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Permanent Cardiothoracic Surgery Job in Marion Illinois with Community Health Systems
Seeking Cardio-thoracic surgeon to further grow a young open heart program. Presently there are six cardiologists in our community (three interventionalists). Incoming physician would be part of Cardiothoracic
Permanent Cardiothoracic Surgery Job in Longview Texas with Community Health Systems
Heres a great opportunity to join a busy group in one of the best mid-sized communities in scenic East Texas:
Locum Tenens Cardiothoracic Surgery Job in Cardiovascular Thoracic Surgeon needed in OH Ohio with LocumTenens.com
Our client in Ohio is looking for a Cardiovascular/Thoracic Surgeon to cover call one weekend a month Friday -Monday (very flexible) and 5 weeks out of the year to fill in for vacation days. The provider

UPHS - Penn Cardiac Care Newsletter

Penn Cardiac Care Ranked 12th in Nation
Penn Cardiac Care at the Hospital of the University of Pennsylvania has been ranked 12th in the nation, and best in the Philadelphia region, for heart care and heart surgery by U.S.News and World Report's 2008 Best Hospitals ranking. Since 1990, U.S.News has published this annual special issue, which provides a ranking of hospital quality of care on a nationwide basis and is meant to help consumers make informed decisions when looking for hospital care.
Join the 2008 Start Heart Walk
The 10th Annual Heart Walk will take place on Saturday, November 15, 2008 at Citizen’s Bank Park - Home to our own Philadelphia Phillies! We encourage you to join Penn’s Heart Walk team today! Your participation will help support Penn Cardiac Care and the American Heart Association’s efforts to develop programs and research dedicated to finding better treatments and cures for heart disease and stroke. These issues truly affect our business and touch our families, friends, associates, and the communities we serve.
Penn Cardiovascular Institute
Over the past decade, cardiovascular research and clinical care at the University of Pennsylvania has grown tremendously with many nationally and internationally recognized research and clinical programs. The Penn Cardiovascular Institute (CVI) was established in 2005 to build bridges between scientists and clinicians. This collaborative spirit has facilitated the development of novel treatments and therapies, which patients at Penn have been among the first in the world to benefit from. Our researchers and clinicians continue to discover new breakthroughs that lead to life-saving procedures, devices and medications that will positively impact the care of individuals with cardiovascular disease.

The Journal of Thoracic and Cardiovascular Surgery current issue

[Editorial] Fifty years of cardiothoracic surgery through the looking glass and what the future holds
Turina, M. Mon, 24 Nov 2008 00:00:00 -0000

[Expert Commentary] Regional heterogeneity within the aorta: Relevance to aneurysm disease
Ruddy, J. M., Jones, J. A., Spinale, F. G., Ikonomidis, J. S. Mon, 24 Nov 2008 00:00:00 -0000
Vascular remodeling within the aorta results in a loss of structural integrity with consequent aneurysm formation. This degradation is more common in the abdominal aorta but also occurs above the diaphragm in the thoracic aorta. Conventionally, the aorta has been considered a large vascular conduit with uniform cellular and extracellular structure and function. Evidence is accumulating, however, to suggest that variations exist between the thoracic and abdominal aorta, thereby demonstrating regional heterogeneity. Further pathophysiologic studies of aortic dilation in each of these regions have identified disparities in atherosclerotic plaque deposition, vessel mechanics, protease profiles, and cell-signaling pathways. Improved understanding of this spatial heterogeneity might promote evolution in the management of aneurysm disease through computational models of aortic wall stress, imaging of proteolytic activity, targeted pharmacologic treatment, and application of region-specific gene therapy.
[Expert Commentary] The legacy of coronary sinus interventions: Endogenous cardioprotection and regeneration beyond stem cell research
Mohl, W., Mina, S., Milasinovic, D., Kasahara, H., Wei, S. Mon, 24 Nov 2008 00:00:00 -0000

[Surgery for Acquired Cardiovascular Disease] Impact of left ventricular function on immediate and long-term outcomes after pericardiectomy in constrictive pericarditis
Ha, J.-W., Oh, J. K., Schaff, H. V., Ling, L. H., Higano, S. T., Mahoney, D. W., Nishimura, R. A. Mon, 24 Nov 2008 00:00:00 -0000
Objective Most patients with constrictive pericarditis have normal measures of left ventricular function when assessed by the ejection phase index of ejection fraction, yet there is a wide spectrum of outcome after pericardiectomy. We hypothesized that parameters of non-ejection indexes of cardiac function (+dP/dt and tau) may predict postoperative prognosis. Methods The immediate and long-term outcomes of pericardiectomy were analyzed in 40 patients (30 male, mean age 62 years) with surgically confirmed constrictive pericarditis who underwent preoperative cardiac catheterization using high-fidelity micromanometer pressures. Left ventricular pressures were digitized at 5-msec intervals during end expiration, from which peak positive dp/dt and tau measurements were obtained. Patients were classified into 3 groups: Group 1 (n = 13) included those with abnormal +dP/dt and tau (defined as +dP/dt < 1200 mm Hg/s, tau > 50 msec); group 2 (n = 11) included those with either abnormal +dP/dt or tau; and group 3 (n = 16) included those with normal +dP/dt and tau. Results There were no significant differences of gender, New York Heart Association class, duration of symptoms, and underlying cause among the 3 groups. Group 1 patients had lower preoperative ejection fraction and higher left and right ventricular end-diastolic pressures. Postoperative inotropic support was more frequently needed in group 1, and postoperative mortality was higher in group 1 than in groups 2 and 3. All postoperative deaths but 1 were in group 1. The median postoperative follow-up was 2.4 years. The postoperative long-term survival of group 1 was significantly lower compared with that of groups 2 and 3. Conclusion In patients with constrictive pericarditis undergoing pericardiectomy, those with abnormal left ventricular contractility and relaxation properties assessed by cardiac catheterization before surgery incur higher operative mortality and poor long-term outcome after surgery.
[Surgery for Acquired Cardiovascular Disease] Bovine pericardial versus porcine stented replacement aortic valves: Early results of a randomized comparison of the Perimount and the Mosaic valves
Chambers, J. B., Rajani, R., Parkin, D., Rimington, H. M., Blauth, C. I., Venn, G. E., Young, C. P., Roxburgh, J. C. Mon, 24 Nov 2008 00:00:00 -0000
Objective A stented bovine pericardial valve might be less obstructive than a stented porcine valve. This study compared early hemodynamic function in a prospective series of 99 patients randomized to receive either a Mosaic or Perimount replacement aortic valve. Methods Echocardiography was performed early after surgery and at 1 year after surgery. Patients also filled in psychologic questionnaires and underwent a 6-minute walk. Results The groups were matched demographically. The Perimount valve was significantly less obstructive in terms of mean pressure difference (11 ± 5 vs 17 ± 7 mm Hg; P < .0001), with a trend in favor of a larger effective orifice area (1.47 ± 0.45 vs 1.28 ± 0.46 cm2; P = .05) postoperatively. There were no differences in left ventricular mass regression, aortic regurgitation, 6-minute walk, psychologic questionnaires, or mortality and clinical events. Conclusion The stented bovine pericardial valve was less obstructive than the stented porcine valve. Both valves were associated with similar and significant improvements in quality of life, exercise ability, and regression of left ventricular mass.
[Surgery for Acquired Cardiovascular Disease] Influence of preoperative renal dysfunction on one-year bypass graft patency and two-year outcomes in patients undergoing coronary artery bypass surgery
Mehta, R. H., Hafley, G. E., Gibson, C. M., Harrington, R. A., Peterson, E. D., Mack, M. J., Kouchoukos, N. T., Califf, R. M., Ferguson, T. B., Alexander, J. H., Project of Ex-vivo Vein Graft Engineering via Transfection (PREVENT)-IV Investigators Mon, 24 Nov 2008 00:00:00 -0000
Objective Limited information exists on the impact of preoperative renal dysfunction on internal thoracic artery and saphenous vein graft failure and 2-year clinical outcomes in patients undergoing coronary artery bypass surgery. Methods We studied the impact of preoperative renal dysfunction (creatinine clearance < 60 mL/min) on 1-year internal thoracic artery and saphenous vein graft failure (defined as ≥ 75% angiographic stenosis) and 2-year clinical events (death; death or myocardial infarction; and death, myocardial infarction, or revascularization) in 3014 patients undergoing coronary artery bypass surgery enrolled in the Project of Ex-vivo Vein Graft Engineering via Transfection-IV study. Results Of 2973 patients (98.6%) with preoperative measurement of renal function, 440 (14.8%) had renal dysfunction. Most baseline comorbidities were higher in these patients. Two-year clinical events were higher in patients with preoperative renal dysfunction (adjusted death, myocardial infarction, or revascularization, hazard ratio 1.21, 95% confidence interval 0.97–1.50; adjusted death or myocardial infarction, hazard ratio 1.35, 95% confidence interval 1.05–1.74; adjusted death, hazard ratio 1.47, 95% confidence interval 0.98–2.21). However, saphenous vein graft (odds ratio 1.02, 95% confidence interval 0.79–1.33) and internal thoracic artery (odds ratio 0.76, 95% confidence interval 0.40–1.44) failure were similar in the 2 groups. Conclusion Although the risk of adverse clinical events is higher in patients with preoperative renal dysfunction, that of internal thoracic artery and saphenous vein graft failure is not. This suggests that factors other than graft failure account for the worse clinical outcomes in this high-risk cohort. Further studies are needed to identify other mechanisms of these worse outcomes so that appropriate measures can be developed to improve long-term outcomes in patients with renal dysfunction undergoing coronary artery bypass surgery.

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