Elizabeth Evans💆‍♀️👩‍⚕️

Placing a tape around the right coronary artery.

Pleased to share our latest publication in @JSHBPS Journal of HBP Sciences on the Safety and Outcomes of LCBDE in Elderly Patients. In 494 patients, outcomes in ≥70 vs <70 years were equivalent despite higher comorbidity, with ~100% duct clearance, no mortality, and similar morbidity. LOS was slightly longer in the elderly group. LCBDE remains a safe, definitive single-stage approach and age alone should not preclude LCBDE in specialist centres. Link to paper: onlinelibrary.wiley.com/share/author/J…

Basic surgical exercises to improve fine motor skills ⤵️💥🔪! @TomVargheseJr @AmCollSurgeons @monteromiguel @CiruAndes2 @pferrada1 @SWexner

#TechniquesThursday: Uniportal fully robotic-assisted lobectomy via the fifth intercostal space with a cross-arm technique. Surgeons say this enabled surgeon-driven robotic surgery without requiring an assistant. Read in #JTCVS Techniques: doi.org/10.1016/j.xjtc…

Aortic Valve Anatomy #1 — Aortic Leaflet 👉The aortic valve comprises three semilunar leaflets, forming the primary coaptation system for valve competence. 👉Each leaflet consists of hinge line, body, free margin, lunula, and nodulus of Arantius—ensuring precise central coaptation.

Respect the Tissue: A Fundamental Principle 👉Excellent threads by @rbarbosa91 showing how refined needle control preserves delicate tissue. 👉In grasping, needle driving, suturing, and tying, respect for tissue is essential. 🎥"Coronary artery bypass anastomosis": the coronary artery is paper-thin and fragile. @pferrada1 @TomVargheseJr @rbarbosa91 @juliomayol @SWexner @CiruAndes2 @PipeCabreraV

It turns out that when people that were at the top of the class, and were required to endure extreme self-sacrifice for 15+ years, and start their first real job at age 35, that they do in fact want to be able to live in the nice neighborhood along with the corporate types.

Surgeons in Vietnam recently published this study on totally endoscopic extensive resection and reconstruction of the left atrial wall for myxoma with unusual origin. Read more about this approach in #JTCVS Techniques: doi.org/10.1016/j.xjtc…

Aorto bifemoral bypass with end to end infrarenal aorta anastomosis to avoid graft prominence a risk of duodenal erosion ⤵️💥🔪🩸! @pferrada1 @SWexner @TomVargheseJr @monteromiguel

AAA with a hostile neck of 1.3, treated with a bifurcated endoprosthesis and endoanchor!@AortaEd @ThinkAorta @THINK__AORTA @CelestinoGutirr @Dr_Ma_of_PUMC @UofUVascular @UMichVIR @VascularHull @CleClinicHVTI @ccfvascmed @CCFVascSurg

Lymphatic Circulation #3: Failure in Fontan Circulation 👉Elevated CVP impairs the pressure gradient required for central lymphatic drainage 👉Absence of subpulmonary pump and reduced diastolic suction promote lymphatic congestion and leak 👉Result: PLE, plastic bronchitis, and chylothorax

Always enjoy teaching the microsurgery course. Proud of our residents' commitment to excellence. @PennStNeurosurg @PennStHershey #PennStNeurosurgCerebrovascular #PennStMoyamoya #PennStCerebralBypass #Moyamoya

Editor's Choice Article in #JTCVS: A prospective cohort study on the impact of preoperative computed tomography planning on surgical outcomes in patients with obstructive hypertrophic cardiomyopathy. Read how surgeons shortened operation times: doi.org/10.1016/j.jtcv…

@farkomd @t_intheleadcoat @SriniTummala @ragsxray @kmadass @vascularis @cfbechara Very well. Done for dominant LVA w ostial stenosis and recurrent drop attacks and vertigo.

A recanalized umbilical vein with huge collaterals can be a bleeding trap. Preop CT helps define the superficial and intra-abdominal venous anatomy. Open the right lateral side first, staple the umbilical vein, and never pull or divide it just above the liver. Because…

Fresh off the press in Journal of Neurosurgery: Deep dive into Inferolateral Trunk (ILT) anatomy for lateral transcavernous EES. Key takeaways: Use sellar floor & LPL as landmarks. ILT can be safely sacrificed — no permanent CN deficits in our cases. Article: thejns.org/doi/abs/10.317… Stanford Skull Base Team @StanfordNsurg @TheJNS @neurosurgatlas

Surgical devices: The Fogarty Catheter! Developed in the early 1960s by Dr. Thomas J. Fogarty, the Fogarty catheter revolutionized vascular surgery by introducing a minimally invasive method to remove blood clots (embolectomy). Inspired by ships in a bottle! Published in @acsJACS

@JOSEPH45075332 If a hospitals payer mix is heavily medicaid, nobody can fix that.

x.com/ResisttheMS/st… Elon says it best here In order to make the best decisions, you have to understand the process Time and again, non-MD CEOs demonstrate that they don’t. Physician-Led Hospitals Deliver Better Care. Non-physician led hospitals are just not oriented to make the best healthcare decisions. Yes, they can analyze revenue streams and identify what's most profitable, but that is not the right lens. Of course you have to pay the bills. A bankrupt hospital helps no one. But a hospital run as a business optimizing for profit is fundamentally different from one optimizing to care for the patients in its network. An MBA-led hospital asks: How do I maximize revenue from my patient mix? A physician-led hospital asks: How do I maximize care for my patients, given the mix and constraints? Those are very different questions, and they lead to very different outcomes. The data backs this up. Studies show that physician-led hospitals tend to have greater patient satisfaction, lower costs, and equal or better outcomes. Critics argue that patient mix explains these differences, but the gap holds even when controlling for it. And even if a physician specialty hospital, say, one focused on orthopedics, outperforms a general hospital partly due to patient mix, that's fine from the patient's perspective. Patients want to go where they get the best care. They shouldn't have to settle for sub-optimal care in order to cross-subsidize other parts of the hospital. Thanks to Obamacare, non-physician-run hospitals scored a major victory, and legislatively blocked physician-run competitors. The result: worse care at higher cost. It's time to reverse that. If community hospitals need financial support after losing certain patient subgroups, despite their higher billing rates, non-tax status, and other structural advantages, we can still direct healthcare dollars their way. Just not at the expense of destroying what actually works. { References in the first comment }

@WithAScalpel Patients with supravalvular aortic stenosis often have left ventricular hypertrophy and rely on diastolic pressure for coronary perfusion, making them particularly sensitive to hemodynamic fluctuation

Supravalvular Aortic Stenosis: Perioperative Strategy 👉Induction is high risk: hypertrophied LV, limited coronary reserve, and possible double obstruction (SVAS + branch PA stenosis). 👉Surgical goal is symmetric STJ/root enlargement while preserving aortic valve function and coronary origins. 👉Postoperative management requires balancing coronary perfusion (adequate diastolic pressure) against bleeding risk.