2022
Causal determinants of postoperative length of stay in cardiac surgery using causal graphical learning
Lee JJR, Srinivasan R, Ong CS, Alejo D, Schena S, Shpitser I, Sussman M, Whitman GJR, Malinsky D. Causal determinants of postoperative length of stay in cardiac surgery using causal graphical learning. Journal Of Thoracic And Cardiovascular Surgery 2022, 166: e446-e462. PMID: 36154975, PMCID: PMC9968823, DOI: 10.1016/j.jtcvs.2022.08.012.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresHumansLength of StayPostoperative ComplicationsRenal DialysisRetrospective StudiesConceptsAortic valve replacement surgeryPostoperative lengthCoronary artery bypassValve replacement surgeryElectronic health record dataHealth record dataArtery bypassReplacement surgeryRetrospective electronic health record dataMean postoperative lengthCardiac surgery patientsRecord dataClinical knowledgeIndirect causesPreoperative dialysisPostoperative complicationsSurgery patientsCardiac surgeryPatient managementStayClinical protocolsPatientsSurgeryOperating roomStatistical associationEarly Reexploration for Bleeding Is Associated With Improved Outcome in Cardiac Surgery
Shou BL, Aravind P, Ong CS, Alejo D, Canner JK, Etchill EW, DiNatale J, Prokupets R, Esfandiary T, Lawton JS, Schena S. Early Reexploration for Bleeding Is Associated With Improved Outcome in Cardiac Surgery. The Annals Of Thoracic Surgery 2022, 115: 232-239. PMID: 35952856, DOI: 10.1016/j.athoracsur.2022.07.037.Peer-Reviewed Original ResearchMeSH KeywordsAdultCardiac Surgical ProceduresHumansLogistic ModelsMorbidityPostoperative HemorrhageReoperationRetrospective StudiesRisk AssessmentConceptsCardiac surgeryActive bleedingAdult cardiac surgery patientsSingle-institution retrospective reviewMultivariable logistic regression modelCardiac surgery patientsEarly surgical interventionRisk-adjusted analysisLogistic regression modelsEarly reexplorationEligible patientsPostoperative bleedingNonoperative managementSurgery patientsRetrospective reviewUnivariable analysisMorbidity rateSurgical interventionCommon siteMediastinal structuresReexplorationKruskal-Wallis testMortality rateBleedingPatient harmDeep Learning to Predict Mortality After Cardiothoracic Surgery Using Preoperative Chest Radiographs
Raghu VK, Moonsamy P, Sundt TM, Ong CS, Singh S, Cheng A, Hou M, Denning L, Gleason TG, Aguirre AD, Lu MT. Deep Learning to Predict Mortality After Cardiothoracic Surgery Using Preoperative Chest Radiographs. The Annals Of Thoracic Surgery 2022, 115: 257-264. PMID: 35609650, PMCID: PMC11373441, DOI: 10.1016/j.athoracsur.2022.04.056.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresCoronary Artery BypassDeep LearningFemaleHumansRisk AssessmentRisk FactorsConceptsMassachusetts General HospitalPreoperative chest radiographSTS-PROMIndex procedureC-statisticChest radiographsTesting cohortPostoperative mortalityCardiac surgeryMortality riskPostoperative mortality riskSTS-PROM scoreRisk of mortalityGood calibrationMGH patientsWomen's HospitalGeneral HospitalCardiothoracic surgeryThoracic surgeonsSurgeryMortalityPatientsHospitalCohortPreoperative CXR
2021
Leveraging Machine Learning to Predict 30-Day Hospital Readmission After Cardiac Surgery
Sherman E, Alejo D, Wood-Doughty Z, Sussman M, Schena S, Ong CS, Etchill E, DiNatale J, Ahmidi N, Shpitser I, Whitman G. Leveraging Machine Learning to Predict 30-Day Hospital Readmission After Cardiac Surgery. The Annals Of Thoracic Surgery 2021, 114: 2173-2179. PMID: 34890575, DOI: 10.1016/j.athoracsur.2021.11.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultCardiac Surgical ProceduresCohort StudiesHumansMachine LearningPatient DischargePatient ReadmissionRetrospective StudiesRisk FactorsConceptsElectronic medical record dataDays of dischargeMedical record dataHospital readmissionThoracic Surgeons Adult Cardiac Surgery DatabaseArt performanceAdult Cardiac Surgery DatabaseRecord dataCardiac Surgery DatabaseLength of stayRandom forest modelFlexible machineTest setMachinePreoperative comorbiditiesPostoperative complicationsAnalysis cohortCardiac surgeryPreoperative variablesSurgery DatabaseIntraoperative riskInpatient careReadmissionRisk scoreRehabilitation facilityPrediction of operative mortality for patients undergoing cardiac surgical procedures without established risk scores
Ong CS, Reinertsen E, Sun H, Moonsamy P, Mohan N, Funamoto M, Kaneko T, Shekar PS, Schena S, Lawton JS, D'Alessandro DA, Westover MB, Aguirre AD, Sundt TM. Prediction of operative mortality for patients undergoing cardiac surgical procedures without established risk scores. Journal Of Thoracic And Cardiovascular Surgery 2021, 165: 1449-1459.e15. PMID: 34607725, PMCID: PMC8918430, DOI: 10.1016/j.jtcvs.2021.09.010.Peer-Reviewed Original ResearchRed blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery
Padiyath A, Lo BD, Ong CS, Goswami D, Steppan DA, Frank SM, Steppan J. Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery. Vox Sanguinis 2021, 116: 965-975. PMID: 33761164, DOI: 10.1111/vox.13098.Peer-Reviewed Original ResearchMeSH KeywordsBlood PreservationCardiac Surgical ProceduresChildErythrocyte TransfusionErythrocytesHumansRetrospective StudiesConceptsLength of stayRed blood cell (RBC) storage durationPediatric cardiac surgeryComposite morbidityRBC transfusion volumeCardiac surgeryOld bloodTransfusion volumePediatric cardiac surgery patientsMultivariable logistic regression modelFresh bloodRetrospective cohort studyCardiac surgery patientsPeri-operative outcomesRisk of morbidityRBC storage durationLonger durationRisk-adjusted modelsLogistic regression modelsCohort studySecondary outcomesSurgery patientsPediatric patientsPrimary outcomeClinical outcomes
2020
Association of Heparin Dose, Route, Timing, and Duration With Heparin-Induced Thrombocytopenia
Crow JR, Nam L, Chasler JE, Ong CS, Dane KE, Kickler T, Lawton J, Streiff MB, Alejo D, Canner JK, Schena S. Association of Heparin Dose, Route, Timing, and Duration With Heparin-Induced Thrombocytopenia. The Annals Of Thoracic Surgery 2020, 112: 32-37. PMID: 33217393, DOI: 10.1016/j.athoracsur.2020.09.033.Peer-Reviewed Original ResearchConceptsCardiac surgery patientsAdult cardiac surgery patientsSurgery patientsUFH doseHeparin doseRetrospective case-control studyMultivariable conditional logistic regressionCardiopulmonary bypass durationHIT-positive patientsPrevalence of heparinUnfractionated heparin doseHeparin-Induced ThrombocytopeniaReceiver-operating characteristic curveCase-control studyConditional logistic regressionBypass durationIntravenous UFHUFH administrationUFH infusionSubcutaneous routeContinuous infusionMean agePatientsTotal doseLogistic regressionCommentary: Can Machines Predict Kidney Injury After Cardiac Surgery Better Than Humans?
Ong CS, Lawton JS. Commentary: Can Machines Predict Kidney Injury After Cardiac Surgery Better Than Humans? Seminars In Thoracic And Cardiovascular Surgery 2020, 33: 748-749. PMID: 33171235, DOI: 10.1053/j.semtcvs.2020.10.017.Peer-Reviewed Original ResearchNutrition Support After Cardiac Surgery: Lessons Learned From a Prospective Study
Ong CS, Yesantharao P, Brown PM, Canner JK, Brown TA, Sussman MS, Whitman GJR. Nutrition Support After Cardiac Surgery: Lessons Learned From a Prospective Study. Seminars In Thoracic And Cardiovascular Surgery 2020, 33: 109-115. PMID: 32610197, DOI: 10.1053/j.semtcvs.2020.06.043.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresDiarrheaEnteral NutritionHumansMalnutritionParenteral NutritionProspective StudiesRespiration, ArtificialConceptsCardiac surgery patientsNutrition supportDaily caloric needsSurgery patientsCardiac surgeryCaloric needsPostoperative nutrition supportPercent of patientsMultivariable logistic regressionRisk of diarrheaPN supplementationPostpyloric feedsPostpyloric routeSemielemental formulaEnteral feedingParenteral nutritionCommon indicationMechanical ventilationProspective studySingle institutionTF volumeCommon reasonPatientsLogistic regressionMorbidityVasoactive and Inotropic Support, Tube Feeding, and Ischemic Gut Complications After Cardiac Surgery
Ong CS, Brown PM, Yesantharao P, Zhou X, Young A, Canner JK, Quinlan M, Brown EF, Sussman MS, Whitman GJR. Vasoactive and Inotropic Support, Tube Feeding, and Ischemic Gut Complications After Cardiac Surgery. Journal Of Parenteral And Enteral Nutrition 2020, 44: 1461-1467. PMID: 32010992, DOI: 10.1002/jpen.1769.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresCardiovascular AgentsEnteral NutritionGastrointestinal MicrobiomeHumansConceptsCardiac surgery patientsSurgery patientsTube feedsGut complicationsInotropic supportIntra-aortic balloon pumpElemental formula usePressor supportGastric routeBalloon pumpCardiac surgeryTube feedingTF administrationAcute embolusSingle institutionPatientsFormula useComplicationsHighest VIsDecreased amountDaysInotropicEmboliSurgeryMortality
2019
Trends and Updates on Cardiopulmonary Bypass Setup in Pediatric Cardiac Surgery
Medikonda R, Ong CS, Wadia R, Goswami D, Schwartz J, Wolff L, Hibino N, Vricella L, Nyhan D, Barodka V, Steppan J. Trends and Updates on Cardiopulmonary Bypass Setup in Pediatric Cardiac Surgery. Journal Of Cardiothoracic And Vascular Anesthesia 2019, 33: 2804-2813. PMID: 30738750, DOI: 10.1053/j.jvca.2019.01.025.Peer-Reviewed Original ResearchMeSH KeywordsAlbuminsCardiac Surgical ProceduresCardioplegic SolutionsCardiopulmonary BypassChildCrystalloid SolutionsDrainageEquipment DesignHumansInfusion PumpsSurface PropertiesConceptsCardiac surgeryCardiopulmonary bypassPediatric cardiac surgery outcomesPediatric cardiac surgeryEvidence-based guidelinesCardiac surgery outcomesCardiopulmonary bypass managementUniform evidence-based guidelinesExtracorporeal circuit componentsInconsistent study resultsPediatric patientsClinical outcomesSurgery outcomesCardiopulmonary bypass (CPB) setupBypass managementPerfusion strategyPerfusion practiceSurgeryBypassCurrent literatureOutcomesConsiderable variabilityPatientsStudy resultsCrystalloids
2018
A Review of Goal-Directed Cardiopulmonary Bypass Management in Pediatric Cardiac Surgery
Medikonda R, Ong CS, Wadia R, Goswami D, Schwartz J, Wolff L, Hibino N, Vricella L, Barodka V, Steppan J. A Review of Goal-Directed Cardiopulmonary Bypass Management in Pediatric Cardiac Surgery. World Journal For Pediatric And Congenital Heart Surgery 2018, 9: 565-572. PMID: 30157729, DOI: 10.1177/2150135118775964.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresCardiopulmonary BypassChildGoalsHeart Defects, CongenitalHumansTreatment OutcomeConceptsGoal-directed therapyVenous oxygen saturationPerfusion managementOxygen saturationCentral venous oxygen saturationGoal-directed perfusionVital clinical parametersEnd-organ perfusionPediatric cardiac surgeryCardiopulmonary bypass managementPatient's specific needsTransfusion ratePostoperative outcomesArterial pressureCardiac surgeryPerfusion flow rateClinical parametersPlatelet countPatient outcomesPostoperative monitoringCardiothoracic surgeryCoagulation stateBypass managementPerfusion pulsatilityPerfusionDigital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training
Chen SA, Ong CS, Malguria N, Vricella LA, Garcia JR, Hibino N. Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training. World Journal For Pediatric And Congenital Heart Surgery 2018, 9: 454-458. PMID: 29945510, DOI: 10.1177/2150135118771323.Peer-Reviewed Original ResearchConceptsSurgical simulationDigital designDigital 3D modelsThree-dimensional modeling softwareComputer-aided designModeling softwareSegmentation softwareTraining modelScan imagesSoftwareTomography scan imagesLife-sized modelSurgical suturingAortic arch morphologyTechnologyDesignSurgical trainingSimulationsThree-dimensional printing technologyReconstructionImagesSegmented modelTrainingModelPrinting technology
2017
Virtual Surgery for Conduit Reconstruction of the Right Ventricular Outflow Tract
Ong CS, Loke YH, Opfermann J, Olivieri L, Vricella L, Krieger A, Hibino N. Virtual Surgery for Conduit Reconstruction of the Right Ventricular Outflow Tract. World Journal For Pediatric And Congenital Heart Surgery 2017, 8: 391-393. PMID: 28520540, PMCID: PMC5695863, DOI: 10.1177/2150135117692777.Peer-Reviewed Original ResearchConceptsRight ventricular outflow tractVentricular outflow tractCardiac surgeryOutflow tractPulmonary artery conduit replacementTranscatheter pulmonary valve implantationRV-PA conduitPulmonary valve implantationIndividual patient dataHistory of tetralogyPatient's own heartConduit sizeVirtual surgeryImplantation of prosthesesConduit replacementImplantation of devicesPreoperative magnetic resonance imaging (MRI) dataPulmonary atresiaYoung adolescent malesValve implantationConduit reconstructionIntrathoracic spaceRight ventricleMagnetic resonance imaging dataPatient education
2016
Constrictive Pericarditis Following Correction of Partial Anomalous Pulmonary Venous Drainage
Ong CS, Shankar S, Yip JWL, Tay ELW, Teo LLS, Quek SC. Constrictive Pericarditis Following Correction of Partial Anomalous Pulmonary Venous Drainage. World Journal For Pediatric And Congenital Heart Surgery 2016, 8: 540-542. PMID: 27647341, DOI: 10.1177/2150135116652116.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresDrainageHeart Defects, CongenitalHumansMalePericardiectomyPericarditis, ConstrictivePostoperative ComplicationsTomography, X-Ray ComputedYoung AdultConceptsConstrictive pericarditisPartial anomalous pulmonary venous drainagePartial anomalous pulmonary venous connectionPersistent right heart failureAnomalous pulmonary venous connectionAnomalous pulmonary venous drainagePulmonary valve replacementRight heart failurePulmonary venous connectionPulmonary venous drainageRepair of tetralogyFailure of surgeryCongenital cardiac surgeryMagnetic resonance imagingRadical pericardiectomyResidual complicationsValve replacementVenous connectionCardiac surgeryHeart failureCardiac failureMedical managementVenous drainageBetter outcomesResonance imaging