cardiothoracic

Retrograde Cerebral Perfusion (RCP)

Retrograde cerebral perfusion (RCP) is a neuroprotective technique originally described in the early 1990s to deliver cold, oxygenated blood via the cardiopulmonary bypass (CPB) circuit to the cerebral vasculature by way of the superior...

Type A Dissection

Acute ascending aortic dissection (type A) is a true surgical emergency. Arterial walls are comprised of the intima (innermost layer), media, and adventitia (outermost layer). In a dissection, an intimal tear creates a plane...
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Lumbar Drain

Lumbar drains are a mainstay for spinal cord protection when patients undergo operations like thoracoabdominal aortic aneurysm (TAAA) repairs and thoracic endovascular aortic repairs (TEVAR) with subclavian artery debranching. Why? Because the anterior spinal...

Anesthetic Considerations For Cardiac Compression And Tamponade

Over the course of my training as a cardiac anesthesiologist and intensivist, I've come across many manifestations of cardiac compression ranging from hemorrhagic pericardial effusions to massive clots. Although the general teaching is to...

Chylothorax

The thoracic duct is the primary conduit which carries chyle (lymphatic fluid containing triglycerides, immune cells, proteins, etc.) from the cisterna chyli to the subclavian-jugular vein junction where it empties into the circulatory system....

How Chest Tube Drainage Systems Work

Although small amounts of air and fluid in the pleural space are generally well tolerated, pneumothorax, hemothorax, chylothorax, etc. necessitates chest tube placement. For large air collections, smaller bore tubes can often be utilized...

Antegrade Cerebral Perfusion (ACP)

Deep hypothermic circulatory arrest ("circ arrest") is often required for partial or total aortic arch reconstructions. At this point in the surgery, there is no blood flow anywhere. Because of systemic cooling, we mitigate...

Double Lumen Endotracheal Tubes (DLT)

Double lumen endotracheal tubes (DLTs) are considered the gold standard for lung isolation - a procedure where we selectively ventilate a single lung or lobe. This is necessary to "protect" healthy lung tissue from...

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