Clauden Louis MD MHA MPH MS FACC | Brigham and Women's Hospital (original) (raw)

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Papers by Clauden Louis MD MHA MPH MS FACC

IntechOpen eBooks, Nov 26, 2023

Endobronchial ultrasound (EBUS) is a diagnostic procedure that allows for the diagnosis and stagi... more Endobronchial ultrasound (EBUS) is a diagnostic procedure that allows for the diagnosis and staging of lung cancer and other lung-related diseases such as tuberculosis, sarcoidosis, and sarcoma. The radial probe for the EBUS device was first introduced to visualize the inside of the lungs and airway structures, and identify the extent of tumor invasion in the airway and surrounding lymph nodes. The EBUS transbronchial needle aspiration (TBNA) is an acceptable first test in the pretreatment staging of lung cancer to appropriately understand the prognosis for curative therapies. In the future, EBUS is likely to become widely available and accessible to patients, given its low cost and minimal risk of complications compared to other diagnostic and therapeutic procedures. The development of more advanced EBUS technologies, such as radial EBUS, virtual bronchoscopy, fluorescence-guided bronchoscopy, and artificial intelligence will allow for improved visualization of the lungs and adequate lymph node yield, leading to more accurate diagnoses and better treatment outcomes. In conclusion, the future of EBUS modalities combined with the additions of bronchoscopic advances is expected to further improve the accuracy and precision of the procedure while limiting morbidity, and complications, and improving clinical workflow availability in the outpatient setting.

International Journal of Medical Students, Dec 3, 2023

has a strong interest in cardiac care, cardiac surgery, and mechanical circulatory support, parti... more has a strong interest in cardiac care, cardiac surgery, and mechanical circulatory support, particularly ECMO and LVAD support.

Authorea (Authorea), Oct 7, 2022

Objective(s): Trainee assessments aim to identify areas for improvement and address problems with... more Objective(s): Trainee assessments aim to identify areas for improvement and address problems within training programs. However, effectiveness is limited by an inability to assess programs anonymously. We hypothesized concern for undesired repercussions may discourage honest responses. To test this, we conducted a comprehensive survey of trainees to assess their educational and work-related experiences anonymously. Design: A 51-question survey was distributed electronically to the Thoracic Surgery Residents Association (TSRA) membership. Questions were multiple-choice. The Likert scale was utilized. Setting: The survey was accessed electronically and was completed by participants nationwide. Participants: Trainees were incentivized to complete the survey with the opportunity to receive a $50 gift card or TSRA textbook. 109 of 551 cardiothoracic surgery trainees completed the survey. Results: 109 trainees (109/551, 19.8%) completed the survey. 57.8% of respondents reported complying with work hour restrictions, but 32.2% (n=35) did not feel comfortable reporting violations honestly. The majority of respondents agreed or strongly agreed that their program was preparing them to independently perform low risk cardiac (4.19 [1.22]) and thoracic (4.08 [1.13]) cases independently, 30.3% of chief residents reported planning to pursue additional training. 66% of respondents stated they would select the same program again. 33% reported having high morale, 47.7% moderate and 19.3% poor or declining morale. 84.4% of respondents did not feel their race or gender significantly impacted their training, 26.6% reported systemic bias in recruitment of new trainees or faculty, and 38.5% believed there was inadequate diversity among faculty and trainees. 30.3% reported experiencing verbal or physical harassment by an attending or fellow (14.7%). Conclusions: Despite reporting an overall positive operative experience, a significant number of trainees plan to pursue additional training. The survey identifies important areas for attention including underreporting of issues related to diversity, as well as verbal and physical harassment by fellows and attendings.

The Journal of Thoracic and Cardiovascular Surgery

The Spine Journal, Aug 1, 2018

Journal of Cardiac Surgery, Apr 21, 2022

Cardiac surgeons have variable exposure to thoracic aortic EndoVascular repair (TEVAR) as the pri... more Cardiac surgeons have variable exposure to thoracic aortic EndoVascular repair (TEVAR) as the primary surgeon. As paradigms evolve and EndoVascular structural heart interventions expand, TEVAR utilization by cardiac surgeons is of particular interest. In order to definitively manage thoracic aortic pathologies in the modern era, cardiac surgeons must incorporate TEVAR into their armamentarium during surgical training or risk a prolonged learning curve.

Journal of Heart and Lung Transplantation, Apr 1, 2021

Purpose The purpose of the present study is to examine the effect of operative time of day on out... more Purpose The purpose of the present study is to examine the effect of operative time of day on outcomes in orthotopic heart transplant (OHT) recipients. We hypothesized that nighttime OHT operations would be associated with increased 1-year mortality when compared to daytime OHT operations. Methods We performed a retrospective analysis of adult heart transplant recipients in the United Network for Organ Sharing (UNOS) database from January 2000 to December 2019. Operative time of day was derived from the donor cross-clamp time (night, 6 pm-4 am; day, 4 am-6 pm). The primary outcome was survival at 1 year. Kaplan-Meier curves and log-rank statistics were generated to compare the effect of operative time and were further stratified by age, transplant center yearly volume (low volume, Results Of the 42,007 patients included in the study, 24,200 (57.6%) underwent nighttime and 17,807 (42.4%) daytime OHT (Table 1). Preoperative patient characteristics were similar between cohorts. 1-year survival (Figures 1) was not different between the cohorts (89.7 vs 89.5%, p=0.630). When further stratified by age, center volume, or VAD status, 1-year survival between operative times still remained insignificant. Conclusion There is no significant association between nighttime operations and 1-year post-transplant survival in adult heart transplant recipients.

Seminars in Thoracic and Cardiovascular Surgery, 2018

Maintaining the branch pulmonary artery architecture in the repair of truncus arteriosus could be... more Maintaining the branch pulmonary artery architecture in the repair of truncus arteriosus could be considered to reduce right ventricular outflow tract re-operation. Perspective Statement Early right ventricular outflow tract re-operation following the repair of truncus arteriosus is a common problem. Using a modified repair, the branch pulmonary arteries are kept in-situ. Using this approach, we have observed excellent early and mid-term results.

JTCVS open, Jun 1, 2023

A wide array of imaging modalities is used to evaluate both preoperative and postoperative cardia... more A wide array of imaging modalities is used to evaluate both preoperative and postoperative cardiac and thoracic surgery patients, including radiographs ("plain films"), computed tomography (CT) and magnetic resonance imaging (MRI) scans, cardiac ultrasounds (echocardiograms), and coronary angiography.

Journal of Heart and Lung Transplantation, Apr 1, 2021

Journal of surgery and research, 2023

IntechOpen eBooks, Nov 26, 2023

Endobronchial ultrasound (EBUS) is a diagnostic procedure that allows for the diagnosis and stagi... more Endobronchial ultrasound (EBUS) is a diagnostic procedure that allows for the diagnosis and staging of lung cancer and other lung-related diseases such as tuberculosis, sarcoidosis, and sarcoma. The radial probe for the EBUS device was first introduced to visualize the inside of the lungs and airway structures, and identify the extent of tumor invasion in the airway and surrounding lymph nodes. The EBUS transbronchial needle aspiration (TBNA) is an acceptable first test in the pretreatment staging of lung cancer to appropriately understand the prognosis for curative therapies. In the future, EBUS is likely to become widely available and accessible to patients, given its low cost and minimal risk of complications compared to other diagnostic and therapeutic procedures. The development of more advanced EBUS technologies, such as radial EBUS, virtual bronchoscopy, fluorescence-guided bronchoscopy, and artificial intelligence will allow for improved visualization of the lungs and adequate lymph node yield, leading to more accurate diagnoses and better treatment outcomes. In conclusion, the future of EBUS modalities combined with the additions of bronchoscopic advances is expected to further improve the accuracy and precision of the procedure while limiting morbidity, and complications, and improving clinical workflow availability in the outpatient setting.

International Journal of Medical Students, Dec 3, 2023

has a strong interest in cardiac care, cardiac surgery, and mechanical circulatory support, parti... more has a strong interest in cardiac care, cardiac surgery, and mechanical circulatory support, particularly ECMO and LVAD support.

Authorea (Authorea), Oct 7, 2022

Objective(s): Trainee assessments aim to identify areas for improvement and address problems with... more Objective(s): Trainee assessments aim to identify areas for improvement and address problems within training programs. However, effectiveness is limited by an inability to assess programs anonymously. We hypothesized concern for undesired repercussions may discourage honest responses. To test this, we conducted a comprehensive survey of trainees to assess their educational and work-related experiences anonymously. Design: A 51-question survey was distributed electronically to the Thoracic Surgery Residents Association (TSRA) membership. Questions were multiple-choice. The Likert scale was utilized. Setting: The survey was accessed electronically and was completed by participants nationwide. Participants: Trainees were incentivized to complete the survey with the opportunity to receive a $50 gift card or TSRA textbook. 109 of 551 cardiothoracic surgery trainees completed the survey. Results: 109 trainees (109/551, 19.8%) completed the survey. 57.8% of respondents reported complying with work hour restrictions, but 32.2% (n=35) did not feel comfortable reporting violations honestly. The majority of respondents agreed or strongly agreed that their program was preparing them to independently perform low risk cardiac (4.19 [1.22]) and thoracic (4.08 [1.13]) cases independently, 30.3% of chief residents reported planning to pursue additional training. 66% of respondents stated they would select the same program again. 33% reported having high morale, 47.7% moderate and 19.3% poor or declining morale. 84.4% of respondents did not feel their race or gender significantly impacted their training, 26.6% reported systemic bias in recruitment of new trainees or faculty, and 38.5% believed there was inadequate diversity among faculty and trainees. 30.3% reported experiencing verbal or physical harassment by an attending or fellow (14.7%). Conclusions: Despite reporting an overall positive operative experience, a significant number of trainees plan to pursue additional training. The survey identifies important areas for attention including underreporting of issues related to diversity, as well as verbal and physical harassment by fellows and attendings.

The Journal of Thoracic and Cardiovascular Surgery

The Spine Journal, Aug 1, 2018

Journal of Cardiac Surgery, Apr 21, 2022

Cardiac surgeons have variable exposure to thoracic aortic EndoVascular repair (TEVAR) as the pri... more Cardiac surgeons have variable exposure to thoracic aortic EndoVascular repair (TEVAR) as the primary surgeon. As paradigms evolve and EndoVascular structural heart interventions expand, TEVAR utilization by cardiac surgeons is of particular interest. In order to definitively manage thoracic aortic pathologies in the modern era, cardiac surgeons must incorporate TEVAR into their armamentarium during surgical training or risk a prolonged learning curve.

Journal of Heart and Lung Transplantation, Apr 1, 2021

Purpose The purpose of the present study is to examine the effect of operative time of day on out... more Purpose The purpose of the present study is to examine the effect of operative time of day on outcomes in orthotopic heart transplant (OHT) recipients. We hypothesized that nighttime OHT operations would be associated with increased 1-year mortality when compared to daytime OHT operations. Methods We performed a retrospective analysis of adult heart transplant recipients in the United Network for Organ Sharing (UNOS) database from January 2000 to December 2019. Operative time of day was derived from the donor cross-clamp time (night, 6 pm-4 am; day, 4 am-6 pm). The primary outcome was survival at 1 year. Kaplan-Meier curves and log-rank statistics were generated to compare the effect of operative time and were further stratified by age, transplant center yearly volume (low volume, Results Of the 42,007 patients included in the study, 24,200 (57.6%) underwent nighttime and 17,807 (42.4%) daytime OHT (Table 1). Preoperative patient characteristics were similar between cohorts. 1-year survival (Figures 1) was not different between the cohorts (89.7 vs 89.5%, p=0.630). When further stratified by age, center volume, or VAD status, 1-year survival between operative times still remained insignificant. Conclusion There is no significant association between nighttime operations and 1-year post-transplant survival in adult heart transplant recipients.

Seminars in Thoracic and Cardiovascular Surgery, 2018

Maintaining the branch pulmonary artery architecture in the repair of truncus arteriosus could be... more Maintaining the branch pulmonary artery architecture in the repair of truncus arteriosus could be considered to reduce right ventricular outflow tract re-operation. Perspective Statement Early right ventricular outflow tract re-operation following the repair of truncus arteriosus is a common problem. Using a modified repair, the branch pulmonary arteries are kept in-situ. Using this approach, we have observed excellent early and mid-term results.

JTCVS open, Jun 1, 2023

A wide array of imaging modalities is used to evaluate both preoperative and postoperative cardia... more A wide array of imaging modalities is used to evaluate both preoperative and postoperative cardiac and thoracic surgery patients, including radiographs ("plain films"), computed tomography (CT) and magnetic resonance imaging (MRI) scans, cardiac ultrasounds (echocardiograms), and coronary angiography.

Journal of Heart and Lung Transplantation, Apr 1, 2021

Journal of surgery and research, 2023