Surgical Procedures, Operative Commons^™

Double-Port Totally Endoscopic Mitral Valve Replacement Through A Prosthesis-Sized Working Incision With Posterior Subvalvular Preservation, Cao Dang Khang, Tran Duc Quang, Phan Quang Thuan, Vuong Ngoc Minh, Pham Tran Viet Chuong, Nguyen Hoang Dinh

Journal of the Saudi Heart Association

Objective: To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.

Methods: In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported …

Integrating Music Therapy Into Post-Surgical Care: A Quality Improvement Strategy For Reducing Post-Operative Anxiety, Yosdania Hernandez Benitez

Doctor of Nursing Practice Final Project Abstract

Integrating Music Therapy into Post-Surgical Care: A Quality Improvement Strategy for Reducing Post-Operative Anxiety

Purpose

This quality improvement (QI) project aimed to reduce postoperative anxiety among adult patients after general surgery in the post-anesthesia care unit (PACU) by 30% using nurse-led music therapy in an ambulatory surgical center.

Results

Mean VAS-A scores decreased from 6.9 (SD = 0.5) pre-intervention to 4.0 (SD = 0.5) post-intervention, representing a 2.9-point (41.9%) reduction in anxiety and exceeding the project's target of 30%. Nurse adherence to the intervention protocol was 100%, and the mean patient satisfaction score was 4.6/5.0. All 100 patients completed both …

Intravenous Versus Oral Tranexamic Acid In Shoulder Arthroplasty, Tarishi Parmar, Akin Adio, Mohammad Daher, Adam Khan, John Horneff, Joseph A. Abboud

Rothman Institute Papers

PURPOSE: Tranexamic acid (TXA) is used in shoulder arthroplasty to reduce blood loss. While intravenous (IV) TXA is standard, oral TXA offers advantages in cost and administration. This study compares 90-day complications and postoperative laboratory values between IV and oral TXA in total shoulder arthroplasty (TSA).

METHODS: A retrospective cohort study using TriNetX identified adults undergoing primary TSA (2005-2025) receiving TXA on the day of surgery, stratified by route (IV vs. oral). One-to-one propensity score matching was performed. Ninety-day outcomes included transfusion, thromboembolic events, cardiac and renal complications, neurologic events, infection, wound dehiscence, readmissions, emergency department visits, opioid utilization, and …

Non-Tobacco Nicotine Dependence Is Associated With Increased Complications Following Clavicle Open Reduction Internal Fixation, Akin A. Adio, Rahul K. Goyal, Abby Skiena, Mohammad Daher, John G. Horneff, Hafiz F. Kassam, Brian W. Hill, Joseph A. Abboud

Rothman Institute Papers

BACKGROUND: Tobacco dependence is well established to impair bone healing and increase postoperative complications. However, the independent effects of nicotine, separate from combustion-related factors, remain unclear. This study aimed to evaluate the impact of non-tobacco nicotine dependence (NTND) following open reduction and internal fixation (ORIF) of clavicle fractures, including midshaft and lateral fracture subtypes.

METHODS: A retrospective cohort study was performed using a large national database. Patients undergoing ORIF of clavicle fractures were identified using procedural and diagnostic codes. Patients with non-tobacco nicotine dependence (e.g., vaping, patches, or gum) were identified and propensity score matched to (1) patients without nicotine …

Evaluating Normothermic Machine Perfusion For Dcd Liver Transplants: Outcomes, Costs, And Value Implications, Meet S. Patel, Alisha Williams, Kyrillos Ayoub, Noor Kamaladin, Charles S. Day

Medical Student Research Symposium

Background: As liver transplantation expands to include marginal donor organs, technologies such as the TransMedics Organ Care System (OCS) offer the potential to improve graft viability and clinical outcomes. However, limited institution-level evidence exists evaluating the cost-outcomes balance of OCS use in Donation-After-Circulatory-Death (DCD) liver transplantation. This study assesses the clinical, operational, and economic value of OCS implementation within a high-volume transplant center.

Methods: A retrospective cohort analysis was conducted of all DCD liver transplants performed at Henry Ford Hospital from January 2021 to April 2024. Outcomes were compared between traditional cold storage (2021; n=23) and OCS perfusion (2023–2024; n=82). …

Pcl And Pegdma Nanoyarns Feasibility For Antimicrobial Suture Applications, Wynn Bastianelli, Dominique Hassinger, Vincent Beachley, Sean Mcmillan

Rowan-Virtua Research Day

Abstract Title: PCL and PEGDMA Nanoyarns Feasibility for Antimicrobial Suture

Nanofibers represent an innovative class of materials with diverse applications, including tissue engineering and drug delivery.¹ Among the most promising areas of research is their use in surgical sutures, particularly for complex orthopedic injuries with high re-tear rates. Polycaprolactone (PCL) nanofibers have shown promise as alternatives to standard sutures as their unique properties support superior healing compared to standard materials.² Our lab aims to further optimize these healing capabilities by adding Poly(ethylene glycol) dimethacrylate (PEGDMA), a molecule that tethers peptides to PCL nanoyarns, developing a suture with greater …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Quantitative Fluorescence Imaging Using A Paired Agent Approach For Improving Surgical Decision Making, Sanjana Pannem

Dartmouth College Ph.D Dissertations

Surgical resection remains to be the cornerstone of treatment for most solid tumors, where the primary objective is to remove all visible and microscopic disease. However, the extent of tumor resection is inherently limited by the surgeon’s ability to distinguish tumor from normal tissue, intraoperatively. As a result, positive surgical margins (PSM), where residual tumor remains after surgery, are a common occurrence and are associated with increased recurrence, need for adjuvant therapies, dismal patient outcomes, and high healthcare costs.

Fluorescence guided surgery (FGS) has emerged as a promising technique to enhance intraoperative visualization of tumors and may help reduce the …

The Impact Of Normothermic Regional Perfusion Compared With Cold Storage On Warm Ischemia Time In Donation After Circulatory Death Organ Transplantation: A Scoping Review, Chris Turner

Student Works

ABSTRACT

2.Structured summary:

Background: Donation after circulatory death (DCD) has expanded the donor pool but introduces an inevitable period of warm ischemia that threatens graft viability. Preservation techniques such as normothermic regional perfusion (NRP) and static cold storage (SCS) aim to minimize this injury and improve transplant outcomes.

Objective: This scoping review identifies and synthesizes published evidence comparing NRP with SCS in DCD organ transplantation, focusing on their respective effects on warm ischemia time, graft function, and early post‑transplant outcomes.

Methods: Following the PRISMA‑ScR framework [23], searches were conducted in MEDLINE, PubMed, Embase, and Scopus for English‑language studies involving DCD …

Addition Of Prg4 To Optimize The Anti‑Adhesive Properties Of Tissue Barrier Sepraflm®, Ava J. Marks, Khaled A. Elsaid, Ling X. Zhang, Timmy Lin, Janette Baird, Tannin A. Schmidt, Gregory D. Jay

Pharmacy Faculty Articles and Research

Purpose

Postsurgical adhesion remains a significant clinical challenge. Seprafilm^® is widely used as a barrier to reduce adhesion formation, however its efficacy may be inconsistent. Recombinant human proteoglycan-4 (rhPRG4), a surface-active, anti-inflammatory glycoprotein found in synovial fluid inhibits cell and protein adhesion. This study investigated whether coating Seprafilm with rhPRG4 could enhance its anti-adhesive potential.

Methods

Macrophages (J774), human fibroblast-like synoviocytes (HFLS), and melanoma (A375) cells were cultured on tissue culture wells treated with rhPRG4 or bovine submaxillary mucin (BSM) to determine optimal seeding density. Seprafilm sheets were coated with rhPRG4 or BSM (0.78–200 µg/mL). Cell adhesion was quantified …

Pharmacological Treatment Options For Vasoplegia Syndrome During And After Cardiopulmonary Bypass: A Scoping Review, Bradley Darby

Student Works

ABSTRACT

2: Structured summary

Background

Vasoplegia Syndrome (VS) is a form of distributive shock that is characterized by profound hypotension, low systemic vascular resistance, and high to normal cardiac output during/after cardiopulmonary bypass. VS is associated with increased mortality, morbidity, and length of stay in the intensive care unit.

Objective

The main objectives of this scoping review are to note the available treatment options, characterize potential risk factors, and identify gaps in knowledge for vasoplegia syndrome during and after cardiopulmonary bypass.

Method

This scoping review utilized the Preferred Reporting Items for Systematic reviews and MetaAnalyses extension for Scoping Reviews (PRISMA-ScR) …

Vasculature Of The Anterior Abdominal Wall And Surface Anatomy Of The Liver And Stomach: Considerations For Minimal Access Surgeries In Neonates, Daniël J. Van Tonder, Natalie Keough, Martin Louis Van Niekerk, Albert Van Schoor

COM Scholarship

Background: Minimal access surgeries are growing more common in neonatal care, but the risk of accidental injury to abdominal wall blood vessels remains a concern. This risk is increased by limited precise anatomical data specific to neonates. Therefore, this study aimed to quantitatively map the superficial and deep blood vessels of the neonatal anterior abdominal wall concerning important surgical landmarks to develop evidence-based recommendations for safer laparoscopic port placement. Methods: Thirty formalin-fixed low-birth-weight neonatal body donations (≤4 weeks old) were dissected. An anatomical grid based on palpable landmarks—including the umbilicus, xiphoid process, and anterior superior iliac spines—was utilised to measure …

A “Found-Down” Non-Traumatic Compartment Syndrome Of Upper Extremity Requiring Amputation, Nicholas Ray, Aileen Ebadat

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Selfwrap-Assisted Arteriovenous (Save) Fistulas Study: Updates And Preliminary Safety Data, Sydney Parker, Ahmad Lambert, Shir Yelovitch, Mike Barakat, Tim Boire, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Dual Antiplatelet Therapy And Bleeding Risk In Carotid Endarterectomy, Sara Khan, Sydney Parker, Ryan Turley

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Gastric Outlet Obstruction And Bowel Perforation Secondary To Ingestion Of Multiple Foreign Bodies: A Case Review, Kassidy Fix, Mark Jay Cheek

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Obesity As A Barrier To Living Kidney Donation: A Decade Of Donor Pre-Screening From A High-Volume Center, Courtney Evans, Nassir Thalji, Tamer Shaker, Ranjeeta Chand, Matthias Kapturczak

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Reducing Surgical Site Infection After Colorectal Surgery: A Multidisciplinary Review Of Process Improvement, Robin Daemmrich, Quentin Dipasquale, Deborah Klepac, Nick Mathers, Travis Holloway

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Diagnostic Challenges And Surgical Management Of A Cervical Ectopic Pregnancy Mimicking Cesarean Scar Implantation, Xena Morataya, Laura Reguero, Uti Essien, Stacy Sassaman, Jorge Venegas

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

A Retrospective Study On The Associations Of Clinical Measures To Mortality In Pediatric Extracorporeal Membrane Oxygenation (Ecmo) Patients, Ammar F. Chauhdri, Ryan Davis Md, Christina Shanti Md, Michelle Veenstra Md, Megan Zacarias, Samantha Carranza, Laura Sansoterra, Nimr Assaf, Christian Hudson-Bradford Md, Elika Ridelman Phd

Medical Student Research Symposium

A Retrospective Study on the Associations of Clinical Measures to Mortality in Pediatric Extracorporeal Membrane Oxygenation (ECMO) Patients

Ammar Chauhdri; Ryan Davis, MD; Christina Shanti, MD; Michelle Veenstra, MD; Megan Zacarias; Samantha Carranza; Laura Sansoterra; Nimr Assaf; Christian Hudson-Bradford, MD; Elika Ridelman, PhD

Background: Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary support used in critically ill pediatric patients when conventional therapies fail, yet survival to discharge remains only ~50% nationwide. Prior studies have identified candidate mortality predictors and developed basic risk scores, but these models have limited accuracy and are often derived from registry-level or narrowly defined …

Goal-Directed Perfusion Strategies And Postoperative Acute Kidney Injury: A Scoping Review, Austin Davis

Student Works

Background: Acute kidney injury (AKI) remains a frequent and clinically important complication following cardiopulmonary bypass (CPB). Goal-directed perfusion (GDP) strategies—most commonly targeting indexed oxygen delivery (DO₂i) and/or other hemodynamic and metabolic parameters—have been proposed to reduce renal injury by improving renal oxygenation and perfusion during CPB.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Review (PRISMA-ScR) compliant scoping review identified 28 adult CPB studies evaluating GDP strategies and postoperative AKI outcomes.

Results: Maintenance of indexed oxygen delivery (DO2i) above critical thresholds and minimizing hemodilution were consistently associated with reduced AKI.

Conclusion: GDP strategies centered on maintaining …

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Free Versus In Situ Right Internal Mammary Artery As A Conduit In Coronary Artery Bypass Surgery: A Meta-Analysis, Yuta Kikuchi, Tomoki Sakata, Tomonari Shimoda, Shinichi Fukuhara, Junichi Shimamura, Makoto Hibino, Tsuyoshi Kaneko, Hiroo Takayama, Hisato Takagi, Michel Pompeu Sa, Toshiki Kuno

Department of Medicine Faculty Papers

OBJECTIVES: There is debate regarding the optimal choice for a second conduit in coronary artery bypass grafting. The right internal mammary artery (RIMA) is commonly employed as a second conduit; however, it is unclear whether the free (fRIMA) or in situ (isRIMA) configuration yields superior outcomes. We performed a systematic review and meta-analysis to compare clinical outcomes between fRIMA and isRIMA as the second conduit.

METHODS: A comprehensive search of PubMed (MEDLINE), EMBASE, and CENTRAL was performed through May 2025 to identify studies comparing outcomes in patients undergoing coronary artery bypass grafting with either fRIMA or isRIMA as a second …

Increasing Utilization Trends Of Robotic Assistance In Orthopaedic Surgery, Anish K. Ponna, Alec Giakas, Anthony A. Khoudary, Spencer N. Uggla, Sina Ramtin, Yousef A. Soliman, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.

METHODS: A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were …

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

Student Works

1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …

Exploring The Optimal Age For Total Knee Arthroplasty To Minimize Risk Of Adverse Outcomes: Machine Learning Analysis Of A Statewide Cohort, Chloe Heiting, Yiyuan Wu, Susan M. Goodman, Peter Sculco, Fei Wang, Said A. Ibrahim, Peter Cram, Rich Caruana, Bella Mehta

Department of Medicine Faculty Papers

BACKGROUND: Rates of total knee arthroplasty (TKA) in the United States have risen in patients of a wide age range. Although rates of postoperative TKA complications have decreased, they remain a significant concern. In this study, we aim to determine how the risk of adverse TKA outcomes changes dynamically with age and explore the optimal ages with the lowest risk for adverse outcomes.

METHODS: This retrospective cohort study included patients who underwent elective primary TKA from 2012 to 2018 in the Pennsylvania Health Care Cost Containment Council Database. We trained (70% train:30% test) an explainable boosting machine (EBM), a modern …

Safety And Feasibility Of Same-Admission Transcarotid Arterial Revascularization Prior To Heart Surgery For Patients Presenting With Concurrent, Severe Carotid Artery Stenosis, And Surgical Cardiac Disease, Brittany Landavazo, Matthew D. Kenny, Chandler Vernon, Nicolas Zea, David Nation, Bradley Boone, Jeff Apple, Kofi Quaye, Shir Yelovitch, Ryan S. Turley

HCA Healthcare Journal of Medicine

Introduction

Carotid artery stenosis and coronary artery disease are often co-morbid, with a prevalence of concurrent carotid and coronary artery stenosis approaching 50%. The optimal treatment for these patients has long been debated, with open carotid revascularization generally reserved for those with severe symptomatic carotid disease that precludes cardiac surgery. In this scenario, the role of less-invasive carotid artery stenting, particularly transcarotid arterial revascularization (TCAR), remains controversial and is not yet well studied. This study aims to present our outcomes and methodology for treating severe carotid stenosis with TCAR prior to cardiac surgery.

Methods

A retrospective chart review of the …

Comparison Of Ventilation Support During Laser Treatment Of Retinopathy Of Prematurity, Jason Peng, Raghav Taneja, Barry N. Wasserman, Krystal Hunter, Vineet Bhandari, Alla Kushnir

Wills Eye Hospital Papers

Highlights: What are the main findings? Preterm infants undergoing ROP laser surgery with routine elective intubation had significantly longer durations of post-operative mechanical ventilation. Routine intubation during this procedure did not improve short-term clinical outcomes, such as overall hospital length of stay or timing of laser intervention in the infant’s life. What are the implications of the main findings? Routine intubation strategies may unnecessarily increase exposure to mechanical ventilation without improving clinical outcomes. Standardization of perioperative intubation practices across hospitals may be needed to optimize respiratory support in this vulnerable population. Objective: To compare respiratory outcomes between infants undergoing retinopathy …

How Does Pattern Of Bone Healing Affect The Strain Of Plate Implant Via Frequency Detection? A Biomechanical Cadaveric Study, Chavarin Amarase, Chanyaphan Virulsri, Pairat Tangpornprasert, Pisitpong Chancharoen, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Detecting bone union is a crucial process in treating bone fractures to prevent complications, including implant failure and bone nonunion. Nowadays, there are many methods and new innovative devices for detecting bone union through strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. There is also a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods still do not provide a standard for determining the true bone healing process. The aim of this study is to identify the most appropriate bone healing pattern for …

Elbow Ulnar Collateral Ligament Reconstruction And Repair: A Systematic Review And Meta-Analysis Of Biomechanical Studies, Austin Looney, Adeeb Hanna, Carlo Coadonato, John Sonnier, Blake Bodendorfer, Christopher Anderson, Neil Sarna, Kevin Freedman, Michael G. Ciccotti, Michael C. Ciccotti, Brandon Erickson, Steven Cohen

Rothman Institute Papers

BACKGROUND: Technical variations in elbow ulnar collateral ligament reconstruction (UCLR) include graft source, graft/tunnel configuration, and humeral and ulnar fixation. While the biomechanical performance of various constructs has been reported, these studies have small sample sizes and compare at most a few technical variations.

PURPOSE: To quantitatively synthesize the results of biomechanical investigations of UCLR and repair.

STUDY DESIGN: Systematic review.

METHODS: A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses); included articles were published between 1998 and 2020. Biomechanical metrics were utilized to compute effect sizes (standardized mean difference [SMD]) …