By Dr. Ross Feldman,
Medical Lead,
Cardiac Sciences Manitoba

December 07, 2021


Cardiac Sciences Program Highlight of the month

The Intensive Care Cardiac Surgery  Unit (ICCS): A snap shot of a once-in-a-lifetime year

The Intensive Care Cardiac Surgery Unit, ICCS manages the care of post-operative open-heart surgery patients – from valve repair/replacement surgery to valve & coronary artery bypass surgery to complex, intricate heart-to-aorta procedures and venous-arterial extracorporeal membrane oxygenation procedures (VA-ECMO).

While the patients are in ICCS, their care is managed by cardiac intensivists, led by co-directors Rakesh Arora and Johann Strumpher. The unit also has a group of dedicated nurses who are experts in the care of the post-operative cardiac surgery patient. The team also includes health care aides, unit clerks, unit attendants, perfusionists, respiratory therapists, physiotherapists, nutrition services, and housekeepers, who take pride in our environment and the care we provide to our patients. The team provides excellent care and makes sure the patient receives the best possible rehabilitation after surgery.

Did you know…. patients are mobilized to sitting position at the side of the bed as early as 6 hours after surgery. We also strive to support our patients and families as they navigate through the process of having had open heart surgery.

This past year has been additionally challenging for the ICCS team with the COVID pandemic. ICCS beds have been utilized for overflow from the other critical care units at SBH (both the coronary care unit- ACCU, and the Med/Surg ICU- ICMS) to assist in the increase in critically ill patients due to COVID and increasing cardiac critical care demands.  ICCS nurses have been asked to assist in many other units over the course of the last year, this challenge of being pulled from one’s home unit is recognized and appreciated as is the way they maintain their excellent standards of care.

Sals Star of the Week:  Felix Michouchenko (introduced by Michael Foth)

‘Felix in 5’

People are, and will always be, our greatest asset. 

‘A hungry stomach, an empty wallet and a broken heart can teach you the best lessons of life’. (Robin Williams).  Now I don’t pretend to understand what others have gone through, and I do realize this may parallel many.  Fact is, this individual overcame obstacles and excelled while doing so.  Felix Michouchenko arrived to Canada with little English and learned it while working.  He re-did the majority of his high school at various adult education centers in order to have the opportunity to attend university.  After completing a BSc, he was one of the select few to complete the RRC Echocardiography program, and has been working as a cardiac sonographer at SBH since 2017.

‘A great man is hard on himself; a small man is hard on others’. (Confucius).  In a profession where the smallest details are considered – Felix is a perfectionist, critical of his work, but always helpful to offer insight and to volunteer his time to others.  He champions teamwork, staff education, and takes initiative for further specialized learning. 

‘If I had eight hours to chop down a tree, I’d spend six hours sharpening my ax’. (Abraham Lincoln).  Work smart.  Take initiative.  Without being asked, he evaluated all department workstations and provided a quality update on each, including an inventory assessment on immediate ordering.  Felix offers solutions, not barriers, that ultimately enhances patient care allowing a more efficient echo lab.

I’ve had the opportunity to work side by side with Felix over the years and have admired his work ethic, attitude, and positivity.  He is the first to pick up shifts, stay late, or assist when needed.  Felix, I have stopped counting the times you have made your team proud because it has been happening pretty often.  ‘Quality means doing it right when no one is looking.’ (Henry Ford).

On that note, I’m happy to recognize Felix Michouchenko as this week’s Sal’s Star.

Please join us in welcoming our two newest members of the CIA/PA group

Congratulations to members of our Cardiac Science community recognized for their 15 years of committed service to the care of cardiac patients in Manitoba.

This Week’s Faculty Publications

Abdelsalam M Elhenawy, Dale C Lien, Abbas Khani-Hanjani, Nitin Ghorpade  Redo Heart Double-Lung Transplant in a Previous Double-Lung Transplant Recipient With Pneumonectomy: A Case Report  Case Reports Transplant Proc. 2021 Oct;53(8):2616-2618. doi: 10.1016/j.transproceed.2021.06.015. Epub 2021 Jul 8.

Iosif Xenogiannis, Khaldoon Alaska, Oleg Krestyaninov, Dmitrii Khelimskii, Jaikirshan J Khatri, James W Choi, Farouc A Jaffer, Mitul Patel, Ehtisham Mahmud, Anthony H Doing, Phil Dattilo, Michalis Koutouzis, Ioannis Tsiafoutis, Barry Krensky, Brian K Jefferson, Taral Patel, Wissam Jaber, Habib Samady, Abdul M Sheikh, Robert W Yeh, Hector Tamez, Basem Elbarouni, Michael P Love, Nidal Abi Rafeh, Assaad Maalouf, Abou Jaoudeh Fadi, Catalin Toma, Alpesh R Shah, Raj H Chandwaney, Mohamed Omer, Michael S Megaly, Evangelia Vemmou, Ilias Nikolakopoulos, Bavana V Rangan, Santiago Garcia, Shuaib Abdullah, Subhash Banerjee, M Nicholas Burke, Dimitri Karmpaliotis, Emmanouil S Brilakis  Impact of adherence to the hybrid algorithm for initial crossing strategy selection in chronic total occlusion percutaneous coronary intervention  Rev Esp Cardiol (Engl Ed). 2021 Dec;74(12):1023-1031. doi: 10.1016/j.rec.2020.09.009. Epub 2020 Nov 12.

Matheus Simonato, Brian Whisenant, Henrique Barbosa Ribeiro, John G Webb, Ran Kornowski, Mayra Guerrero, Harindra Wijeysundera, Lars Søndergaard, Ole De Backer, Pedro Villablanca, Charanjit Rihal, Mackram Eleid, Jörg Kempfert, Axel Unbehaun, Magdalena Erlebach, Filip Casselman, Matti Adam, Matteo Montorfano, Marco Ancona, Francesco Saia, Timm Ubben, Felix Meincke, Massimo Napodano, Pablo Codner, Joachim Schofer, Marc Pelletier, Anson Cheung, Mony Shuvy, José Honório Palma, Diego Felipe Gaia, Alison Duncan, David Hildick-Smith, Verena Veulemans, Jan-Malte Sinning, Yaron Arbel, Luca Testa, Arend de Weger, Helene Eltchaninoff, Thibault Hemery, Uri Landes, Didier Tchetche, Nicolas Dumonteil, Josep Rodés-Cabau, Won-Keun Kim, Konstantinos Spuria’s, Panagiota Kourkoveli, Ori Ben-Yehuda, Rui Campante Teles, Marco Barbanti, Claudia Fiorina, Arun Thukkani, G Burkhard Mackensen, Noah Jones, Patrizia Presbitero, Anna Sonia Petronio, Abdelhakim Allali, Didier Champagnac, Sabine Bleiziffer, Tanja Rudolph, Alessandro Iadanza, Stefano Salizzoni, Marco Agrifoglio, Luis Nombela-Franco, Nikolaos Bonaros, Malek Kass, Giuseppe Bruschi, Nicolas Amabile, Adnan Chhatriwalla, Antonio Messina, Sameer A Hirji, Martin Andreas, Robert Welsh, Wolfgang Schoels, Farrel Hellig, Stephan Windecker, Stefan Stortecky, Francesco Maisano, Gregg W Stone, Danny Dvir  Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement: Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry   Circulation. 2021 Jan 12;143(2):104-116. doi: 10.1161/CIRCULATIONAHA.120.049088. Epub 2020 Sep 25.

Anna M Chudyk, Sandra Ragheb, David Kent, Todd A Duhamel, Carole Hyra, Mudra G Dave, Rakesh C Arora, Annette Schultz  Patient Engagement in the Design of a Mobile Health App That Supports Enhanced Recovery Protocols for Cardiac Surgery: Development Study  JMIR Perioper Med. 2021 Nov 30;4(2):e26597. doi: 10.2196/26597.

Rohan M Sanjanwala, Brett Hiebert, David Kent, Sandy Warren, Hilary Grocott, Rakesh C Arora  A Quality Improvement Initiative to Reduce Postoperative Delirium among Cardiac Surgery Patients  Geriatrics (Basel). 2021 Nov 16;6(4):111. doi: 10.3390/geriatrics6040111.

I hope you are staying safe and healthy — and warm.