For selected patients with a history of AF undergoing cardiac surgery, concomitant CM4 did not add significantly to postoperative morbidity or mortality and was associated with improved late survival compared with patients with untreated AF and a similar survival to patients without a history of AF.

Introduction: The goal of this study was to assess the influence of the coronavirus disease 2019 pandemic on the orthopaedic surgery residency application process in the 2020 to 2021 application cycle. Methods: A survey was administered to the program directors of 152 Accreditation Council for Graduate Medical Education–accredited orthopaedic surgery residency programs. The following questions were assessed: virtual rotations, open houses/meet and greet events, social media, the selection criteria of applicants, the number of applications received by programs, and the number of interviews offered by programs. Results: Seventy-eight (51%) orthopaedic residency programs responded to the survey. Of those, 25 (32%) offered a virtual away rotation, and 57 (75%) held virtual open houses or meet and greet events. Thirteen of these programs (52%) reported virtual rotations as either “extremely important” or “very important.” A 355% increase was observed in social media utilization by residency programs between the 2019 to 2020 and 2020 to 2021 application cycles, with more programs finding social media to be “extremely helpful” or “very helpful” for recruiting applicants in 2020 to 2021 compared with the previous year (39% versus 10%, P < 0.001). Conclusion: Although many of the changes seen in the 2020 to 2021 application cycle were implemented by necessity, some of these changes were beneficial and may continue to be used in future application cycles.

No abstract

Study Design Systematic review Objectives We sought to synthesize the literature investigating the disparities that Medicaid patients sustain with regards to 2 types of elective spine surgery, lumbar fusion (LF) and anterior cervical discectomy and fusion (ACDF). Methods Our review was constructed in accordance with Preferred Reporting Items and Meta-analyses (PRISMA) guidelines and protocol. We systematically searched PubMed, Embase, Scopus, CINAHL, and Web of Science databases. We included studies comparing Medicaid beneficiaries to other payer categories with regards to rates of LF and ACDF, costs/reimbursement, and health outcomes. Results A total of 573 articles were assessed. Twenty-five articles were included in the analysis. We found that the literature is consistent with regards to Medicaid disparities. Medicaid was strongly associated with decreased access to LF and ACDF, lower reimbursement rates, and worse health outcomes (such as higher rates of readmission and emergency department utilization) compared to other insurance categories. Conclusions In adult patients undergoing elective spine surgery, Medicaid insurance is associated with wide disparities with regards to access to care and health outcomes. Efforts should focus on identifying causes and interventions for such disparities in this vulnerable population.

Objectives Most patients with atrial fibrillation (AF) undergoing cardiac surgery do not receive concomitant ablation. This study reviewed outcomes of patients with AF undergoing Cox-Maze IV (CMIV) with radiofrequency and cryoablation and CABG at our institution. Methods Between the introduction of radiofrequency ablation in 2002 and 2015, 135 patients underwent left- or bi-atrial CMIV with CABG. Patients undergoing other cardiac procedures, except mitral valve repair, or who had emergent, reoperative or off-pump procedures were excluded. Eighty-three patients remained in the study group after exclusion criteria were applied. Freedom from atrial tachyarrhythmias (ATA) was ascertained using EKG, Holter monitor, or pacemaker interrogation at 1 to 5 years postoperatively. Results Operative mortality was 3%. Freedom from ATA at 1 year in the CMIV group was 98%, with 88% off antiarrhythmic drugs; freedom from ATA and antiarrhythmic drugs was 70% at 5 years. Conclusions The addition of CMIV to CABG resulted in excellent freedom from ATA at one-to-five years. These patients are at increased risk for nonfatal complications compared with others undergoing concomitant surgical ablation.

No abstract

No abstract

Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience.