Cardiothoracic Surgery Department Research Articles

Prevention of surgical site infections: a personal odyssey

Prevention of surgical site infections: a personal odyssey

A Single-Centre Cardioplegia Audit Using the Troponin-T Biomarker

The cardiothoracic surgery and clinical perfusion departments at this institution recently altered their cardioplegia system and strategy. In an ongoing commitment to best practice, the department has audited the outcomes of this practice change.

CT and PET/CT findings of primary pulmonary malignant melanoma: a case report and literature review.

Primary malignant melanoma of the lung (PMML) is an extremely rare and refractory tumor, and its diagnosis is a significant challenge. The current study presents the case of a 62-year-old man who presented to the Department of Cardiothoracic Surgery (Lishui Municipal Central Hospital, Lishui, China) with chest tightness and fatigue for 3 months. Chest computed tomography (CT) revealed a 1.5- × 1.9-cm mass with irregular borders and heterogenous density located in the right lower lung lobe. Contrast-enhanced CT revealed slight enhancement of the mass, but there was no clear evidence of malignancy. Positron emission tomography (PET)/CT revealed a defined-margin mass, with slightly high uptake (standardized uptake value [SUV]: 3.6). The patient underwent video-assisted thoracoscopic surgery (VATS), and the final diagnosis was PMML on the basis of the results of the pathological examination. The patient received four courses of immunotherapy after the operation, and eventually declined further immunotherapy owing to the high cost. The patient was followed-up for 1 year without metastasis or recurrence.

The clinical German Registry for Acute Aortic Dissection Type A (GERAADA) score: go and see your patient!

Journal Article Accepted manuscript The clinical German Registry for Acute Aortic Dissection Type A (GERAADA) score: Go and see your patient! Get access Maximilian Luehr, MD, PhD Maximilian Luehr, MD, PhD Department of Cardiothoracic Surgery, Heart Center of the University Hospital, University of Cologne, Cologne, Germany Corresponding author: Maximilian Luehr, MD, PhD, Department of Cardiothoracic Surgery, Heart Center of the University Hospital, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany Phone: +49 (0)221 478 32405 Fax: +49 (0) 221 478 32509 E-mail: maximilian.luehr@uk-koeln.de Search for other works by this author on: Oxford Academic PubMed Google Scholar European Journal of Cardio-Thoracic Surgery, ezad169, https://doi.org/10.1093/ejcts/ezad169 Published: 22 April 2023 Article history Received: 16 April 2023 Accepted: 21 April 2023 Published: 22 April 2023

ROMA:Women: Innovative Approaches for the First Cardiac Surgery Trial in Women.

HomeCirculationAhead of PrintROMA-Women: Innovative Approaches for the First Cardiac Surgery Trial in Women Free AccessArticle CommentaryPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessArticle CommentaryPDF/EPUBROMA-Women: Innovative Approaches for the First Cardiac Surgery Trial in Women Mario Gaudino, Stephen E. Fremes, Roxana Mehran, Noel Bairey Merz and on behalf of the ROMA-Women Steering Committee and Investigators Mario GaudinoMario Gaudino Correspondence to: Mario Gaudino, MD, MSCE, PhD, Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065. Email E-mail Address: [email protected] https://orcid.org/0000-0003-4680-0815 From the Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York (M.G.) Search for more papers by this author , Stephen E. FremesStephen E. Fremes https://orcid.org/0000-0003-1723-3049 Division of Cardiac Surgery, Schulich Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Ontario Canada (S.E.F.) Search for more papers by this author , Roxana MehranRoxana Mehran https://orcid.org/0000-0002-5546-262X Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York (R.M.) Search for more papers by this author , Noel Bairey MerzNoel Bairey Merz https://orcid.org/0000-0002-9933-5155 Barbra Streisand Women’s Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA (N.B.M.). Search for more papers by this author and on behalf of the ROMA-Women Steering Committee and Investigators Search for more papers by this author Originally published3 Apr 2023https://doi.org/10.1161/CIRCULATIONAHA.123.064033Circulation. 2023;0FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Sources of Funding and Disclosures, see page XXX.Correspondence to: Mario Gaudino, MD, MSCE, PhD, Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065. Email [email protected]cornell.edu Previous Back to top Next FiguresReferencesRelatedDetails Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.123.064033PMID: 37009730 Originally publishedApril 3, 2023 Keywordscoronary artery diseasecoronary artery bypasswomenthoracic surgeryclinical studies as topicPDF download Advertisement SubjectsCardiovascular SurgeryClinical StudiesCoronary Artery DiseaseCoronary CirculationDisparities

Building Bridges to Longevity: The Value of Composite Bridge Grafting.

Journal Article Accepted manuscript Building Bridges to Longevity: The Value of Composite Bridge Grafting Get access Hristo Kirov, Hristo Kirov Department of Cardiothoracic Surgery, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany Search for other works by this author on: Oxford Academic PubMed Google Scholar Torsten Doenst Torsten Doenst Department of Cardiothoracic Surgery, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany Address for correspondence: Torsten Doenst, MD, PhD, Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, Am Klinikum 1, 07747 Jena, Germany. ph: +49-3641-932-2901 fax: +49-3641-932-2902. email: doenst@med.uni-jena.de Search for other works by this author on: Oxford Academic PubMed Google Scholar European Journal of Cardio-Thoracic Surgery, ezad153, https://doi.org/10.1093/ejcts/ezad153 Published: 21 April 2023 Article history Received: 24 March 2023 Accepted: 20 April 2023 Published: 21 April 2023

Anterior leaflet prolapse: does the evidence imply the need for a change in our repair strategy?

Journal Article Accepted manuscript Anterior leaflet prolapse: does the evidence imply the need for a change in our repair strategy? Get access Anton Tomšič, MD, PhD, Anton Tomšič, MD, PhD Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, Netherlands Corresponding author: Anton Tomšič, MD, PhD; Department of Cardiothoracic Surgery, Leiden University Medical Center, K6-S, PO Box 9600, 2300 RC Leiden, Netherlands. Tel: +31-71-5263445; fax: +31-71-5266899; e-mail: a.tomsic@lumc.nl Search for other works by this author on: Oxford Academic PubMed Google Scholar Meindert Palmen, MD, PhD, Meindert Palmen, MD, PhD Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert J M Klautz, MD, PhD Robert J M Klautz, MD, PhD Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, Netherlands Search for other works by this author on: Oxford Academic PubMed Google Scholar European Journal of Cardio-Thoracic Surgery, ezad109, https://doi.org/10.1093/ejcts/ezad109 Published: 22 March 2023 Article history Received: 08 February 2023 Accepted: 21 March 2023 Published: 22 March 2023

Left Atrial Function as a Predictor for Postoperative Atrial Fibrillation

Background: One of the most frequent complications following heart surgery is atrial fibrillation (AF). The most popular diagnostic procedure for evaluating atrial function is echocardiography, however it has certain drawbacks. Originally, 2D echocardiography has been used to measure volumes to determine left atrial function. Objective: to examine the relationship between the development of post-operative AF following isolated CABG and preoperative evaluation of LA function using 2D echocardiography and left atrium 2D speckle tracking strain echocardiography. Patients and Methods: A set of 149 consecutive patients enrolled in a prospective observational study, they admitted to cardio-thoracic surgery department for elective isolated coronary artery bypass grafting surgery, during July 2018 to June 2019. 22 patients were excluded from the study due to bad image quality. Results: Readings of speckle tracking data showed significant less LA reservoir strain (OR 1.75, 95% CI: 0.65-4.69, P≤0001), LA conduit strains (OR 0.6, 95% CI: 0.22-1.62, P=0.31) and LA contractile strain (OR 0.65, 95% CI: 0.24-1.77, P=0.40) in POAF (+). Remaining parameters were non-significant. Also, Age (P=0.03), LA diameter (P=0.04), and LAVI (P=0.03) were the only factors that were identified as potential predictors of POAF in multivariate logistic regression analysis. Conclusion: we concluded that, age, LA size and LAVI are significantly associated with the occurrence of POAF in our patients.

Challenges to Cardiac Rehabilitation Post Coronary Artery Bypass Grafting: A Qualitative Study in Pune.

Background Adherence to cardiac rehabilitation (CR) regimen is crucial in the post-coronary artery bypass grafting (CABG) period. Cardiac rehabilitation involves various lifestyle changes, including diet and exercise, regular follow-up in OPD, and implementing secondary prevention recommendations. This study aims to understand the challenges to CRpost-CABG. Methodology Seven in-depth interviews using aninterview guide were carried out in the outpatient section of the cardiothoracic vascular surgery (CTVS) department of a tertiary health care facility in Pune, India. A purposive sampling technique was followed. Results The qualitative study revealed that dietary restrictions were difficult to follow, that some patients could not quit smoking even after surgery, and that transportation costs were an issue regarding CR follow-up. The majority of the participants appreciated the importance of regular exercise in their post-surgery life. Conclusion Despite the hurdles, the majority of participants stated that the fact that CABG is a major treatment pushed them to attend routine CR follow-ups and adhere to the CR regimen. A solid CR team was one of the study's strengths, and the team established a routine of telephonic reminders for regular follow-up, which resulted in lower rates of loss to follow-up.

Incidence of recurrent laryngeal nerve injury following esophagectomy in esophageal cancer patients

Objective: To determine the incidence of recurrent laryngeal nerve injury (RLNI) in patients with esophageal cancer who have undergone esophagectomy. Materials and Methods: This was a prospective observational study that was conducted at the Department of Cardiothoracic Surgery in Hayat Medical Complex, Peshawar. Non-probability consecutive sampling technique was used to select 62 patients with esophageal carcinoma. Patients with benign lesions, preoperative hoarseness of voice, or macroscopically advanced locoregional disease on preoperative evaluation were excluded. The study recorded data on age, gender, type of surgical procedure, and injury to the recurrent laryngeal nerve (RLN). The association of RLN injury with age, gender, and type of surgery was evaluated using the chi-square test. Results: The study participants had a mean age of 34.97 ± 9.96 years. Males accounted for 35 (56.45%) of the patients, while females accounted for 27 (43.55%). The study found that 6 (9.68%) participants had RLN injury. There was a statistically significant association between age and RLN injury (p=0.018). RLN injury was more common in the older age groups, with 5 (83.33%) cases occurring in the 41-58 years age group and 1 (16.67%) case in the 26-40 years age group.

Commentary: sublobar versus lobar resection: further added favourable outcomes in addition to survival.

Journal Article Accepted manuscript Commentary: Sub-lobar Versus Lobar Resection; Further Added Favorable Outcomes in Addition to Survival Get access Shaikha Al-Thani, MD, Shaikha Al-Thani, MD Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Mohammed Rahouma, MD, MSc, MS Mohammed Rahouma, MD, MSc, MS Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, USASurgical Oncology Department, National Cancer Institute, Cairo University, Egypt Corresponding author. mhmdrahouma@gmail.com Search for other works by this author on: Oxford Academic PubMed Google Scholar European Journal of Cardio-Thoracic Surgery, ezad054, https://doi.org/10.1093/ejcts/ezad054 Published: 16 February 2023 Article history Received: 08 February 2023 Accepted: 14 February 2023 Published: 16 February 2023

Efficacy and safety of transcutaneous electrical acupoints stimulation for preoperative anxiety in thoracoscopic surgery: study protocol for a randomised controlled trial

IntroductionPreoperative anxiety occurs at a very high rate in patients undergoing video-assisted thoracoscopic surgery (VATS). Moreover, it will result in poor mental state, more analgesic consumptions, rehabilitation delay and extra...

Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation

HomeCirculation: Cardiovascular ImagingVol. 16, No. 1Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation No AccessResearch ArticleRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessResearch ArticleRequest AccessFull TextMycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation Kevin Shahbahrami, MD, Candice Y. Lee, MD and Masaki Tsukashita, MD, PhD Kevin ShahbahramiKevin Shahbahrami Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author , Candice Y. LeeCandice Y. Lee Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author and Masaki TsukashitaMasaki Tsukashita Correspondence to: Masaki Tsukashita, MD, PhD, Department of Cardiothoracic Surgery, Allegheny General Hospital, 320 East North Ave, South Tower 14th Floor, Pittsburgh, PA 15212. Email E-mail Address: [email protected] https://orcid.org/0000-0001-9387-4759 Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author Originally published17 Jan 2023https://doi.org/10.1161/CIRCIMAGING.122.014278Circulation: Cardiovascular Imaging. 2023;16"Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation." Circulation: Cardiovascular Imaging, 16(1), pp. e014278–FootnotesFor Sources of Funding and Disclosures, see page 110.Correspondence to: Masaki Tsukashita, MD, PhD, Department of Cardiothoracic Surgery, Allegheny General Hospital, 320 East North Ave, South Tower 14th Floor, Pittsburgh, PA 15212. Email masaki.[email protected]org

Survival in Patients with Post-myocardial Infarction Ventricular Septal Rupture: A Retrospective Observational Study

Introduction: Post-myocardial infarction ventricular septal rupture (post-MI-VSR) is a dreaded complication with high mortality. There is a varied survival pattern among patients who have undergone surgical repair. Aim: To assess the survival rates in patients who underwent surgical repair for post-MI-VSR in a single centre. Materials and Methods: A retrospective observational study was conducted in the Department of Cardiothoracic Surgery at Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India. The patient records from January 2005 to December 2020, who underwent surgical repair of postMI-VSR, were reviewed. The perioperative variables, mortality, and survival data were analysed. Kaplan-Meier analysis was performed to assess the survival time. Results: The mean age of the studied patients was 58.4±7.5 years. A total of 73 patients underwent surgery for post-MIVSR. A total of 40 (55.80%) were males and 33 (45.20%) were females. Overall, 36 (49.32%) patients had diabetes, and 27 (36.99%) had hypertension. Anterior Myocardial Infarction (MI) (n=56, 76.71%) was the most common location of MI. The mean Cardiopulmonary Bypass (CPB) and clamp times were 144.05±59.09 and 105.38±38.34 minutes, respectively. The mean survival time was 2619.564 days {95% Confidence Interval (CI) 2105.936 to 3133.192}. Conclusions: As revascularisation confers a significant survival advantage, VSR repair with concomitant Coronary Artery Bypass Graft (CABG) appears beneficial.

Surgical treatment of congenital diaphragmatic hernia in a single institution

BackgroundThis study aimed to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of congenital diaphragmatic hernia (CDH) in a larger series compared with conventional open surgery. Additionally, we summarized the experience of thoracoscopic surgery in the treatment of CDH in infants.MethodsWe retrospectively analysed the clinical data of 109 children with CDH who underwent surgical treatment at the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2011 to January 2021. According to the surgical method, the children were divided into an open group (62 cases) and a thoracoscopy group (47 cases).Patients who underwent surgical correction had the diaphragmatic defect size graded (A–D) using a standardized system. We compared the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay, postoperative CCU admission time and other surgical indicators as well as the recurrence rate, mortality rate and complication rate of the two groups of children.ResultsThe index data on the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P < 0.05). We compared the number of incision infections, lung infections, atelectasis, pleural effusion, and chylothorax between the two groups. There were more children in the open group than in the thoracoscopy group. The overall incidence of postoperative complications in the open group (51.61%) was higher than that in the thoracoscopy group (44.68%).The recurrence rate of the thoracoscopy group (8.51%) was higher than that of the open group (3.23%). In the open group, 7 patients died of respiratory distress after surgery, and no patients died in the thoracoscopy group.ConclusionsThoracoscopic surgery and open surgery can effectively treat CDH. Compared with conventional open surgery, thoracoscopy has the advantages of shorter operation time, less trauma, faster recovery and fewer complications. We believe that thoracoscopic surgery for type A/B diaphragmatic defect has certain advantages, but there is a risk of recurrence.

Patients’ experiences regarding severe leg wound infection associated with coronary artery bypass grafting: A qualitative study

IntroductionCoronary artery bypass grafting (CABG) is the most common cardiac surgery throughout the world. The most commonly used graft is the saphenous vein. Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2% to 20%. Surgical site infection can be long-lasting, and the wound healing can be difficult and also presumably troublesome for the patient. CABG patients’ experiences of severe infection in the harvesting site have not been studied before. Aim: The aim of this study was to describe patients’ experiences associated with acquiring a severe infection in the harvesting site after CABG. MethodA qualitative study with descriptive design was conducted at the department of vascular and cardiothoracic surgery in a Swedish university hospital from May to December 2018. Patients diagnosed with a severe surgical site infection in the harvesting site following CABG were included. Data from 16 face-to-face interviews were analysed with inductive qualitative content analysis. ResultThe main category, varying impact on body and mind, was the core of the patients’ experiences of severe wound infection in the harvesting site after CABG. Two generic categories were identified: physical impact and thoughts about the complication. The patients described experiencing different degrees of pain, anxiety, and limitation in daily life. ConclusionThese findings indicate that a severe infection in the harvesting site after CABG was experienced as an important issue with varying impact. Overall, the participants experienced pain, anxiety, and limitations in daily life. However, most of them were satisfied with the outcome after the wound had healed. Patients should be advised to seek care at an early stage if symptoms of infection occur. Improved individual pain management is needed for those with severe pain, and varied experiences imply a need for person-centred care.

STUDY ON VARICOSES FROM A TERTIARY CARE HOSPITAL, GUNTUR

Introduction: Varicoses are part of the penalty we pay for adoption of the erect posture. Varicose veins and its associated symptoms and complications constitute the most common vascular insufciency and a substantial number suffer economic hardship from the resulting disability. Aims&amp;objectives: The objectives of the present study were to enumerate various clinical modalities of varicose veins and to determine varicose veins with reference to clinical presentations, common site of incompetence, involvement of perforators, different modalities of treatment, response to treatment and cause of recurrence if any Methods:All patients attending the cardiothoracic surgery department, Government General Hospital, Guntur from August 2021 - August 2022 presented with varicose veins who were diagnosed by using clinical and radiological methods. All patients were operated in Elective theatres with aseptic precaution under Spinal / Epidural anaesthesia. All patients were applied Elastocrepe Bandage immediately after surgery. Patients were encouraged ambulation only after 48 hours and instructed to contract the leg and dorsiex the foot against the railing of the bed. All patients were thoroughly assessed for complications and discharged after suture removal with instructions to attend surgical OPD 1 month and 3 months after surgery and follow up was done. Results: The majority of patients were in the age group of 30–60 years (72%). i.e. young adults and elderly with predominant being males (90%). Left limb involvement is more common than Right. Most of them are agricultural labourers and belonged to low socio- economic group. In all the patients varicose veins were of primary variety. Supercial venous system is only involved in all the patients. In more than 60% of cases the site of incompetence is saphenofemoral junction. Majority of cases (84 %) were treated by Trendelenberg's operation. Trendelenberg's operation with or without sapheno – femoral ligation had given good results in our set up. Recurrence rate was 10%. Conclusions: Appropriate management of the condition is extremely important for better quality of life and to prevent recurrence.

Management of clinical teaching for nursing students in the Department of Cardiothoracic Surgery under the COVID-19 epidemic

Management of clinical teaching for nursing students in the Department of Cardiothoracic Surgery under the COVID-19 epidemic

Incidence and Predictors of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery

Objective: To study the incidence of postoperative atrial fibrillation (POAF) and its predictors after coronary artery bypass grafting (CABG) in an Asian cohort.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: The study was conducted at the department of Cardiothoracic Surgery, Almana Hospital, Al Khobar, Saudi Arabia, which is a tertiary care hospital. The study duration was form Oct 2019 to Dec 2021. &#x0D; Methodology: All the male and female consecutive patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) were included in the study. All the surgeries were performed through median sternotomy using cardiopulmonary bypass. Patients with emergency CABG, off pump CABG and those undergoing multiple procedures were excluded from the study. A total of 220 consecutive patients were included in the study. Patients were followed in the perioperative period. Various variables were recorded on a preformed proforma. Patients were divided into two groups, those who had atrial fibrillation (AF) and those who did not have AF. Data was analyzed using SPPS version 23 (SPSS, Inc., Chicago,IL).&#x0D; Results: The mean age of the patients was 51.50±11 years in the AF group and 49.38±9 years in the no AF group. The incidence of atrial fibrillation postoperatively in our cohort was (n=52, 25%). There was no statistically significant difference between the groups with respect to hypertension and diabetes (p=0.408 and p=0.054) respectively).&#x0D; Conclusion: In spite of a younger population, the incidence of AF in our cohort undergoing CABG is comparable to the international literature. Lack of preoperative β-blockers, statins and low ejection fraction are predictors of new onset POAF.

Understanding outcomes of emergency aortic dissection repair during COVID-19 pandemic: What lessons have we learnt?

Journal of Cardiac SurgeryVolume 37, Issue 12 p. 4552-4554 COMMENTARY Understanding outcomes of emergency aortic dissection repair during COVID-19 pandemic: What lessons have we learnt? Sundas Butt MBChB, Sundas Butt MBChB Department of Trauma and Orthopedic Surgery, Queen's Medical Centre, Nottingham, UKSearch for more papers by this authorBishop Ghimire MBBS, BSc, Bishop Ghimire MBBS, BSc Department of Gastroenterology, Russells Hall Hospital, Dudley, UKSearch for more papers by this authorAmer Harky MRCS, MSc, Corresponding Author Amer Harky MRCS, MSc [email protected] orcid.org/0000-0001-5507-5841 Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK Correspondence: Amer Harky, MRCS, MSc, Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, L14 3PE, UK. Email: [email protected]Search for more papers by this author Sundas Butt MBChB, Sundas Butt MBChB Department of Trauma and Orthopedic Surgery, Queen's Medical Centre, Nottingham, UKSearch for more papers by this authorBishop Ghimire MBBS, BSc, Bishop Ghimire MBBS, BSc Department of Gastroenterology, Russells Hall Hospital, Dudley, UKSearch for more papers by this authorAmer Harky MRCS, MSc, Corresponding Author Amer Harky MRCS, MSc [email protected] orcid.org/0000-0001-5507-5841 Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK Correspondence: Amer Harky, MRCS, MSc, Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, L14 3PE, UK. Email: [email protected]Search for more papers by this author First published: 03 November 2022 https://doi.org/10.1111/jocs.17088Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume37, Issue12December 2022Pages 4552-4554 RelatedInformation