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Article: Could Blockchain Help With COVID-19 Crisis?

Kassab, Mohamad Hassan / Neto, Valdemar Vicente Graciano / Destefanis, Giuseppe / Malas, Tarek

IT professional

2021 Volume 23, Issue 4, Page(s) 44–50

Abstract: The novel coronavirus that causes the Coronavirus Disease 2019 (COVID-19) has spread all over the world at an unprecedented rate. With growing recognition of the distributed nature of health services, the technology of blockchain has recently reached the ...

Abstract	The novel coronavirus that causes the Coronavirus Disease 2019 (COVID-19) has spread all over the world at an unprecedented rate. With growing recognition of the distributed nature of health services, the technology of blockchain has recently reached the impetus of the healthcare domain. This article provides: 1) a panoramic overview of existing solutions and scenarios incorporating blockchain to combat COVID-19 in the healthcare domain along with their benefits and challenges; as well as 2) a framework that will facilitate new research activities on this subject.
Language	English
Publishing date	2021-08-19
Publishing country	United States
Document type	Journal Article
ISSN	1520-9202
ISSN	1520-9202
DOI	10.1109/MITP.2021.3072585
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Article ; Online: Five Maneuvers to Facilitate Faster Robotic Mitral Valve Repair.

Malas, Tarek / Mick, Stephanie / Wierup, Per / Gillinov, Marc

Seminars in thoracic and cardiovascular surgery

2018 Volume 31, Issue 1, Page(s) 48–50

Abstract: Robotically assisted mitral valve reconstruction has become a cornerstone in the management of degenerative mitral valve regurgitation. High-volume centers report exceptional outcomes with minimal morbidity and mortality in select patient populations. As ...

Abstract	Robotically assisted mitral valve reconstruction has become a cornerstone in the management of degenerative mitral valve regurgitation. High-volume centers report exceptional outcomes with minimal morbidity and mortality in select patient populations. As compared to conventional sternotomy, robotically assisted surgery has yielded comparable efficacy and safety, with potential benefits of improved cosmesis and a faster recovery period. Despite the potential benefits of a robotic approach, there has been a reluctance in widespread adoption due to concerns over increased operative and crossclamp times as compared to conventional sternotomy approaches. In light of this specific concern, we have identified opportunities to improve the efficiency of robotic mitral valve repair by application of 5 innovations and surgical strategies.
MeSH term(s)	Diffusion of Innovation ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/physiopathology ; Mitral Valve/surgery ; Mitral Valve Annuloplasty/adverse effects ; Mitral Valve Annuloplasty/methods ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/physiopathology ; Mitral Valve Insufficiency/surgery ; Operative Time ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2018-11-12
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	1038278-1
ISSN	1532-9488 ; 1043-0679
ISSN (online)	1532-9488
ISSN	1043-0679
DOI	10.1053/j.semtcvs.2018.10.016
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Zs.A 2747: Show issues

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Article ; Online: Early to midterm survival of patients with deep sternal wound infection managed with laparoscopically harvested omentum.

Marzouk, Mohamed / Baillot, Richard / Kalavrouziotis, Dimitris / Amhis, Nawal / Nader, Joseph / Hould, Frederic S / Biertho, Laurent / Mohammadi, Siamak / Malas, Tarek

Journal of cardiac surgery

2021 Volume 36, Issue 11, Page(s) 4083–4089

Abstract: Objective: The optimal management of deep sternal wound infection (DWSI) remains controversial. Our objective was to evaluate outcomes of patients with DSWI managed with transposition of laparoscopically harvested omentum (LHO).: Methods: Between ... ...

Abstract	Objective: The optimal management of deep sternal wound infection (DWSI) remains controversial. Our objective was to evaluate outcomes of patients with DSWI managed with transposition of laparoscopically harvested omentum (LHO). Methods: Between 2000 and 2020, a total of 38,623 adult patients who underwent full median sternotomy for cardiac surgery were analyzed retrospectively at our institution. DSWI occurred in 455 (1.2%), of whom 364 (93.2%) were managed with pectoralis myocutaneous flap (PMF) and 33 (7.2%) with LHO. Univariate and multivariate analysis models were used to determine predictors of cumulative late mortality and adjusted survival curves were generated. Results: Among patients who received LHO, average age was 65.7 ± 9.7 years and a larger proportion of patients were male. A majority of patients (88%) had coronary bypass surgery, with bilateral internal mammary arteries use in only 21.2%. Mean length of stay (LOS) was 58.90 days and early hospital mortality occurred in 4 patients (12.1%). Patients who received LHO compared to only PMF had larger body mass index and had more heart failure. Furthermore, the hospital LOS was also significantly prolonged in the LHO group (58.9 vs. 27.4 days, p = .002), with a slightly higher in-hospital mortality (12.1% vs. 3.3%, p = .03). Late survival for LHO patients at 5 and 10 years was 71.9% and 44.8%, respectively. Conclusion: Use of LHO is a safe and viable alternative to traditional myocutaneous flaps to manage complex DSWI. Early and late survival were favorable in this high-risk population.
MeSH term(s)	Adult ; Aged ; Humans ; Male ; Middle Aged ; Omentum/surgery ; Retrospective Studies ; Risk Factors ; Sternotomy ; Sternum/surgery ; Surgical Wound Infection
Language	English
Publishing date	2021-09-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.15955
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Article ; Online: Missing the Goal With the 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization.

Ruel, Marc / Williams, Anne / Ouzounian, Maral / Sun, Louise / Légaré, Jean-Francois / Poirier, Paul / Malas, Tarek / Farkouh, Michael E / Chedrawy, Edgar / Hassan, Ansar / Higgins, Jennifer / Connelly, Kim / McClure, R Scott / Bewick, David / Whitlock, Richard / Graham, Michelle / Arora, Rakesh C

The Canadian journal of cardiology

2022 Volume 38, Issue 6, Page(s) 705–708

MeSH term(s)	American Heart Association ; Angioplasty, Balloon, Coronary ; Coronary Vessels ; Goals ; Humans ; Myocardial Revascularization ; United States
Language	English
Publishing date	2022-03-24
Publishing country	England
Document type	Editorial
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2022.03.013
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Article ; Online: Impact of visualization on simulation training for vascular anastomosis.

Malas, Tarek / Al-Atassi, Talal / Brandys, Tim / Naik, Viren / Lapierre, Harry / Lam, Buu-Khanh

The Journal of thoracic and cardiovascular surgery

2017 Volume 155, Issue 4, Page(s) 1686–1693.e5

Abstract: Objective: There is mounting evidence supporting the benefit of surgical simulation on the learning of skills independently and in a patient-safe environment. The objective of this study was to examine the effect of visualization of surgical steps via ... ...

Abstract	Objective: There is mounting evidence supporting the benefit of surgical simulation on the learning of skills independently and in a patient-safe environment. The objective of this study was to examine the effect of visualization of surgical steps via instructional media on performance of an end-to-side microvascular anastomosis. Methods: Thirty-two first- and second-year surgical trainees from the University of Ottawa received an expert-guided, didactic lecture on vascular anastomosis and performed an end-to-side anastomosis on a procedural model to assess baseline skills. Assessments were performed by 2 blinded, expert observers using validated measurements of skill. Subjects were then proctored to perform anastomoses using the model. Subjects were then randomized to watch an instructional video on performance of vascular anastomosis using visualization as the education strategy. One week later, subjects were again assessed for technical skill on the model. The primary outcome was the score achieved on the Objective Structured Assessment of Technical Skill (OSATS) scale. Secondary outcomes included an anastomosis-specific End-Product Rating Score and time to completion. Results: Compared with residents who received expert-guided simulator training alone, those who used the supplementary multimedia scored significantly greater on OSATS (17.4 ± 2.9 vs 14.2 ± 3.2, P = .0013) and on End-Product Rating Score (11.24 ± 3.0 vs 7.4 ± 4.1, P = .011). However, performance time did not differ between groups (15.7 vs 14.3 minutes, P = .79). Conclusions: Residents with supplemental instructional media performed an end-to-side anastomosis more proficiently as assessed by OSATS and with a greater quality end-product. This suggests that both didactic simulation training as well as use of visualization multimedia improves learning and performance of vascular anastomosis and should be incorporated into surgical curricula.
MeSH term(s)	Anastomosis, Surgical/education ; Clinical Competence ; Curriculum ; Education, Medical, Graduate/methods ; Educational Measurement ; Educational Status ; Humans ; Ontario ; Simulation Training ; Single-Blind Method ; Task Performance and Analysis ; Vascular Surgical Procedures/education ; Video Recording ; Visual Perception
Keywords	covid19
Language	English
Publishing date	2017-11-09
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Video-Audio Media
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2017.10.080
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Article ; Online: Mitral valve interventions in heart failure.

Al-Atassi, Talal / Malas, Tarek / Mesana, Thierry / Chan, Vincent

Current opinion in cardiology

2014 Volume 29, Issue 2, Page(s) 192–197

Abstract: Purpose of review: This review describes new developments in mitral valve interventions for patients with heart failure. The review also discusses innovative therapies in the treatment of mitral regurgitation in patients with heart failure and describes ...

Abstract	Purpose of review: This review describes new developments in mitral valve interventions for patients with heart failure. The review also discusses innovative therapies in the treatment of mitral regurgitation in patients with heart failure and describes novel risk factors of recurrent mitral regurgitation following repair in this population. Recent findings: Percutaneous strategies are rapidly emerging as an important adjunct to conventional mitral surgery, specially for patients with functional mitral regurgitation and heart failure. Percutaneous therapies are a well-tolerated alternative to surgery in high-risk patients, but their long-term efficacy is not established. Partial ring annuloplasty and preoperative galectin-3 levels may be associated with recurrent mitral regurgitation after repair. Preclinical work has focused on injectable substances, which may ameliorate adverse left ventricular remodeling and recurrent mitral regurgitation after surgery. Summary: Percutaneous therapies will continue to evolve and serve as an alternative to conventional surgery for patients with mitral regurgitation and heart failure. Determining anatomic and biochemical risk factors associated with recurrent mitral regurgitation after repair is crucial in tailoring therapy to individual patients. Preclinical work regarding infarct stabilization may benefit future patients with heart failure.
MeSH term(s)	Animals ; Heart Failure/complications ; Humans ; Mitral Valve Annuloplasty/trends ; Mitral Valve Insufficiency/etiology ; Mitral Valve Insufficiency/surgery ; Percutaneous Coronary Intervention/instrumentation ; Percutaneous Coronary Intervention/trends ; Recurrence
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645186-x
ISSN	1531-7080 ; 0268-4705
ISSN (online)	1531-7080
ISSN	0268-4705
DOI	10.1097/HCO.0000000000000045
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Article ; Online: Mapping and ablation of autonomic ganglia in prevention of postoperative atrial fibrillation in coronary surgery: MAAPPAFS atrial fibrillation randomized controlled pilot study.

Al-Atassi, Talal / Toeg, Hadi / Malas, Tarek / Lam, Buu-Khanh

The Canadian journal of cardiology

2014 Volume 30, Issue 10, Page(s) 1202–1207

Abstract: Background: Postoperative atrial fibrillation (POAF) remains common after coronary artery bypass grafting (CABG). Limited efforts to intervene on cardiac autonomic ganglionic plexi (AGP) during surgery show mixed results. In this pilot study, we ... ...

Abstract	Background: Postoperative atrial fibrillation (POAF) remains common after coronary artery bypass grafting (CABG). Limited efforts to intervene on cardiac autonomic ganglionic plexi (AGP) during surgery show mixed results. In this pilot study, we evaluated the safety and feasibility of map-guided ablation of AGPs during isolated CABG in the prevention of POAF. Methods: In this pilot study, patients undergoing isolated CABG were randomized into an intervention group (mapping and ablation of AGP [AGP+] group), and a control group (no mapping and ablation [AGP-] group). Using high-frequency stimulation, active AGPs were identified and ablated intraoperatively using radiofrequency. Continuous rhythm monitoring, serum electrolytes, postoperative medications, and postoperative complications were recorded until discharge. Results: Randomization of 47 patients (24 AGP+ and 23 AGP-) resulted in similar baseline characteristics, past medical history, and preoperative medication use. The intervention added a median of 14 minutes to the operative time. The incidence of POAF, mean time in POAF, and median length of stay in hospital were: AGP+ 21% vs AGP- 30%; AGP+ 298 minutes vs AGP- 514 minutes; AGP+ 5 days vs AGP- 6 days; respectively). Postoperative complications, medication use, and daily serum electrolyte profiles were similar in both groups. Conclusions: This pilot study demonstrated the safety and feasibility of mapping and ablation of AGP during CABG with minimal added operative time. Results further suggest a potentially clinically significant effect on POAF. A multicentre trial is warranted.
MeSH term(s)	Atrial Fibrillation/prevention & control ; Catheter Ablation ; Coronary Artery Bypass/adverse effects ; Feasibility Studies ; Ganglia, Autonomic/surgery ; Humans ; Intraoperative Period ; Length of Stay ; Pilot Projects ; Postoperative Complications/therapy
Language	English
Publishing date	2014-10
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2014.04.018
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Article ; Online: The role of pulmonary embolectomy in the treatment of acute pulmonary embolism: a literature review from 1968 to 2008.

Samoukovic, Gordan / Malas, Tarek / deVarennes, Benoit

Interactive cardiovascular and thoracic surgery

2010 Volume 11, Issue 3, Page(s) 265–270

Abstract: Acute massive or submassive pulmonary embolism (PE) requires prompt diagnosis, risk-stratification and aggressive treatment. Mortality rates can rise up to 70% within the first hour of presentation and are strongly correlated with the degree of right ... ...

Abstract	Acute massive or submassive pulmonary embolism (PE) requires prompt diagnosis, risk-stratification and aggressive treatment. Mortality rates can rise up to 70% within the first hour of presentation and are strongly correlated with the degree of right ventricular (RV) dysfunction, cardiac arrest, and consequential congestive heart failure. While anticoagulation is universally employed, there are inadequate data to establish definitive guidelines for the management of massive PE despite the availability of multiple treatment modalities. Medical thrombolytic therapy has not been shown to significantly reduce mortality in patients with massive PE but is still widely employed, whereas surgical and catheter embolectomy are only reserved as last resort treatments for critically ill patients with hemodynamic instability, or for those who are either not candidates for or have failed thrombolysis. Following an extensive review of medical literature, we outline the treatment options for this clinical scenario while focusing on the role of surgical embolectomy. Although traditionally reserved as rescue therapy for cases of failed thrombolysis, surgical embolectomy is a safe procedure with low mortality when performed early and in a selected group of patients. Sufficient evidence exists to extend the criteria for surgical embolectomy from strictly rescue therapy to include hemodynamically stable patients with RV dysfunction. Multidisciplinary approach to this condition coupled with a meticulous surgical technique has significantly lowered the mortality associated with this surgical procedure over the last 10 years.
MeSH term(s)	Acute Disease ; Algorithms ; Anticoagulants/therapeutic use ; Critical Pathways ; Embolectomy/adverse effects ; Embolectomy/mortality ; Hemodynamics ; Humans ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/drug therapy ; Pulmonary Embolism/mortality ; Pulmonary Embolism/physiopathology ; Pulmonary Embolism/surgery ; Thrombolytic Therapy ; Treatment Outcome
Chemical Substances	Anticoagulants
Language	English
Publishing date	2010-09
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1510/icvts.2009.228361
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Article: Repair of quadricuspid aortic valve associated with ascending aorta dilatation.

Elmistekawy, Elsayed M / Malas, Tarek / Hynes, Mark / Boodhwani, Munir

The Journal of heart valve disease

2012 Volume 21, Issue 6, Page(s) 740–742

Abstract: Quadricuspid aortic valve is a rare congenital anomaly that may require surgical intervention because of valvular dysfunction. Rarely, it may be associated with enlargement of the ascending aorta. Here, the case is presented of a quadricuspid aortic ... ...

Abstract	Quadricuspid aortic valve is a rare congenital anomaly that may require surgical intervention because of valvular dysfunction. Rarely, it may be associated with enlargement of the ascending aorta. Here, the case is presented of a quadricuspid aortic valve-associated enlargement of the ascending aorta and functional aortic annulus dilatation in a 36-year-old patient. The patient subsequently underwent a successful aortic valve repair and replacement of the ascending aorta.
MeSH term(s)	Adult ; Aortic Aneurysm/complications ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/surgery ; Aortic Valve/abnormalities ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Insufficiency/etiology ; Aortic Valve Insufficiency/surgery ; Blood Vessel Prosthesis Implantation ; Cardiac Valve Annuloplasty ; Dilatation, Pathologic ; Echocardiography, Transesophageal ; Heart Defects, Congenital/complications ; Heart Defects, Congenital/diagnostic imaging ; Heart Defects, Congenital/surgery ; Humans ; Male ; Treatment Outcome
Language	English
Publishing date	2012-11
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1205265-6
ISSN	2053-2644 ; 0966-8519
ISSN (online)	2053-2644
ISSN	0966-8519
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Article ; Online: Severe tracheobronchial compression in a patient with Turner's syndrome undergoing repair of a complex aorto-subclavian aneurysm: anesthesia perspectives.

Hudson, Christopher C C / Stewart, Jeremie / Dennie, Carole / Malas, Tarek / Boodhwani, Munir

Annals of cardiac anaesthesia

2014 Volume 17, Issue 4, Page(s) 302–305

Abstract: We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner's syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful ... ...

Abstract	We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner's syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful preoperative preparation, maintenance of spontaneous breathing when possible, and consideration of having an alternative source of oxygenation and circulation established prior to induction of general anesthesia. Cardiopulmonary monitoring is essential for safe general anesthesia and diagnosis of unexpected intraoperative events.
MeSH term(s)	Adult ; Airway Obstruction/complications ; Anesthesiology/methods ; Anesthetics, Inhalation ; Aortic Aneurysm, Thoracic/complications ; Aortic Aneurysm, Thoracic/surgery ; Bronchial Diseases/complications ; Cardiopulmonary Bypass/methods ; Catheterization, Swan-Ganz/methods ; Circulatory Arrest, Deep Hypothermia Induced/methods ; Constriction, Pathologic/complications ; Echocardiography, Transesophageal/methods ; Female ; Humans ; Methyl Ethers ; Positive-Pressure Respiration/methods ; Subclavian Artery/abnormalities ; Subclavian Artery/surgery ; Tracheal Stenosis/complications ; Turner Syndrome/surgery
Chemical Substances	Anesthetics, Inhalation ; Methyl Ethers ; sevoflurane (38LVP0K73A)
Language	English
Publishing date	2014-10
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	2106866-5
ISSN	0974-5181 ; 0971-9784
ISSN (online)	0974-5181
ISSN	0971-9784
DOI	10.4103/0971-9784.142071
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