https://lnkd.in/gDziQ92Q Delighted to share our latest work exploring thrombotic risk in patients undergoing CRS + HIPEC. This study focuses on a key challenge in peritonectomy practice, namely high postoperative pulmonary embolism rates and identifying those most at risk. Key Findings: - ROTEM-defined hypercoagulability was common preoperatively (39–77%, depending on definition) - Postoperative PE rates were significant (11% at 7 days, 18% at 30 days) - Bayesian modelling consistently demonstrated a strong association between hypercoagulability and PE risk (RR ~1.7–2.1) - There was poor agreement between existing ROTEM definitions, highlighting a lack of standardisation in this space These findings suggest a potential role for ROTEM in risk stratification, though standardised criteria and prospective validation are needed. A big thank you to the multidisciplinary team across surgery and anaesthesia at St George Hospital. #CRSHIPEC #PeritonealMalignancy #Surgery #Thrombosis #ROTEM #Research

🔴 𝗠𝗶𝗻𝗶𝗺𝗮𝗹𝗹𝘆 𝗶𝗻𝘃𝗮𝘀𝗶𝘃𝗲 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗯𝘆𝗽𝗮𝘀𝘀 𝗶𝗻 𝗮 𝗻𝗼𝗻-𝘃𝗶𝘀𝗶𝗯𝗹𝗲 𝗹𝗲𝗳𝘁 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 𝗱𝗲𝘀𝗰𝗲𝗻𝗱𝗶𝗻𝗴 𝗮𝗿𝘁𝗲𝗿𝘆 𝗮𝗳𝘁𝗲𝗿 𝘀𝗶𝗹𝗲𝗻𝘁 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝗶𝗻𝗳𝗮𝗿𝗰𝘁𝗶𝗼𝗻❤️🩹 I recently operated on a young patient with a 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝗶𝗻𝗳𝗮𝗿𝗰𝘁𝗶𝗼𝗻 that had gone clinically unrecognized. As a consequence, he was left without vascularization in the anterior territory, specifically with a 𝐧𝐨𝐧-𝐯𝐢𝐬𝐢𝐛𝐥𝐞 𝗹𝗲𝗳𝘁 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 𝗱𝗲𝘀𝗰𝗲𝗻𝗱𝗶𝗻𝗴 𝗮𝗿𝘁𝗲𝗿𝘆 (𝐋𝐀𝐃). 🩺 Clinical context Despite the apparent severity, myocardial scintigraphy showed a significant 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝘃𝗶𝗮𝗯𝗶𝗹𝗶𝘁𝘆, with approximately 80% of the myocardium preserved. However, the LAD was not vascularized and therefore not visualized on coronary angiography. Based on this finding, several centers considered that 𝗰𝗮𝗿𝗱𝗶𝗮𝗰 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 𝐰𝐚𝐬 𝐧𝐨𝐭 𝐟𝐞𝐚𝐬𝐢𝐛𝐥𝐞 𝐚𝐧𝐝 𝐭𝐡𝐞 𝐩𝐚𝐭𝐢𝐞𝐧𝐭 𝐰𝐚𝐬 𝐝𝐞𝐜𝐥𝐢𝐧𝐞𝐝. ⚙️ Technical approach I recommended repeating the angiography with a modified protocol, allowing a longer contrast delay. This simple adjustment enabled visualization of the LAD. The patient underwent 𝗺𝗶𝗻𝗶𝗺𝗮𝗹𝗹𝘆 𝗶𝗻𝘃𝗮𝘀𝗶𝘃𝗲 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗯𝘆𝗽𝗮𝘀𝘀 via 𝗺𝗶𝗻𝗶-𝘁𝗵𝗼𝗿𝗮𝗰𝗼𝘁𝗼𝗺𝘆, performing a 𝗟𝗜𝗠𝗔-𝘁𝗼-𝗟𝗔𝗗 𝗯𝘆𝗽𝗮𝘀𝘀. Intraoperatively, the vessel proved to be of good caliber, although affected by atherosclerosis. Importantly, there was a well-developed collateral circulation, with retrograde flow through septal branches, clearly visible at the level of the bypass anastomosis. 💡 Takeaway This case highlights the importance of: - correctly assessing 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝘃𝗶𝗮𝗯𝗶𝗹𝗶𝘁𝘆 - adapting imaging techniques before ruling out revascularization The procedure was successful, and the patient was discharged on postoperative day 4. 📞 Patients who have been advised to schedule a 𝐜𝐚𝐫𝐝𝐢𝐨𝐯𝐚𝐬𝐜𝐮𝐥𝐚𝐫 𝐬𝐮𝐫𝐠𝐞𝐫𝐲 𝐜𝐨𝐧𝐬𝐮𝐥𝐭𝐚𝐭𝐢𝐨𝐧 can book now an appointment at: +𝟒 𝟎𝟕𝟓𝟗 𝟎𝟑𝟒 𝟐𝟎𝟒. #TheodorCebotaru #DrTheodorCebotaru #CardiacSurgery #CoronaryBypass #MinimallyInvasiveCardiacSurgery #CardiovascularSurgery #CoronaryArteryDisease #M𝗶𝗻𝗶T𝗵𝗼𝗿𝗮𝗰𝗼𝘁𝗼𝗺𝘆 #M𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹I𝗻𝗳𝗮𝗿𝗰𝘁𝗶𝗼𝗻 #A𝗻𝘁𝗲𝗿𝗶𝗼𝗿D𝗲𝘀𝗰𝗲𝗻𝗱𝗶𝗻𝗴A𝗿𝘁𝗲𝗿𝘆 #𝐋𝐀𝐃

🔴 A case that reminded me how important it is not to stop at the first “no”. A young patient with a 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝗶𝗻𝗳𝗮𝗿𝗰𝘁𝗶𝗼𝗻 that went unnoticed was left without a visible 𝗹𝗲𝗳𝘁 𝗮𝗻𝘁𝗲𝗿𝗶𝗼𝗿 𝗱𝗲𝘀𝗰𝗲𝗻𝗱𝗶𝗻𝗴 𝗮𝗿𝘁𝗲𝗿𝘆 (LAD). Despite a high degree of 𝗺𝘆𝗼𝗰𝗮𝗿𝗱𝗶𝗮𝗹 𝘃𝗶𝗮𝗯𝗶𝗹𝗶𝘁𝘆, the case was initially considered inoperable. 👉 Instead of accepting that conclusion, we reassessed the imaging strategy. 👉 A simple adjustment in the angiographic protocol made the difference — the LAD became visible. I performed a 𝗺𝗶𝗻𝗶𝗺𝗮𝗹𝗹𝘆 𝗶𝗻𝘃𝗮𝘀𝗶𝘃𝗲 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗯𝘆𝗽𝗮𝘀𝘀 using a 𝗟𝗜𝗠𝗔-𝘁𝗼-𝗟𝗔𝗗 graft, and intraoperatively the vessel proved to be suitable for revascularization, with good collateral support. ✔️ Good surgical outcome ✔️ Discharge on postoperative day 4 💡 This case reinforces a key principle: sometimes, the difference lies in looking one step further — both diagnostically and surgically. Curious to hear your perspective: how often do you reconsider “non-visualized” vessels in similar scenarios? 👇 📞 Patients who have been advised to schedule a 𝐜𝐚𝐫𝐝𝐢𝐨𝐯𝐚𝐬𝐜𝐮𝐥𝐚𝐫 𝐬𝐮𝐫𝐠𝐞𝐫𝐲 𝐜𝐨𝐧𝐬𝐮𝐥𝐭𝐚𝐭𝐢𝐨𝐧 can book now an appointment at: +𝟒 𝟎𝟕𝟓𝟗 𝟎𝟑𝟒 𝟐𝟎𝟒.

Proud to share our new publication with a select group of academic colleagues in the Journal of Cardiothoracic Surgery: Postoperative magnesium sulfate and atrial fibrillation after coronary artery bypass grafting: a single-center retrospective comparative cohort study Our findings suggest that early postoperative magnesium sulfate after on-pump CABG was associated with lower rates of postoperative atrial fibrillation, fewer premature ventricular contractions, and a shorter hospital stay. Read the article here: https://lnkd.in/dimJkxv7 #JournalofCardiothoracicSurgery #CardiacSurgery #CABG #AtrialFibrillation #MagnesiumSulfate #CardiovascularResearch #NursingResearch #OpenAccess

Nine observational studies were included. There was no significant difference found for the following outcomes: procedural death, 30-day mortality, 1-year all-cause mortality, annulus rupture, acute kidney injury, stroke, and moderate/severe paravalvular leak between BEV and SEV.Still, having a BEV was associated with a lower risk of needing a pacemaker or requiring second valve surgery. From this analysis, it seems that BEVs may provide better results than SEVs in terms of reducing the need for a pacemaker and a second valve in patients with BAV stenosis treated with TAVR. The number of deaths and serious complications was about the same for the two valves. Additional randomized controlled trials are needed to study both the lasting effects and the factors that shape these results. Balloon-expandable vs. self-expandable transcatheter aortic valve implantation in bicuspid aortic valve stenosis: a meta-analysis of observational studies. https://lnkd.in/dQMDai8d

Surgical Correction of Craniosynostosis. A Single Institution’s Outcome Analysis of 70 Patients (Kilipiris et al, 2017). DOI: https://lnkd.in/d4qQW2nr ABSTRACT Purpose: The goal of the current study is to provide outcome data for open cranial vault reconstruction at a single institution by a single craniofacial-neurosurgical team. Patients and Methods: A total of 70 patient records were reviewed. The inclusion criteria were patients less than 3 years of age undergoing primary surgery with open cranial vault reshaping and a minimum follow up time of 2 years. Findings: Of the 70 patients meeting the selection criteria (32 female, 38 male), 5 were syndromic and 65 nonsyndromic. Average age and weight were 8.8 months and 9 kg respectively. The oldest child was 21 months and the youngest 3.5 months at the time of surgery. The estimated blood volume lost was 35.8% of total calculated blood volume. Average surgical time was 223.2 minutes. Conclusion: Our review of 70 open repairs of patients with craniosynostosis demonstrates good long-term results with an overall low complication rate and represents open cranial vault reconstruction as a valuable method for repair of such defects. FIGURE 4. CT scan coronal projection of one patient developing a subgaleal hematoma (arrow) requiring drainage postoperatively. #craniosynostosis EVANGELOS KILIPIRIS OMF Publishing

Editor’s Choice: Universal ESD outperforms selective EMR in early esophageal adenocarcinoma   In a cohort of 311 esophageal adenocarcinomas, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) were appropriately selected in only 63% and 61% of cases, respectively, indicating substantial misclassification. ESD consistently achieved superior R0 resection rates for both T1a and T1b lesions (93% and 63%) compared with EMR (80% and 27%); thus current endoscopic triage is frequently inadequate. Given its markedly higher complete resection rates and its potential to prevent unnecessary surgery, ESD should be considered the preferred resection strategy for early esophageal adenocarcinoma.   Find the article at: https://lnkd.in/dbAMbGk9 Fadi Younis, Thomas Rösch, Mario Anders et al. Universal submucosal dissection outperforms selective mucosal resection in early esophageal adenocarcinoma   Endoscopy 2026; 58: 443–453 DOI 10.1055/a-2767-6165 ISSN 0013-726X © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG, Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany   Empowering GI Professionals! 💪🌐 Join the #EndoscopyJrnl community on LinkedIn and discover the latest innovations in endoscopy   #Endoscopy #Gastroenterology European Society of Gastrointestinal Endoscopy (ESGE)  

Fascinating retrospective study in Endoscopy Journal - a prelude to randomised results in the future. In short, we are not yet good enough to differentiate between T1a and T1b in the oesophagus during the pre-resection endoscopic assessment. ESD leads to higher rates of R0 resection vs. EMR (82.0% vs 71.3%) given this. However, curative resection rates for T1a were not significantly different (80.5% vs. 78.4%) although T1b resections with ESD resulted in higher curative rates (23.9% vs 13.3% for EMR). As such, until we are able to better determine invasion depth endosocpically, a universal ESD approach may be preferable for centres that can support such a strategy. I will certainly be having this conversation with colleagues in my unit; Christian Mårtensson, Per Löfdahl and Jóhann P. Hreinsson, feel free to opine in the comments. However, there are currently at least two ongoing RCTs exploring this very question, and these may more convincingly tell us which strategy to employ. Results are eagerly awaited. #endoscopy #barretts #esd #emr

#DYK New-onset atrial fibrillation (AFib) is one of the most common complications after heart surgery, affecting up to 50% of patients and often leading to longer hospital stays, reduced quality of life and increased risks of stroke, heart failure and death. Researchers at Sarasota Memorial’s Kolschowsky Research and Education Institute are working to address this challenge through participation in the BoxX-NoAF clinical trial. Led locally by Jeffrey Sell, MD, FACS, cardiothoracic surgeon with Sarasota Memorial's First Physicians Group, the study will evaluate whether performing surgical ablation and left atrial appendage exclusion (LAAE) during planned heart surgery can safely and effectively reduce new-onset AFib in patients who have risk factors for the condition but no prior history of it. 💬 “If successful, this approach could provide physicians with a proactive strategy to help prevent AFib before it begins, potentially improving recovery and reducing complications for thousands of heart surgery patients each year,” said Dr. Sell.