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Myocardial infarction and surgery

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https://www.readbyqxmd.com/read/29655951/acef-score-adapted-to-st-elevation-myocardial-infarction-patients-the-acef-stemi-score
#1
Martin Reindl, Sebastian Johannes Reinstadler, Christina Tiller, Markus Kofler, Markus Theurl, Nora Klier, Katherina Fleischmann, Agnes Mayr, Benjamin Henninger, Gert Klug, Bernhard Metzler
BACKGROUND: The age, creatinine and ejection fraction (ACEF) score has originally been developed for risk stratification of patients undergoing elective cardiac surgery. In patients with stable coronary artery disease treated by percutaneous coronary intervention (PCI), the prognostic accuracy of ACEF could be further improved by modifying the original scoring system (called "modified ACEF" or "ACEF-MDRD"). We aimed to specifically adapt the ACEF score for risk assessment of ST-elevation myocardial infarction (STEMI) patients...
April 6, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#2
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#3
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29649610/evaluating-the-effect-of-growing-patient-numbers-and-changing-data-elements-in-the-national-surgical-quality-improvement-program-nsqip-database-over-the-years-a-study-of-posterior-lumbar-fusion-outcomes
#4
B N Shultz, P Bovonratwet, N T Ondeck, T D Ottesen, R P McLynn, J N Grauer
BACKGROUND CONTEXT: The use of national databases in spinal surgery outcomes research is increasing. A number of variables collected by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) changed between 2010 and 2011, coinciding with a rapid increase in the number of patients included per year. However, there has been limited study evaluating the effect that these changes may have on the results of outcomes studies. PURPOSE: To investigate the influence of changing data elements and growth of the NSQIP database on results of lumbar fusion outcomes studies...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29643966/cosmetic-effects-of-skin-crease-camouflage-incision-versus-longitudinal-incision-following-carotid-endarterectomy
#5
Arkadiusz Kazimierczak, Anita Rybicka, Pawel Rynio, Piotr Gutowski, Ireneusz Wiernicki
Introduction: Despite the increasing use of carotid angioplasty and stenting (CAS), carotid endarterectomy (CEA) nonetheless remains a more medically beneficial method of treatment for carotid artery stenosis. Therefore, one possibility for progress within this procedure may be to use minimally invasive carotid surgery, especially when the scar is in plain sight: the use of the natural wrinkles (skin crease) as a camouflage of the skin incision provides significant cosmetic improvements...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29643872/surgical-repair-of-post-infarction-ventricular-septal-rupture-determinants-of-operative-mortality-and-survival-outcome-analysis
#6
Muhammad Yasir Khan, Tariq Waqar, Perisa Gul Qaisrani, Adnan Zafar Khan, Muhammad Shahrukh Khan, Haider Zaman, Anjum Jalal
Background and Objective: Ventricular septal rupture (VSR) is one of the fatal complications of myocardial infarction (MI). Surgery provides the maximum survival benefit. Our objective was to investigate the risk factors of surgical mortality and to do the survival analysis in the past six years at our hospital. Methods: All the patients operated at CPE Institute of Cardiology Multan Pakistan, between 2009 and 2015 for repair of post MI VSR were analysed retrospectively for demographics, comorbidities, operative and post operative outcomes...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643130/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-prior-coronary-artery-bypass-grafting-trends-in-utilization-and-propensity-matched-analysis-of-in-hospital-outcomes
#7
Tanush Gupta, Sahil Khera, Dhaval Kolte, Kashish Goel, Ankur Kalra, Pedro A Villablanca, Herbert D Aronow, J Dawn Abbott, Gregg C Fonarow, Cynthia C Taub, Neal S Kleiman, Giora Weisz, Ignacio Inglessis, Sammy Elmariah, Charanjit S Rihal, Mario J Garcia, Deepak L Bhatt
BACKGROUND: A significant proportion of patients requiring aortic valve replacement (AVR) have undergone prior coronary artery bypass grafting (CABG). Reoperative heart surgery is associated with increased risk. Data on relative utilization and comparative outcomes of transcatheter (TAVR) versus surgical AVR (SAVR) in patients with prior CABG are limited. METHODS AND RESULTS: We queried the 2012 to 2014 National Inpatient Sample databases to identify isolated AVR hospitalizations in adults with prior CABG...
April 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29625498/platelet-inhibition-and-bleeding-in-patients-undergoing-non-cardiac-surgery-the-bianca-observational-study
#8
Elisabeth Mahla, Helfried Metzler, Helmar Bornemann-Cimenti, Florian Prueller, Reinhard B Raggam, Gudrun Pregartner, Andrea Berghold, Anneliese Baumann, Christian Goeroeg, Paul A Gurbel
Nearly 20% of patients will need non-cardiac surgery within 1 year of coronary stenting and their management is complicated by concomitant antiplatelet therapy. Platelet function testing may optimize the timing of surgery in these patients. In this prospective observational study, we explored the association between platelet reactivity and bleeding in patients undergoing non-cardiac surgery treated with clopidogrel with or without aspirin within 7 days before surgery. The timing of surgery was at the surgeon's discretion...
April 6, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29625103/aortic-valve-reoperation-following-stentless-bioprosthesis-short-and-long-term-outcomes
#9
Bo Yang, Himanshu J Patel, Elizabeth L Norton, Christina Debenedictus, Linda Farhat, Xiaoting Wu, Kevin He, Whitney E Hornsby, Donald S Likosky, G Michael Deeb
BACKGROUND: Limited data are available regarding outcomes for stentless aortic valve reoperation. The reported reoperative mortality has been unacceptably high. METHODS: Between 1997-2017, a retrospective analysis was performed on 143 patients that underwent open aortic valve reoperations for failed stentless aortic valve bioprostheses. We evaluated both short- and long-term outcomes on this cohort of patients. RESULTS: Bicuspid aortic valve was present in 107/143 (75%) of patients at the time of the initial Freestyle procedure and 84% (120/143) patients underwent a modified inclusion aortic root replacement procedure...
April 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29624086/does-acute-myocardial-infarction-kill-more-people-on-weekends-analysis-of-in-hospital-mortality-rates-for-weekend-admissions-in-portugal
#10
Francesca Fiorentino, Raquel Ascenção, Nicoletta Rosati
Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011-2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29623673/the-relationship-between-age-and-chronic-kidney-disease-in-patients-undergoing-pancreatic-resection
#11
Derrick Antoniak, Chandrakanth Are, Chad Vokoun, Kaeli Samson, Lynette Smith, Jason Shiffermiller
BACKGROUND: Severe chronic kidney disease (CKD) predicts adverse outcomes in patients undergoing pancreatectomy, but the impact of milder CKD is unknown. Additionally, some authors have suggested that, due to physiologic changes of aging, CKD is over-diagnosed in patients above age 65. METHODS: Patients undergoing pancreatectomy for malignancy from 2005 to 2014 were identified from the National Surgical Quality Improvement Program. Primary outcomes were all-cause mortality and major complication, defined as myocardial infarction, cardiac arrest, stroke, venous thromboembolism, respiratory failure, deep surgical site infection, pneumonia, acute kidney injury, coma > 24 h, or re-operation occurring within 30 days of surgery...
April 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29623167/current-indications-for-stenting-symptoms-or-survival-cme
#12
REVIEW
Suzanne V Arnold
The major goals of treating ischemic heart disease are to reduce angina, improve quality of life, and ultimately reduce mortality. While medical therapy can effectively address these aims, there is still much research and debate about the role of percutaneous coronary intervention in the treatment spectrum-specifically, whether or not stenting prolongs life or simply treats symptoms without impacting survival. The data supporting revascularization for survival benefit came from patients who underwent bypass graft surgery prior to the introduction of effective medical management...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29622354/perioperative-risk-factors-for-hospital-readmission-after-elective-endovascular-aortic-aneurysm-repair
#13
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Fady Gabra, Roy M Fujitani
BACKGROUND: Elective endovascular aneurysm repair (EVAR) is generally well tolerated. However, the incidence of hospital readmission after EVAR and the risk factors and reasons for it are not well studied. This study sought to determine the incidence, to characterize the indications, and to identify perioperative patient-centered risk factors for hospital readmission within 30 days after elective EVAR. METHODS: All patients who underwent EVAR electively in 2012 to 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program Targeted Vascular database (n = 3886)...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29618572/influence-of-diabetes-on-trends-in-perioperative-cardiovascular-events
#14
Jonathan D Newman, Tanya Wilcox, Nathaniel R Smilowitz, Jeffrey S Berger
OBJECTIVE: Patients undergoing noncardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of cardiovascular disease. It is unknown whether temporal declines in the frequency of perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) apply to patients with DM. RESEARCH DESIGN AND METHODS: Patients ≥45 years of age who underwent noncardiac surgery from January 2004 to December 2013 were identified using the U.S. National Inpatient Sample...
April 4, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29617839/outcomes-of-aortic-valve-replacement-via-partial-upper-sternotomy-versus-conventional-aortic-valve-replacement-in-obese-patients
#15
Henryk A Welp, Isabell Herlemann, Sven Martens, Heinz Deschka
OBJECTIVES: Excellent outcomes after minimally invasive aortic valve replacement (mini-AVR) have been reported. Therefore, mini-AVR has become a popular treatment option in many cardiac surgery centres. However, whether obese patients particularly benefit from mini-AVR remains unclear. The aim of the present study was to evaluate outcomes of AVR performed through partial upper sternotomy compared to AVR through a full sternotomy (full-AVR) in obese patients. METHODS: We retrospectively reviewed the medical records of all patients who underwent isolated AVR at our institution, and 217 consecutive obese [body mass index (BMI) >30 kg/m2] patients were identified...
March 30, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29617154/n-terminal-pro-brain-natriuretic-peptide-and-high-sensitivity-troponin-t-exhibit-additive-prognostic-value-for-the-outcome-of-critically-ill-patients
#16
Max Lenz, Konstantin A Krychtiuk, Georg Goliasch, Klaus Distelmaier, Johann Wojta, Gottfried Heinz, Walter S Speidl
BACKGROUND: Patients treated at medical intensive care units suffer from various pathologies and often present with elevated troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Both markers may reflect different forms of cardiac involvement in critical illness. Therefore, the aim of our study was to examine the synergistic prognostic potential of NT-proBNP and high-sensitivity TnT (hs)TnT in unselected critically ill patients. METHODS: We included all consecutive patients admitted to our intensive care unit within one year, excluding those suffering from acute myocardial infarction or undergoing cardiac surgery and measured NT-proBNP and TnT plasma levels on the day of admission and 72 hours thereafter...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29615352/long-term-comparative-effectiveness-of-carotid-stenting-versus-carotid-endarterectomy-in-a-large-tertiary-care-vascular-surgery-practice
#17
Robert P Garvin, Evan J Ryer, Andrea L Berger, James R Elmore
OBJECTIVE: Carotid interventional trials have strict inclusion and exclusion criteria that make translation of their results to the real-world population challenging. Furthermore, the specialty of the operating surgeon and the role of clinical decision-making are not well studied. This study compares the effectiveness of carotid endarterectomy (CEA) vs carotid artery stenting (CAS) in a real-world setting when the procedure is performed by fellowship-trained vascular surgeons. METHODS: A retrospective study was conducted of all consecutive patients undergoing CEA and CAS performed by vascular surgeons in a large rural tertiary health care system from 2004 to 2014...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29613817/acute-kidney-injury-after-non-cardiovascular-surgery-risk-factors-and-impact-on-development-of-chronic-kidney-disease-and-long-term-mortality
#18
Leili Pourafkari, Pradeep Arora, Jahan Porhomayon, Hasan H Dosluoglu, Preksha Arora, Nader D Nader
OBJECTIVE: To identify factors associated with acute kidney injury (AKI) and its progression to chronic kidney disease (CKD) in a non-cardiac/non-vascular surgery setting. METHODS: We examined Veterans Affairs Surgical Quality database for surgical entries between 2000-2014. Demographics, comorbidities, laboratory findings and hospital outcomes were assessed. Primary endpoint was occurrence of AKI defined as increase of ≥0.3 mg/dL, 48 hours postoperatively...
April 3, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29607816/rosai-dorfman-disease-five-years-retrospective-analysis-from-tertiary-cancer-center
#19
K Aradhana, B Thejaswini, A Shamsundar, R Nanda, Usha Amritham, G V Giri
AIM: To study the pattern of presentation and management of nodal and extranodal primary RDD. METHODOLOGY: From 2010 to 2015, eleven patients diagnosed with Rosai-Dorfman Disease (RDD) presented at our institute. Nine of them were analyzed as they received treatment at our center. We had five neck primaries, three intracranial and one cutaneous disease. Hematological, radiological, histopathological and immunohistochemistry evaluation along with the treatment data was collected and analyzed...
January 2018: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/29606641/is-transcatheter-aortic-valve-replacement-better-than-surgical-aortic-valve-replacement-in-patients-with-chronic-obstructive-pulmonary-disease-a-nationwide-inpatient-sample-analysis
#20
Tomo Ando, Oluwole Adegbala, Emmanuel Akintoye, Said Ashraf, Mohit Pahuja, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso, Theodore Schreiber
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients are at increased risk of respiratory related complications after cardiac surgery. It is unclear whether transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in favorable outcomes among COPD patients. METHODS AND RESULTS: Patients were identified from the Nationwide Inpatient Sample database from 2011 to 2014. Patients with age ≥60, COPD, and either went transarterial TAVR or SAVR were included in the analysis...
April 1, 2018: Journal of the American Heart Association
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