About Andrea Merrill

Andrea Merrill

Andrea is a 2015-2016 NEJM Group Editorial Fellow. She is currently in the middle of her General Surgery residency at Massachusetts General Hospital and is also conducting research focusing on improvements in breast cancer surgery. She plans to pursue a fellowship in Surgical Oncology at the completion of her residency.

All posts by Andrea Merrill

Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

• December 7th, 2016

On the first day of my second year of residency, I showed up to the cardiac surgery intensive care unit (CSICU) terrified for what awaited me.  It wasn’t uncommon for patients recovering from cardiac surgery to be on three different vasopressors while intubated with four chest tubes and pacing wires. Even after a year of… Read More…

Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States

• November 23rd, 2016

Imagine you are assessing a relatively healthy 85-year-old man who was brought to the hospital after a fall at home. Due to concern for spinal fractures, he underwent CT scans of his head, C-spine, chest, abdomen, and pelvis. Although no traumatic injuries were found, an incidental finding of a 5.5 cm infrarenal abdominal aortic aneurysm… Read More…

Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage

• July 27th, 2016

What is the ideal blood pressure goal for spontaneous cerebral hemorrhage? Results of the ATACH-2 trial are discussed. As a surgery resident, one of the first concepts I learned was that high blood pressure was bad in a patient who was actively bleeding.  This meant that for a trauma patient with a large liver or splenic… Read More…

Extending Aromatase-Inhibitor Treatment in Breast Cancer

• June 29th, 2016

I am approaching the end of my general surgery residency and trying to decide on a sub-specialty going forward.  Over the past 2 years I have found myself drawn to the field of breast surgery, in large part due to the large breadth of research being done in the field.  Research in breast cancer has… Read More…

Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients

• April 27th, 2016

I’ve sometimes wondered if I’m embarking on the field of surgery in the wrong era.  As a medical student, and now as a resident, the big open operations have always seemed to be the most exhilarating and rewarding.  It always seems more thrilling to have your hands deep in a patient’s abdomen or chest than… Read More…

Carotid artery stenting versus carotid endarterectomy: Results of two randomized trials

• March 14th, 2016

As a 4th year medical student I rotated on the vascular surgery service at a local hospital. One of the vascular surgeons loved music (all music!) and would quiz me on the musicians as each song came on. I usually got them wrong and longed for him to just ask me an anatomy question instead… Read More…

Residency Duty Hours: FIRST, do no harm

• February 2nd, 2016

When I started general surgery residency in 2011, my training program was on probation for violating the 80 hour work week as mandated by the Accreditation Council for the Graduate Medical Education (ACGME).  In addition, new regulations were being introduced that year that limited the maximum number of hours an intern and resident could work… Read More…

Belatacept and Long-Term Outcome in Kidney Transplantation

• January 27th, 2016

Medicine is a constant balance of risks and benefits.  The importance of maintaining this balance is especially evident in kidney transplantation.   While methods of immunosuppression in kidney transplantation have improved substantially since the use of total body irradiation to induce tolerance in the 1950s, current immunosuppressive agents such as calcineurin inhibitors still come with  clinically… Read More…

Andexanet Alpha for the Reversal of Factor Xa Inhibitor Activity

• December 14th, 2015

As a general surgery resident more than half-way through my training career, I have taken care of my fair share of trauma patients. However, the trauma patients I’m referring to aren’t the stereotypical victims of gun-shot and stab wounds seen on TV. One of my most common trauma patients is the frail 80-something year old… Read More…

Prospective Validation of a 21-Gene Expression Assay (OncotypeDX) in Breast Cancer

• November 18th, 2015

Imagine it is 1970. You are a 50-something year old woman and your doctor has just palpated a 1 cm mass in your left breast.  What are your options for treatment?  Unfortunately, radical mastectomy, introduced by Dr. William Halsted in 1894, remained the standard of care at that time.  Breast cancer treatment as it was… Read More…