MITRAL RUMBLES

Category: CSP News

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

December 16, 2022

ANNOUNCEMENTS

Sals Star of the Week: Kathy Puzio  

(Introduced by Linda McLean)

I am pleased to announce that the NICT selection for Sal’s Star of the Week is Kathy Puzio. Kathy is one of our long time Cardiology Technologists. She started as a Health Care Aide in The Emergency Department, took her training at Red River College and successfully completed the CSCT registration exam to join our team 15 years ago.

Kathy is one of the most patient focused healthcare providers I have ever seen.

Her skills as an RCT and dedication to patient advocacy have resulted in a number of good catches where her keen eyes and knowledge resulted in patients being brought back to our emergency department or code blues and CPR started in hallways where signs of prearrest are seen by the techs stationed close by and acted upon. She supports patients in her care by responding to all their needs in a friendly compassionate manner be it bringing them blankets, water or engaging the nursing group or healthcare aides.  As a preceptor or mentor Kathy shines with her attributes of patience, supportive instruction and excellence in clinical knowledge; retained, kept current and shared with all whom she works with.

Kathy’s work ethic and dedication in managing her busy life with two young children Matthew and Lucas and husband Richard yet still being able to fill in for staffing gaps has sustained our department through tough times over the last few years.  Her flexibility to move shifts and provide task assistance in all areas needing coverage ensure that the supported diagnostic are delivered to maintain and reduce waitlists and meet standard of care targets. I am proud to call Kathy my colleague.

Please join me in celebrating Kathy Puzio as the NICT Sal’s Star of the week.

Shout Out!

Congratulations to Dr. Colette Seifer on her recent appointment as Provincial Medical Lead for Noninvasive Cardiac Testing, Shared Health Diagnostic Services.

Dr. Seifer will be working with the Diagnostic Services team on several NICT initiatives.

National Physician Assistant Day was this past weekend on Sunday, November 27th.  Physician Assistants and Clinical Assistants are a vital part of Cardiac Sciences.  PA/CA’s work closely with physicians and contribute greatly to the quality of care and patient satisfaction in our Program.  Thank you to all our PA/CA’s for their valuable contributions to Cardiac Sciences.

This Week’s Faculty Publications

Thomas M Roston, Derek Y So, Shuangbo Liu, Christopher B Fordyce, Brian Grunau, Jacob C Jentzer, Akshay Bagai, Adriana Luk, Shaun G Goodman, Sean van Diepen Leveraging Existing STEMI Networks to Regionalize Cardiogenic Shock Systems of Care: Efforts to Expand the Scope Could Improve Shock Outcomes  Can J Cardiol. 2022 Nov 16;S0828-282X(22)01040-6. doi: 10.1016/j.cjca.2022.11.005. Online ahead of print.

Robert S Sheldon, Colette Seifer, Ratika Parkash, Roopinder K Sandhu, Rasha Hamzeh, Satish R Raj Atomoxetine for suppression of vasovagal syncope  Clin Auton Res. 2022 Nov 19. doi: 10.1007/s10286-022-00905-x. Online ahead of print.

Malek Kass, Nasir Shaikh, Owen Mooney, Ashish H Shah Resting Hypoxia and a Strongly Positive Bubble Test: Do Not Forget Hepato-Pulmonary Syndrome  Heart Lung Circ. 2022 Nov;31(11):e149-e150. doi: 10.1016/j.hlc.2022.05.047. Epub 2022 Aug 15.

Judit Karacsonyi, Spyridon Kostantinis, Bahadir Simsek, Khaldoon Alaswad, Dimitri Karmpaliotis, Ajay Kirtane, Farouc Jaffer, James W Choi, Michalis Koutouzis, Ioannis Tsiafoutis, David E Kandzari, Paul Poommipanit, Jaikirshan J Khatri, Basem Elbarouni, Sevket Gorgulu, Ahmed ElGuindy, Nidal Abi Rafeh, Omer Goktekin, Imre Ungi, Bavana V Rangan, Yader Sandoval, Salman Allana, M Nicholas Burke, Emmanouil S Brilakis Use of the Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention  JACC Cardiovasc Interv. 2022 Nov 28;15(22):2284-2293. doi: 10.1016/j.jcin.2022.08.052

October 28, 2022

ANNOUNCEMENTS

Sals Stars of the Month:

Jonathan Hsiung (Introduced by Sara Unrau)

For Sals Star of the Week, I would like to recognize Jonathan Hsiung.  Jonathan is a hardworking, dedicated nurse, with a keen sense of curiosity about what and why things are going the way they are. He does not hesitate to ask questions to make sure he understands the rationale behind any care changes or changes in patient condition. For example, he recently cared for a patient with some unexplained neurological changes that were not explained by any testing that had been completed to date. During multidisciplinary rounds Jonathan questioned whether this could be related to meningitis. After some testing this was confirmed and the treatment plan was adjusted to treat his meningitis. As Dr. Luqman stated, it was his questions that led to making sure the patient was receiving the appropriate treatment. A thank you to Jonathan and his questioning mind. Keep it up! Join me in congratulating Jonathan Hsiung on being Sals Star of the Week.

Justin Poulsen (Introduced by Linda MacLean)

I am pleased to introduce NICT’s Justin Poulsen, General Duty Cardiology Technologist as the Sal’s Star of the week.   Justin graduated from the Cardiology Technology Diploma program at Stenberg College in 2020. He secured a part time position at SBH on the day/night shift and jumped into the demanding and often chaotic EKG world. Justin has a friendly and approachable attitude and always looks for the positive in people and situations. He tries to see the bigger picture when confronted with challenges and approaches complex situations with calm. He has great attention to detail and has been valuable in coaching out any new processes with peers. Justin is appreciated as a team player in his flexibility and easy going nature when he is reassigned from area to area. Justin has continued to support our profession by appearing at the Stenberg College information sessions online to speak on the student experience and the employment opportunities in this field. He is an active participant in our department as a part of the social committee in planning events and recognizing special occasions for our team. Recently Justin became our first D/N tech to complete training in Holter analysis. He approached the training with a keen interest, great computer skills and a solid arrhythmia knowledge which allowed him to pick up this modality quickly and accurately. He will lead the night duo initiating Holter analysis on this shift to assist in maintaining the turnaround time goals for NICT.

He commutes daily from Elm Creek Manitoba where he lives with his wife Alex and his dog Dunsten.

Wanda Penner and Michaele Rivet (Introduced by Anita Maric)

I would like to recognize Wanda Penner and Michaele Rivet, Patient Safety Consultants (PSCs) as this week’s Sals Stars of the Week.

Wanda and Michaele are both much valued and respected members of the cardiac team and are an integral part of our patient safety processes. They lead and are heavily involved in the Cardiac Sciences Critical Incident (CI) Review Process and work closely with our program providers, patients and their families, management, and leadership, and other stakeholders to provide patient safety expertise, guidance, and overall support. The PSCs monitor the RL patient safety event reporting system and provide follow-up support to and consultation with the units/areas as patient safety trends and themes arise. Most recently, with a spike in CIs and recent influx of patient safety events, Wanda and Michaele have worked diligently to review these events with our team, identifying several gaps in our processes and procedures, and helped our teams learn from these events, mitigate risks, and make significant strides in our quality improvement and patient safety work across our program.

Wanda and Michaele are an asset to our team. Their leadership and support with the CI process is invaluable. Each CI or patient safety event is thoroughly reviewed including a review of the clinical documentation, interviews with providers, patients and their families, and other key stakeholders to gain all perspectives on the event, the gaps, learnings, and explores ways to mitigate these risks and prevent these events from happening to another patient. The final report prepared by the PSCs highlight the results of the investigation and provide meaningful and actionable recommendations (a roadmap for patient safety and quality improvement) for our program.

Thank you Wanda and Michaele for your patient safety science and quality management systems expertise, your professional independent and unbiased perspective, and for your thoughtful reviews, recommendations and overall support with the patient safety follow-up work! Your people-centered and thoughtful approach to this dynamic and complex work is admirable and sets the bar for excellence. Your passionate advocacy for patient safety and collaborative and caring approach doesn’t go unnoticed. Thank you for facilitating and promoting a culture of safety, learning, and continuous quality improvement for our team.

The Cardiac Sciences team is fortunate and grateful for Wanda and Michaele’s dedication and contributions to our program. It is a true pleasure and honor to work alongside these experts. Thank you, Wanda and Michaele (and your patient safety team), for everything you do to enhance patient safety in our program and health system!

Shout Outs!

Congratulations to Melanie Beauchemin, Physician Assistant, and her husband, Sunny,  on the arrival of their new baby girl.   Ruby Grace Rooprai was born October 23rd weighing 7lb 14oz.  Mom and baby are doing great and bit brother Felix is excited to have a little sister!

This past week was Canadian Patient Safety Week, Oct 24-28, 2022.  The theme for this year is “Safer Care for Older Adults”.   

Resources:  Patient harm in Canadian hospitals? It does happen. | CIHI     Now’s the time to “press play on safety conversations” (healthcareexcellence.ca)

November  is National Fall Prevention Month.  The FPM website has been recently  updated with new activities.  To access, click on the link:https://www.fallpreventionmonth.ca/

This Month’s Faculty Publications

Hellmuth R Muller Moran, Michael H Yamashita , Rakesh C Arora Reply: Right, wrong, or somewhere in between?  JTCVS Open. 2022 Apr 29;11:153. doi: 10.1016/j.xjon.2022.04.037. eCollection 2022 Sep

Monica Parry, Sarah Visintini, Amy Johnston, Tracey Jf Colella, Deeksha Kapur, Kiera Liblik, Zoya Gomes, Sonia Dancey, Shuangbo Liu, Catherine Goodenough, Jacqueline L Hay, Meagan Noble, Najah Adreak, Helen Robert, Natasha Tang, Arland O’Hara, Anice Wong, Kerri-Anne Mullen Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map BMJ Open. 2022 Oct 5;12(10):e067812. doi: 10.1136/bmjopen-2022-067812.

Sarah Gibbs, Evan J Wiens, Kunal Minhas One-year outcomes in patients who underwent coronary intravascular shockwave lithotripsy for highly-calcified coronary lesions  Indian Heart J. 2022 Oct 8;S0019-4832(22)00144-4. doi: 10.1016/j.ihj.2022.10.001. Online ahead of print.

Evan J Wiens, Meagan Deviaene, Ashish H Shah Clinical Applications of High-Sensitivity Troponin Testing: From Diagnosis to Prognosis  Can J Cardiol. 2022 Oct;38(10):1521-1524. doi: 10.1016/j.cjca.2022.05.008. Epub 2022 May 13.

Monica Parry, Sarah Visintini, Amy Johnston, Tracey Jf Colella, Deeksha Kapur, Kiera Liblik, Zoya Gomes, Sonia Dancey, Shuangbo Liu, Catherine Goodenough, Jacqueline L Hay, Meagan Noble, Najah Adreak, Helen Robert, Natasha Tang, Arland O’Hara, Anice Wong, Kerri-Anne Mullen Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map  BMJ Open. 2022 Oct 5;12(10):e067812. doi: 10.1136/bmjopen-2022-067812.

James O Burton, Andrew J S Coats, Csaba P Kovesdy, Biff F Palmer, Ileana L Piña, Giuseppe Rosano, Manish M Sood, Shelley Zieroth An international Delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum  Eur J Heart Fail. 2022 Sep;24(9):1467-1477. doi: 10.1002/ejhf.2612. Epub 2022 Aug 4.

Raghu S Nagalingam, Sikta Chattopadhyaya, Danah S Al-Hattab, David Y C Cheung, Leah Y Schwartz, Sayantan Jana, Nina Aroutiounova, D Allison Ledingham, Teri L Moffatt, Natalie M Landry, Rushita A Bagchi, Ian M C Dixon, Jeffrey T Wigle, Gavin Y Oudit, Zamaneh Kassiri, Davinder S Jassal, Michael P Czubryt Scleraxis and fibrosis in the pressure-overloaded heart  Eur Heart J. 2022 Oct 6;ehac362. doi: 10.1093/eurheartj/ehac362. Online ahead of print

Pedram Hassan-Tash, Umar Ismail, Iain D C Kirkpatrick, Amir Ravandi, Davinder S Jassal, Brett Hiebert, Malek Kass, Richard A Krasuski, Ashish H Shah Correlation of impedance cardiography-derived and cardiac magnetic resonance-derived stroke volumes  Curr Probl Cardiol. 2022 Oct 20;101457. doi: 10.1016/j.cpcardiol.2022.101457. Online ahead of print.

Andrija Matetic, Bonnie Ky, Eric H Yang, Phyo K Myint, Muhammad Rashid, Shelley Zieroth, Timir K Paul, Ayman Elbadawi, Mamas A Mamas Prevalence, characteristics and mortality of cancer patients undergoing pericardiocentesis in the United States between 2004 and 2017  Cancer Med. 2022 Oct 20. doi: 10.1002/cam4.5373. Online ahead of print.

Jacqueline Saw, Andrew Starovoytov, Eve Aymong, Taku Inohara, Mesfer Alfadhel, Cameron McAlister, Rohit Samuel, Tejana Grewal, Johandra Argote Parolis, Tej Sheth, Derek So, Kunal Minhas, Neil Brass, Andrea Lavoie, Helen Bishop, Shahar Lavi, Colin Pearce, Suzanne Renner, Mina Madan, Robert C Welsh, Brent M McGrath, Ram Vijayaraghavan, Bryan Har, Reda Ibrahim, Pulkit Chaudhary, Santhi K Ganesh, John Graham, Alexis Matteau, Giuseppe Martucci, Dennis T Ko, Karin Humphries, Gb John Mancini Canadian Spontaneous Coronary Artery Dissection Cohort Study: 3-Year Outcomes J Am Coll Cardiol. 2022 Oct 25;80(17):1585-1597. doi: 10.1016/j.jacc.2022.08.759.

Charles Michael Pearman, David Lee, Brianna Davies, Habib Khan, Rafik Tadros, Julia Cadrin-Tourigny, Jason D Roberts, Shubhayan Sanatani, Christopher Simpson, Paul Angaran, Simon Hansom, Erkhan Ilhan, Colette Seifer, Martin Green, Martin Gardner, Mario Talajic, Zachary Laksman, Jeff S Healey, Andrew D KrahnThe Incremental Value of the Signal Averaged ECG for Diagnosing Arrhythmogenic Cardiomyopathy  Heart Rhythm. 2022 Oct 13;S1547-5271(22)02491-2. doi: 10.1016/j.hrthm.2022.10.005. Online ahead of print.

Rachel Eikelboom, Michael H Yamashita Commentary: Until the ideal aortic valve prosthesis is invented, pick your poison!  J Thorac Cardiovasc Surg. 2022 Nov;164(5):1456-1457. doi: 10.1016/j.jtcvs.2020.11.123. Epub 2020 Dec 3.

Abdul Mannan Khan Minhas, Dmitry Abramov, Joshua S Chung, Jay Patel, Mamas A Mamas, Shelley Zieroth, Richa Agarwal, Marat Fudim, David G Rabkin Current status of perioperative temporary mechanical circulatory support during cardiac surgery J Card Surg. 2022 Oct 13. doi: 10.1111/jocs.17020. Online ahead of print.

September 26, 2022

ANNOUNCEMENTS

Sals Star of the Week: Eva Stephens  

(Introduced by Lorraine Avery

I would like to introduce Eva Stephens, Registered Nurse with the Dr. David Mymin Lipid Clinic as the Sal’s Star of the Week. Eva brings a wealth of knowledge and expertise to her current position including an extensive background working in ambulatory care and chronic disease clinics.

Eva’s evidence informed approach to nursing practice facilitates care based on the best research evidence and is grounded in the healthcare goals and values of each individual patient. Eva consistently and successfully applies this knowledge and skill to effect excellence in patient care.

Eva exemplifies professionalism in nursing practice. She is empathic, respectful, committed to patient advocacy, has strong problem-solving skills, and continually seeks out ongoing learning opportunities. Eva is authentic in her communication with patients and colleagues characterized by honesty, integrity, empathy, and self-awareness.

Eva is passionate about her work and is always willing to share her knowledge and expertise with others. Eva is an accomplished public speaker and has provided numerous presentations to the public and to healthcare professionals. Most recently, she was asked to present at St. Paul’s Hospital on phytosterolemia. She has presented at national conferences including the Canadian Cardiovascular Society.

Eva is a role model, mentor and leader who inspires excellence in patient care and is well deserving of this recognition.

Congratulations to Shelley Zieorth on her recent accomplishment!

This Week’s Faculty Publications

Kaveh Rayani, Brianna Davies , Matthew Cheung, Drake Comber, Jason D Roberts, Rafik Tadros, Martin S Green, Jeffrey S Healey, Christopher S Simpson, Shubhayan Sanatani, Christian Steinberg, Ciorsti MacIntyre, Paul Angaran, Henry Duff, Robert Hamilton, Laura Arbour, Richard Leather, Colette Seifer, Anne Fournier, Joseph Atallah, Shane Kimber, Bhavanesh Makanjee, Wael Alqarawi, Julia Cadrin-Tourigny, Jacqueline Joza, Martin Gardner , Mario Talajic, Richard D Bagnall, Andrew D Krahn, Zachary W M Laksman  Identification and in-silico characterization of splice-site variants from a large cardiogenetic national registry  Eur J Hum Genet. 2022 Sep 22. doi: 10.1038/s41431-022-01193-9. Online ahead of print.

Rimpy Dhingra, Inna Rabinovich-Nikitin, Sonny Rothman, Matthew Guberman, Hongying Gang, Victoria Margulets, Davinder S Jassal, Keshav Narayan Alagarsamy, Sanjiv Dhingra, Carla Valenzuela Ripoll, Filio Billia, Abhinav Diwan, Ali Javaheri, Lorrie A Kirshenbaum Proteasomal Degradation of TRAF2 Mediates Mitochondrial Dysfunction in Doxorubicin-Cardiomyopathy  Circulation. 2022 Sep 20;146(12):934-954. doi: 10.1161/CIRCULATIONAHA.121.058411. Epub 2022 Aug 19.

Muhammad Usman Ali, G B John Mancini, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Shelley Zieroth, Eileen O’Meara, Kim A Connelly, Diana Sherifali Response to Dr. Du letter to the editor  Can J Cardiol. 2022 Sep 21;S0828-282X(22)00866-2. doi: 10.1016/j.cjca.2022.09.017. Online ahead of print.

September 16, 2022

ANNOUNCEMENTS

Sal’s Stars of the Week: Benjamin Bakulu

(Introduced by Dalibor Gavranovic)

This week Sal’s Star of the week is Benjamin Bakulu.

Ben has been an educator since 2018 for Medicine, Palliative and Cardiac Programs. As all the other educators are supporting their teams and cross covering for each other on every day basis, Ben has been an integral part of 6A team.  Ben is patient focused, driven to support staff in continuing education and working on patient flow improvements. When PRU transitioned to 5A Cardiology, he was very involved to support and educate staff, move appropriate equipment and supplies.  Lately, there has been staff shortages on every unit, which leads to balancing the needs across the whole hospital. One morning 6A ended up being short a charge nurse, even though his schedule was solid booked, he was able to reschedule and find a support within educator group. He took partial charge role on the unit while supporting nurse who had minimal charge training. His calm demeanor, capabilities to listen and understand staff needs has led to positive outcomes and staff satisfaction.

Please join me in congratulating Ben on being the Sal’s star of the week.

Shout out to the Cardiac Sciences Website Team!

Our website team continues to explore ways to best promote this information across the health system – to providers, patients, and the public.

The CSMB website was recently featured in the Doctors Manitoba weekly Message to Members (Sept. 14, 2022): This new partnership will help promote our website, and invites the physician community at large to review the valuable resources available, apply to their practice, and provide feedback and content suggestions for future website enhancements. The feature introduces our new website, highlights the core content available and its benefits for improving access to care. Check out the latest feature! https://doctorsmanitoba.ca/managing-your-practice/weekly-member-message/member-message-september-14-2022#cardiac

Congrats to the website team and the cardiac community as a whole for your efforts to help keep the website content current, to continue to build on the rich resources available, and spread the message  across your teams!

MitraClip Program at St. Boniface Hospital

On September 13, 2022, the MitraClip program at St. Boniface Hospital officially started. The first patient was an 87 year old female with severe mitral regurgitation, multiple co-morbidities but very functional. The procedure was done under general anesthesia, led by Drs. Kass and Shah and performed as a multi-disciplinary team (echo led by Drs. Barac and Promislow, and anesthesia by Dr. Van De Heever). One MitraClip XTW was placed in the middle scallops of the mitral valve and left with final trace mitral regurgitation. This is a resounding success and the entire team should be congratulated.

World Patient Safety Day 2022

On September 17, World Health Organization celebrated World Patient Safety Day 2022.

“Medications are the most widely utilized interventions in health care, and medication-related harm constitutes the greatest proportion of the total preventable harm due to unsafe care, let alone the economic and psychological burden imposed by such harm. Acknowledging this substantial burden and recognizing the complexity of medication-related harm prevention and reduction, the theme of World Patient Safety Day 2022 is “Medication Safety” (World Patient Safety Day 2022 (who.int)).

Canadian PS Week is celebrated Oct. 24-28, 2022. This year’s theme is Safer Care for Older Adults. For more info, contest details, how to get involved, and access to valuable resources like the medication safety ‘It’s Safe to Ask’ tool, please visit the Shared Health’s website at https://sharedhealthmb.ca/health-providers/patient-safety-week/

World Patient Safety Day: September 17, 2022 – Shared Health Intranet (sharedhealthmb.ca)

This Week’s Faculty Publications

Lauren A Yee, Hui-Chen Han, Brianna Davies, Charles M Pearman, Zachary W M Laksman, Jason D Roberts, Christian Steinberg, Rafik Tadros, Julia Cadrin-Tourigny, Christopher S Simpson, Martin Gardner, Ciorsti MacIntyre, Laura Arbour, Richard Leather, Anne Fournier, Martin S Green, Shane Kimber, Paul Angaran, Shubhayan Sanatani, Jacqueline Joza, Habib Khan , Jeffrey S Healey, Joseph Atallah, Colette Seifer, Andrew D Krahnn  Sex Differences and Utility of Treadmill Testing in Long-QT Syndrome   Intensive Care Med. 2022 Jul;48(7):801-810. doi: 10.1007/s00134-022-06660-x. Epub 2022 May 19

September 13, 2022

ANNOUNCEMENTS

Sals Star of the Week: Oksana Sosnovska  

(Introduced by Tim Dyck)

This week I would like to take a moment to recognize Oksana Sosnovska as the Sals Star of the week. Oksana is a nurse on 5A Cardiology, and this week was placed in the unenviable position of being assigned charge nurse responsibility with little to no prior training or experience in that role, during a challenging week with high acuity and high patient volumes. Oksana managed this responsibility with poise, acting as an advocate for patients, safe patient care and for her team. Her communication was honest and respectful, and she was thoughtful in her decision making.

Congrats Oksana on being named Sals Star of the week.

Celebrating TAVI Tuesday

September 11 is the 10th anniversary of performing TAVIs in Manitoba! In this time, we have provided care to over 600 patients. It takes a team to deliver exceptional care and to celebrate this team, there was a drop in celebration on September 6th. Posters sharing a timeline of TAVI in Manitoba, outcomes, and volumes were created and will be housed in the CR1 clinic area. There were video messages from the TAVI MDs, patients, and many of the team members who support TAVI sharing congratulations, thanks, and the various roles supporting TAVI. Thank you to all who attended and to the entire team who cares for TAVI patients. We look forward to the future of TAVI in Manitoba!

Emily Hyde, RN, MN, CCN(C)
Clinical Nurse Specialist
Cardiac Sciences Manitoba

https://cccn.ca/_uploads/6308ed86cc433.pdf

This Week’s Faculty Publications

Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi , Khaldoon Alaswad, Oleg Krestyaninov , Dmitrii Khelimskii, Dimitri Karmpaliotis, Farouc A Jaffer, Jaikirshan J Khatri, Paul Poommipanit, James W Choi, Wissam A Jaber, Stéphane Rinfret, William Nicholson, Mitul P Patel , Ehtisham Mahmud, Philip Dattilo, Sevket Gorgulu, Michael Koutouzis, Ioannis Tsiafoutis, Basem Elbarouni, Abdul M Sheikh, Barry F Uretsky, Ahmed M ElGuindy, Brian K Jefferson, Taral N Patel, Jason Wollmuth, Robert F Riley, Stewart M Benton Jr, Rhian E Davies, Raj H Chandwaney, Catalin Toma , Robert W Yeh, Daniel R Schimmel, Nidal Abi Rafeh , Omer Goktekin, Jimmy L Kerrigan, Olga C Mastrodemos, Bavana V Rangan, Santiago Garcia, Yader Sandoval, M Nicholas Burke, Emmanouil Brilakis   In-hospital outcomes and temporal trends of percutaneous coronary interventions for chronic total occlusion  EuroIntervention. 2022 Sep 6;EIJ-D-22-00599. doi: 10.4244/EIJ-D-22-00599. Online ahead of print.

Arjun K GuptaZubair LuqmanBasem ElbarouniOptical Coherence Tomography Evaluation of Extraluminal Left Circumflex Artery Compression Following Mitral Valve Replacement  CJC Open. 2022 May 18;4(8):735-736. doi: 10.1016/j.cjco.2022.05.002. eCollection 2022 Aug.

Biobelemoye Ebehireme Irabor, Asha Kothari, Jonathan Hong, Bronte Burnette-Chiang, David Kent, Todd Duhamel, Rakesh C Arora Use of intraoperative haemostatic checklists on blood management in patients undergoing cardiac surgery: a scoping review protocol  BMJ Open. 2022 Aug 24;12(8):e064098. doi: 10.1136/bmjopen-2022-064098.

Alexandra Bastiany, Christine Pacheco, Tara Sedlak, Jaqueline Saw, Steven E S Miner, Shuangbo Liu, Andrea Lavoie, Daniel H Kim, Martha Gulati, Michelle M Graham A Practical Approach to Invasive Testing in Ischemia With No Obstructive Coronary Arteries (INOCA)  CJC Open. 2022 May 4;4(8):709-720. doi: 10.1016/j.cjco.2022.04.009. eCollection 2022 Aug.

Stephanie Poon, Benjamin Leis, Laurie Lambert, Kendra MacFarlane, Kim Anderson, Claudia Blais, Catherine Demers, Justin A Ezekowitz, Nathaniel M Hawkins, Douglas S Lee, Gordon Moe, Roopinder K Sandhu, Sean A Virani, Stephen Wilton, Shelley Zieroth, Robert McKelvie The State of Heart Failure Care in Canada: Minimal Improvement in Readmissions Over Time Despite an Increased Number of Evidence-Based Therapies CJC Open. 2022 Aug 12;4(8):667-675. doi: 10.1016/j.cjco.2022.04.011. eCollection 2022 Aug.

Vishnu Vasanthan, Amy Brown, Aaron Spooner, William D T Kent, Daniel Holloway  Virtual Adaptation of Multimodal Cardiac Surgery Residency Interview: For the Pandemic and the Future  Ann Thorac Surg. 2022 Sep;114(3):618-620. doi: 10.1016/j.athoracsur.2021.09.022. Epub 2021 Oct 19.

August 22, 2022

ANNOUNCEMENTS

Sals Star of the Week:  Marge Wiebe

(Introduced by Chris Kuttnig)

Marge Wiebe is one of the cardiac pacemaker clinic nurses and also continues to casual in the ICU.  This week Marge was scheduled to work early evenings in ICMS when we reassigned her to ACCU.  5A was short staffed, the CRN had a patient assignment and ACCU was staffed to census.  Marge was asked if she would volunteer to go to 5A for the early evening shift instead and she eagerly agreed to go and help out the unit with tasks, vitals, and whatever they could use.  She stated she had never been there before but was eager to assist them.  The CRN and staff on 5A couldn’t thank Marge enough.  She kept coming to them and saying what else can I do or help with?  An emergency nurse had been reassigned as well to 5A and had limited exposure to the unit.  A patient needed to come to 5A to recover from their pacemaker implant and the newer nurse had never recovered a post-implant patient before.  Marge identified that she’s a pacemaker clinic nurse and she’ll recover that patient.  5A said they “didn’t know what they would have done without her”.  Marge is known for her flexibility, hard-working and helping nature.  Thank you, Marge.  Congratulations on being the Sals Star of the Week.

What’s New…

 A new Echocardiography Department officially opened at the Grace Hospital on Monday August 22, 2022.  The addition of this device enables new on-site capacity for this diagnostic test, reducing the need for transfers to other acute facilities and improving turnaround times for Grace Hospital patients requiring this diagnostic exam. The echocardiography scanner will provide approximately 1,500 additional exams each year.  The new department was made possible with the support of The Grace Hospital Foundation.

August Faculty Publications

Nicole R Guinn, Jonathon Schwartz, Vicki Morton-Bailey, Solomon Aronson, Charles Scott Brudney, Elliott Bennett-Guerrero, Perioperative Quality Initiative (POQI-8) and the Enhanced Recovery After Surgery-Cardiac Society (ERAS-C) Investigators  Perioperative Quality Initiative and Enhanced Recovery After Surgery-Cardiac Society Consensus Statement on the Management of Preoperative Anemia and Iron Deficiency in Adult Cardiac Surgery Patients  Anesth Analg. 2022 Sep 1;135(3):532-544. doi: 10.1213/ANE.0000000000006148. Epub 2022 Aug 17.

Kevin R Bainey, Alexandra Bastiany, Eric Cohen, Janine Eckstein, Basem Elbarouni, Michelle M Graham, Bakhtiar Kidwai, Andrea Lavoie, Shuangbo Liu, Samer Mansour, Alexis Matteau, Blair O’Neill, Janarthanan Sathananthan, Mathew Sibbald, Robert C Welsh, Mina Madan  2022 CCS/CAIC Guidelines for Training and Retraining in Adult Interventional Cardiology Can J Cardiol. 2022 Aug;38(8):1307-1311. doi: 10.1016/j.cjca.2022.02.027. Epub 2022 Mar 4.

Muhammad Usman Ali, G B John Mancini, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Shelley Zieroth, Eileen O’Meara, Kim A Connelly, Diana Sherifali The Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-like Peptide-1 Receptor Agonists on Cardiorenal Outcomes: Systematic Review and Meta-analysis Can J Cardiol. 2022 Aug;38(8):1201-1210. doi: 10.1016/j.cjca.2022.05.011.

Malek Kass, Nasir Shaikh, Owen Mooney, Ashish H Shah Resting Hypoxia and a Strongly Positive Bubble Test: Do Not Forget Hepato-Pulmonary Syndrome  Heart Lung Circ. 2022 Aug 15;S1443-9506(22)00968-4. doi: 10.1016/j.hlc.2022.05.047. Online ahead of print.

Marat Fudim, Izza Shahid, Sitaramesh Emani, Liviu Klein, Kara Dupuy-McCaulley, Shelley Zieroth, Robert J Mentz Evaluation and Treatment of Central Sleep Apnea in Patients with Heart Failure  Curr Probl Cardiol. 2022 Aug 19;101364. doi: 10.1016/j.cpcardiol.2022.101364. Online ahead of print.

Paloma Jordà, Laurens P Bosman, Alessio Gasperetti, Andrea Mazzanti, Jean Baptiste Gourraud, Brianna Davies, Tanja Charlotte Frederiksen, Zoraida Moreno Weidmann, Andrea Di Marco, Jason D Roberts, Ciorsti MacIntyre, Colette Seifer, Antoine Delinière, Wael Alqarawi, Deni Kukavica, Damien Minois, Alessandro Trancuccio, Marine Arnaud, Mattia Targetti, Annamaria Martino, Giada Oliviero, Daniel C Pipilas, Corrado Carbucicchio, Paolo Compagnucci, Antonio Dello Russo, Iacopo Olivotto, Leonardo Calò, Steven A Lubitz, Michael J Cutler, Philippe Chevalier, Elena Arbelo, Silvia Giuliana Priori, Jeffrey S Healey, Hugh Calkins, Michela Casella, Henrik Kjærulf Jensen, Claudio Tondo, Rafik Tadros, Cynthia A James, Andrew D Krahn, Julia Cadrin-Tourigny Arrhythmic risk prediction in arrhythmogenic right ventricular cardiomyopathy: external validation of the arrhythmogenic right ventricular cardiomyopathy risk calculator  Eur Heart J. 2022 Aug 21;43(32):3041-3052. doi: 10.1093/eurheartj/ehac289.

Rimpy Dhingra, Inna Rabinovich-Nikitin, Sonny Rothman, Matthew Guberman, Hongying Gang, Victoria Margulets, Davinder S Jassal, Keshav N Alagarsamy, Sanjiv Dhingra, Carla Valenzuela Ripoll, Filio Billia, Abhinav Diwan, Ali Javaheri, Lorrie A Kirshenbaum Proteasomal Degradation of TRAF2 Mediates Mitochondrial Dysfunction in Doxorubicin-Cardiomyopathy  Circulation. 2022 Aug 19;101161CIRCULATIONAHA121058411. doi: 10.1161/CIRCULATIONAHA.121.058411. Online ahead of print.

Biobelemoye Ebehireme Irabor, Asha Kothari, Jonathan Hong, Bronte Burnette-Chiang, David KentTodd Duhamel, Rakesh C Arora Use of intraoperative haemostatic checklists on blood management in patients undergoing cardiac surgery: a scoping review protocol  BMJ Open. 2022 Aug 24;12(8):e064098. doi: 10.1136/bmjopen-2022-064098.

July 31, 2022

ANNOUNCEMENTS

Sal’s Stars of the Week: The Medical Director Team of Cardiac Sciences MB  

(introduced by me!)

From Left to Right: Dr. Scott MacKenzie, Dr. Rakesh Arora, and Dr. Colette Seifer.

The purpose of the Sal’s Stars Program is to identify 1) individuals who have made a difference in the care of cardiac patients 2) focus on a recent event 3) focus on direct patient care.  This week I will use my prerogative as Medical Lead (and author of the rules for the Sal’s Star Program) to break all of them and present, this my last Sal’s Star Award, to my Medical Directors: Colette Seifer, Rakesh Arora and Scott MacKenzie for the support they have provided me over the past 5 years and especially through the initial waves of the COVID pandemic. On a daily basis. I am indebted to this team for their commitment to the cause of cardiac care and to their support of our efforts to bring together the Cardiac Sciences community. However, I am especially grateful for the work they did, on a 24/7 basis, as we reacted to the once-in-a-lifetime event of the early waves of the COVID-19 pandemic – working to minimize cardiac morbidity and mortality through those initial shutdowns that happened so quickly in 2020.  The systems they and their teams developed, essentially overnight, were critical in having a coordinated cardiac response to the pandemic.  On a personal basis, they were each individually and as a group a huge support for me as we all muddled through.

Thank you Colette, Rakesh and Scott for all the work you do to support cardiac care…. but today, for the support you have given me in the course of the most tumultuous period in healthcare I have been through– over my almost 50 years in Medicine!

Announcing the formation of the Precision Cardiovascular Medicine Group (PCMG) at St. Boniface Hospital/Cardiac Sciences MB.

There is a wealth of omics capacity currently at St. Boniface Research Centre. With formation of the PCMG we will now be able to offer this resource technologies to cardiovascular investigators at St. Boniface Hospital and St. Boniface Hospital Research Centre to develop novel diagnostics and therapeutics for patients with cardiovascular disease utilizing lipidomic and metabolomics.  

Core members of PCMG are Amir Ravandi, Ashish Shah, Michel Aliani, Harold Aukema

PCMG support for cardiovascular researchers will include help in:

1) Experimental design: Given the specific needs of implementing cardiovascular omics studies our team will offer assistance in experimental design, sample handling and logistics to ensure successful study.

2) Sample Analysis: Based on the current support the PCMG can offer Mass spectrometric analysis for clinical cardiovascular samples. This will include extraction and mass spectrometric analyses on our three platforms. For non-clinical samples and for cardiovascular investigators outside of St. Boniface Hospital in Manitoba and Canada to offer our services as a fee for service basis designed for cost recovery.

3) Bioinformatic analysis: The PCMG will also offer bioinformatic analysis for the samples analysed.

4) Assist in manuscript preparation: This will also include assistant with generating figures for publications, assistance with manuscript preparation and offer technical expertise.

The PCMG will establish the Cardiac Sciences Program and ICS at St. Boniface Hospital as the leading centre in Canada for cardiovascular lipidomics and metabolomic research. The goal of the PCMG is to  consolidate expertise in several areas of basic research at the ICS with clinical research in the Cardiac Sciences Program at SBH to encourage interaction, discussion and collaboration. The group is also intended to function as a broader resource for the research community in Manitoba offering intellectual and technical expertise on a collaborative basis.

This Week’s Faculty Publications

Stephanie P B Caligiuri, Grant N Pierce, Amir Ravandi, Harold M Aukema  The Plasma Oxylipidome Links Smoking Status to Peripheral Artery Disease  Metabolites. 2022 Jul 7;12(7):627. doi: 10.3390/metabo12070627.

Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Rhian Davies, Jeremy Rier,  Omer Goktekin, Sevket Gorgulu, Ahmed ElGuindy, Raj H Chandwaney, Mitul Patel, Nidal Abi Rafeh, Dimitrios Karmpaliotis, Amirali Masoumi, Jaikirshan J Khatri, Farouc A Jaffer, Darshan Doshi, Paul B Poommipanit, Bavana V Rangan, Yader Sanvodal, James W Choi, Basem Elbarouni, William Nicholson, Wissam A Jaber, Stephane Rinfret, Michael Koutouzis, Ioannis Tsiafoutis, Robert W Yeh, M Nicholas Burke, Salman Allana, Olga C Mastrodemos, Emmanouil S Brilakis  Predicting Periprocedural Complications in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Complication Scores JACC Cardiovasc Interv. 2022 Jul 25;15(14):1413-1422. doi: 10.1016/j.jcin.2022.06.007.

Michael C Grant, Sylvain A Lother, Daniel T Engelman, Ansar Hassan, Pavan Atluri, Rainer Moosdorf, J Awori Hayanga , HelenMari Merritt-Genore, Subhasis Chatterjee, Michael S Firstenberg, Hitoshi Hirose , Jennifer Higgins, Jean-Francois Legare, Yoan Lamarche, Malek Kass, Samer Mansour, Rakesh C Arora Surgical Triage and Timing for Patients With Coronavirus Disease: A Guidance Statement from The Society of Thoracic Surgeons Ann Thorac Surg. 2022 Aug;114(2):387-393. doi: 10.1016/j.athoracsur.2022.05.001. Epub 2022 May 18.

Ariane Marelli, Luc Beauchesne, Jack Colman, Robin Ducas, Jasmine Grewal, Michelle Keir, Paul Khairy, Erwin Oechslin, Judith Therrien, Isabelle F Vonder Muhll, Rachel M Wald, Candice Silversides, David J Barron, Lee Benson, Pierre-Luc Bernier, Eric Horlick, Réda Ibrahim, Giuseppe Martucci, Krishnakumar Nair, Nancy C Poirier, Heather J Ross, Helmut Baumgartner, Curt J Daniels, Michelle Gurvitz, Jolien W Roos-Hesselink, Adrienne H Kovacs, Christopher J McLeod, Barbara J Mulder, Carole A Warnes, Gary D Webb Canadian Cardiovascular Society 2022 Guidelines for Cardiovascular Interventions in Adults With Congenital Heart Disease Can J Cardiol. 2022 Jul;38(7):862-896. doi: 10.1016/j.cjca.2022.03.021. Epub 2022 Apr 20.

Ross

July 24, 2022

ANNOUNCEMENTS

Sal’s Stars of the Week: Trina Toro from NICT

(Introduced by Linda McLean)

Trina is currently a General Duty Cardiology Technologist in NICT who works in the Stress Lab as well as EKG. Trina came to Winnipeg in April of 2014 to work at Seven Oaks then later at HSC. We were fortunate to hire her permanently in December of 2014. Trina exemplifies the many quality dimensions of teamwork. Trina self-initiates assistance wherever she finds a gap and always steps up with a positive demeanor for task assistance no matter what the job at hand is. When we are short staffed, Trina has shifted her schedule to accommodate whatever we can use to ensure staffing levels with a pleasant helpful attitude. In addition, when there are staffing deficiencies Trina stays late or arrives early to assist with the workload so that her co-workers do not have to work alone. 

When providing orientation in Stress Lab to colleagues or students she is detail oriented, takes time  and provides complete explanations and background making her a sought out mentor in this area. Whenever Trina finds herself questioning a process or determining the correct action or strategy to follow, she seeks clarification from appropriate sources and then coaches out the resulting information to improve practices in the department. Trina challenges herself to always pursue excellence and provide the best care possible to all of her patients. When faced with intimidating circumstances Trina uses a logical approach and advocates for her patients, looks to use Team Stepps and enhance her communication and faces challenges with courage and optimism. She continues to challenge herself to grow as a technologist and as a person.

Trina has served her fellow Cardiology Technologists in the role of the MACT treasurer over multiple terms, and kindly offered to stay involved to mentor the incoming rookie in order to preserve and pass on the knowledge she has gained in the new systems that have been implemented during her tenure. Trina has guided the MACT Board of Directors for timelines and policy review and updates throughout her service and is appreciated by the board for her expertise. She maintains contact with the provincial technologists and administers the accounts and financial statements for the Association. She is humble and unassuming with a kind heart and generous spirit and one of the many terrific techs in the NICT department who deserve this recognition.

This Week’s Faculty Publications

Nebojša Oravec, Mackenzie A M King, Tyler Spencer, Rachel Eikelboom, David Kent, Kristin Reynolds, Renée El-Gabalawy, Anna M Chudyk, Colleen Metge, Alexandra Cornick, Rohan M Sanjanwala, Erika Lee, Brett Hiebert, Kristina Nugent, Mudra G Dave, Todd A Duhamel, Rakesh C Arora Barriers to successful discharge after cardiac surgery: A focus group study and cross-sectional survey  Semin Thorac Cardiovasc Surg. 2022 Jul 13;S1043-0679(22)00152-6. doi: 10.1053/j.semtcvs.2022.07.003. Online ahead of print.

Martin R Cowie, Ricardo Mourilhe-Rocha, Hung-Yu Chang, Maurizio Volterrani , Ha Ngoc Ban, Denilson Campos de Albuquerque, Edward Chung, Cândida Fonseca, Yuri Lopatin, José Antonio Magaña Serrano, Lilyana Mircheva, Gustavo Adolfo Moncada-Paz, Zurab Pagava, Eugenio B Reyes, Clara Saldarriaga, Pedro Schwartzmann, David Sim Kheng Leng, Marcelo Trivi, Yoto Trifonov Yotov, Shelley Zieroth, OPTIMIZE Heart Failure Care program coordinators The impact of the COVID-19 pandemic on heart failure management: Global experience of the OPTIMIZE Heart Failure Care network  Int J Cardiol. 2022 Sep 15;363:240-246. doi: 10.1016/j.ijcard.2022.06.022. Epub 2022 Jun 22.

Ross

July 18, 2022

ANNOUNCEMENTS

Sal’s Stars of the Week: Adrian Eisma

(Introduced by Chris Kuttnig)

Today’s Sals Star of the Week is ACCU & CCRT critical care educator Adrian Eisma.  Following the completion of his Bachelor of Nursing from U of M in 2008 he took a position on the Cardiac Surgery Inpatient Unit following his senior practicum there.  From there he continued to round out his cardiac experience and expertise by taking the ICU course in 2012, working in ICCS and then the Heart Cath lab until 2021.  He joined ACCU & CCRT as the clinical educator in November of 2021.

Adrian has been an invaluable addition to the ACCU and CCRT team.  Not only does he bring a wealth of cardiac and critical care knowledge but also a keen eye to patient safety and quality improvements.  He has been an integral part of the critical educator group that launched the new Sharepoint Critical Care resource page – amazing work.

Adrian is always readily available to pitch in on the unit.  Although he has an office away from ACCU, he spends most of his time in ACCU to be available to the staff and lend a helping hand.  This past week was an example of his strong sense of teamwork and support – without his help ACCU could not have assisted Y2 in the recovery of TAVIs and performing a pericardiocentesis all the while orientating and supporting new staff.  He never hesitates when the unit is short and acuity is high to take a patient assignment, help with admissions, be in charge or help with bed management.  Thank you and congrats Adrian.

Adrian Eisma, ACCU & CCRT Critical Care Educator

Shout Out!

Congratulations to Hilary Bews for being awarded the Donald Peters Award. 

Hilary Bews, this year’s recipient of the Donald Peters Cardiac Sciences Award.

Donald John Peters became a member of the Department of Anesthesia at St. Boniface General Hospital in 1972 and was involved in the care of cardiac patients for over 30 years before his retirement in 2008. He was honored with the Canadian Anesthetists Society highest award for excellence in clinical work in 2005. He has also been involved with Medical Ministries International for many years. Medical Ministries is an international organization that prides itself in providing spiritual and medical care to the world’s poor. Donald and his wife Margaret have traveled to many third world countries to help those less fortunate. He has always practiced with personal integrity, compassion, and a true dedication to patient needs.

The Donald Peters Cardiac Sciences Award was created in 2008 to establish a legacy that honors his outstanding contributions to cardiac patients and the personal integrity that defined his care of those patients. These are qualities we all agree are critically important to instill in our young trainees.

This award is eligible to all trainees in the Cardiac Sciences Program and is awarded annually in May to the trainee who best demonstrates  integrity, compassion, and dedication to the care of patients as individuals. The award also recognizes high standards of character, conduct, leadership, and the promotion of those qualities in others. We are very pleased to announce that this year’s recipient is Hilary Bews.

Hilary completed a BSc (Honours) degree in biochemistry at The University of Winnipeg with a special interest in environmental and analytical chemistry.   She then completed both medical school and internal medicine at the University of Manitoba, where she served as one of the Chief Medical Residents while in the internal medicine program.  She is currently in her PGY5 year and served as Co-Associate Chief Resident.

Her interests within cardiology include cardiac imaging, heart failure, and palliative cardiology.  Hilary is extremely well rounded, well liked, and respected by all her peers.  Her compassion, dedication to her patients, and warm, engaging style with staff, patients and families have not gone unnoticed.   Congratulations Hilary on this well-deserved recognition.

This Week’s Faculty Publications

Morten H Møller, Waleed Alhazzani, Kimberley Lewis, Emilie Belley-Cote, Anders Granholm, John Centofanti, William B McIntyre, Jessica Spence, Zainab Al Duhailib, Dale M Needham, Laura Evans, Annika Reintam Blaser, Margaret A Pisani, Frederick D’Aragon, Manu Shankar-Hari, Mohammed Alshahrani, Giuseppe Citerio , Rakesh C Arora, Sangeeta Mehta, Timothy D Girard , Otavio T Ranzani , Naomi Hammond , John W Devlin , Yahya Shehabi , Pratik Pandharipande, Marlies Ostermann Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline  Intensive Care Med. 2022 Jul;48(7):801-810. doi: 10.1007/s00134-022-06660-x. Epub 2022 May 19

Ross

July 11, 2022

ANNOUNCEMENTS

Sal’s Stars of the Week:   Cardiac Surgery Perioperative Team

(Introduced by Rakesh Arora)

For my final announcement for the SALS Star of the Week Award, I am going to take a little artist license and acknowledge the entire cardiac surgery perioperative team.  I have had the privilege to stand shoulder to shoulder with an incredibly dedicated, engaged and caring group for the past 16 years. I would like to personal thank and congratulate the members of our team in the Access Office, Perfusion, CR1 clinics, CSIU and ICCS (sorry I don’t have pictures of everyone).

Working with a team that is generally committed in doing the right things for excellent patient care every single day has resulted in the best in country CIHI results over the past decade. Furthermore, while perhaps not adequately acknowledged outside of our group, I would like to express my gratitude to everyone on your immediate willingness to step-up, respond and adapt in immensely challenging circumstances over the past 2 years. This speaks volumes to the skill and grit of a truly remarkable group of people with whom I have honour to work.

In addition, I would like to acknowledge Ms. Terri Hillier who, for some unknown reason, has chosen to stick with me over the past 6 years despite the craziness of my administrative duties. I thank you for all your diligence and more importantly, your patience with me over the years.

Words can not adequately express my deep gratitude to you all, but I thank all of you for all the fun during my time here in Winnipeg.

This Week’s Faculty Publications

James O Burton, Andrew Js Coats, Csaba P Kovesdy, Biff F Palmer , Ileana L Piña, Giuseppe Rosano, Manish M Sood, Shelley Zieroth An international Delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum  Eur J Heart Fail. 2022 Jul 5. doi: 10.1002/ejhf.2612. Online ahead of print.

Ross