwide.
@VipinZamvar
@RCSEd
@TaviFeb
@STS_CTsurgery
@AATSHQ
@ACCinTouch
Most outcomes are improving over past 7 years however stroke and pacemaker after TAVI in the U.S. have not improved since the introduction of TAVI into the U.S. in 2011. Not good. A challenge for our community! We must improve for the benefit of our patients.
@dompagano
@pin0li
@pomyers
@rafasadaba
@cardiobrief
@CMO_England
Thanks for these updates. The US needs to learn from the Italian data. We are not dissimilar. Rich parts of the world, democratic countries, and generally free. The only difference is that we have a few extra weeks than Italy did. All the respect to your physicians and nurses.
@rafasadaba
I generally do not transect; I try to work around the Innominate Vein. Like others have mentioned, it can be a major nuisance. If I do transect I try to reattach at the end with chest partially closed and will sometimes need a “slightly smaller” diameter Dacron interposition.
@chrisryanburke
@PrashanthVall12
Thanks Chris. An important operation for
#Valve
and
#Aortic
#surgeons
to learn well. Attention to reconstructive detail is critical for great outcomes. We need to continuously teach and also to examine our results with presentations at meetings like
#STS
@dompagano
@pin0li
Like the sunset we see has already happened 10 minutes ago, we see our future in North America by studying the Italian data in a sophisticated manner. We need not rely on empiric models alone. We have some relevant history.
@DrZeigler1
@DrAliAzizzadeh
@keaglemd
@AortaSurg
I believe this is the result of a severe calcium metabolism issue. Possibly emanating from the combination of Renal dysfunction, Pulmonary dysfunction, some family history or genetics. Manifestations are osteopenia and calcified aorta. I’ve seen some of these.
@DrZeigler1
@DrAliAzizzadeh
Wow. Great case. The definition of Cathedral Arch. Absolutely “High Gothic”. Sainte-Chapelle worthy!! Not too unusual in RIGHT arches. I think the LV wire was a fine enabling technique. My experience: keep an eye for Retrograde Dissection as the conformation is significant.
@DrZeigler1
@DrAliAzizzadeh
@keaglemd
@AortaSurg
If he’s quite young, then one will probably have to offer a definitive treatment realizing that there is a mortality risk with that route. Difficult decision. Need shared decision making here.
@dompagano
@pin0li
Yes. The prediction models used so far in the US have been horrific. Wrong in multiple domains since early March. The overall Italian national and regional data is terrific.
@dompagano
@pin0li
Philadelphia is exactly 20 days behind Emilia Romagna and Veneto. Philadelphia's relationship to the National epicenter (NYC) is exactly the same as ER and Veneto are to Lombardia. We can learn from these facts. Kudos to the Italian dataset!
@DrZeigler1
@DrAliAzizzadeh
@keaglemd
@AortaSurg
That definitive procedure could be done sequentially but need to be prepared for concomitant procedures. If inflammatory, would be nice to calm that down a bit first.....
@DrZeigler1
@DrAliAzizzadeh
@keaglemd
@AortaSurg
There could also be a significant inflammatory component with sed rates, CRP, etc. treatment will probably require a more precise diagnosis but eventually will need (depending on severity): Proximal Aortic Repair (I would favor an Ascending plus Zone 2 Arch).
@DrZeigler1
@DrAliAzizzadeh
@keaglemd
@AortaSurg
However, if lungs are that bad may need to be done “With a Lung Transplant”. We’ve done the combination of Double Lung Transplant with Proximal Aortic surgery. May end up on Dialysis. Must address the CAD as well.