Heterotopic Heart Transplantation

The heterotopic heart transplant was pioneered by Christian Barnard in the late 1970s as a way to treat acute rejection in the pre-cyclosporine era. The technique was also used for the treatment of severe pulmonary hypertension, in patients unable to have an orthotopic heart transplant. Some surgeons have used the heterotopic heart transplant as a way to increase the donor heart pool around the world in more recent years. The heterotopic heart transplant is a good viable option for severe pulmonary hypertension patients, and, severe pulmonary vascular resistance patients, who would otherwise, not qualify for an orthotopic heart transplant. The outcomes for these recipients have been comparable to survival outcomes for similar orthotopic heart transplant recipients

A Guide to Academic Podcasting

THIS GUIDEBOOK is an open educational resource for current and future Amplify podcasters, and anyone interested in how to approach academic podcasting. What is academic podcasting? And why might you want to start an academic podcast in the first place? Academic podcasting is the communication of scholarly knowledge through the digital medium of podcasting. Podcasting can take on many forms, including interviews, audio documentary, fiction, or experimental sound forms. Podcasting can be a radical, open, and subversive way of creating publicly accessible and community engaged scholarship. We hope you’ll find this guidebook useful in the classroom, in the studio, and even at home, alongside your cup of morning coffee. Think of this as an invitation into the world of academic podcasting that you can return to time and time again throughout the development of your podcast. While this guidebook is far from exhaustive, we hope it will offer you a selection of best practices, templates, and resources that will benefit seasoned producers and podcast newcomers alikehttps://scholars.wlu.ca/books/1002/thumbnail.jp

The Amplify Manifesto: Rewind, Replay, Reflect

We are the Amplify Podcast Network, a research project working to develop sustainable models for producing, peer-reviewing, and publishing scholarly podcasts. The Amplify Manifesto aims to capture the spirit of our network: playful, experimental, and multi-voiced. As a radically political written form, the manifesto provides a creative ground to communicate a set of ideals, goals, and intentions with purpose. In revisiting the manifesto for Radio Doc Review, we unpack the construction of the manifesto as sound-first multimodal scholarship

Commentary: Cannulate, extubate, ambulate, but not so easy to replicate

This article is made available for unrestricted research re-use and secondary analysis in any form or be any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Comment on doi: 10.1016/j.jtcvs.2022.02.04

Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia and circulatory arrest

Background Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds. Methods Open repair of arch by left thoracotomy and descending thoracic and thoracoabdominal aortic pathology using deep hypothermia was performed in 664 patients from 1995 to 2015. A subset of this cohort had chronic thoracoabdominal aortic dissection (n = 196). All nonemergency cases received coronary angiography and echocardiography preoperatively. Significant coronary artery disease or severe aortic insufficiency was addressed before repair of the chronic dissection. In recent years, lumbar drains were placed preoperatively in the most extensive repairs (extents II and III). Important intercostal arteries from T8 to L1 were revascularized with smaller-diameter looped grafts. Multibranched grafts for the visceral segment have been preferred in recent years. Results Mean age of patients was 58 ± 14 years. Men comprised 74% of the cohort. Aortopathy was confirmed in 18% of the cohort. Prior thoracic aortic repair occurred in 57% of patients, and prior abdominal aortic repair occurred in 14% of patients. Prior type A aortic dissection occurred in 44% of patients, and prior type B occurred in 56% of patients. Operative mortality was 3.6%, permanent spinal cord ischemia occurred in 2.6% of patients, permanent hemodialysis occurred in 0% of patients, and permanent stroke occurred in 1% of patients. Reexploration for bleeding was 5.1%, and respiratory failure requiring tracheostomy occurred in 2.6%. Postoperative length of stay was 11.9 ± 9.7 days. Reintervention for pseudoaneurysm or growth of a distal aneurysm was 6.9%. The 1-, 5-, and 10-year survivals were 93%, 79%, and 57%, respectively. Conclusions Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia and circulatory arrest has low morbidity and mortality. The need for reintervention is low, and long-term survival is excellent. We believe that open repair continues to be the gold standard in patients who are suitable candidates for surgery

Acute respiratory distress syndrome in the cardiothoracic patient: State of the art and use of veno-venous extracorporeal membrane oxygenation

Central Message: Acute respiratory distress syndrome after cardiopulmonary bypass can be managed with veno-venous extracorporeal membrane oxygenation

Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft

Background Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. Methods Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016. Intravenous antibiotics were continued postoperatively for 6 weeks. Long-term suppressive antibiotics were uncommonly used (8 patients). Follow up imaging occurred at 6, 18 and 42 months postoperatively. Initial follow up was 93% complete. Results Males comprised 64% of the cohort. The mean age was 63±14 years. The procedures performed included reoperations in 37, replacement of the aortic root, ascending aorta or transverse arch in 19, replacement of the descending or thoracoabdominal aorta in 27 and extensive replacement of the ascending, arch and descending or thoracoabdominal aorta in 4. Intraoperative cultures revealed most commonly staphylococcus 24%), enterococcus (12%), candida (6%) and gram negative rods (14%). Operative mortality was 8%, stroke 4%, paralysis 2%, hemodialysis 6%, and respiratory failure requiring tracheostomy 6%. Early reoperation for pseudoaneurysm of the CPA was necessary in 4 patients. One, two and five year survival was 84%, 76% and 64%, respectively. Conclusions Radical resection and in-situ reconstruction with CPA avoids placing prosthetic material in an infected field and provides good early and mid-term outcomes. However, early postoperative imaging is necessary given the risk of pseudoaneurysm formation

Multispecies Livelihoods: A Posthumanist Approach to Wildlife Ecotourism That Promotes Animal Ethics

Research on animal ethics in tourism has gained traction but posthumanist approaches to wildlife (eco)tourism remain sparse. There has never been a more urgent need to redress this paucity in theory and practice. More than 60% of the world’s wildlife has died-off in the last 50 years, 100 million-plus nonhuman animals are used for entertainment in wildlife tourist attractions (WTAs), more than one billion “wildlife” live in captivity, and some scholars argue that earth has entered its sixth mass extinction event known as the Anthropocene. This paper presents a posthumanist multispecies livelihoods framework (MLF) based on an applied ethnographic study of 47 wildlife ecotourism (WE) operators and wildlife researchers in protected area WTAs across four countries. Like any framework, it is a snapshot of the authors’ thinking at a particular time and must be improved upon. The MLF does not purport to solve the negative treatment of nonhumans that can occur in tourism settings, but rather responds to calls in the tourism literature to acknowledge our effects on other species and advocates for equitable human-nonhuman livelihoods. This paper argues that we have a moral responsibility to nonhumans and the environment, and the authors hope to generate reflexive discourse concerning the role tourism can play in redressing the ecological crisis and improving the treatment of individual nonhumans to foster wildlife-human coexistence

Aortic dissections in Marfan disease during pregnancy: Review article

We want to thank Dr. Raveenthiran and Dr. Harky for their interest in our paper and in the topic of Marfans in the setting of pregnancy. Certainly, the reduction of adverse outcomes would be improved with early knowledge of Marfans syndrome in the mother which would aid in preparation and clinical consideration during the perioperative period, and, prior to pregnancy