cardiothoracic

As part of traditional cardiac surgeries, the aorta can be extensively manipulated - especially when performing arterial cannulation and applying the aortic cross-clamp. This can dislodge plaques systemically leading to strokes and other…

There’s a complex yet beautiful architecture within the heart's fibrous skeleton and valvular geometry. To become a proficient perioperative echocardiographer, one must understand these spatial relationships in three dimensions and the…

Mechanical circulatory support (MCS) devices allow us to offload myocardial work from the heart, and for the purposes of this post, the left ventricle (LV). Referring to my previous post on the work of breathing, we can extrapolate the same…

"Starling forces" describe the movement across capillaries as a balance between hydrostatic and oncotic pressure gradients within the capillary and in the surrounding interstitium. Filtration across the capillary membrane occurs along its…

Left ventricular outflow tract (LVOT) obstruction is a potentially catastrophic etiology for hypotension due to several etiologies: idiopathic hypertrophic subaortic stenosis (IHSS), hypertrophic obstructive cardiomyopathy (HOCM), systolic…

A standard double lung transplantation includes a series of steps involving incision (median sternotomy or clamshell thoracotomy), cardiopulmonary bypass (CPB) in many cases, right and left pneumonectomies of the native lungs, preparation…

Pleurodesis is a procedure aimed to obliterate the intrapleural space and is performed for recurrent malignant/non-malignant effusions and recurrent pneumothorax. 

Impella® is a percutaneous axial heart pump placed retrograde across the aortic valve into the left ventricle (LV) utilizing fluoroscopy +/- echocardiography. Its indications include high risk percutaneous coronary intervention (PCI,…

This post outlines the steps in traditional, central cannulation for cardiopulmonary bypass (CPB). Depending on the nature of the surgery and patient's comorbidities, other sites are often cannulated (left heart bypass, femoral-femoral…

My Littmann Cardiology III black edition served me well for all of medical school and residency, and over eight years later, I'm now replacing it for my second stethoscope - the Littmann Master Cardiology black edition.