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Acute aortic injury

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https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#1
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#2
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28638973/a-retrospective-observational-cohort-study-investigating-the-association-between-acute-kidney-injury-and-all-cause-mortality-among-patients-undergoing-endovascular-repair-of-abdominal-aortic-aneurysms
#3
Kimito Minami, Yoko Sugiyama, Hiroki Iida
BACKGROUND: Acute kidney injury (AKI) has been found to be associated with short- and long-term mortality and morbidity in various clinical settings. However, it is unknown whether AKI after endovascular repair of abdominal aortic aneurysms (EVAR) is associated with postoperative mortality. METHODS: This observational study analyzed patients who underwent EVAR. The primary outcome was all-cause mortality. The outcomes of patients with and without postoperative AKI were compared using the Kaplan-Meier method and log-rank test...
June 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28619541/can-renal-resistive-index-predict-acute-kidney-injury-after-acute-type-a-aortic-dissection-repair
#4
Hai-Bo Wu, Huai Qin, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Li-Zhong Sun
BACKGROUND: This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD). METHODS: This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28612571/-correlation-between-serum-concentrations-of-catecholamines-and-oxygen-index-in-acute-aortic-dissection
#5
Hong Qian, Lei Du, Jing-Xiu Fan, Hui Yu, Er-Yong Zhang, Jia Hu
OBJECTIVES: To explore whether the serum concentration of adrenaline (AD) and noradrenaline (NA) elevate and its correlation with oxygenation index (OI) in the patients of acute aortic dissection (AAD). METHODS: From April 2013 to December 2013, clinical data were collected from three groups of patients (38 cases of AAD in Group A, 28 cases of ascending aortic aneurysm in Group B, and 22 cases of angina in Group C). All patients received the measurement of serum concentrations of AD, NA and endotoxin (ET)...
January 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#6
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#7
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28597767/increased-mortality-from-complications-of-pulmonary-hypertension-in-patients-undergoing-transcatheter-aortic-valve-replacement
#8
Raj Parikh, Benson Varghese, Huma N Khatoon, Julie A Kovach, Clifford J Kavinsky, Rajive Tandon
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#9
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28595747/transcathether-aortic-valve-implantation-with-the-new-repositionable-self-expandable-evolut-r-versus-corevalve-system-a-case-matched-comparison
#10
Cristina Giannini, Marco De Carlo, Corrado Tamburino, Federica Ettori, Azeem M Latib, Francesco Bedogni, Giuseppe Bruschi, Patrizia Presbitero, Arnaldo Poli, Franco Fabbiocchi, Roberto Violini, Carlo Trani, Pietro Giudice, Marco Barbanti, Marianna Adamo, Paola Colombo, Susanna Benincasa, Mauro Agnifili, A Sonia Petronio
BACKGROUND: Despite promising results following transcatheter aortic valve implantation (TAVI), several relevant challenges still remain. To overcome these issues, new generation devices have been developed. The purpose of the present study was to determine whether TAVI with the new self-expanding repositionable Evolut R offers potential benefits compared to the preceding CoreValve, using propensity matching. METHODS: Between June 2007 and November 2015, 2148 consecutive patients undergoing TAVI either CoreValve (n=1846) or Evolut R (n=302) were prospectively included in the Italian TAVI ClinicalService® project...
May 29, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28586115/early-detection-of-postoperative-acute-kidney-injury-in-acute-stanford-type-a-aortic-dissection-with-doppler-renal-resistive-index
#11
Huai Qin, Haibo Wu, Yi Chen, Nan Zhang, Zhanming Fan
OBJECTIVES: This study aimed to evaluate the early efficiency of Doppler renal resistive index (DRRI) in prediction of acute kidney injury (AKI) after surgery in acute Stanford Type A aortic dissection (AAAD) patients. METHODS: Sixty-one AAAD patients who planned to receive Sun's surgical management were prospectively enrolled. The DRRI was measured by ultrasonography Doppler on the day before surgery (DRRIpre ), on admission to the intensive care unit (DRRIT0 ), 6 hours after surgery (DRRIT6 ), 24 hours after surgery (DRRIT24 ), and 48 hours after surgery (DRRIT48 )...
June 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28579290/improved-outcomes-and-value-in-staged-hybrid-extent-ii-thoracoabdominal-aortic-aneurysm-repair
#12
Robert B Hawkins, J Hunter Mehaffey, Adishesh K Narahari, Amit Jain, Ravi K Ghanta, Irving L Kron, John A Kern, Gilbert R Upchurch
OBJECTIVE: Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared with traditional open repair over 10 years. METHODS: A prospectively collected database was used to identify all patients with an extent II TAAA undergoing repair at a single institution between 2005 and 2015...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28576265/incidence-and-outcomes-of-heparin-induced-thrombocytopenia-in-patients-undergoing-transcatheter-aortic-valve-replacement
#13
Tesfaye Telila, Emmanuel Akintoye, Tomo Ando, Obsinet Merid, Sagar Mallikethi-Reddy, Alexandros Briasoulis, Cindy Grines, Luis Afonso
The main objective of this study was to investigate the incidence and magnitude of impact of heparin-induced thrombocytopenia (HIT) on outcomes of patients undergoing transcatheter aortic valve placement (TAVR). The impact of HIT on procedural outcomes after cardiac surgery has been described. We sought to investigate the incidence and outcomes of HIT after TAVR using the Nationwide Inpatient Sample (NIS) database. We identified patients who underwent TAVR from 2011 to 2014. The primary outcome was the effect of HIT on inpatient mortality...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28570236/transcatheter-aortic-valve-replacement-versus-surgical-valve-replacement-in-low-intermediate-surgical-risk-patients-a-systematic-review-and-meta-analysis
#14
Aakash Garg, Sunil V Rao, Gautam Visveswaran, Sahil Agrawal, Abhishek Sharma, Lohit Garg, Indrajeet Mahata, Jalaj Garg, Dinesh Singal, Marc Cohen, John B Kostis
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a viable alternative to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (SAS) who are at high risk for surgery. We sought to evaluate the outcomes of TAVR vs SAVR in low-intermediate risk patients with SAS. METHODS AND RESULTS: We performed random-effects meta-analysis of randomized controlled trials (RCTs) and propensity-matched observational studies comparing TAVR vs SAVR for low-intermediate risk patients...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28569144/the-incidence-risk-factors-and-in-hospital-mortality-of-acute-kidney-injury-in-patients-after-abdominal-aortic-aneurysm-repair-surgery
#15
Ying Tang, Junzhe Chen, Kai Huang, Dan Luo, Peifen Liang, Min Feng, Wenxin Chai, Erik Fung, Hui Yao Lan, Anping Xu
BACKGROUND: Acute kidney injury (AKI) is a severe complication associated with abdominal aortic aneurysm (AAA) repair. In this study, we evaluated the incidence, risk factors and in-hospital mortality of AKI in patients after the AAA repair surgery. METHODS: A total of 314 Chinese AAA patients who underwent endovascular aneurysm repair (EVAR) or open aneurysm repair (OPEN) were enrolled in this study. AKI was diagnosed according to the 2012 KDIGO criteria. Logistic regression modeling was used to explore risk factors of AKI, while risk factors associated with in-hospital mortality in AKI patients were investigated using Cox proportional hazards model and Kaplan-Meier analysis, respectively...
May 31, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28568013/a-multicenter-review-of-ablation-in-the-aortic-cusps-in-young-people
#16
Minh B Nguyen, Scott R Ceresnak, Christopher M Janson, Steven B Fishberger, Barry A Love, Andrew D Blaufox, Kara S Motonaga, Anne M Dubin, Lynn Nappo, Robert H Pass
BACKGROUND: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. METHODS: A retrospective, descriptive study of aortic cusp ablation in 5 pediatric EP centers from 2008-2014 was performed. All patients < 21 years of age who underwent ablation in the aortic cusps were included. Factors analyzed included patient demographics, procedural details, outcomes and complications...
June 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28550495/core-curriculum-illustration-acute-traumatic-aortic-injury
#17
Manuel Trevino, Shaked Laks, Noemi Brunner
This is the 34th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at http://www.aseronline.org/curriculum/toc.htm .
May 26, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28545062/association-of-frailty-status-with-acute-kidney-injury-and-mortality-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#18
Charat Thongprayoon, Wisit Cheungpasitporn, Natanong Thamcharoen, Patompong Ungprasert, Wonngarm Kittanamongkolchai, Michael A Mao, Ankit Sakhuja, Kevin L Greason, Kianoush Kashani
OBJECTIVE: Frailty is a common condition in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). The aim of this systematic review was to assess the impact of frailty status on acute kidney injury (AKI) and mortality after TAVR. METHODS: A systematic literature search was conducted using MEDLINE, EMBASE, and Cochrane databases from the inception through November 2016. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no...
2017: PloS One
https://www.readbyqxmd.com/read/28536830/transcatheter-aortic-valve-implantation-in-patients-on-corticosteroid-therapy
#19
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Keitaro Mahara, Itaru Takamisawa, Jun Shimizu, Shuichiro Takanashi, Morimasa Takayama
Transcatheter aortic valve implantation (TAVI) is recommended for patients who are inoperable or at high risk for surgical aortic valve replacement (SAVR). Corticosteroid therapy is considered to be a risk factor for SAVR, but there is a paucity of information about TAVI in patients taking corticosteroids. The aim of this study is to elucidate the outcome of TAVI in patients on chronic corticosteroid therapy, compared with SAVR. We retrospectively analyzed patients on corticosteroid therapy who underwent TAVI (n = 21) or SAVR (n = 30) for severe aortic stenosis in Sakakibara Heart Institute...
May 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28525506/haptoglobin-administration-in-cardiovascular-surgery-patients-its-association-with-the-risk-of-postoperative-acute-kidney-injury
#20
Kenta Kubota, Moritoki Egi, Satoshi Mizobuchi
BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, may have the potential to prevent postoperative AKI (pAKI). However, there have been few studies in which the association of intraoperative administration of haptoglobin with the incidence of AKI after cardiac surgery was assessed. METHODS: This study was a retrospective observational study to assess the independent association of intraoperative administration of haptoglobin with the incidence pAKI in cardiac surgery patients...
June 2017: Anesthesia and Analgesia
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