Circuit Surfers

The Currents, Eddys & Riptides- of Open-Heart Surgery

FAMASK

I Woke up Friday and I DIDN’T CARE

That’s my Son 🙂 Editor’s Note: Anyone reading the title would have to be discouraged. It sucks to say that but at the same time I need to share those feelings- because I think there are many of us that have conversations in our own heads in terms of the the things we are about…

Air-Bubbles

A CO2 PE during SGV Harvesting? WTF?

Editor’s Note: I had an interesting case the other day, here at hospital 56. It was an op cab – and it ended up being more than the original grafts that were advertised. This was a fairly routine patient presentation in terms of degree of difficulty, with a particular surgeon for whatever reason always works…

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A Locum’s ScrapBook: Unmasking COVID: Virtual Reality has BECOME our Economy.

Editor’s Note: – That is my family. Up there- I want to be able to say that a year from now… – We (or better stated) “I” have worn Masks for YEARS. – Today is a continuation of more than a years struggle in terms of trying to cope with an entirely innocuous yet devastatingly…

Birds-eye-view

Excerpts from: Heart Surgery in America: The Heart-Lung Machine

This book is NOW over 99% written and moving into the Editing Phase! The title of the book is “The Tips of Spears- An Inside Look At Heart Surgery in America” It is a rendering of the reality, sometimes sad and at times funny, emotional, and clinical vignettes of the many different aspects relating to open heart surgery- from the perspective…

Sequester

Perfusion Art: “Sequester”

Perfusion Art: “Sequester” Photographer: Frank Aprile Equipment: IPhone 10 ish Editing: Anger Hair Filter Narrative: Sequestering Blood during Circ Arrest 🙂 Time & Place:   2021: South of the Savannah About The Artist:  CCP Commentary: Removing blood from unnecessary trauma and turbulence during the circulatory Arrest phase of an Aortic Arch reconstruction/repair

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Molecular Cardioprotection and the Role of Exosomes: The Future Is Not Far Away

This review discusses anesthetic implications of exosome production and the future micro-RNA applications for cardioprotection.

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The COVID Wars: At What Point do you Not Answer “YES” ?

Editor’s Note: This is January 27, 2021. A year ago news stories were talking about the Wuhan virus in China, and few of us really took note although it to catch my attention. I think perhaps the American response to all of this was dampened by the political morass that we were embroiled in, and…

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Perfusion Art: “A Different Kind of Filter”

Perfusion Art: “A A Different Kind of Filter” Photographer: Frank Aprile Equipment: IPhone 10 ish Editing: Heavy Filters Narrative: Lunch Break- Selfie at Subway🙂 Time & Place:   2020: South of the Savannah About The Artist:  CCP Commentary: Chilling at a vendor table outside of Subway. Grabbing lunch before the next run

Picture-in-a-Picture

Perfusion Art: “A Picture Within”

Perfusion Art: “A Picture Within” Photographer: Frank Aprile Equipment: IPhone 10 ish Editing: Heavy Filters Narrative: Taking a picture of them taking a picture 🙂 Time & Place:   2020: South of the Savannah About The Artist:  CCP Commentary: Reassessing VA ECMO Cannulation…

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Morphing to 2021: Hello and Happy New Year!

Editor’s Note: What is there say about the 2020? In my opinion probably one of the most transitional years we’ve ever experienced. At this point in time we as a medical community are like a punch-drunk fighter who is completely desensitized to the imminent pain that he is currently or about to suffer. A reasonable…

Love-in-your-Heart-2b

Perfusion Art: “Put a Little LOVE in your Art…”

Perfusion Art: “Put a Little Love in your Art…” – = Photographer: Frank Aprile, BBA, LP, CCP Equipment: Iphone 8+ Editing: Photoshop Narrative:   What stands out in this picture is not the first set of hands holding the crystal heart- RATHER the second set- supporting the first 🙂 Time & Place:  South of the Savanna River, 2020 About…

The Lobster Tank

The COVID Wars: The Lobster Tanks… Inside Looking Out

Editor’s Note: It was that kind of day, here on the other side of the Savannah river.  When I came down here to assist at the first apex of the COVID-19 crisis, everything was shut down, and fear was palpable in the air.  More ubiquitous than the virus itself, was an apprehension of the organism’s…

Access DENIED

Perfusion Art: “Access DENIED!”

Perfusion Art: “Access DENIED !” – Photographer: Frank Aprile, BBA, LP, CCP Equipment: Iphone 8+ Editing: Photoshop Narrative:   And….   The Cryptic Reality of COVID-19-   This is our Chief Cardiac Anesthesiologist- Truly a gatekeeper to ALL things deleterious to our outcomes.  My sincerest respect 🙂 Time & Place:  South of the Savanna River, 2020 About The…

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Del Nido Microplegia Compared to Standard 1:4 Crystalloid Del Nido for Myocardial Protection

Editor’s Note: We had a fun discussion with a couple of our surgeons today regarding the use of Del Nido cardioplegia.  At this institution we have been deploying the microplegia version of Del Nido, and subsequently substituting Blood as the crystalloid component, delivering the primary dose in 1,200 ml aliquots, and then redosing at 60…

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The COVID Wars: Fighting An Apex Predator…

Editor’s Note:   I thought I would highlight the last week we have experienced here down South of the Mason-Dixon Line- in pictures with annotations that are just a brief glimpse of the furious pace that we are engaged in, in terms of trying to circumvent a culling of our species, by an opportunistic Apex…

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The COVID Wars: We Have Become Ostriches…

Editor’s Note: The only thing that Perfusion and Politics have in common is the letter “P”.  Nothing else and nothing more. I respect medicine, have given my life to it, and never thought I would see the day when the clarity of clinical reasoning would become muddled and muddied into an opaque morass of ambiguous…

Social Distancing

Excerpts from: Heart Surgery in America: Perfusion Dreams

Editor’s Note: This book is NOW over 99% written and moving into the Editing Phase! The title of the book is “The Tips of Spears- An Inside Look At Heart Surgery in America” It is a rendering of the reality, sometimes sad and at times funny, emotional, and clinical vignettes of the many different aspects…

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Excerpts from: Heart Surgery in America: Forged by Fire

Editor’s Note: This book is NOW over 99% written and moving into the Editing Phase! The title of the book is “The Tips of Spears- An Inside Look At Heart Surgery in America” It is a rendering of the reality, sometimes sad and at times funny, emotional, and clinical vignettes of the many different aspects…

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The COVID Wars: Frontline Perfusion

Editor’s Note: I guess the question becomes- It was named COVID 19 for the year it emerged.  As it mutates to 2021- will that strain mitigate all of our current and previous efforts to defeat it? There is no real answer to that question, but as frontline responders, Perfusionists are taking more than their share…

G Man2

Perfusion Art: “The G-Man Cometh…”

  Perfusion Art: “The G-Man Cometh…” Photographer: Frank Aprile, BBA, LP, CCP Equipment: Iphone 8+ Editing: Photoshop Narrative: And….   It’s AngioVac Day! Time & Place: South of the Ohio River, 2020 About The Artist:  Perfusionist Commentary:  The 3rd of 3 consecutive A-Vac Cases–  G-Man brings it!!

Impella Man

Perfusion Art: “IMPELLA MAN…”

Perfusion Art: “IMPELLA MAN…” Photographer: Frank Aprile, BBA, LP, CCP Equipment: Iphone 8+ Editing: Photoshop Narrative: A long Operation where Attention to the Mitral Valve and Grafts Overcome a Low EF- With a Little bit of Help 🙂 Time & Place: South of the Ohio River, 2020 About The Artist:  Perfusionist Commentary:  A new and…

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Perfusion Art: “Crimson Misfits…”

Perfusion Art: “Crimson Misfits…” Photographer: Frank Aprile, BBA, LP, CCP Equipment: Iphone 8+ Editing: Photoshop Narrative: Errant Blood splatter during removal of an Aortic Root Cardioplegia Needle Time & Place: South of the Ohio River, 2020 About The Artist:  Perfusionist Commentary:  The blood droplets look like glossy ladybugs on a translucent sheet to Plastic 🙂

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A Locum’s ScrapBook: Sister’s of the Heart

Editorial Tagline:  “Our Cultural Challenge is whatever you want it to be:  I see it as hope-“ Addendum:  The above quote is from the perspective of white privilege.  It’s enunciated more clearly here: “This  quote doesn’t grasp the movement and it’s not a cultural challenge we’re facing. Everyone can have our culture but not everyone…

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The COVID WARS: Is it Covid 19 “ISH” ? We Need a GamePlan!

  YES… They are US! Editor’s Note:   I’ve been down South for a couple of months now.  I was standing on the side lines for 10 weeks- which in all honesty is a far sicker place to be than confronting this elusive snake- COVID 19 ISH. The reason that “ISH” is even in the…