Audible Bleeding

Dr. Sherene Shalhub and Dr. Nick Mouawad join us to discuss a new survey coordinated by the SVS Wellness Taskforce and the APDVS to assess the impact of COVID-19 on surgeon well-being.

Complete the anonymous survey here!

April 9th, 2020

Update from New York City: Lessons learned from the first weeks of the COVID-19 pandemic

As part of our ongoing series of COVID-19 related episodes, we interview several New York City vascular surgeons to see what lessons can be gleaned from their experiences during the first few weeks of the pandemic. We discuss such topics as call coverage, redeployment, setting up a line service, and protecting ourselves from infection while caring for the COVID-19 patient. We also get some insight into how to take care of our own well-being, and what people have found uplifting during these difficult times. 

Dr. Daniel Han is an Associate Professor of Surgery at the Icahn School of Medicine at Mount Sinai, associate program director of the integrated vascular residency, and Co-Director of the Surgery Clerkship. He is active in numerous vascular societies, and is an assistant editor of the Journal of Vascular Surgery.

Dr. Evan Lipsitz is Professor of Vascular Surgery in the Department of Cardiovascular & Thoracic Surgery and Chief of the Division of Vascular and Endovascular Surgery at the Montefiore Medical Center and Albert Einstein College of Medicine in the Bronx. He is Medical Director of the Vascular Laboratory there as well.

Dr. Robert Rhee is a Clinical Professor of Surgery at SUNY Downstate Medical College and the Director of Vascular and Endovascular Surgery at Maimonides Medical Center in Brooklyn. He is also the Program Director for the Vascular Surgery Fellowship at Maimonides hospital

Dr. Darren Schneider is Chief of Vascular and Endovascular Surgery at NewYork Presbyterian Hospital/Weill Cornell Medical Center and is a returning guest on the podcast.  Episode 12 -Paclitaxel-Coated Balloons and Stents - Increased mortality or statistical anomaly?

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In our next installment of the JVS Editor’s choice series, Jacob discusses the JVS April Editor’s Choice articles with Senior Editor, Dr. Peter Lawrence. 

Dr. Lawrence YouTube Video

STABLE II clinical trial on endovascular treatment of acute, complicated type B aortic dissection with a composite device design - CME and Editor’s Choice

Surgeon specialty significantly affects outcome of asymptomatic patients after carotid endarterectomy

Cerebrospinal fluid drainage complications during first stage and completion fenestrated-branched endovascular aortic repair

Outcomes of atherectomy for lower extremity ischemia in an office endovascular center

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April 4th, 2020

Dr. Antonio Lanfranchi is a Cardiologist at the University of Milan, Luigi Sacco Hospital. He has practiced for over 20 years and has substantial expertise in echocardiography, interventional cardiology and clinical adult cardiology. He also has formal training in analytical psychology, having trained at the Carl Jung Institute in Zürich. In 2018 he published a book about medical consumerism in Italian and English called "Modern Myths and Medical Consumerism, The Asclepius Complex." He joins us today to share his experience and what he has learned from his work in a coronavirus unit in one of the global epicenters of the COVID-19 pandemic.

Risk stratification and clinical course of patients with COVID-19:

COVID-19 Illness in Native and Immunosuppressed States: A Clinical-Therapeutic Staging Proposal. Siddiqi HK and Mehra MR. J Heart and Lung Transplantation. 2020. 

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Zhou, F et al. Lancet. 2020. 

Cardiovascular implications of COVID-19:

COVID-19 and the cardiovascular system. Zheng, Y et al. Nature. 2020.

Cardiovascular Considerations for Patients, Health Care Workers, and HealthSystems During the Coronavirus Disease 2019 (COVID-19) Pandemic. Driggen, E et al. JACC. 2020.

ACE2 receptor and management of ACEi/ARBs:

HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. www.acc.org. March 2020.

Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19. Vaduganathan, M et al. NEJM. 2020.

Role of Lung Ultrasound in triage and management of COVID-19:

VIDEO: Imaging COVID-19 with Point-of-care Ultrasound (POCUS). www.itnonline.com. March 2020.

VIDEO: Lung Ultrasound Explained (Point of Care, Bedside, Clinical). www.youtube.com. 2019.

Point-of-care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020.

The Socioeconomic Implications of the Pandemic:

Redefining vulnerability in the era of COVID-19. Lancet. 2020.

As Coronavirus Deepens Inequality, Inequality Worsens Its Spread. www.nytimes.com 2020.

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Graphics Courtesy of @FOAMecmo:

https://twitter.com/FOAMecmo/status/1237477129014648835/photo/1

Dr. Jim Littlejohn is an anesthesiologist and critical care physician practicing at Weill Cornell Medicine.  He completed his anesthesiology residency at Weill Cornell and went onto fellowship in surgical critical care at the University of Pennsylvania. He currently specializes in cardiothoracic surgical intensive care (including ECMO), liver transplant, surgical critical care and complex anesthesiology. 

Valuable COVID resources:

NEJM Prone Positioning Video: https://www.nejm.org/doi/full/10.1056/NEJMoa1214103

Surviving Sepsis COVID Guidelines: https://www.sccm.org/getattachment/Disaster/SSC-COVID19-Critical-Care-Guidelines.pdf?lang=en-US

LitCovid:  https://www-ncbi-nlm-nih-gov.ezproxy.med.cornell.edu/research/coronavirus/

Dr. Littlejohn COVID and ICU Lectures:

https://drive.google.com/open?id=1AIG6ESwoxB2CD-YOn2MZyC8NFdqylOdM

https://drive.google.com/open?id=1Y0uvS0lRIkMPvJ3UtFiDeeIPqxKWFUo0

Disclaimer: The views and opinions expressed in the episode are those of Dr. Littlejohn and do not represent those of any specific agency or institution.

Dr. Amy Reed is a professor and chief of the division of vascular surgery at the University of Minnesota in Minneapolis, MN.  She is an accomplished academic surgeon and clinically active across a broad scope of vascular surgery practice but is here today mostly in her role as the Society for Vascular Surgery (SVS) secretary to discuss SVS membership opportunities and recently available resources put out by the SVS to address the COVID-19 pandemic.

COVID-19 Links

• SVS COVID-19 Resources
• SVS COVID-19 Townhall - March 27, 2020
• Upcoming Debakey Live Content - HD, “Let’s not learn alone” and Impact on education
• COVID-19 Guidelines for Triage of Vascular Surgery Patients
• American Board of Surgery (ABS) COVID-19 Updates

SVS Links

• SVS Membership
• History and Giants of Vascular Surgery
• SVSConnect
• SVSPulse

In this special episode of Audible Bleeding, we explore the impact of the COVID-19 pandemic on vascular surgeons in private practice with Dr. Russel Samson, Dr. Cliff Sales and Dr. Ty Garland. We discuss challenges, including protecting staff, managing call coverage and clinical responsibilities, providing care in the era of social distancing, and the business challenges associated with a sudden drop in revenue. We also discuss opportunities that this crisis presents.  

Dr. Russell Samson is a vascular surgeon in Sarasota, Florida and is affiliated with Sarasota Memorial Hospital. He received his medical degree from University of the Witwatersrand and his general surgery residency and vascular surgery fellowship at Albert Einstein medical college in New York

Dr. Clifford Sales is a vascular surgeon practicing with Atlantic medical group at Morristown medical center and Overlook medical center in New Jersey He went to Medical School at Mt. Sinai in New York and did his General surgery residency and fellowship at Albert Einstein medical college Montefiore in New York City

Dr. Ty Garland is a vascular surgeon practicing with Vascular Institute of the Rockies  and the director of vascular surgery at St. Joseph's hospital in Denver, Colorado.  Dr. Garland attended medical school at the University of Washington where he also completed an integrated vascular surgery residency.

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3/27/20 

Impact of COVID19 on resident and fellow education

In this special episode of Audible Bleeding, we explore the impact of the COVID-19 pandemic on the education of vascular trainees with Dr. Jason Lee, Dr. Chris Abularrage, and Dr. Lori Pounds. We discuss challenges, including the precipitous drop in case volume, protecting staff, managing call coverage and clinical responsibilities, and didactic education in the face of social distancing. We also discuss educational opportunities that this crisis presents, including crowdsourcing and sharing of educational resources across departments.  

Dr. Jason Lee is a Professor of Surgery, the Director of Endovascular Surgery, and the Vascular Surgery Residency and Fellowship Program Director at Stanford University Medical Center. He is also the Secretary and Treasurer of the Association of Program Directors in Vascular Surgery

Dr. Chris Abularrage is an Associate Professor of Surgery Director of the Diabetic Foot and Wound Clinic and Vascular Surgery Fellowship Program Director at The Johns Hopkins Department of Surgery. He is also Chair of the Curriculum committee of the Association of Program Directors in Vascular Surgery and Editor-in-Chief of VSCORE for the American Board of Surgery. 

Dr. Lori Pounds is a Professor of Vascular Surgery and Vascular Surgery Fellowship Program Director at UT Health San Antonio, as well as Chief of Vascular Surgery at the San Antonio VA. She is also Chair of the Education Committee of the Association of Program Directors in Vascular Surgery. 

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