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Mitral Regurgitation Can Be Reliably Assessed In The Operating Room Under General Anesthesia

Literature Reviews

Acute Kidney Injury After Cardiac Surgery Focus on Modifiable Risk Factors

Intensive versus Conventional Glucose Control in Critically Ill Patients

Glycemic variability: A strong independent predictor of mortality in critically ill patients

Enhanced exercise capacity in mice with severe heart failure treated with an allosteric effector of hemoglobin, myo-inositol trispyrophosphate

Differences in mitral valve-left ventricle dimensions between a beating heart and during saline injection test

Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease

Comparison of Early Surgery versus Conventional Treatment in Asymptomatic Severe Mitral Regurgitation

Foundation Update

SCA Foundation to host reception honoring Michael Roizen on Sunday, April 19

The Society of Cardiovascular Anesthesiologists (SCA) publishes the SCA Bulletin bimonthly. The information presented in the SCA Bulletin has been obtained by the editors. Validity of opinions presented, drug dosages, accuracy and completeness of content are not guaranteed by SCA.



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foundation updateLast Call

Congress passed Title IX in 1971. As if overnight, the new law transformed college sports by mandating that schools provide equal funding for male and female athletic programs. 

I was a college freshman at the time, aspiring to participate in women’s collegiate gymnastics. Although I had minimal training and experience, the coach encouraged me to attend daily practices and to concentrate on one gymnastics event. I chose the balance beam.  My high school cheerleading had perfected my handspring front-flip; I reasoned that it would be a simple matter to execute this maneuver on a 10 cm wide wooden beam, elevated 1.25 meters above the floor.

As I soon learned, completing a handspring front-flip on the floor is very different than ‘sticking-it’ on a balance beam.  The reality of the elevated narrow beam, combined with the unseen but ever present effects of inertia and gravity, made the task far more difficult and demanding than it had looked from the ground.

Glenn Gravlee, one of our Society’s past-presidents, recently asked me how I had found the SCA presidency.  I answered that, much like performing on the balance beam, the job of the president is much harder than it looks.  But, much like the joy I found upon successfully planting a flip on the balance beam and completing a routine, I cannot imagine finding more reward than I have received over the past two years as SCA president. Allow me to use this, my last president’s message, to confess to the aspects of my presidential gig that were the most challenging, confide as to which tasks and outcomes were priceless, express appreciation for the opportunity to serve, and acknowledge  those whose support sustained me throughout.

The challenges

Those of you who know me, as I have written in my previous eleven presidential messages, understand that I believe the future of our specialty lies in a close collaboration with the other professionals who provide care for cardiovascular and thoracic surgery patients (i.e., the surgeons and perfusionists).   The majority of my initiatives (both realized and failed) sought to further and to foster this collegial vision.   The majority of the SCA leadership, and perhaps most of our members, found my aspirations for extensive cofunctioning with the non-anesthesia medical community to be overly ambitious; and therefore much of my vision remains beyond our reach for the present.  I am willing to accept that I was a leader who was ahead of her time, but I believe that my contribution is to have nudged forward the processes that will enhance inter-specialty communication and collaboration in the years to come.   

The early part of my presidency focused on identifying the best journal to represent our Society.  As you know, in the end, we maintained our affiliation with the IARS and A&A.  Although I was disappointed that we did not go further, as were the many of you who communicated support for the reassessment of our relationships, I continue to believe that our patients will benefit from our exposure to a knowledge base grounded in an inter-disciplinary instrument.  Although the journal selection process was at times contentious and unpleasant, that process ‘greased’ the tracks for improving communication among CT anesthesiologists, surgeons and perfusionists.  Indeed, the last two years have witnessed a substantial increase in the communication between the SCA and our colleagues on the other side of the screen. Being a contributing part of these interdenominational conversations has been a priceless experience.

The inter-disciplinary outcomes

What are the major constituents of our ecumenical achievements? 

  • Both major cardiothoracic surgery journals (The Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery) now include CT anesthesiologists on their editorial boards.
  • The SCA Foundation recruited and is collaborating with the Society of Thoracic Surgeons (STS) (and several other groups) on the FOCUS project.  Joyce Wahr met with the STS Work Group on Patient Safety at their Annual Meeting and the STS Patient Safety Chair is now a member of the FOCUS Steering Committee.  (Nancy Nussmeier and I also take credit for persuading Joyce to accept the nomination to serve as President of the SCA Foundation.)
  • The SCA, under the guidance of Linda Shore-Lesserson and Mike D’Ambra, established a task force to write practice guidelines for the conduct of cardiopulmonary bypass, with the active participation of the STS and AMSECT
  • The SCA, benefiting from the leadership of David Reich and Sol Aronson, has developed a module to collect anesthesia data for the STS database.  This endeavor positions the SCA as the leader in collecting outcome data as related to care provided by CT anesthesiologists.

It has been my privilege to have a part in these inter-disciplinary endeavors.

My thank you

When I was growing up, before Title IX changed our world, I was taught to try to leave the world a better place. I am confident that my tenure in office ends with our having left the SCA a better organization. All of you have made this possible.

I thank the members for their commitment to their patients and to this profession, and for their continuing commitment to the mission, programs, and collegiality of the SCA.  I spoke with many of you in the course of selecting a journal, and more recently, in discussing the role that the SCA plays in your professional life. Each of the individuals with whom I spoke expressed a commitment to furthering clinical excellence through ongoing education.  I am proud to be a member of our chosen group.  Perhaps, more than in any other anesthesia sub-specialty group, CT anesthesiologists recognize that their knowledge, skill and expertise determines the well being of the patients for whom we care on a daily basis. 

I particularly thank Al Cheung and David Reich, and each of the members of the SCA Board of Directors, especially our Founding Fathers, George Burgess and Bob Marino.  I thank Linda Shore for her contributions as the only other woman on the Board.  And, I am forever indebted to Heather Spiess, whose energy and commitment to the health and integrity of the SCA surpasses all, and without whom we could not function effectively.

Lastly, I thank Mark Thomas, Gabriella, Antonio and Luca, my sons and daughter.  They allowed me to pursue this privilege; they are my reward at the beginning and at the end of every day.


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