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Heart Surgery Forum

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https://www.readbyqxmd.com/read/28846534/the-skeleton-in-the-closet-harvesting-a-skeletonized-ima
#1
Curtis G Tribble
There is a considerable amount of data that using more than one arterial graft provides a survival advantage for patients undergoing coronary bypass operations. The Society of Thoracic Surgeons has a set of official guidelines for the use of arterial grafts which include the following recommendations:Internal mammary arteries (IMA's) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated.As an adjunct to left internal mammary artery (LIMA), a second arterial graft (right IMA or radial artery [RA]) should be considered in appropriate patients...
August 28, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846533/the-prognostic-risk-factors-of-ecmo-in-patients-with-cardiogenic-shock-a-retrospective-cohort-analysis
#2
Xiao-Zu Liao, Zhi-Bin Zhou, Zhou Cheng, Xiao-Yu Yang, Xue Zhou, Bin-Fei Li, Xia Feng
BACKGROUND: Advances in ECMO have rapidly progressed in recent years; however, the clinical mortality rate remains high. This study aimed to identify the risk factors of ECMO in patients with cardiogenic shock. METHODS: Data of patients with cardiogenic shock who received ECMO from January 2006 to August 2013 at the Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. All patients with cardiogenic shock were divided into two groups according to whether death occurred in the hospital...
August 28, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846532/randomized-trial-of-sternal-closure-for-low-risk-patients-rigid-fixation-versus-wire-closure
#3
Graham Graham, Jeevan Kumar, Shinya Unai, Diehl T James, Hitoshi Hirose Md
BACKGROUND: A previous retrospective analysis of our cardiac surgery patients showed shortened ventilation time and hospital stay among patients receiving rigid sternal fixation compared to sternal wire fixation. We performed a prospective randomized study to further investigate these outcomes and determine if rigid closure can provide reduced pain after cardiac surgery. METHODS: Patients undergoing cardiac surgery between July 2011 and May 2014 were prospectively randomized into wire closure (Group C) or rigid fixation using sternal plates (Group R) groups...
August 28, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846531/post-myocardial-infarction-ventricular-septal-defect-six-months-following-coronary-artery-bypass-grafting
#4
Amy G Fiedler, Thoralf M Sundt Iii, George Tolis
Mechanical complications following acute myocardial infarction are associated with high mortality. We present the first reported case of a new post myocardial infarction ventricular septal defect (VSD) within six months of coronary artery bypass grafting. The patient underwent successful surgical correction of the VSD with the assistance of mechanical circulatory support (MCS). This case highlights the importance of mechanical circulatory support in the management of cardiogenic shock associated with rare complications of myocardial infarction, even after surgical revascularization...
August 25, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846530/diazoxide-attenuates-ischemic-myocardial-injury-in-a-porcine-model
#5
Henna Elisa Sarja, Tuomas Anttila, Caius Mustonen, Hannu-Pekka Honkanen, Johanna Herajärvi, Henri Haapanen, Hannu Tuominen, Ilkka Miinalainen, Tatu Juvonen, Vesa Anttila
BACKGROUND: We hypothesized that diazoxide, a mitochondrial ATP-sensitive potassium channel opener, has cardioprotective effects during acute myocardial ischemia. Diazoxide is suggested to act through protein kinase Cε (PKCε) activation. METHODS: Twelve piglets were randomly assigned to receive intravenous infusion of diazoxide (3.5 mg/kg) with solvent or only solvent (6 animals per group) before cardiac ischemia. Myocardial ischemia was induced by occluding the left circumflex artery (LCX) for 40 minutes...
August 25, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846529/association-between-preoperative-cardiac-left-ventricular-dysfunction-and-perioperative-intraaortic-balloon-pump-in-patients-undergoing-off-pump-coronary-artery-bypass-surgery
#6
Go Kusumoto, Kenji Shigematsu, Kouhei Iwashita, Kenji Tominaga, Takaaki Totoki, Ken Yamaura
BACKGROUND: Prophylactic use of intraaortic balloon pump (IABP) reduces hospital mortality in patients with left ventricular (LV) systolic dysfunction undergoing coronary artery bypass surgery (CABG); however, its association in patients with LV diastolic dysfunction is unclear. This retrospective study investigated the association between preoperative LV function and perioperative use of IABP in patients undergoing off-pump CABG (OPCAB) at a university hospital. METHODS: 100 consecutive patients who underwent OPCAB between January 1, 2011 and August 31, 2014 were studied...
August 25, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846528/effects-of-preoperative-tricuspid-valve-diameters-on-early-postoperative-surgical-outcomes-in-patients-undergoing-tricuspid-valve-surgery
#7
Fatih Ada, Kemalettin Ucanok, Ahmet Ruchan Akar, Mustafa Bahadir Inan, Serkan Durdu, Mustafa Sirlak, Levent Yazicioglu, Adnan Uysalel, Sadik Eryilmaz
BACKGROUND: Many of the previous studies on tricuspid valve surgery were on the materials that were used and the advantages and disadvantages of them. In this study, effects of preoperative tricuspid valve diameter on early postoperative outcomes were investigated. Methods: A total of 43 patients who underwent tricuspid valve repair surgery with the ring between the years 2012-2014 were included in this study. Tricuspid valve diameters and other cardiac functions of patients undergoing tricuspid intervention were evaluated with transthoracic echocardiography...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846527/kinking-of-the-outflow-graft-consequent-ventricular-tachycardia-and-the-need-for-reoperation-in-a-patient-with-left-ventricular-assist-device
#8
Dusko Terzic, Emilija Nestorovic, Svetozar Putnik, Dejan Markovic, Miljko Ristic
BACKGROUND: Left ventricular assist devices (LVAD) have become a lifesaving solution for patients awaiting heart transplantation as well as an option to support the failing hearts of non-transplant candidates as a lifelong, or destination therapy (DT). Improvements in LVAD design have enabled greater durability and broader patient applicability, but not without complications. Ventricular arrhythmias in LVAD patients were considered benign in the early days of LVADs, but today are increasingly recognized for their harmful impact on morbidity and quality of life...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846526/clinical-and-angiographic-outcomes-in-coronary-artery-bypass-surgery-with-multiple-versus-single-distal-target-grafts
#9
Aws Alherbish, Colleen M Norris, Jay Shavadia, Mohammad Almutawa, Seraj Abualnaja, Jayan Nagendran, Michelle M Graham, Sean Van Diepen
BACKGROUND: Coronary artery bypass grafting (CABG) with multiple distal target (MDT) grafts requires less graft material and reduces cardiopulmonary bypass time; however, there may be a higher incidence of graft failure. A real-world analysis reporting long-term outcomes associated with MDT grafts is lacking. MATERIAL AND METHODS: In 6262 consecutive patients who underwent an isolated first CABG from 2004-2012, patients with MDTs were propensity matched to those with single distal target (SDT) grafts...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846525/timing-of-surgery-for-fungal-infective-endocarditis
#10
Changhua Chen, Ching-Hui Huang, Ying-Chen Chen
Fungal endocarditis rarely occurs and is difficult to treat. Taguchi et al described that a 55-year-old man, who developed severe mitral regurgitation with persistent fungal infective endocarditis (IE) 8 months after coronary artery bypass grafting, was cured with mitral valve replacement via the anterolateral right thoracotomy without cross-clamping method [Taguchi 2016].
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28846524/outcome-of-patients-with-low-flow-low-gradient-severe-aortic-stenosis-who-underwent-aortic-valve-replacement
#11
Xing Li Fan, Jiajun Zhang, Chong Wang, Hongmei Chong, Guanxin Zhang, Qing Xue, Yangfeng Tang, Lin Han
It is well-documented that stroke volume and gradient are indexed to classify patients with aortic stenosis into several phenotypes. The purpose of the present study was to estimate the impact of stroke volume and gradient on the clinical outcome of patients with AS who have undergone aortic valve replacement. Methods: A total of 154 consecutive patients were studied. They all had severe aortic stenosis (aortic valve area [AVA] ≤ 1 cm², left ventricular ejection fraction [LVEF] ≥ 50%) and underwent aortic valve replacement (AVR) from January 1, 2004 to December 31, 2010...
July 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671869/prognostic-value-of-neutrophil-to-lymphocyte-ratio-and-risk-factors-for-mortality-in-patients-with-stanford-type-a-aortic-dissection
#12
Kursad Oz, Taner Iyigun, Zeynep Karaman, Ömer Çelik, Ertan Akbay, Okan Akınc, Okan Akınc, Korhan Erkanli
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group...
June 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671868/stemi-and-nstemi-acs-in-a-30-year-old-patient-an-extremely-rare-complication-of-a-left-atrial-myxoma
#13
Francesco Bartolomucci, Antonio Tito, Eliano Pio Navarese, Fortunato Iacovelli, Marco Mele, Claudio Larosa, Marco Matteo Ciccone, Mauro Cassese, Martino Pepe
Primary cardiac tumors are a rare entity whose incidence in the general population ranges from 0.0017% to 0.28%. Myxomas represent nearly half of all primary benign cardiac tumors and they prevalently affect female patients. Embolic manifestation is rare with a reported incidence of 0.06%.We present the case of a 30-year-old male patient with acute anterolateral infarction caused by total occlusion of the left anterior descending artery as a consequence of a left atrial myxoma embolization. Urgent surgical resection of the mass didn't avoid early recurrence of atrial myxoma, whose second presentation was again myocardial infarction...
June 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671867/knockin-on-heaven-s-door-end-of-life-decisions-and-discussions
#14
Curt Tribble Md
More than 2.5 million people die in the United States each year. For the majority who live out their final days in various institutions or in hospice care, decisions must be made about which treatments to administer, which treatments to stop, which treatments to continue, and which treatments to back off of. Thus, while death remains inevitable, its timing is often very much a function of human agency. Once it was common to speak of "nature taking its course," but now it has become as common to view death as something about which people have some control [Meisel 2008]...
June 29, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671866/application-of-autologous-blood-cell-salvage-in-off-pump-coronary-artery-bypass-graft-operation
#15
Hui Zhao, Huimin Ma, Li Meng, Ziniu Zhao, Xiaoqiang Quan, Zhaoyun Cheng
To analyze whether application of autologous blood cell salvage can reduce the transfusion volume of allogeneic blood and complications of blood transfusion in off-pump coronary artery bypass operations. Methods: We randomly divided 120 patients into autologous blood cell salvage group (experimental group, n = 60) and non-autologous blood cell salvage group (control group, n = 60). Volume of perioperative allogeneic blood transfusion of each patient was recorded. Moreover, complications and ICU retention times (H) of each patient were also recorded...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671865/quality-of-life-after-surgery-for-stanford-type-a-aortic-dissection-influences-of-different-operative-strategies
#16
Tamer Ghazy, Mohamed Eraqi, Adrian Mahlmann, Helena Hegelmann, Klaus Matschke, Utz Kappert, Norbert Weiss
BACKGROUND: Outcome of surgery for acute Stanford type A aortic dissection extends beyond mortality and morbidity. More than one operative strategy is available but little is known regarding their influence on quality of life. This study analyzes the influence of defensive and aggressive operative strategies on the patients' midterm quality of life (QoL). METHODS: From July 2007 to July 2010, 95 patients underwent surgery for acute Stanford type A aortic dissection in our institution...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671864/a-case-report-on-pulmonary-arteriovenous-fistula-with-recurrent-cerebral-infarction
#17
Lu He, Ge-Sheng Cheng, Ya-Juan Du, Yu-Shun Zhang
Patent foramen ovale (PFO) and pulmonary arteriovenous fistula (PAVF) have been both proposed as a mechanism for cerebral infarction. However, there are only a few reports on how to distinguish the role of the two factors in cerebral infarction.
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671863/rethinking-the-paradigm-modern-approach-to-proximal-aortic-reconstruction-demonstrates-excellent-outcomes
#18
Jonathan M Hemli, Edward R R DeLaney, Kush R Dholakia, Dror Perk, Nirav C Patel, S Jacob Scheinerman, Derek R Brinster
BACKGROUND: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. METHODS: The majority of our patients were male, mean age 61...
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671862/median-sternotomy-for-lung-transplantation-techniques-and-advantages
#19
Nicholas R Teman, Jianzhou T Xiao, Curtis G Tribble, Patrick E Parrino
Lung transplantation is traditionally performed with a clamshell thoracotomy or bilateral anterior thoracotomy incisions. We have performed 121 lung transplants with a median sternotomy incision from 2013-2017. We present our technique for lung transplantation utilizing cardiopulmonary bypass with a median sternotomy, and discuss the potential advantages of this technique.
June 19, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671861/the-transcranial-doppler-sonography-for-optimal-monitoring-and-optimization-of-cerebral-perfusion-in-aortic-arch-surgery-a-case-series
#20
Tamer Ghazy, Ayham Darwisch, Torsten Schmidt, Phong Nguyen, Sohaila Elmihy, Zuzana Fajfrova, Claudia Zickmüller, Klaus Matschke, Utz Kappert
OBJECTIVE: To analyze the feasibility and advantages of transcranial doppler sonography (TCD) for monitoring and optimization of selective cerebral perfusion (SCP) in aortic arch surgery. METHODS: From April 2013 to April 2014, nine patients with extensive aortic pathology underwent surgery under moderate hypothermic cardiac arrest with unilateral antegrade SCP under TCD monitoring in our institution. Adequate sonographic window and visualization of circle of Willis were to be confirmed...
June 16, 2017: Heart Surgery Forum
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