MITRAL RUMBLES

 

 

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

January 17, 2022

Announcements

Reconfiguration of the Quality Initiative of Cardiac Sciences: new organization, new leadership

SDO realignment has brought many changes in the organization and implementation of care for patients with cardiac disease in Manitoba.  One of the most direct consequences has been the transfer/deletion of most of the staff that supported the former Cardiac Sciences Program- including those focused on QI.  Recognizing this new reality we are undergoing a reorganization of our QI program to increase the efficiency of  our efforts and to ensure that those initiatives that we embark on are truly our highest priorities.   This reorganization includes the consolidation of the Standards and Quality Committees into a single entity and a redirection from the previous focus of the Standards Committee on mortality audits.  As well this reorganization includes the integration of the newly formed Transformation Team (comprising the CNSs, QI leadership and analytics support staff) and the CI monitoring process.  The details of this reorganization will be shared over the next several weeks (including a preview in the course of tomorrow’s Cardiology Grand Rounds).

     Coupled to this reorganization process is the reconfiguration of the leadership structure of the QI Program.  In this context,  am pleased to announce that Michael Love has agreed to take on the role of Medical Lead of the Cardiac Sciences Quality Program.  He will  serve as the co-lead of the Program in conjunction with our Quality Manager, Anita Maric. 

Thank you Michael for stepping up during this critical transition of the quality program of CSMB.

Sals Star of the Week: Chamiel Leviste  (introduced by Dalibor Gavranovic)

This week Sal’s Star is Chamiel Leviste.  Over the last couple of months, 5A Cardiology has been extremely busy with a high patient turnaround, shortage of staff of all classifications, pulling staff to different areas, mandating and constant updates and changes due to COVID. The CRNs are constantly being involved in making sure that nursing staff can provide safe care in the course of assigning patient, reviewing patient charts for proper room placement (isolation, dialysis) and ensuring that diagnostics/treatments are being performed.

Chamiel has been focused on patients by constantly reviewing their needs to facilitate discharge/transfer, keeping doctors up to date, and supporting the unit (most often not taking breaks). At times she works as unit clerk, bed side nurse and a leader by providing support to staff. This week we had a code blue in the middle of hallway and unfortunately patient did not make it. Chamiel took upon herself to debrief with the nurse that was caring for this patient, offered emotional support and updated her manager of the situation. As a member in the leadership role, she is always absorbing new information, asking appropriate questions, and providing solutions. Chamiel is always ready to take challenges in a positive manner and assist her coworkers.

Please join me in congratulating Chamiel on being this week’s Sal’s Star.

Shout out!!!

Congratulations to Amir Ravandi and associates for this recent acknowledgment from the American Journal of Physiology

The American Journal of Physiology recently listed a paper published by a group of researchers out of St. Boniface Hospital Research Centre, as one of the top four papers cited in 2021. AJP publishes hundreds of papers annually and has an impact factor of five.

The paper, titled: “Oxidized phosphatidylcholines trigger ferroptosis in cardiomyocytes during ischemia-reperfusion injury was downloaded 605 times last year. Contributors include: Aleksandra Stamenkovic, Kimberley A. O’Hara, David C. Nelson, Thane G. Maddaford, Andrea L. Edel, Graham Maddaford, Elena Dibrov, MohamadReza Aghanoori, Lorrie A. Kirshenbaum, Paul Fernyhough, Michel Aliani, Grant N. Pierce, and Amir Ravandi.

“We have shown that bioactive lipids generated during a heart attack can kill heart muscle cells, a pathway that had not been shown before. We are currently working to use this pathway to come up with therapies that protect heart cells during a heart attack,” Dr. Amir Ravandi elaborated.

This Week’s Faculty Publications

Devesh Rai, Syed Hamza Waheed, Miranda Guerriero, Muhammad Waqas Tahir, Ritambhara Pandey, Harsh Patel, Samarthkumar Thakkar, Sharon L Mulvagh, Alexandra Bastiany, Shelley Zieroth, Colleen M Norris, Harriette G C Van Spall, Erin D Michos, Martha Gulati National Trends of Gender Disparity in Canadian Cardiovascular Society Guideline Authors, 2001-2020 CJC Open . 2021 Apr 10;3(12 Suppl):S12-S18. doi: 10.1016/j.cjco.2021.04.003. eCollection 2021 Dec.

Charles Yin, Hellmuth R Muller Moran, Rakesh C Arora Commentary: In it for the long haul: Posthospital recovery after venovenous extracorporeal membrane oxygenation for coronavirus disease 2019-related acute respiratory distress syndrome J Thorac Cardiovasc Surg. 2021 Dec 18;S0022-5223(21)01809-2. doi: 10.1016/j.jtcvs.2021.12.024. Online ahead of print.

Duncan J Maguire, Rakesh C Arora, Brett M Hiebert, Brenden Dufault, Mullein D Thorleifson The Epidemiology of Endocarditis in Manitoba: A Retrospective Study CJC Open. 2021 Jul 29;3(12):1471-1481. doi: 10.1016/j.cjco.2021.07.014. eCollection 2021 Dec

Alexander J Gregory, Rakesh C Arora, Subhasis Chatterjee, Michael C Grant, Kevin W Lobdell, Vicki Morton, Seenu Reddy, Rawn Salenger, Daniel T Engelman Selecting Elements for a Cardiac Enhanced Recovery Protocol J Cardiothorac Vasc Anesth . 2021 Dec;35(12):3847-3848. doi: 10.1053/j.jvca.2021.05.006. Epub 2021 May 11.

Felipe H Valle, Shaun G Goodman, Mary Tan, Andrew Ha, Samer Mansour, Robert C Welsh, Andrew T Yan, Kevin R Bainey, Stephane Rinfret, Brian J Potter, Razi Khan, Gerald Simkus, Madhu K Natarajan, J D Schwalm, Benoit Daneault, Mark J Eisenberg, Joseph Abunassar, Bryan Har, Jean Gregoire, Jean-Francois Tanguay, Christopher B Overgaard, Jean-Pierre Dery, Robert De Larochelliere, Jean-Michel Paradis, Mina Madan, Basem Elbarouni, Derek Y F So, Ata-Ur-Rehman Quraishi, Akshay Bagai, CONNECT AF+PCI Study Investigators Antithrombotic Therapy After Percutaneous Coronary Intervention in Patients With Atrial Fibrillation: Findings From the CONNECT AF+PCI Study CJC Open. 2021 Jul 6;3(12):1419-1427. doi: 10.1016/j.cjco.2021.07.003. eCollection 2021 Dec.

Hilary Bews, Mahwash Saeed, Shuangbo Liu  Cardiomyopathie périnatale CMAJ. 2022 Jan 10;194(1):E34. doi: 10.1503/cmaj.210468-f.

Charlotte C McEwen, Takhliq Amir, Yuan Qiu, Jack Young, Kevin Kennedy, Hilary P Grocott, Hesham Kessani, David Mazer, Scott Brudney, Morvarid Kavosh, Eric Jacobsohn, Anne Vedel, Eugene Wang, Richard P Whitlock, Emilie P Belley-Coté, Jessica Spence Morbidity and mortality in patients managed with high compared with low blood pressure targets during on-pump cardiac surgery: a systematic review and meta-analysis of randomized controlled trials Can J Anaesth. 2022 Jan 10. doi: 10.1007/s12630-021-02171-3. Online ahead of print.

Annette Schultz, Thang Nguyen, Moneca Sinclaire, Randy Fransoo, Elizabeth McGibbon Historical and Continued Colonial Impacts on Heart Health of Indigenous Peoples in Canada: What’s Reconciliation Got to Do With It? CJC Open . 2021 Sep 24;3(12 Suppl):S149-S164. doi: 10.1016/j.cjco.2021.09.010. eCollection 2021 Dec.

Ross


January 11, 2022

Announcements

Sals Star of the Week: Dr. Justin Cloutier (introduced by Colette Seifer)

This week’s Sals Star has been a member of Cardiac Sciences and the Section of Cardiology since 2019, having completed his training at the University of Manitoba.

What makes him stand out, is he was attending last week on CTU B– a challenging task at the best of times being on intake for new patients or post intake of new patients every weekday.  However, he also was covering the service for the second straight week therefore, technically, being on call since last year!

He has managed approximately 60 admissions and consults and discharged 30 patients, making room for the low risk STEMI’s, new SBH ED patients and other patients across the province needing cardiac care. 

In his true team player style, our Sals Star reports that he would not have been able to do this without “our awesome CA/PA’s, house staff and trainees”.

Congratulations Dr Justin Cloutier!

Cardiac Sciences Program Highlight of the Month

Perioperative Cardiac Anesthesia (POCA) Clinical Assistants

Within the Cardiac Sciences Program the Section of Cardiac Anesthesia has the privilege of working with a subgroup of Anesthesia Clinical Assistants (ACA) that help to provide high quality care to our cardiac patients at St. Boniface Hospital. They are an integral part to the structure of clinical service delivery provided by the Section of Cardiac Anesthesia.

The Anesthesia Clinical Assistants (officially designated as Clinical Assistants in Anesthesia or CI.A.) are allied health professionals, qualified by advanced academic and clinical education to provide anesthetic care under the supervision of a fellowship-trained Anesthesiologist or a Physician trained in Anesthesiology and credentialed to practice the specialty in a WHRA/Shared Health facility. The  ACA is licensed by CPSM as a clinical assistant. The ACA executes complementary and supplementary therapeutic interventions and monitoring tasks that allow the Supervising Anesthesiologist to use his or her own skills more efficiently and effectively.

The role of the Clinical Assistant within any given anesthesia service is:

•        dependent on the nature of the services that the hospital/facility provides

•        as directed by the assigned Supervising Physician

•        defined by the job description approved by the CPSM

The ACA possesses a defined body of knowledge, clinical skills, procedural skills and professional attitudes, which are directed to effective patient centered care in the anesthesia and operative environment. They apply these competencies to collect and interpret information, make appropriate clinical decisions, and carry out diagnostic and therapeutic interventions. They do so within the boundaries of the discipline in which they are practicing, personal expertise, the healthcare setting, and the delegator relationship with their Supervising Physician(s) and the patient context. Specifically within Cardiac Anesthesia the ACA’s are directly involved in patient care as Physician Extenders as described above in the operating room, ICCS, and Bergen Centre.

This Week’s Faculty Publications

Danyal Ladha, Karima Khamisa, Steven Promislow Hemolytic anemia and a new murmur in a 77-year-old man  CMAJ. 2021 Sep 7;193(35):E1389. doi: 10.1503/cmaj.202620.

Kevin F Boreskie, Jacqueline L Hay, Patrick E Boreskie, Rakesh C Arora, Todd A Duhamel Frailty-aware care: giving value to frailty assessment across different healthcare settings BMC Geriatr. 2022 Jan 3;22(1):13. doi: 10.1186/s12877-021-02722-9.

Rosie Fountotos, Haroon Munir, Michael Goldfarb, Sandra Lauck, Dae Kim, Louis Perrault, Rakesh Arora, Emmanuel Moss, Lawrence G Rudski, Melissa Bendayan, Palina Piankova, Victoria Hayman, Julia Rodighiero, Marie-Claude Ouimet, Sarah Lantagne, Nicolo Piazza, Jonathan Afilalo  Prognostic Value of Handgrip Strength in Older Adults Undergoing Cardiac Surgery  Can J Cardiol. 2021 Nov;37(11):1760-1766. doi: 10.1016/j.cjca.2021.08.016. Epub 2021 Aug 28.

Hilary Bews, Mahwash Saeed, Shuangbo Liu Peripartum cardiomyopathy CMAJ. 2021 Nov 15;193(45):E1733. doi: 10.1503/cmaj.210468.

Hoping everyone in the CSMB community is keeping safe and warm!

Ross


January 03, 2022

Announcements

Sals Star of the Week: Natasha Esau (introduced by Sara Unrau)

This week’s Sals Star is Natasha Esau.

Her kind, quiet leadership in ICCS is appreciated by all, colleagues and students alike. Over the last few months she has demonstrated a “can do” attitude to provide the best care to all of our patients. This was evident when she was recently in charge, with a full unit, staffing issues and limited flow.

In order to accommodate cardiac surgery cases, Natasha offered to take on a patient as well as maintain her charge responsibilities during her shift. Patients and families also routinely express appreciation of her compassion and care in all that she does.

In her downtime and to rejuvenate, Natasha goes to Churchill to kayak with the beluga whales. On top of being an excellent nurse, she is also an avid photographer taking nature pictures that are used in the sympathy cards for our grief baskets, which are handed to families in situations of comfort care. Her work is evident, even when she is not here in person.

Please join me in congratulating Natasha as this week’s Sals Star.

Congratulations to members of our Cardiac Sciences community recognized for their years of committed service to cardiac patients in Manitoba.

From left to right; Linda McLean 40 years, Irene Ekosky 25 years, Rajinder Ghuman 20 years, Orla Nazarko 15 years, and Amanda Colvin 15 years.

This Week’s Faculty Publications

Schultz ASH, Nguyen T, Sinclaire M, Fransoo R, McGibbon E (2021). Historical and Continued Colonial Impacts on Heart Health of Indigenous Peoples in Canada: What’s Reconciliation Got to Do With It? CJC Open, Volume 3, Issue 12, S149 – S164

Ashim K Bagchi, Akshi Malik, Gauri Akolkar, Davinder S Jassal, Pawan K Singal Endoplasmic Reticulum Stress Promotes iNOS/NO and Influences Inflammation in the Development of Doxorubicin-Induced Cardiomyopathy Antioxidants (Basel). 2021 Nov 26;10(12):1897. doi: 10.3390/antiox10121897.

Elizabeth O Ferreira, J Kelly MacDonald, Davinder S Jassal, Dennis D Rhee Atypical presentation of Takayasu aortitis and myocarditis contributing to sudden death in a young Canadian first nations adult  Case Reports Cardiovasc Pathol. Sep-Oct 2021;54:107347. doi: 10.1016/j.carpath.2021.107347. Epub 2021 May 24.

Ashish H Shah, Rishi Puri, Richard A Krasuski Transcatheter Closure of Patent Foramen Ovale: Not Always an “Open or Shut” Case Circulation. 2021 Apr 20;143(16):1539-1541. doi: 10.1161/CIRCULATIONAHA.120.050961. Epub 2021 Apr 19.

Ansar Hassan, Maral Ouzounian, Francois Dagenais, Ismail El-Hamamsy, Michael C Moon, Zlatko Pozeg, R Scott McClure, Michael Yamashita, Mark D Peterson, Roderick MacArthur, Jehangir J Appoo, Michael W A Chu, Canadian Thoracic Aortic Collaborative (CTAC) Development of Quality Indicators for the Management of Acute Type A Aortic Dissection  Can J Cardiol. 2021 Oct;37(10):1635-1638. doi: 10.1016/j.cjca.2021.05.015. Epub 2021 Jun 6.

Danyal Ladha, Karima Khamisa, Steven Promislow  Anémie hémolytique et nouveau souffle cardiaque chez un homme de 77 ans  CMAJ. 2021 Sep 27;193(38):E1511-E1512. doi: 10.1503/cmaj.202620-f.

Wishing everybody in the CSMB community a happy and healthy 2022!

Ross


December 29, 2021

Announcements

Sals Star of the Week: Brett Hiebert (introduced by Ross Feldman)

It goes without saying that this has been a difficult year for everyone- especially in healthcare and especially for us in Cardiac Sciences.  To keep going with business as usual in the setting of a once-in-a-lifetime (but seemingly never-ending) healthcare emergency and in the setting where the Cardiac Sciences Program has been dismantled (at least as an entity of WRHA ) requires much more than a business as usual effort.  You all do it and have done it through both the pandemic and through the “transformation” of Cardiac Sciences, but this week I want to focus on one of us who has done the work to keep things going “as usual”—and will still be helping even after when he has departed from the scene on Jan 7.  This week I want to recognize Brett Hiebert Lead Programmer/Statistical Analyst for CSMB as our Sals Star of the Week.  After 10 years of dedicated service, Brett will be leaving us Jan 7 for a new role as Principal Biostatistician at IQUIVIA.

     The most proximate contribution Brett is being cited for has been the extraordinary work he has done in managing his own transition as he leaves us- as both his position and roles move to Shared Health’s responsibility.  His work over the past several weeks to create a how-to guide for his reporting functions will considerably minimize the gap that will occur in the reporting of key cardiac deliverables with his departure and the migration of his role.  However, I would also like to acknowledge the key roles he served not only in his provincial reporting role, but as well in his support for the ACS Network and for the almost daily tasks he took on to try to turn anecdotes and impressions into data and evidence-based decision making.  His work was critical in informing the business case for the expansion of cardiac services that was part of the Phase 2 Consolidation Plan.  Further he was integral in shaping the evidence base for Heart Team initiatives- mostly notably the revascularization goodness of fit audit.  He will also be missed for his role in working “off the side of his desk” to enrich the studies of countless trainees and students.

    Brett is a highly deserving Sals Star of the Week for the efforts he has made in the course of his departure.  However, he will be most remembered by an extraordinary pattern of service as the lynch pin for the decision support that in my view distinguished Cardiac Sciences from most of the other former WRHA Programs. 

This Week’s Faculty Publications

Eugene B Wu , Emmanouil S Brilakis , Kambis Mashayekhi, Etsuo Tsuchikane, Khaldoon Alaswad, Mario Araya, Alexandre Avran , Lorenzo Azzalini, Avtandil M Babunashvili, Baktash Bayani, Michael Behnes, Ravinay Bhindi, Nicolas Boudou, Marouane Boukhris, Nenad Z Bozinovic, Leszek Bryniarski, Alexander Bufe, Christopher E Buller, M Nicholas Burke, Achim Buttner, Pedro Cardoso, Mauro Carlino, Ji-Yan Chen, Evald Hoej Christiansen, Antonio Colombo , Kevin Croce, Felix Damas de Los Santos , Tony de Martini, Joseph Dens, Carlo di Mario, Kefei Dou, Mohaned Egred, Basem Elbarouni, Ahmed M ElGuindy, Javier Escaned, Sergey Furkalo, Andrea Gagnor , Alfredo R Galassi, Roberto Garbo, Gabriele Gasparini, Junbo Ge , Lei Ge , Pravin Kumar Goel, Omer Goktekin, Nieves Gonzalo, Luca Grancini, Allison Hall, Franklin Leonardo Hanna Quesada, Colm Hanratty, Stefan Harb, Scott A Harding, Raja Hatem , Jose P S Henriques , David Hildick-Smith, Jonathan M Hill , Angela Hoye, Wissam Jaber, Farouc A Jaffer, Yangsoo Jang, Risto Jussila, Artis Kalnins , Arun Kalyanasundaram, David E Kandzari, Hsien-Li Kao, Dimitri Karmpaliotis, Hussien Heshmat Kassem, Jaikirshan Khatri, Paul Knaapen, Ran Kornowski, Oleg Krestyaninov, A V Ganesh Kumar, Pablo Manuel Lamelas, Seung-Whan Lee , Thierry Lefevre, Raymond Leung, Yu Li, Yue Li , Soo-Teik Lim, Sidney Lo, William Lombardi, Anbukarasi Maran, Margaret McEntegart, Jeffrey Moses, Muhammad Munawar, Andres Navarro, Hung M Ngo, William Nicholson, Anja Oksnes, Goran K Olivecrona, Lucio Padilla, Mitul Patel, Ashish Pershad, Marin Postu, Jie Qian, Alexandre Quadros, Nidal Abi Rafeh , Truls Råmunddal, Vithala Surya Prakasa Rao, Nicolaus Reifart, Robert F Riley, Stephane Rinfret, Meruzhan Saghatelyan, George Sianos , Elliot Smith , Anthony Spaedy, James Spratt, Gregg Stone, Julian W Strange , Khalid O Tammam , Craig A Thompson, Aurel Toma, Jennifer A Tremmel, Ricardo Santiago Trinidad, Imre Ungi, Minh Vo, Vu Hoang Vu, Simon Walsh, Gerald Werner, Jaroslaw Wojcik, Jason Wollmuth, Bo Xu, Masahisa Yamane, Luiz F Ybarra Robert W Yeh, Qi Zhang Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review  J Am Coll Cardiol. 2021 Aug 24;78(8):840-853. doi: 10.1016/j.jacc.2021.05.055.

Zahra Solati, Arun Surendran Andrea Edel, Marynia Roznik, David Allen, Amir Ravandi Increase in Plasma Oxidized Phosphatidylcholines (OxPCs) in Patients Presenting With ST-Elevation Myocardial Infarction (STEMI) Front Med (Lausanne). 2021 Dec 1;8:716944. doi: 10.3389/fmed.2021.716944. eCollection 2021.

Nebojša Oravec , Rakesh C Arora, Brian Bjorklund, April Gregora, Caroline Monnin, Mudra G Dave, Todd A Duhamel, David E Kent, Annette S H Schultz, Anna M Chudyk Patient and caregiver preferences and prioritized outcomes for cardiac surgery: A scoping review and consultation workshop  J Thorac Cardiovasc Surg. 2021 Nov 27;S0022-5223(21)01675-5. doi: 10.1016/j.jtcvs.2021.11.052. Online ahead of print.


Wishing everybody in the CSMB community and happy and healthy holiday season!

Ross


December 15, 2021

Announcements

Sals Star of the Week: Vanessa Jaillet  (introduced by Linda McLean)

Vanessa came to us at SBH in 2011, interested in a career as a Cardiology Technologist. She enrolled in BCIT, and completed her practicum with our team. Graduating in 2013 and successful in her CSCT registration exams she continued to seek out opportunities for growth and experience. One of only a few technologists with expertise in all areas and test types of NICT, Vanessa was instrumental in creating standard work for SICD Stress patients and developing orientation checklists and plans. She excels at process improvements, questioning redundancies and waste, offers alternatives and assists in implementing change.

Vanessa was the lead instructor for Stenberg College Lab blocks for Stress Testing teaching for a number of years, mentoring students and holding them to a high standard to prepare them for success. She shows integrity and stands up for her principles and values with a focus on delivering quality patient care. Vanessa knows her strengths and uses them to support the team while recognizing her weaknesses and strives to improve them. Coupled with excellent clinical skills and critical thinking abilities she is sought out as a preceptor and mentor by colleagues and students alike. Never one to let the Christmas spirit elude us in the day-to-day business of healthcare, she has taken on organizing our NICT Christmas party on several occasions!

Always an early bird, Vanessa goes above and beyond to assist using her time well and being able to calmly pitch in whenever there is a need. She rolls up her sleeves and has a ‘get it done’ attitude. In our recent crisis with no clerks, Vanessa jumped in as a quick study to accomplish getting all the Holter results out in an afternoon. Vanessa does not run from challenges, but rises to them.

A star – when all is dark, it shines, it is something to look up to, something to guide us.

Vanessa Jaillet has been our star, one of a constellation of many that make up the NICT.

This Week’s Faculty Publications

No new publications this week.


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

Ross


December 07, 2021

Announcements

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.

Ross


November 29, 2021

Announcements

Sals Star of the Week:  Eldilie (Eldie) Reyes  (introduced by Chris Kuttnig)

Eldie has been a member of the ACCU team since it’s opening in July 2016.  Prior to coming to ACCU Eldie worked at Seven Oaks Hospital first as nurse in family medicine and then in the ICU.  She came to St. Boniface to ICCS in February of 2016 before transitioning to ACCU as a bedside nurse.  She took on the role of CRN in January of 2020.

Eldie has grown tremendously as a leader within ACCU. She has been a preceptor and mentor to many of the new staff in ACCU.  New nurses have looked for rotations that follow Eldie’s – a huge sign of respect and admiration for her. Eldie, like most of the ACCU staff, has a hunker down and let’s make it work attitude.  When the unit is short staffed she takes an assignment, along with her charge duties, ensuring that patient care is safe. She often looks ahead to the schedule and recognizes staffing needs and offers to change her shifts to fill the holes.  She’s been known to work the day and offer to come back that night to help out the team avoiding anyone being mandated.  During the recent snowstorm she along with the other ICU CRNs, were commended for working together to ensure that patient care was safely managed when the snowstorm made it difficult for some staff to make it in.

Even with busy workloads and lean staffing levels, Eldie is always lending a helping hand on the floor and offering support.  She is especially considerate when staff are moving on to different career paths and getting farewell cards, gifts and cakes planned.  She is a valued and respected member of our ACCU family. 

Please join me in congratulating Eldie as this week’s Sals Star.

National Physician Assistant Day – November 27th

On November 27th Canada celebrated National Physician Assistant Day, which recognizes the physician assistant (PA) profession and it’s contribution to health care in Canada. PAs/CIAs are critical members of the inpatient teams on both Cardiac Surgery and Cardiology Units.  Please join me in recognizing  them for their contributions– both on their special day as well as every other day of the year!

This Week’s Faculty Publications

Jeffrey Javidfar, Akram M Zaaqoq, Michael H Yamashita, Greg Eschun, Jeffrey P Jacobs, Silver Heinsar, Jeremiah W Hayanga, Giles J Peek, Rakesh C Arora Venovenous extracorporeal membrane oxygenation in obese patients  JTCVS Tech. 2021 Oct 28. doi: 10.1016/j.xjtc.2021.08.048. Online ahead of print.

Sung-Min Cho, Lavienraj Premraj, Jonathon Fanning, Samuel Huth, Adrian Barnett, Glenn Whitman, Rakesh C Arora, Denise Battaglini, Diego Bastos Porto, HuiMahn Choi, Jacky Suen, Gianluigi Li Bassi, John F Fraser, Chiara Robba, Matthew Griffee  Ischemic and Hemorrhagic Stroke Among Critically Ill Patients With Coronavirus Disease 2019: An International Multicenter Coronavirus Disease 2019 Critical Care Consortium Study     Crit Care Med. 2021 Dec 1;49(12):e1223-e1233.

Kevin R An, Jessica G Y Luc, Derrick Y Tam, Olina Dagher, Rachel Eikelboom, Joel Bierer, Andréanne Cartier, Thin X Vo, Olivier Vaillancourt, Keir Forgie, Malak Elbatarny, Sophie Weiwei Gao, Richard Whitlock, Wiplove Lamba, Rakesh C Arora, Corey Adams, Bobby Yanagawa  Infective Endocarditis Secondary to Injection Drug Use: A Survey of Canadian Cardiac Surgeons  Ann Thorac Surg. 2021 Nov;112(5):1460-1467. doi: 10.1016/j.athoracsur.2020.12.003. Epub 2021 Jan 6.

Evan J Wiens, Jaime C Sklar, Yi Hui Wei, Qaiser Aleem, Kunal Minhas Real-world outcomes in treatment of highly calcified coronary lesions with intravascular shockwave lithotripsy   Indian Heart J. Sep-Oct 2021;73(5):653-655. doi: 10.1016/j.ihj.2021.09.002. Epub 2021 Sep 6.


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

Ross


November 23, 2021

Announcements

Sals Star of the Week:  Sara Unrau  (introduced by Rakesh Arora)

The Section of Cardiac Surgery and Intensive Care Cardiac Surgery’s pick for this week’s Sals Star of the week is Sara Unrau. 

Sara is the Program Team Manager for Intensive Care-Cardiac Surgery.  She started in this position in July of 2021.  She graduated as a Registered Nurse in 1996 and began her nursing career at Boundary Trails Hospital where she gained experience in several areas of the hospital including the surgery recovery room, medicine, surgery, labour and delivery as well as other units.  In 1999, Sara completed the Adult Intensive Care Nursing Program and transitioned to St. Boniface Hospital ICCS where she worked until 2007.  After an interlude where she served as both a Clinical Nurse Educator, as well as a Clinical Team Manager at Selkirk Regional Hospital, she rejoined our team in July of 2020.

We have had the opportunity to work with several program team managers in the ICCS over the past 15 years, and there have been many excellent team members.  Sara certainly stands shoulder to shoulder with all our previous team managers and has worked tirelessly and quite often above and beyond the call of duty on numerous occasions.  The ability of the Unit to of provide excellent patient care through these incredibly challenging times over the past 20 months has been in no small part due to her leadership. Sara’s continual engagement with the team, also stepping up to work at the bedside when needed, are only a few examples of her commitment to the care of our patients. We can’t express enough how much our Section and the Intensive Care Team appreciate Sara’s presence and extraordinary efforts.  We congratulate her on this very deserving recognition as the Sals Star of the Week for all she does for us and for the patients of Manitoba– every week of the year.

This Week’s Faculty Publications

Hilary BewsMahwash SaeedShuangbo Liu  Peripartum cardiomyopathy CMAJ. 2021 Nov 15;193(45):E1733. doi: 10.1503/cmaj.210468.

Pema RajSijo Joseph ThandapillyJeffrey WigleShelley ZierothThomas NetticadanA Comprehensive Analysis of the Efficacy of Resveratrol in Atherosclerotic Cardiovascular Disease, Myocardial Infarction and Heart Failure Molecules. 2021 Oct 31;26(21):6600. doi: 10.3390/molecules26216600.


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

Ross


November 16, 2021

Announcements

Sals Star of the Week:  Anita Maric  (introduced by Sarah Gilchrist)

This week we celebrate Anita Maric for her leadership in navigating our teams through accreditation amongst a challenging time. Anita was able to formulate and synthesize ROP’s , standards, previous unmet criteria in a functional way to allow our already overwhelmed staff to shine during accreditation. She was also able to provide additional opportunity for us to highlight the excellent work that has been done outside of the standards shining a light on CSP passion for innovation (virtual clinic, digital health collaborations, tech advances). Her empathic yet forward moving approach to accreditation is much appreciated and recognized by leaders and staff.  

With this issue we will be introducing Program Highlights as a recurring feature of the Rumbles,  highlighting the many initiatives that comprise Cardiac Sciences MB- clinically, scholarly and educationally.  This week we will kick off with a Program Highlight of our Adult Congenital Heart Program.  We encourage submissions (with pictures) from across the Cardiac Sciences community

MACH – Manitoba Adult Congenital Heart  Clinic cares for all adults with congenital heart disease in Manitoba, Northwestern Ontario, and Nunavut. We care for over 1500 patients and will continue to grow as we receive over 100 new referrals annually.

They provide clinics for all aspects of the care of patients with congenital heart disease including in pregnancy, palliation and structural care.

The MACH team consists of Robin Ducas, Ashish Shah, James Tam, Dawn Barker, Ana Maria, Amy Vickers, and Barb King.

National Nurse Practitioner Week Nov 7-13.

Join us in honoring and celebrating just a few of our Nurse Practitioners and the impact they make in providing access to high-quality care to individuals across the continuum of care.

This Week’s Faculty Publications

Murdoch Leeies, Hayley B Gershengorn, Emmanuel Charbonney, Anand Kumar, Dean A Fergusson, Alexis F Turgeon, Allan Garland, Donald S Houston, Brett Houston, Emily Rimmer, Eric Jacobsohn, Srinivas Murthy, Rob Fowler, Robert Balshaw, Ryan Zarychanski  Epidemiology of intravenous immune globulin in septic shock: a retrospective cohort analysis of the Premier Healthcare Database  Can J Anaesth. 2021 Nov;68(11):1641-1650. doi: 10.1007/s12630-021-02081-4. Epub 2021 Aug 10.

J W Awori Hayanga, Subhasis Chatterjee, Bo Soo Kim, HelenMari Merritt-Genore, Rita Carrie Karianna Milewski, Jonathan W Haft, Rakesh C Arora Venovenous extracorporeal membrane oxygenation in patients with COVID-19 respiratory failure  J Thorac Cardiovasc Surg. 2021 Oct 12;S0022-5223(21)01432-X. doi: 10.1016/j.jtcvs.2021.09.059. Online ahead of print.

HelenMari Merritt-Genore, Rainer Moosdorf, Erin Gillaspie, Sylvain Lother, Daniel Engelman, Shahnur Ahmed, Frank A Baciewicz, Michael C Grant, Rita Milewski, Kelly Cawcutt, J Awori Hayanga, Subhasis Chatterjee, Rakesh C Arora, Society of Thoracic Surgeons Workforce on Critical Care Perioperative Coronavirus Vaccination-Timing and Implications: A Guidance Document Ann Thorac Surg. 2021 Nov;112(5):1707-1715. doi: 10.1016/j.athoracsur.2021.07.016. Epub 2021 Aug 8.

Christopher D Pascoe, Neilloy Roy, Emily Turner-Brannen, Alexander Schultz, Jignesh Vaghasiya, Amir Ravandi, Andrew J Halayko, Adrian R West  Oxidized phosphatidylcholines induce multiple functional defects in airway epithelial cells  Am J Physiol Lung Cell Mol Physiol . 2021 Oct 1;321(4):L703-L717. doi: 10.1152/ajplung.00539.2020. Epub 2021 Aug 4.


I hope you are staying safe and healthy.

Ross


November 01, 2021

Announcements

Sals Star of the Week:  Dianna Erwin  (introduced by Scott MacKenzie)

This week’s Sals Star is Dianna Erwin from the Department of Anesthesia at St. Boniface Hospital.

Dianna began working in Anesthesia in 2013 as an Administrative Secretary. She became an Administrative Assistant in 2019 supporting the Anesthesia Site Lead at SBH. Dianna also plays a critical role in the provincial wide scheduling of anesthesia consultants which is a huge undertaking with many moving parts. The Cardiac Sciences Program is fortunate to have such a knowledgeable and committed individual in this role.

The majority of Cardiac Anesthesiologists work at different sites and in different subspecialties such as critical care, administration and cardiac ultrasound. Dianna ensures there are enough consultants on a daily basis to staff the cardiac operating rooms, the EP lab and the ICCS. This is no small feat with multiple sites involved, pre/post call days to consider and physicians working in other subspecialty areas. Dianna works with other schedulers in the region to ensure a stable and consistent cardiac anesthesia manpower supply.

Dianna is extremely dedicated in her role and recently came in to work on her vacation to pick up the shortfall created by the absence of another secretary. Dianna loves dogs, Halloween and a good laugh. It truly is a pleasure to work with and have support from such a skilled and hard working person.

Congratulations Dianna!

This Week’s Faculty Publications

Arun Surendran, Negar Atefi, Hannah Zhang, Michel Aliani, Amir Ravandi Defining Acute Coronary Syndrome through Metabolomics Review Metabolites. 2021 Oct 6;11(10):685. doi: 0.3390/metabo11100685.

Sanjay Aragola, Benjamin Arenson, Marshall Tenenbein, Eric Bohm, Eric Jacobsohn, Thomas Turgeon Prospective randomized trial of continuous femoral nerve block with posterior capsular injection versus periarticular injection for analgesia in primary total knee arthroplasty  Randomized Controlled Trial Can J Surg. 2021 Apr 28;64(3):E265-E272. doi: 10.1503/cjs.020519.

Brett L Houston, Dean A Fergusson, Jamie Falk, Emily Krupka, Iris Perelman, Rodney H Breau, Daniel I McIsaac, Emily Rimmer, Donald S Houston, Allan Garland, Robert E Ariano, Alan Tinmouth, Robert Balshaw, Alexis F Turgeon, Eric Jacobsohn, Jason Park, Gordon Buduhan, Michael Johnson, Joshua Koulack, Ryan Zarychanski Evaluation of Transfusion Practices in Noncardiac Surgeries at High Risk for Red Blood Cell Transfusion: A Retrospective Cohort Study  Review Transfus Med Rev. 2021 Jan;35(1):16-21. doi: 10.1016/j.tmrv.2020.08.001. Epub 2020 Aug 28.

Sonu S Varghese, Will J Johnston, Cameron R Eekhoudt, Melanie R Keats, Davinder S Jassal, Scott A Grandy Exercise to Reduce Anthracycline-Mediated Cardiovascular Complications in Breast Cancer Survivors Curr Oncol. 2021 Oct 13;28(5):4139-4156. doi: 10.3390/curroncol28050351.   


I hope you are staying safe and healthy.

Ross