1.Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes.
Jignesh KOTHARI ; Ketav LAKHIA ; Parth SOLANKI ; Divyakant PARMAR ; Hiren BORANIYA ; Sanjay PATEL
The Korean Journal of Thoracic and Cardiovascular Surgery 2016;49(5):383-386
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular a rrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.
Arteries
;
Bland White Garland Syndrome
;
Cardiopulmonary Bypass
;
Coronary Artery Bypass
;
Coronary Vessels*
;
Death, Sudden
;
Dyspnea
;
Female
;
Humans
;
Middle Aged
;
Mortality
;
Pulmonary Artery*
2.Effect of Drain Duration and Output on Perioperative Outcomes and Readmissions after Lumbar Spine Surgery
Brian KARAMIAN ; Parth KOTHARI ; Gregory TOCI ; Mark James LAMBRECHTS ; Jose CANSECO ; Jennifer MAO ; Raj NARAYAN ; Samuel ALFONSI ; Francis SIRCH ; Nadim KHEIR ; Nicholas SEMENZA ; Barrett WOODS ; Jeffrey RIHN ; Mark KURD ; Kris RADCLIFF ; Ian David KAYE ; Alan HILIBRAND ; Christopher KEPLER ; Alexander Richard VACCARO ; Gregory SCHROEDER
Asian Spine Journal 2023;17(2):262-271
Methods:
Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (<40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05.
Results:
Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify any of the drain variables as independent predictors of hospital readmission, postoperative blood transfusion, or postoperative anemia. ROC analysis demonstrated the drain variables to be poor predictors of hospital readmission, with the highest area under curve of 0.524 (drain duration), corresponding to a sensitivity of 61.3% and specificity of 49.9%.
Conclusions
Drain output or duration did not affect readmission rates following lumbar spine surgery.