Surgical Procedures, Operative Commons^™

Laser Atherectomy For Complex Cad In Ischemic Heart Failure: A Systematic Review Of Revascularization Outcomes, Avneet Chawla, Jared Aftel, Moiuz Chaudhri, Mohamad Hammad, Ahmed Al Mahrizi, John Socci, Aditya Mehra

Rowan-Virtua Research Day

This review evaluates how laser atherectomy compares to angioplasty and stenting for revascularization in patients with heart failure and complex coronary artery disease (CAD). The review explored whether laser atherectomy could improve procedural success and reduce the risk of restenosis, major cardiovascular events (MACE), and other complications. A search across multiple medical databases yielded six studies directly comparing these treatment methods. Findings showed that procedural success rates were similar between laser atherectomy (ranging from 80% to 95%) and angioplasty/stenting (85% to 98%). Restenosis rates at six and twelve months were also generally equivalent, although laser atherectomy showed potential advantages in …

Periprosthetic Femur Fractures After Total Hip Arthroplasty: Risk Factors And Management Strategies, Clarence Julian Clark Ii, Adam Friedman, Jaylyn Thompson

Rowan-Virtua Research Day

Background: Periprosthetic femur fractures (PFFs) are increasingly recognized as a significant complication following total hip arthroplasty (THA), particularly as the number of procedures rises. While THA is one of the most successful orthopedic surgeries, PFFs can compromise outcomes and demand complex management.

Objective: To review current literature and identify patient- and implant-related risk factors for PFFs, as well as to summarize effective management strategies guided by classification systems.

Methods: A structured literature review was conducted using PubMed, focusing on articles published in the past 10 years. Eight peer-reviewed studies were selected based on relevance to femoral fractures post-THA. Data on …

Left Atrial Appendage Occlusion In Heart Failure Patients: A Nationwide Evaluation Of Clinical Outcomes, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Between 2010-2019 the global risk of atrial fibrillation has risen. Our research sought to explore the database of patients with AF who underwent left atrial appendage occlusion.

Clinical Outcomes For Patients Who Have Hyperlipidemia Who Underwent Mechanical Directed Thrombolysis For Pulmonary Embolism: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Mechanical-directed thrombolysis for PE is a recently established therapy option for patients with sub-massive PE with hemodynamic instability. With limited availability on the impact of superimposed anemia on patients that undergo MDT treatment we sought to look more closely at the inpatient population.

Perioperative Goal-Directed Fluid Therapy In Neurosurgical Patients: A Scoping Review Of Current Evidence And Research Gaps, Daarsh Goradia, Riya Gandhi, Nisarg Shah, Eric Choi

Rowan-Virtua Research Day

Background: Neurosurgical patients are sensitive to fluid imbalances in postoperative settings. Traditional fluid management has been shown to have variable outcomes. Goal-directed fluid therapy (GDFT) is a tailored approach, but its benefits are not well established in neurosurgery.

Hypothesis: The aim of this study is to identify and map the existing literature on perioperative GDFT in neurosurgical patients, including study characteristics, reported outcomes, and knowledge gaps.

Methods: This scoping review follows the PRISMA-ScR reporting guidelines and the Arksey and O’Malley six-stage methodological framework. A literature search was performed across three databases from January 2000 to April 23, 2025. Studies evaluating …

Clinical Outcomes Of Left Atrial Appendage Occlusion In Patients With Hyperlipidemia: A Nationwide Analysis, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample database to explore in-hospital outcomes for patients with HDL with AF who underwent LAAO.

Outcomes Of Octogenarians, Nonagenarians, And Centenarians That Underwent Left Atrial Appendage Occlusion: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

An evaluation of that national inpatient sample database to explore the outcomes for patients above the age of seventy who underwent left atrial appendage occlusion.

How Reliable Is The Assessment Of Fusion Status Following Acdf Using Dynamic Flexion-Extension Radiographs?, Christopher T. Martin, Sangwook Tim Yoon, Ram Kiran Alluri, Edward C. Benzel, Chris M. Bono, Samuel K. Cho, Dean Chou, Xiaolong Chen, Jason P. Y. Cheung, Juan P. Cabrera, Stipe Ćorluka, Andreas K. Demetriades, Matthew F. Gary, Zoher Ghogawala, Waeel Hamouda, Inbo Han, Dimitri Hauri, Patrick C. Hsieh, Amit Jain, Jun S. Kim, Hai V. Le, Philip K. Louie, Zhuojing Luo, Hans-Jörg Meisel, Sathish Muthu, Dal-Sung Ryu, Charles A. Sansur, Andrew J. Schoenfeld, Laura Scaramuzzo, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Veranis Sotiris, Gianluca Vadalà, Pieter-Paul A. Vergroesen, Jeffrey C. Wang, Yabin Wu, K. Daniel Riew

Rothman Institute Papers

Study DesignReliability study.ObjectivesThe radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of < 1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.Methods29 practicing spine surgeons measured ISPM on 19 levels of ACDF from 9 patients. Surgeons relied on these measurements to report on fusion status. Inter-observer correlation co-efficients (ICC), standard error (SEM) and the minimum detectable difference (MD) of these measurements were calculated. We screened for clerical errors by checking measurements more than one standard deviation from the group mean.ResultsThe ICC for ISPM was .76 (.64; .88) with a SEM of 1 mm and a MD of 2.76 mm. Agreement on fusion status was moderate, with an ICC of .6 (.44; .76). After screening for and removing clerical errors, the ICC improved to .82 (.71; .91), SEM improved to .83 mm, and MD improved to 2.29 mm. Six reviewers had an ICC >.9. The ICC from these high performing reviewers was .94 (.9; .97), SEM was .45 mm, and MD was 1.26 mm.ConclusionsThe MD of 2.29 mm in our study group was not precise enough to support a cutoff of < 1 mm ISPM as the sole measurement technique in screening for non-union after ACDF, and there was only moderate agreement amongst surgeons on fusion status based on dynamic radiographs. More stringent techniques are necessary to avoid mis-diagnosing non-union in clinical studies. Future studies should consider auditing measurements to identify clerical errors.

From Molars To Bronchus; The Tale Of An Aspirated Dental Instrument, Yisroel Grabie, Sudeep Acharya, Fasih Sami Siddiqui, Gabriel A. Chavez Reyna, Michel Chalhoub

HCA Healthcare Journal of Medicine

Background

Aspiration of dental instruments is a rare event that carries potentially serious complications when it occurs, especially in older patients, where protective reflexes are diminished. Clinical management may be difficult because of the risk of granulation tissue and different retrieval strategies according to the object’s characteristics. In this report, we describe the case of an 84-year-old man who aspirated a dental bur during a routine dental procedure, necessitating immediate intervention. Timely and precise management was essential to avert severe complications.

Case Presentation

During a routine dental procedure, an 84-year-old man aspirated a bud-shaped cross-cut carbide dental bur. Despite initial …

Evaluating The Efficacy Of Htk (Histidine-Tryptophan-Ketoglutarate) And Potassium-Based Cardioplegia Solutions In Adult Cardiac Surgery: A Scoping Review Of Postoperative Outcomes, Efficiency, And Complications, Lauren Ryan

Student Works

Background/Introduction: Cardioplegia solutions are integral to myocardial protection during cardiac surgery, particularly during ischemic periods induced by cardiopulmonary bypass (CPB). Histidine-Tryptophan-Ketoglutarate (HTK) solution and potassium-based solutions such as Del Nido, St. Thomas, 4:1, and Microplegia are widely utilized for their distinct biochemical mechanisms and protective properties. Despite their widespread application, variability in clinical outcomes and procedural contexts has led to uncertainty about the optimal choice of cardioplegia solution. This scoping review aims to compare HTK and potassium-based solutions, focusing on their efficacy, postoperative outcomes, and complications in adult patients undergoing coronary artery bypass graft (CABG) and valve surgeries, including minimally …

Eye Dissection Video Guide: An Innovative Approach To Anatomy Education Of The Orbit, Eye, And Intraocular Lens, Jack Dryden, Malli Barremkala

Posters

No abstract provided.

Surgical Specimen Management Protocols In The Pre-Analytical Phase, Jordan L. Hall

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to decrease surgical specimen errors during the pre-analytical phase at the target institution by 50% by January 2025 by developing best practices for specimen labeling and documentation.

Background

The QI project was implemented within a level two trauma center with a 24-suite operating room (OR) in The Woodlands, Texas, which provides care across all surgical specialties except ophthalmology.

Methodology

The target institution changed from nurse-hand-written specimen labels and requisition sheets to electronic medical record (EMR) generated specimen labels and requisition sheets. The change was congruent with the target institution’s shift to a new …

Supercharged And Delayed Thoracodorsal And Dorsal Intercostal Artery Perforator Flaps For Autologous Breast Reconstruction, Adeem M. Nachabe, Mohammed S. Rais, Mark A. Maier, Hugo St Hilaire, Robert J. Allen

School of Medicine Faculty Publications

In patients seeking total autologous breast reconstruction following mastectomy, prior abdominal surgery can present as a contraindication to utilizing traditional abdominal-based free flaps. The thoracodorsal artery perforator (TDAP) flap has emerged as a suitable alternative, providing adequate tissue and minimal donor site morbidity. This case report demonstrates further improvement to this technique by utilizing the dorsal intercostal artery perforator vessels to supercharge this pedicled flap, along with a surgical delay of the TDAP and dorsal intercostal artery perforator. This adaptation can provide added bulk and improved perfusion to the traditional TDAP-based total autologous breast reconstruction.

4-Strand Hamstring Versus Single-Bundle Quadriceps Tendon Grafts In Anterior Cruciate Ligament Reconstruction At 2 Years: A Systematic Review And Meta-Analysis Of Randomised Controlled Trials, Jonathan Elias, Mitchell Kaplan, Kunal Shah, Michael Bickford, Chelsea Mcnamara, Elizabeth Ford, Sean Mcmillan

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: To compare the 2-year postoperative outcomes of hamstring tendon (HT) grafts to quadriceps tendon (QT) grafts in anterior cruciate ligament (ACL) reconstruction. We hypothesised no significant differences between the two methods.

METHODS: A systematic review and meta-analysis were conducted following the 2020 PRISMA guidelines. Five online databases (Cochrane, Embase, PubMed, Scopus and Web of Science) were screened for prospective randomised controlled trials (RCT). IKDC, Lysholm, Tegner, side-to-side KT-1000 scores and ages were collected. Statistical analysis was conducted with SPSS v29. Between the two groups, a test of between-subgroup homogeneity

RESULTS: Five RCTs were included in the final analysis. The …

High-Pressure Excursion In Oxygenators During Adult Cardiopulmonary Bypass: A Scoping Review, Anne Nguyen

Student Works

Background: High-pressure excursions (HPE) in oxygenators during cardiopulmonary bypass (CPB) are rare but clinically significant events that can lead to compromised perfusion and adverse patient outcomes. HPE occurs due to fibrin and platelet deposition within the oxygenator, leading to increased transmembrane pressure and potential obstruction of blood flow. Despite its clinical importance, HPE remains an underrecognized issue with limited standardized guidelines for detection, prevention, and management.

Methods: A comprehensive literature search was conducted across multiple databases and grey literature sources to identify studies reporting on HPE in CPB oxygenators. The selection process followed the PRISMA-ScR framework, with articles screened based …

The Benefits Of Leukocyte Depletion Filters For Blood Product Administration During Cardiopulmonary Bypass: A Scoping Review, Amber J. Helms

Student Works

Background: Cardiopulmonary bypass (CPB) is a critical component in cardiac surgery, enabling surgeons to perform complex procedures while maintaining systemic perfusion, oxygenation, and a bloodless field. Despite advancements in the CPB circuit design, prime solutions, and management strategies, complications such as inflammatory responses, coagulopathy, and organ dysfunction remain common. Therefore, identifying best practices that optimize perfusion parameters and improve patient outcomes is paramount.

Despite the best efforts, every patient has an inflammatory response to CPB, and it is not unusual to receive a blood product transfusion during CPB. A leukocyte depletion filter (LDF) is a device used in blood transfusions …

Effects Of Vacuum-Assisted Venous Drainage In Cardiopulmonary Bypass: A Scoping Review, Brandon Williamson

Student Works

Introduction: The use of Vacuum-assisted Venous Drainage (VAVD) in cardiopulmonary bypass is a standard in many perfusion practices. This scoping review targets the need for all positive and negative effects to be accounted for when using VAVD. A well thought out scoping review is the basis for additional research like a systematic review to be assembled. The goal of this scoping review is to encompass this topic to the best of its ability and supply relevant data in this field.

Methods: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping …

The Impact Of Perfusion Techniques On Inflammatory Response During Cardiopulmonary Bypass; A Scoping Review, Rodolfo Alfaro

Student Works

Background: Cardiopulmonary bypass (CPB) is an essential part of cardiac surgery, but it leads to SIRS (systemic inflammatory response syndrome) which in turn increases postoperative complications. There are many proposed approaches to reduce inflammation, but there is no clear best practice on the approach to use. This scoping review aims to explore the literature and classify the studies that investigate the effects of various CPB perfusion techniques on inflammatory responses to determine the possible best practices and the gaps that exist in the literature.

Methods: The present scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews …

Practices In Single Ventricle Repairs: Insights From Computational Fluid Dynamics On Cavopulmonary Connections – A Scoping Review, Olivia K. Osuch

Student Works

Abstract: Single-ventricle congenital heart defects require complex surgical strategies, with computation fluid dynamics (CFD) playing a growing role in optimizing cavopulmonary connections. This scoping review examines CFD-derived insights into power loss, hepatic flow distribution (HFD), and wall shear stress (WSS) across different Fontan geometries.

Methods: A search of available peer-reviewed literature (1995-2024) identified studies using CFD models to analyze hemodynamic performance in second and third-stage single-ventricle repairs. Studies were categorized based on surgical stage, anatomical variations, modeling assumptions, and key outcomes such as power loss, HFD, and WSS.

Results: Of 30 included studies, 28 analyzed power loss, 24 evaluated HFD, …

The Obstetric Experience Among Vascular Surgery Trainees, Ruojia Debbie Li, Eric B. Pillado, Margaret Reilly, Lauren M. Janczewski, Christina Cui, Kathryn Dilosa, Joshua S. Eng, Matthew C. Chia, Malachi G. Sheahan, Karl Y. Bilimoria, Erika L. Rangel, Yue-Yung Hu, Dawn M. Coleman

School of Medicine Faculty Publications

BACKGROUND: Vascular surgery training poses unique risks to pregnancy, including long hours, physically demanding work, and radiation exposure. Our objectives were to (1) understand pregnancy and parenthood experiences among vascular surgery trainees, (2) assess the rate of obstetric complications among vascular trainees, and (3) evaluate factors associated with trainee-parent wellness. METHODS: A survey was administered after the 2021 Vascular Surgery In-Training Examination. Residents and fellows who (or whose partners) experienced pregnancies during their clinical years of training were asked about their perceptions of the learning environment (work hours and mistreatment, including discrimination, bullying, and harassment), obstetric complications (miscarriage, pre-eclampsia, placental …