Publications by authors named "Junaid H Khan"

4 Publications

  • Page 1 of 1

Blood and Blood Product Conservation: Results of Strategies to Improve Clinical Outcomes in Open Heart Surgery Patients at a Tertiary Hospital.

J Extra Corpor Technol 2017 12;49(4):273-282

Sutter Health Alta Bates Summit Medical Center, Oakland, California.

Blood product usage is a quality outcome for patients undergoing cardiac surgery. To address an increase in blood product usage since the discontinuation of aprotinin, blood conservation strategies were initiated at a tertiary hospital in Oakland, CA. Improving transfusion rates for open heart surgery patients requiring Cardiopulmonary bypass (CPB) involved multiple departments in coordination. Specific changes to conserve blood product usage included advanced CPB technology upgrades, and precise individualized heparin dose response titration assay for heparin and protamine management. Retrospective analysis of blood product usage pre-implementation, post-CPB changes and post-Hemostasis Management System (HMS) implementation was done to determine the effectiveness of the blood conservation strategies. Statistically significant decrease in packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelet usage over the stepped implementation of both technologies was observed. New oxygenator and centrifugal pump technologies reduced active circuitry volume and caused less damage to blood cells. Individualizing heparin and protamine dosing to a patient using the HMS led to transfusion reductions as well. Overall trends toward reductions in hospital length of stay and intensive care unit stay, and as a result, blood product cost and total hospitalization cost are positive over the period of implementation of both CPB circuit changes and HMS implementation. Although they are multifactorial in nature, these trends provide positive enforcement to the changes implemented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737420PMC
December 2017

Minimally Invasive Mitral Valve Surgery III: Training and Robotic-Assisted Approaches.

Innovations (Phila) 2016 Jul-Aug;11(4):260-7

From the *Swedish Heart and Vascular Institute, Seattle, WA USA; †Temple University, Philadelphia, PA USA; ‡The Heart Hospital Baylor Plano, Plano, TX USA; §New York University School of Medicine, New York, NY USA; ∥David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA; ¶St. Thomas Hospital, Nashville, TN USA; #University of Virginia, Charlottesville, VA USA; **Saint Elizabeth's Medical Center, Brighton, MA USA; ††Holy Spirit Northside Hospital, Chermside, Australia; ‡‡Penn Presbyterian Medical Center, Philadelphia, PA USA; §§Gulf Coast Cardiothoracic & Vascular Surgeons, Ft. Myers, FL USA; ∥∥East Bay Cardiac Surgery Center, Oakland, CA USA; ¶¶Northwestern University, Feinberg School of Medicine, Chicago, IL USA; ##Penrose St. Francis Hospital, Colorado Springs, CO USA; ***Emory St. Joseph's Hospital, Atlanta, GA USA; †††Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY USA; ‡‡‡South Florida Heart & Lung Institute, Doral, FL USA; §§§TriHealth Heart Institute, Cincinnati, OH USA; ∥∥∥Northeast Georgia Physicians Group, Gainesville, GA USA; ¶¶¶Central Maine Heart and Vascular Institute, Lewiston, ME USA; ###Lankenau Medical Center, Wynnewood, PA USA; and ****Department of Cardiothoracic Surgery, Princeton Baptist Hospital, Birmingham, AL USA.

Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IMI.0000000000000299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051529PMC
May 2017

Minimally Invasive Mitral Valve Surgery I: Patient Selection, Evaluation, and Planning.

Innovations (Phila) 2016 Jul-Aug;11(4):243-50

From the *University of Virginia, Charlottesville, VA USA; †Saint Elizabeth's Medical Center, Brighton, MA USA; ‡Penrose St. Francis Hospital, Colorado Springs, CO USA; §Northeast Georgia Physicians Group, Gainesville, GA USA; ∥Gulf Coast Cardiothoracic and Vascular Surgeons, Ft. Myers, FL USA; ¶Holy Spirit Northside Hospital, Chermside, Australia; #Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN USA; **New York University School of Medicine, New York, NY USA; ††Temple University, Philadelphia, PA USA; ‡‡Penn Presbyterian Medical Center, Philadelphia, PA USA; §§East Bay Cardiac Surgery Center, Oakland, CA USA; ∥∥Swedish Heart and Vascular Institute, Seattle, WA USA; ¶¶Northwestern University, Feinberg School of Medicine, Chicago, IL USA; ##Emory St. Joseph's Hospital, Atlanta, GA USA; ***St. Thomas Hospital, Nashville, TN USA; †††The Heart Hospital Baylor Plano, Plano, TX USA; ‡‡‡Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY USA; §§§South Florida Heart & Lung Institute, Doral, FL USA; ∥∥∥David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA; ¶¶¶TriHealth Heart Institute, Cincinnati, OH USA; ###Central Maine Heart and Vascular Institute, Lewiston, ME USA; ****Lankenau Medical Center, Wynnewood, PA USA; and ††††Department of Cardiothoracic Surgery, Princeton Baptist Hospital, Birmingham, AL USA.

Widespread adoption of minimally invasive mitral valve repair and replacement may be fostered by practice consensus and standardization. This expert opinion, first of a 3-part series, outlines current best practices in patient evaluation and selection for minimally invasive mitral valve procedures, and discusses preoperative planning for cannulation and myocardial protection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IMI.0000000000000301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051530PMC
May 2017

Minimally Invasive Mitral Valve Surgery II: Surgical Technique and Postoperative Management.

Innovations (Phila) 2016 Jul-Aug;11(4):251-9

From the *Northeast Georgia Physicians Group, Gainesville, GA USA; †Northwestern University, Feinberg School of Medicine, Chicago, IL USA; ‡Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN USA; §East Bay Cardiac Surgery Center, Oakland, CA USA; ∥Penn Presbyterian Medical Center, Philadelphia, PA USA; ¶The Toledo Hospital, Toledo, OH USA; #The Heart Hospital Baylor Plano, Plano, TX USA; **University of Virginia, Charlottesville, VA USA; ††Saint Elizabeth's Medical Center, Brighton, MA USA; ‡‡Gulf Coast Cardiothoracic & Vascular Surgeons, Ft. Myers, FL USA; §§Holy Spirit Northside Hospital, Chermside, Australia; ∥∥New York University School of Medicine, New York, NY USA; ¶¶Temple University, Philadelphia, PA USA; ##Swedish Heart and Vascular Institute, Seattle, WA USA; ***Penrose St. Francis Hospital, Colorado Springs, CO USA; †††Emory St. Joseph's Hospital, Atlanta, GA USA; ‡‡‡St. Thomas Hospital, Nashville, TN USA; §§§Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY USA; ∥∥∥South Florida Heart & Lung Institute, Doral, FL USA; ¶¶¶David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA; ###TriHealth Heart Institute, Cincinnati, OH USA; ****Central Maine Heart and Vascular Institute, Lewiston, ME USA; ††††Department of Cardiothoracic Surgery, Princeton Baptist Hospital, Birmingham, AL USA; and ‡‡‡‡Lankenau Medical Center, Wynnewood, PA USA.

Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IMI.0000000000000300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051532PMC
May 2017