Comprehensive Cerebral Protection during Operations involving the Aortic Arch (May 2006) — Gaudiani VA, Castro LC, Vial CM, Shuttleworth P, Fisher A: The Heart Surgery Forum Vol 9, Issue 6, October 2006
Successful aortic arch operations provide comprehensive cerebral protection (CCP) and effective surgical correction. CCP must prevent cerebral embolism (CE) at the onset and conclusion of the pump run and it must minimize intraoperative cerebral ischemia. We have developed a technique that achieves these ends and simplifies most aortic arch operations. Our approach utilizes 3 concepts: (1) separate arterial cannulation of the cerebral (innominate or carotid) and sytemic (distal arch or femoral) circulation, (2) separate heat exchangers for each circulation, (3) clamp separation of the two circulations.
The Risks and Benefits of Reoperative Aortic Valve Replacement (August 2004) — Gaudiani VA, Grunkemeier GL, Castro LJ, Fisher AL, Wu Y The Heart Surgery Forum Vol 7, Issue 2, 2004
Many patients are advised to have mechanical aortic valve replacement (AVR) because their expected longevity exceeds that of tissue prostheses. This strategy may avoid the risks of reoperation but exposes patients to the risks of long-term anticoagulation therapy. Which risk is greater?
Mitral Valve Operations through Standard and Smaller Incisions (April 2004) — The Heart Surgery Forum, Volume 7, Issue 4, 2004.
The objective of this paper is to evaluate the operative results of mitral valve repair (MVV) and mitral valve replacement (MVR) performed through standard and smaller incisions.
Biventricular Pacing during Cardiac Operations (July 2003) — Gaudiani VA, Castro LJ, Fisher AL, The Heart Surgery Forum Vol 6, Issue 6, 2003
Biventricular pacing (resynchronization therapy) improves the duration and quality of life in a subset of patients with congestive heart failure, but this technique has received little attention in the cardiac surgery literature. This report presents some preliminary ideas about its rationale and technique, and some likely indications for this procedure during the performance of cardiac operations.
Routine Enlargement of the Small Aortic Root: A Preventive Strategy to Minimize Mismatch (July 2002) — Castro LJ, Arcidi JM, Fisher AL, Gaudiani VA, Annals of Thoracic Surgery; 76:31-6, July 2002
We routinely use aortic root enlargement (ARE) as part of one strategy to avoid prosthesis-patient mismatch in patients with relatively small aortic roots who are undergoing aortic valve replacement (AVR).
A Contrarian View of Ischemic Mitral Regurgitation (July 2008) — Vincent A. Gaudiani, MD - To be Published on CTSNET.org News & Views, July 2008
Introduction: This condition vexes us because even when we perform a reasonable ring annuloplasty and a competent coronary bypass operation, too often either the MR recurs or the patient does poorly, or both. Naturally this stimulates investigation...
How Can Morbidity and Mortality Conference Contribute to QA? (April 2007) — Vincent A. Gaudiani, MD - Published on CTSNET.org News & Views IMO, April 2007
Rethinking Innovation (September 2005) — Vincent A. Gaudiani, MD - Published on CTSNet.org News & Views IMO, October 3, 2005
For the past half century, innovation has been the tonic chord of cardiac surgery. This essay discusses how the rapid changes in our professional landscape have altered the way we must think about innovation.
Atrial Fibrillation and the Maze Operation (July 2005) — Vincent A. Gaudiani, MD
This paper explains some basic aspects of atrial fibrillation, describes how the maze operation works, and presents our results to date. It begins by describing how normal sinus rhythm works, then explains what atrial fibrillation is and how it causes symptoms, and finally proceeds to the concepts of the maze operation.
Comprehensive Quality Assurance for Cardiac Surgery (November 2004) — Vincent A. Gaudiani, MD - Published on CTSNet.org News & Views IMO, November 11, 2004Customer satisfaction is the epicenter of most businesses, and in medicine the patient has a dual role as the object of quality assurance and an important contributor to the QA process. Comprehensive Quality Assurance in cardiac surgery makes ongoing assessments of the health care environment, and it uses a simple recursive loop to make changes and assess progress.
A Mind of Winter (February 2004) — Vincent A. Gaudiani, MD - Published on CTSNet.org News & Views IMO, February 3, 2004
Thoracic surgery has changed profoundly in the past thirty years. This paper explores some of the changes in the profession and suggests ideas that may represent effective responses.
Comprehensive Quality Assurance for Cardiac Surgery (July 2005) — Vincent Gaudiani MD, Luis Castro MD, Audrey Fisher MPH
Some Surgical Aspects of Atrial Fibrillation (September 2004) — Vincent Gaudiani MD, Luis Castro MD, Audrey Fisher MPH
Mitral Valve Operations through Standard and Smaller Incisions (July 2004) — Vincent Gaudiani, MD, Gary Grunkemeier, PhD, Luis Castro, MD, Audrey Fisher, MPH, YingXing Wu, MD
Intraoperative Biventricular Pacing -- Applications, Techniques, Early Results (September 2003) — Vincent Gaudiani MD, Luis Castro MD, Audrey Fisher MPH
The Risks and Benefits of Reoperation Aortic Valve Replacement (March 2003) — Vincent Gaudiani MD, Gary Grunkemeier PhD, Luis Castro MD, Audrey Fisher MPH, YingXing Wu MD
Aortic Valve Replacement: Strategies to Improve Outcomes (July 2002) — Vincent Gaudiani MD, Luis Castro MD, Audrey Fisher MPH
Mitral Valve Design (July 1998) — Vincent Gaudiani MD
This tutorial about the Mitral Valve was made possible by the Heart Valve Division of Medtronic Inc. In particular we would like to thank Laurie Southerton who designed this format and Julie Foster who encouraged its production. We invite your comments.
Heart Bypass Surgery Explained (February 2009) — Vincent A. Gaudiani, MD
Maximizing Left Ventricular Mass Regression: Surgical Options in Aortic Valve Replacement (December 2004) — Vincent A Gaudiani, MD, Luis J. Castro, MD
Aortic Valve Surgery First Seen Live on Tuesday, December 7, 2004 1:30 PT, 4:30 ET
Drs. Gaudiani and Castro perform aortic valve replacement surgery routinely and they have published a paper on the procedure which demonstrates that the technique allows a larger valve to be placed and that the risk is no higher than that found in aortic valve replacement by the usual means. This webcast presents all the details that permit a surgeon to successfully complete this operation.