Week 2: Let the Immersing Continue

Since the end of last week, I have continued to observe rounds in the cardiology ICU during the mornings. These cases continue to be very interesting as many patients come in with a variety of complications and the doctors have to determine the best course of treatment including the drugs they will be administered and what specific diagnostic procedures are necessary to determine the underlying causes of their symptoms. I am really enjoying being a "fly on the wall" and listening in on the conversations the doctors have together as they attempt to diagnose and treat these patients as soon as possible.

Besides continuing to observe rounds, I have also set up my research project this summer. I met with Dr. Gaudino and his fellows, Dr. Ohmes and Dr. Leonard. As part of my clinical research, I will be performing a meta-analysis on patients who have reoccurring cardiac surgeries after repair of their ascending aortic aneurysm and/or dissections. An aortic aneurysm is essentially an enlarging of the aortic wall caused by damage to the tissue itself, which can be life threatening when it bursts. An aortic dissection is when there is a tear in the inner wall of the aorta which leads to blood traveling through this area into the medial space of the artery creating a "false lumen". Both an aortic aneurysm and dissection are related but patients can have either or both depending on the case. An example figure of an ascending aortic aneurysm and dissection are shown below.

Figure 1: Aortic aneurysm (left) and aortic dissection (right) taken from mayo clinic website
 Many patients who suffer from these life-threatening cardiothoracic diseases often times require multiple surgeries to repair other adjacent areas. The exact cause to why a repair of the aortic dissection or aneurysm leads to further complications is still unknown but its apparent that repairing the aorta is not treating the actual cardiac disease that led to the dissection/aneurysm in the first place. Its simply putting a patch on the apparent symptomatic problem and hoping that's enough for sustaining life. Changes in hemodynamic flow with a synthetic aortic graft could potentially be a cause of the reoccurring problems. Through this collaborative meta-analysis, we hope to shed some light on to what is leading to these reoccurring surgeries following a repair. I look forward to diving into this clinical research in the following weeks. I will also be observing some incredible cardiothoracic surgeries in the following weeks as well so stay tuned!


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