Posts

Posted on

SAVR Following TAVR May Present Extra Risks

Patients undergoing surgical aortic-valve replacement (SAVR) following problems with an initial transcatheter aortic-valve replacement (TAVR) appear to have particularly poor outcomes, according to a retrospective analysis.

As Dr. Oliver K. Jawitz told Reuters Health by email, “SAVR after early failure of TAVR devices appears to be a complex, technically demanding procedure associated with long operative times, increased perioperative morbidity, and higher than expected operative mortality.”

In a paper in JACC: Cardiovascular Interventions, Dr. Jawitz of Duke University School of Medicine, in Durham, North Carolina, and colleagues observe that as TAVR grows more popular, management of device failure will become increasingly important. “However,” they say, “the outcomes of re-operation for TAVR failure are unknown.”

Out of about 40,000 TAVR procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the researchers identified 123 patients with a history of prior TAVR who underwent SAVR between 2011 and 2015.

Continue reading
Posted on

COVID-19 : Clinical Guide to Surgical Prioritisation During The Pandemic

This guidance describes levels of surgical priority, covering all surgical specialties with the exception of obstetrics and gynaecology and ophthalmology. Guidance for these disciplines is available separately, with links provided below.

Patients requiring surgery during the COVID-19 crisis have been classified in the following groups:

Priority level 1a Emergency – operation needed within 24 hours

Priority level 1b Urgent – operation needed with 72 hours

Priority level 2 Surgery that can be deferred for up to 4 weeks

Priority level 3 Surgery that can be delayed for up to 3 months

Priority level 4 Surgery that can be delayed for more than 3 months

These time intervals may vary from usual practice and may possibly result in greater risk of an adverse outcome due to progression or worsening of the condition, but we have to work within the resources available locally and nationally during the crisis.

Continue reading
Posted on

Monsoon Car Care Tips

The monsoon season is here and with it brings heavy rainfall that leads to floods, traffic jams and a whole host of other issues. The rains are also very bad for your car as the mid, dirt and water that tends to accumulate in areas can result in rust and electrical issues. So to make sure your car stays in the best shape possible, here are some top tips to ensure your car stays in top shape this monsoon. We also give you some quick tips on how to drive safer and keep your car as protected as it can be this monsoon.

Continue reading
Posted on

Higher Death Risk With Minimally Invasive Surgery in Gynec Cancers, Studies Implicate

Minimally invasive surgery (MIS) is associated with a higher risk for death in comparison to open surgery for patients with gynecologic cancers, according to two new reports.

In the first study, use of MIS for patients with early-stage ovarian cancer was associated with an increased risk for capsule rupture, which in turn led to an increase in mortality.

“There was a striking association between an increased risk of capsule rupture with use of minimally invasive surgery,” said Jason D. Wright, MD, chief, Division of Gynecologic Oncology, Columbia University Herbert Irving Cancer Comprehensive Center, New York City, who was a coauthor for both studies.

“This is certainly worrisome, as there are limited data describing the safety of minimally invasive surgery for ovarian cancer, and we noted that the use of minimally invasive procedures increased substantially,” he added.

Continue reading