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Heart Surgery Forum

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https://www.readbyqxmd.com/read/29658872/reoperative-cardiac-surgery-part-ii
#1
Curtis G Tribble
The preparation for a reoperative cardiac surgical case was covered in Part I of this two part review [Tribble 2018]. Part II will cover primarily intraoperative strategies and techniques.  As noted in Part I, there has been surprisingly little written about the strategies and techniques of reoperative cardiac surgery. Thus, the goal of this two-part review is to collect and collate some of the lessons, abjurations, and tenets related to reoperative cardiac surgery that may be valuable to cardiac surgeons, especially those in training or early in their careers...
April 10, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658871/new-onset-ventricular-arrhythmias-in-patients-with-left-ventricular-dysfunction-after-coronary-surgery-incidence-risk-factors-and-prognosis
#2
Nan Cheng, Changqing Gao, Rong Wang, Ming Yang, Lin Zhang
BACKGROUND: The incidence, risk factors, and long-term prognosis of new-onset ventricular tachycardia (VT) and ventricular fibrillation (VF) after coronary artery bypass graft surgery (CABG) in patients with impaired left ventricular function have not been thoroughly examined. Methods: This study enrolled 612 consecutive patients with impaired left ventricular function (ejection fraction <50%) undergoing CABG at a single institution between March, 1996, and September, 2015. Outcomes were analyzed and compared, including in-hospital mortality and long-term survival...
March 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658870/descending-thoracic-aortic-aneurysm-rupture-treated-with-thoracic-endovascular-aortic-repair-in-a-patient-with-peripheral-artery-disease
#3
Ovidiu Stiru, Roxana Carmen Geana, Platon Pavel, Marian Croitoru, Cristian Boros, Ion Iovu, Vlad Anton Iliescu
Descending thoracic aortic aneurysm rupture is a life-threatening disease associated with high rates of morbidity and mortality. Treatment in these cases is a surgical emergency. Less invasive therapies for the treatment of this pathology have been developed over time. For descending thoracic aneurysm rupture, endovascular stent grafting is less invasive, life-saving, and a unique alternative to open repair. However, this approach is subject to anatomical and logistic limitations. The purpose of the present study is to report a case of an emergency endovascular repair for a ruptured thoracic aortic aneurysm in a patient with peripheral arterial disease, and to discuss some important issues related to this approach...
March 20, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658869/predictive-model-for-secundum-atrial-septal-defect-closure-with-pulmonary-artery-hypertension-in-adult-when-to-close
#4
Supomo Supomo, Adika Zhulhi Arjana, Handy Darmawan
BACKGROUND: Secundum atrial septal defect (SASD) closure is contraindicated in the presence of severe pulmonary artery hypertension (PAH). However, there is no consensus on the threshold of severe PAH, in terms of mean pulmonary artery pressure (mPAP), which would contraindicate for defect closure surgery in adults. Furthermore, PAH can persist, or even increase in severity, after the closure. The aim of this study was to produce a predictive model correlating mPAP in adult SASD patients with PAH after defect closure surgery...
March 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658868/serum-levels-of-mir-155-mir-326-and-mir-133b-as-early-diagnostic-biomarkers-for-the-detection-of-human-acute-heart-allograft-rejection-in-comparison-with-serum-cardiac-troponin-t
#5
Aghil Esmaeili-Bandboni, Jamshid Bagheri, Ali Reza Bakhshandeh, Javad Mohammadnejad, Esmaeil Sadroddiny
BACKGROUND: Acute heart allograft rejection occurs as a result of antibody-mediated rejection that presents during the first month after transplantation. Finding a non-invasive biomarker is essential for diagnosis of heart allograft rejection. In this research, we intended to compare expression levels of several microRNAs across cardiac troponin T levels between rejected patients (who died before one month following transplantation), non-rejected patients (who survived for at least one month after transplantation), and non-transplanted patients (CABG surgery patients)...
March 12, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658867/repair-of-partial-anomalous-pulmonary-venous-connection-a-rare-case-evaluated-by-multi-slice-computed-tomographic-angiography
#6
Yukun Cao, Tin Yang, Ma Hou, Hongcha Zhang, Xi Chen, Fe Zou
Partial anomalous pulmonary venous connection (PAPVC) is an uncommon congenital heart disease, which may be difficult to identify and often remains undiagnosed. Accurate diagnosis of major aortopulmonary collaterals and partial anomalous pulmonary venous drainage in patients with congenital heart disease is important but problematic. The goal of this publication is to present the diagnosis and surgical repair of this rare pathology in an eight-year-old boy. Atrial septal defect was found by echocardiography, but no anomalous pulmonary vein was found...
March 8, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658866/mechanical-valve-replacement-for-congenital-heart-disease-complicated-by-native-pulmonary-valve-endocarditis-a-case-report-and-literature-review
#7
Qing Wang, Yan Gao, Wang Xi, Hua Shen, Jing Wang, Jian Xiao, Zhinong Wang
Congenital heart disease (CHD) is one of the most common risk factors for infective endocarditis. However, it is rare to find a CHD patient complicated by isolated pulmonary valve endocarditis. Here, we report an adult patient with congenital heart disease complicated by native pulmonary valve endocarditis who underwent a mechanical valve replacement. We also review previous literature to examine key points in the treatment of such patients.
March 7, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658865/hemodynamic-consequence-of-different-pacing-modes-after-aortic-valve-replacement
#8
Arndt H Kiessling
OBJECTIVES: Ventricular pacemaker stimulation may cause deterioration of hemodynamics in patients with left-ventricular hypertrophy following aortic valve replacement. Since the diastolic function is often impaired, it remains unclear which heart rate best optimizes cardiac output. Low heart rates are suggested to treat impaired diastolic function chronically, but it is possible that cardiac output may be augmented by increasing the heart rate in patients with a fixed stroke volume (SV)...
March 6, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658864/right-ventricular-perforation-by-a-defibrillator-lead-migrating-to-the-left-breast
#9
Jerneja Tasic, Rok Zbacnik, Igor Zupan, Jus Ksela
Cardiac perforation after an ICD implantation is a rare complication, with a reported incidence between 0.6-5.2%. Its manifestation might be acute, subacute, or delayed, with an acute perforation occurring within the first 24 hours after implantation, frequently accompanied by severe clinical signs, while subacute and delayed perforations have a more benign progression. Here, we report a case of a 69-year old patient with an acute right ventricular perforation by a defibrillator lead migrating all the way through the pericardium and thoracic wall into the left breast, with an unusually mild and benign clinical course, delaying prompt diagnosis and postponing subsequent surgical treatment...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658863/swallow-syncope-after-whiplash-neck-injury
#10
Luka Lipar, Pia Vovk, Tereza Weiss, Jus Ksela
Swallow syncope is a rare dysautonomic syndrome characterized by temporary loss of consciousness upon swallowing solid foods or liquids, displaying primarily in individuals with an underlying structural or functional esophageal or cardiac pathology. However, the evidence also suggests that isolated vagal dysfunction or abnormal reactions of esophageal mechanoreceptors after mechanical irritation, demyelination, or trauma can potentially evoke  a cardioinhibitory response or vasodepression upon swallowing. We present a case of a 49-year-old otherwise healthy female patient who developed swallow syncope two weeks after whiplash neck injury acquired in a rear-end collision...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658862/progress-in-gene-therapy-for-chronic-heart-failure
#11
Zhi-Qiang Yin, Wan-Hong Xing
Chronic heart failure (CHF) is still the leading cause of morbidity and mortality worldwide, and carries with it large economic and social burdens. Although steady and substantial progress has been made in reducing mortality from heart failure using conventional treatments, novel pharmacologic and surgical interventions have not been effective in extending five year survival rates. Therefore, it is necessary to explore new therapies. Gene therapy was introduced in 1970s with the development of recombinant DNA technology...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658861/monster-lung-cavity-in-a-heart-transplant-recipient
#12
Brandon T Nokes, Octavio Pajaro, Jenise Stephen, Patrick DeValeria, Robert Scott, Sadia Shah, Eric Steidley, Jama Jahanyar
Invasive mucormycosis infections occur in less than 1% of recipients of orthotopic heart transplants. Given the angioinvasive nature of these infections, the mortality rate is high. Little literature exists regarding the presentation and management of these infections. We present a case of a patient who developed an infection after orthotopic heart transplant, describe the successful multidisciplinary management surrounding his care, and review the available literature regarding mucormycosis infections in heart transplant recipients...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658860/pressure-support-breaths-triggered-by-total-artificial-heart-in-invasive-and-non-invasive-mechanical-ventilation
#13
Amit Prasad, Kai Singbartl, Behzad Soleimani, Christoph Brehm, Ali Ghodsizad
Because of the risks associated with extended mechanical ventilation, it is desirable to extubate patients as early as possible. However, weaning patients from mechanical ventilation too early has risks associated with it as well. Thus, it is important to note that in the two cases presented here, pressure-supported breaths were falsely triggered by a patient's a Syncardia® total artificial heart (TAH), influencing decisions about weaning the patient from mechanical ventilation.
March 2, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485968/reoperative-cardiac-surgery-part-i-preoperative-planning
#14
Curt Tribble
While reoperative cardiac surgery has become safer in recent years, it is still more difficult and dangerous than a primary operation. In a recent review of the Cleveland Clinic's experience, 7% of the patients undergoing cardiac reoperations had major intraoperative adverse events (IAEs). In that report, if an IAE occurred, there was a 5% mortality and a 19% incidence of myocardial infarction (MI), stroke, or death [Roselli 2011]. Those are sobering statistics, particularly when reported by one of the busiest cardiac surgical services in the world...
February 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485967/report-of-the-third-heart-surgery-forum-scientific-sessions-zagreb-croatia-december-6-8-2017-conference-highlights
#15
Michael S Firstenberg, Tom C Nguyen, Harold Roberts, Mark M Levinson, Igo Rudez
The Heart Surgery Forum is an online community dedicated to topics related to all aspects of cardiothoracic surgery. It consists of an informative website (www.hsforum.com), a traditional indexed journal both in print and online, and an email-based "list-serv" for discussion of surgical cases and techniques. The email list-serv, "OpenHeart-L" (The Forum) is composed of surgeons and allied specialties (perfusion, anesthesia, nursing). Dr. Mark Levinson (USA) started The Forum originally in 1995...
February 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485966/evaluation-of-p-wave-dispersion-and-tissue-doppler-imaging-for-predicting-paroxysmal-atrial-fibrillation-in-patients-with-hypertension
#16
Xiaohui Zhang, Wei Zeng, Yuanmin Li, Dapeng Hou, Xiuchang Li, Wenbo Xu
BACKGROUND: There are no previous studies dealing with paroxysmal atrial fibrillation (AF) and hypertension using electrocardiogram and tissue doppler imaging (TDI). The aim of this study was to investigate and identify the predictive indicators for paroxysmal AF in hypertensive patients using P wave dispersion (Pd) and TDI. METHODS: Patients with hypertension were enrolled. Patients with paroxysmal AF were classified as the PAF group, and patients without a history of paroxysmal AF were classified as the NAF group...
February 22, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485965/temporary-epicardial-pacing-after-valve-replacement-incidence-and-predictors
#17
Montaser Elsawy Abd Elaziz, Amr Mohammad Allama
Temporary pacemaker wires are usually inserted in patients after valve replacement and may be beneficial for optimizing myocardial function in patients that develop postoperative hemodynamically significant arrhythmias [Elmi 2002]. Indications for temporary cardiac pacing (TCP) are atrial, ventricular or atrioventricular pacing for bradyarrhythmias and for management of both atrial and ventricular tachyarrhythmias [De Belder 1990; Liebold 1998].Pacemaker wires have two ends - one end has a small needle, which is passed into the myocardial surface, then is cut off...
February 19, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485964/expression-of-rho-kinase-and-its-mechanism-in-the-left-atrial-appendage-in-patients-with-atrial-fibrillation
#18
Yongqing Chen, Fangju Su, Juanping Han, Piqi Jiao, Wenyun Guo
To study the expression of Rho kinase (Rho associated coil forming protein kinase-1, ROCK-1) and its substrate myosin phosphatase target subunit 1 (myosin phosphatase target subunit-1, MYPT-1), connexin 40 (Cx40) and connexin 43 (Cx43) in the left atrial appendage of patients with atrial fibrillation, and explore the role of ROCK signaling pathway in patients with atrial fibrillation and its underlying mechanism. Methods: 40 patients undergoing open heart surgery were divided into two groups; atrial fibrillation group (AF group) and sinus rhythm group (SR group)...
February 19, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485963/carcinoid-heart-disease-early-outcomes-after-surgical-valve-replacement-in-nine-patients
#19
Syed Saleem Mujtaba, Stephen Clark
AIM: To describe the early outcomes of carcinoid patients undergoing surgical heart valve replacement. METHODS: In a retrospective study, records of patients with symptomatic carcinoid heart disease referred for valve surgery between 2012 and 2016 were reviewed. The perioperative and early postoperative outcomes were analyzed. RESULTS: Nine patients, with a mean age of 61 years (range 55-70 years) underwent cardiac surgery for carcinoid syndrome...
February 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29485962/validation-of-euroscore-ii-in-chinese-patients-undergoing-coronary-artery-bypass-surgery
#20
Li Shen, Xi Chen, Jianming Gu, Song Xue
BACKGROUND: Comparisons between the EuroSCORE and EuroSCORE II in the patient populations for coronary artery bypass grafting are limited. The aim of the study was to compare the use of the EuroSCORE and EuroSCORE II as risk model for predicting in-hospital mortality in Chinese patients undergoing coronary artery bypass grafting (CABG). METHODS: Patients (n = 1598) with complete records of baseline and operative data were retrospectively collected from computerized records...
January 31, 2018: Heart Surgery Forum
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