New Approach to Remove Blood Clots Catheter-based system removes clots without open heart surgery  
When a large blood clot was discovered attached to the end of a catheter inside the right atrial chamber of a patient’s heart, doctors faced a daunting challenge. If the clot came loose, the consequences would likely be catastrophic for the patient, who suffered from pulmonary hypertension – a dangerous narrowing of blood vessels connecting the heart and lungs.
But experts at the UC San Diego Sulpizio Cardiovascular Center (SCVC) are now able to save patients like this one from potentially fatal outcomes by using a new technology capable of removing blood clots, infected masses or foreign bodies from major cardiac blood vessels without performing open-heart surgery.
The SCVC is the first in San Diego County to use the AngioVac system developed by AngioDynamics. The AngioVac is a catheter-based device in which thin tubes are inserted into two major veins in the body through the neck or groin area. Under X-ray guidance, the flexible tubes are advanced to the proximal veins, right-sided heart chambers and/or lung arteries. Each is equipped with an expandable, balloon-shaped funnel tip that, when attached to a bypass circuit, vacuums the targeted material, such as a blood, clot out of the body.
“In some cases, medications can be used to dissolve blood clots, but this treatment option does not work for all patients, especially those who are in a life-threatening situation,” said Mitul Patel, MD, FACC, interventional cardiologist at UC San Diego Health System. “This new device allows our team to safely extract material, preventing the patient from having to undergo invasive, high-risk surgery.”
Open-heart surgery takes much longer to perform and often requires the surgeon to divide the breastbone lengthwise down the middle and spread the halves apart to access the heart. After the heart is repaired, surgeons use wires to hold the breastbone and ribs in place as they heal.
"Removing a blood clot through open-heart surgery results in longer hospitalization, recovery and rehabilitation times compared to the minimally invasive approach provided by this new device," said Victor Pretorius, MBchB, cardiothoracic surgeon at UC San Diego Health System.
Read more here

New Approach to Remove Blood Clots
Catheter-based system removes clots without open heart surgery 

When a large blood clot was discovered attached to the end of a catheter inside the right atrial chamber of a patient’s heart, doctors faced a daunting challenge. If the clot came loose, the consequences would likely be catastrophic for the patient, who suffered from pulmonary hypertension – a dangerous narrowing of blood vessels connecting the heart and lungs.

But experts at the UC San Diego Sulpizio Cardiovascular Center (SCVC) are now able to save patients like this one from potentially fatal outcomes by using a new technology capable of removing blood clots, infected masses or foreign bodies from major cardiac blood vessels without performing open-heart surgery.

The SCVC is the first in San Diego County to use the AngioVac system developed by AngioDynamics. The AngioVac is a catheter-based device in which thin tubes are inserted into two major veins in the body through the neck or groin area. Under X-ray guidance, the flexible tubes are advanced to the proximal veins, right-sided heart chambers and/or lung arteries. Each is equipped with an expandable, balloon-shaped funnel tip that, when attached to a bypass circuit, vacuums the targeted material, such as a blood, clot out of the body.

“In some cases, medications can be used to dissolve blood clots, but this treatment option does not work for all patients, especially those who are in a life-threatening situation,” said Mitul Patel, MD, FACC, interventional cardiologist at UC San Diego Health System. “This new device allows our team to safely extract material, preventing the patient from having to undergo invasive, high-risk surgery.”

Open-heart surgery takes much longer to perform and often requires the surgeon to divide the breastbone lengthwise down the middle and spread the halves apart to access the heart. After the heart is repaired, surgeons use wires to hold the breastbone and ribs in place as they heal.

"Removing a blood clot through open-heart surgery results in longer hospitalization, recovery and rehabilitation times compared to the minimally invasive approach provided by this new device," said Victor Pretorius, MBchB, cardiothoracic surgeon at UC San Diego Health System.

Read more here

Congratulations to our very own Dr. Quyen T. Nguyen, who received the Presidential Early Career Award for Scientists and Engineers (PECASE) at a ceremony in Washington, D.C. yesterday. She received this award for her work testing fluorescently labeled probes for nerve imaging during surgery. 
More here

Congratulations to our very own Dr. Quyen T. Nguyen, who received the Presidential Early Career Award for Scientists and Engineers (PECASE) at a ceremony in Washington, D.C. yesterday. She received this award for her work testing fluorescently labeled probes for nerve imaging during surgery.

More here

Improving Knee Replacements: UC San Diego Health System first in nation to use device that boosts surgical precision and accuracy  Each year, approximately 600,000 total knee replacement procedures are performed in the United States, a number that is expected to rise exponentially in the next decade as the population ages. Successful surgeries require precise alignment in the knee, a challenging task made even more daunting by the expected rise in procedures. To help meet this demand, UC San Diego Health System is the first in the nation to use iASSIST, a computer navigation system with Bluetooth-like technology that improves surgical precision and accuracy in total knee replacements, decreasing the need for revision surgery.
The FDA-approved iASSIST device, designed by Zimmer Holdings, Inc., allows the surgeon to verify each surgical step, such as bone cuts and overall alignment, in real time, reducing mechanical errors during total knee replacements. The device is made up of small electronic pods, which are essentially mini-computers with wireless technology similar to smartphones. These electronic pods snap onto conventional instruments used in knee replacement surgery. By simply moving the knee in different positions during surgery, the device registers the anatomic axis of the leg unique to that patient, which guides each bone cut and ultimately places the knee implant in a more accurate alignment.
“This innovative technology allows us to deliver a more personalized knee to the patient and provide extreme accuracy in implant placement. Studies have shown that total knee replacement surgery has a higher failure rate when the knee is mal-aligned. This device enables orthopedic surgeons to restore a patient’s normal alignment with precision in a reproducible fashion, decreasing revision surgery and providing a more natural feel of the implant for the patient,” said Francis Gonzales, MD, with the Department of Orthopedic Surgery.
Current robotic and computer-assisted systems are less efficient and rely upon additional equipment, such as a large computer monitor in the operating room. The new device, about two inches wide, is the only piece of equipment needed to guide surgeons during a knee replacement.  There are other patient-specific instruments available, said Gonzales, but the patient must undergo additional procedures, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) prior to surgery.
“The iASSIST system allows us to bypass additional imaging and still get a patient-specific knee. This technology is quite intuitive and adds accuracy and precision to our instruments, giving us the ability to restore mechanical alignment with all patients regardless of their deformity,” said Gonzales.
More here

Improving Knee Replacements: UC San Diego Health System first in nation to use device that boosts surgical precision and accuracy 

Each year, approximately 600,000 total knee replacement procedures are performed in the United States, a number that is expected to rise exponentially in the next decade as the population ages. Successful surgeries require precise alignment in the knee, a challenging task made even more daunting by the expected rise in procedures. To help meet this demand, UC San Diego Health System is the first in the nation to use iASSIST, a computer navigation system with Bluetooth-like technology that improves surgical precision and accuracy in total knee replacements, decreasing the need for revision surgery.

The FDA-approved iASSIST device, designed by Zimmer Holdings, Inc., allows the surgeon to verify each surgical step, such as bone cuts and overall alignment, in real time, reducing mechanical errors during total knee replacements. The device is made up of small electronic pods, which are essentially mini-computers with wireless technology similar to smartphones. These electronic pods snap onto conventional instruments used in knee replacement surgery. By simply moving the knee in different positions during surgery, the device registers the anatomic axis of the leg unique to that patient, which guides each bone cut and ultimately places the knee implant in a more accurate alignment.

“This innovative technology allows us to deliver a more personalized knee to the patient and provide extreme accuracy in implant placement. Studies have shown that total knee replacement surgery has a higher failure rate when the knee is mal-aligned. This device enables orthopedic surgeons to restore a patient’s normal alignment with precision in a reproducible fashion, decreasing revision surgery and providing a more natural feel of the implant for the patient,” said Francis Gonzales, MD, with the Department of Orthopedic Surgery.

Current robotic and computer-assisted systems are less efficient and rely upon additional equipment, such as a large computer monitor in the operating room. The new device, about two inches wide, is the only piece of equipment needed to guide surgeons during a knee replacement.  There are other patient-specific instruments available, said Gonzales, but the patient must undergo additional procedures, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) prior to surgery.

“The iASSIST system allows us to bypass additional imaging and still get a patient-specific knee. This technology is quite intuitive and adds accuracy and precision to our instruments, giving us the ability to restore mechanical alignment with all patients regardless of their deformity,” said Gonzales.

More here

Wound man
Hans von Gersdorff was one of Germany’s most noted surgeons during the late 15th and early 16th centuries, though little is known about the personal life or background of the man. He is best remembered for his illustrated Feldbuch der Wundartzney or Fieldbook of Surgery.
Based largely upon the writings of famed medieval surgeon Guy de Chauliac, Gersdorff’s tome was widely used as a basic surgical text for many years, most notably for its advice on limb amputation, which Gersdorff was reputed to be much experienced, with at least 200 procedures.
Feldbuch contained numerous woodcut images of surgical procedures, such as trephining and bone setting, anatomical schematics and diseases or medical conditions, such as leprosy. The woodcuts were done by Johann Ulrich Wechtlin.
Many of the images created by Gersdorff and Wechtlin were quite technical, if not always complete or precisely accurate. The image above, known as “Wound Man,” is likely intended to be more evocative in nature – a quick guide to injuries that military surgeons might see on a battlefield.
Gersdorff died in 1529 at the age of 74, presumably the consequence of old age and not from one of the mortal afflictions above.

Wound man

Hans von Gersdorff was one of Germany’s most noted surgeons during the late 15th and early 16th centuries, though little is known about the personal life or background of the man. He is best remembered for his illustrated Feldbuch der Wundartzney or Fieldbook of Surgery.

Based largely upon the writings of famed medieval surgeon Guy de Chauliac, Gersdorff’s tome was widely used as a basic surgical text for many years, most notably for its advice on limb amputation, which Gersdorff was reputed to be much experienced, with at least 200 procedures.

Feldbuch contained numerous woodcut images of surgical procedures, such as trephining and bone setting, anatomical schematics and diseases or medical conditions, such as leprosy. The woodcuts were done by Johann Ulrich Wechtlin.

Many of the images created by Gersdorff and Wechtlin were quite technical, if not always complete or precisely accurate. The image above, known as “Wound Man,” is likely intended to be more evocative in nature – a quick guide to injuries that military surgeons might see on a battlefield.

Gersdorff died in 1529 at the age of 74, presumably the consequence of old age and not from one of the mortal afflictions above.

3,000th Lifesaving Heart & Lung Surgery at UC San Diego Health SystemLowest Mortality Worldwide, Most Patients Treated, Heart-Stopping Procedure
Surgeons at UC San Diego Health System have performed their 3,000th pulmonary thromboendarterectomy (PTE), a lifesaving surgery to clear the lung’s arteries of scar-like tissue that robs patients of their ability to breathe. During the extraordinary eight to ten hour surgery, the patient is put into a form of suspended animation in which the heart and blood circulation is completely stopped and the brain ceases activity while surgeons clear the pulmonary arteries of disease.
“Patients arrive at UC San Diego Sulpizio Cardiovascular Center from all over the world seeking this safe, highly specialized surgery. Some patients walk in unaided while others arrive by wheelchair or air ambulance,” said Nick Kim, MD, pulmonologist and director of pulmonary vascular medicine at UC San Diego Health System. “They all share a common burden: breathlessness. The clots cause chronic thromboembolic pulmonary hypertension, which not only leads to shortness of breath, but in most cases, progression to end-stage heart failure, and death, if not effectively treated.”
The surgery is a feat for the patient and the surgeon. In order for the clots to be removed, the surgeon must be able to see clearly into the lung’s tiny arteries. This requires operating without any blood present. To achieve this environment, the patient’s body is cooled and the blood is completely drained while the patient is on a heart-lung machine. The bypass machine is then stopped for 20 minutes while the surgeon races against the clock to remove the blockages. During this time, both heart and brain wave monitors are flat lined.
Using sophisticated techniques and special long, slender instruments, the surgeon rapidly dissects out the chronic clots without perforating the paper-thin artery wall. The clots look like white scar tissue, which when arranged on a surgical table takes the shape of the intricate inner branches of the lung’s arteries.
More here

3,000th Lifesaving Heart & Lung Surgery at UC San Diego Health System
Lowest Mortality Worldwide, Most Patients Treated, Heart-Stopping Procedure

Surgeons at UC San Diego Health System have performed their 3,000th pulmonary thromboendarterectomy (PTE), a lifesaving surgery to clear the lung’s arteries of scar-like tissue that robs patients of their ability to breathe. During the extraordinary eight to ten hour surgery, the patient is put into a form of suspended animation in which the heart and blood circulation is completely stopped and the brain ceases activity while surgeons clear the pulmonary arteries of disease.

“Patients arrive at UC San Diego Sulpizio Cardiovascular Center from all over the world seeking this safe, highly specialized surgery. Some patients walk in unaided while others arrive by wheelchair or air ambulance,” said Nick Kim, MD, pulmonologist and director of pulmonary vascular medicine at UC San Diego Health System. “They all share a common burden: breathlessness. The clots cause chronic thromboembolic pulmonary hypertension, which not only leads to shortness of breath, but in most cases, progression to end-stage heart failure, and death, if not effectively treated.”

The surgery is a feat for the patient and the surgeon. In order for the clots to be removed, the surgeon must be able to see clearly into the lung’s tiny arteries. This requires operating without any blood present. To achieve this environment, the patient’s body is cooled and the blood is completely drained while the patient is on a heart-lung machine. The bypass machine is then stopped for 20 minutes while the surgeon races against the clock to remove the blockages. During this time, both heart and brain wave monitors are flat lined.

Using sophisticated techniques and special long, slender instruments, the surgeon rapidly dissects out the chronic clots without perforating the paper-thin artery wall. The clots look like white scar tissue, which when arranged on a surgical table takes the shape of the intricate inner branches of the lung’s arteries.

More here

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