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Permanent Cardiothoracic Surgery Job in Springfield Oregon with Community Health Systems
Springfield, Oregon a Growing Outdoor Wonderland! Sharing a boundary with Eugene OR, means Springfield has the best of both worlds breathtaking scenery of the Cascade Mountains and the Oregon Coastal
Locum Tenens Cardiothoracic Surgery Job in Looking for a Cardiothoracic Surgeon for an Indiana Opportunity Indiana with LocumTenens.com
Our client in Indiana is looking for a Cardiothoracic Surgeon to cover the dates of December 18th -28th for call coverage only. This is in a great location near the Wabash River and is great compensation.
Permanent Cardiothoracic Surgery Job in Branson Missouri with Skaggs Regional Medical Center
Skaggs Community Health Center is a progressive healthcare center located in the beautiful Ozark country of Branson, Missouri. This 165-bed general acute care and JCAHO accredited hospital is currently

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

[Editorials] Update on the cardiovascular and thoracic service-line concept
Cohn, L. H. Wed, 31 Dec 2008 00:00:00 -0000

[Editorials] Recognition of greatness: "The Jatene operation"
Salerno, T. A., Ricci, M. Wed, 31 Dec 2008 00:00:00 -0000

[Expert Commentary] The post-myocardial infarction scarred ventricle and congestive heart failure: The preeminence of magnetic resonance imaging for preoperative, intraoperative, and postoperative assessment
Dor, V., Civaia, F., Alexandrescu, C., Montiglio, F. Wed, 31 Dec 2008 00:00:00 -0000

[Congenital Heart Disease] Five-year neurocognitive and health outcomes after the neonatal arterial switch operation
Neufeld, R. E., Clark, B. G., Robertson, C. M.T., Moddemann, D. M., Dinu, I. A., Joffe, A. R., Sauve, R. S., Creighton, D. E., Zwaigenbaum, L., Ross, D. B., Rebeyka, I. M., Western Canadian Complex Pediatric Therapies Follow-up Group Wed, 31 Dec 2008 00:00:00 -0000
Objectives We sought to assess the 5-year neurocognition and health of an interprovincial inception cohort undergoing the arterial switch operation for transposition of the great arteries. Methods Sixty-nine consecutive neonates had operations from 1996–2003 with full-flow cardiopulmonary bypass and selective deep hypothermic circulatory arrest. Outcomes were recorded at 58 ± 9 months of age. Univariate and multivariate analyses were used to identify outcome predictors, including surgical subtype and preoperative, operative, and postoperative variables. Results There was 1 (1.5%) operative death. Two children were lost to follow-up, and 1 was excluded because of postdischarge meningitis. Outcomes are reported for 65 survivors. Two (3%) children have cerebral palsy, and 7 (11%) have language disorders, 4 of whom also meet the criteria for autism spectrum disorder. Two of the 4 children with autism have an affected older sibling. Of the 61 children without autism, scores approach those of peers, with a full-scale intelligence quotient of 97 ± 16, a verbal intelligence quotient of 97 ± 18, a performance intelligence quotient of 96 ± 15, and a visual–motor integration score of 95 ± 16. Mother's education, birth gestation or weight, and postoperative plasma lactate values account for 21% to 32% of the variance of these scores. Septostomy adds 7% to the variance of visual–motor integration scores. Conclusions Most preschool children do well after surgical correction for transposition of the great arteries, including complex forms. Potentially modifiable variables include high preoperative plasma lactate levels and septostomy. A minority of children were given diagnoses of language disorders, including autism, in which familial factors likely contribute to outcome.
[Congenital Heart Disease] A prospective observational study of human factors, adverse events, and patient outcomes in surgery for pediatric cardiac disease
Barach, P., Johnson, J. K., Ahmad, A., Galvan, C., Bognar, A., Duncan, R., Starr, J. P., Bacha, E. A. Wed, 31 Dec 2008 00:00:00 -0000
Objective To explore the impact of human factors on intraoperative adverse events and compensation mechanisms in pediatric cardiac surgery. Methods Prospective observations of pediatric cardiac surgical procedures were conducted. Patient complexity scores were calculated and outcomes recorded. The process of care was divided into epochs. Events were extracted and coded into compensated or uncompensated major and minor adverse events. Linear regression and analysis of variance were used to analyze the relationships between epochs, complexity, adverse events, and outcome. Patient-specific and procedure-specific variables were tested in a forward stepwise logistic regression as predictors of cases with 1 or more major adverse events. Results One hundred two patients undergoing pediatric cardiac surgery were observed. An average of 1.2 (range 0–6) major adverse events occurred per case. The most common type of major adverse event was cardiovascular, and most occurred during the surgery/postbypass epoch. Cognitive compensation was the most common compensation mechanism for major adverse events. An average of 15.3 minor adverse events occurred per case. Minor adverse events occurred frequently during the surgery/bypass epoch and related to communication and coordination failures. Higher case complexity, longer surgery duration, and higher number of major adverse events per patient correlated with death compared with other outcome groups (P < .01). Case complexity (P < .01) and surgery duration (P < .05) were both significant predictors of major adverse events. Conclusions Pediatric cardiac surgery is an ideal model to study the coordinated efforts of team members in a complex organizational structure. Adverse events occurred routinely during pediatric cardiac surgery and were mostly compensated. Case complexity was a significant predictor of major adverse events. The number of major adverse events per patient correlated with clinical outcomes.
[Congenital Heart Disease] Borderline hypoplasia of the left ventricle in neonates: Insights for decision-making from functional assessment with magnetic resonance imaging
Grosse-Wortmann, L., Yun, T.-J., Al-Radi, O., Kim, S., Nii, M., Lee, K.-J., Redington, A., Yoo, S.-J., van Arsdell, G. Wed, 31 Dec 2008 00:00:00 -0000
Objectives We sought to compare the usefulness of echocardiography and magnetic resonance imaging in neonates with a borderline small left ventricle. Methods The preoperative magnetic resonance and echocardiography studies of 20 consecutive patients (mean age 10 ± 9 days) undergoing magnetic resonance imaging were analyzed. The diagnoses were aortic stenosis (n = 3), hypoplastic left heart complex (n = 12), and unbalanced atrioventricular septal defect (n = 5). The magnetic resonance imaging protocol included ventricular volumetry, flow measurements, and angiography. Potential left ventricular volumes, assuming an ideal geometric shape, were calculated by mathematically "unfolding" the compressed left ventricle. Results Left ventricular end-diastolic volume was 16.0 ± 7.0 mL/m2 of body surface area by echocardiography and 33.5 ± 15.5 mL/m2 by magnetic resonance imaging. Echocardiography consistently underestimated left ventricular volume and did not correlate with magnetic resonance. Of all echocardiographic parameters, mitral valve z-score was the best predictor of left ventricular end-diastolic volume by magnetic resonance (r = 0.77; P = .02). The average potential volume increase was 8.8% for aortic stenosis, 35.0% for atrioventricular septal defect and 23.0% for hypoplastic left heart complex patients. Aortic valve diameter did not correlate with flow volume in the ascending aorta. Sixteen (80%) of 20 patients underwent biventricular repair, without early mortality. Of these, only 5 (31.3%) had a preoperative left ventricular end-diastolic volume of more than 20 mL/m2 by echocardiography. Conclusions Magnetic resonance imaging is feasible in neonates with borderline left ventricular hypoplasia. Echocardiography does not accurately measure left ventricular hypoplasia in these patients and may unfairly preclude some patients from a biventricular repair in whom magnetic resonance is reassuring.

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