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Myocardial infarction and surgery

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https://www.readbyqxmd.com/read/27926773/associations-of-specific-postoperative-complications-with-outcomes-after-elective-colon-resection-a-procedure-targeted-approach-toward-surgical-quality-improvement
#1
John E Scarborough, Jessica Schumacher, K Craig Kent, Charles P Heise, Caprice C Greenberg
Importance: Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective: To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants: Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#2
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27922810/impact-of-chronic-total-occlusion-revascularization-attempts-on-subsequent-clinical-outcomes
#3
Ahmad Jabbar, Georgios Christopoulos, Aris Karatasakis, Omar M Jeroudi, Georgios E Christakopoulos, Abdallah El Sabbagh, Barbara Danek, Judit Karacsonyi, Michele Roesle, Bavana V Rangan, Jerrold Grodin, Michael Luna, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We examined a contemporary, unselected cohort of patients with coronary chronic total occlusions (CTOs) to determine the impact of CTO revascularization on long-term outcomes. METHODS: We retrospectively assessed the impact of CTO revascularization on clinical outcomes of consecutive patients found to have a CTO during coronary angiography performed at our institution during 2011 and 2012. The primary endpoint was the incidence of a major adverse cardiac event (MACE, defined as a composite of death, myocardial infarction, stroke, and target-vessel revascularization [TVR])...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27919716/postoperative-cardiac-ischemia-detection-by-continuous-12-lead-electrocardiographic-monitoring-in-vascular-surgery-patients-a-prospective-observational-study
#4
Aino Ollila, Juha Virolainen, Joonas Vanhatalo, Pirkka Vikatmaa, Ilkka Tikkanen, Maarit Venermo, Markku Salmenperä, Ville Pettilä, Leena Vikatmaa
OBJECTIVES: Elderly patients undergoing vascular surgery are at major risk for perioperative cardiac complications. The authors investigated continuous electrocardiographic Holter monitoring in a postoperative setting to determine the degree of postoperative ischemic load and its possible associations with perioperative myocardial infarction. DESIGN: A prospective, observational study. SETTING: One university hospital. PARTICIPANTS: The study comprised 51 patients aged 65 years or older undergoing peripheral arterial surgery...
September 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27919293/perioperative-statin-therapy-in-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#5
Alessandro Putzu, Bruno Capelli, Alessandro Belletti, Tiziano Cassina, Enrico Ferrari, Michele Gallo, Gabriele Casso, Giovanni Landoni
BACKGROUND: Several studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients. METHODS: Electronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#6
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#7
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27911394/confirmation-of-myocardial-ischemia-and-reperfusion-injury-in-mice-using-surface-pad-electrocardiography
#8
Stephanie L C Scofield, Krishna Singh
Many animal models have been established for the study of myocardial remodeling and heart failure due to its status as the number one cause of mortality worldwide. In humans, a pathologic occlusion forms in a coronary artery and reperfusion of that occluded artery is considered essential to maintain viability of the myocardium at risk. Although essential for myocardial recovery, reperfusion of the ischemic myocardium creates its own tissue injury. The physiologic response and healing of an ischemia/reperfusion injury is different from a chronic occlusion injury...
November 24, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#9
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#10
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908607/impact-of-remote-ischaemic-preconditioning-on-major-clinical-outcomes-in-patients-undergoing-cardiovascular-surgery-a-meta-analysis-with-trial-sequential-analysis-of-32-randomised-controlled-trials
#11
Shifei Wang, Hairui Li, Nvqin He, Yili Sun, Shengcun Guo, Wangjun Liao, Yulin Liao, Yanmei Chen, Jianping Bin
BACKGROUND: The impact of remote ischaemic preconditioning (RIPC) on major clinical outcomes in patients undergoing cardiovascular surgery remains controversial. We systematically reviewed the available evidence to evaluate the potential benefits of RIPC in such patients. METHODS: PubMed, Embase, and Cochrane Library databases were searched for relevant randomised controlled trials (RCTs) conducted between January 2006 and March 2016. The pooled population of patients who underwent cardiovascular surgery was divided into the RIPC and control groups...
November 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#12
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898433/transcatheter-aortic-valve-implantation-in-nonagenarians
#13
Adam Penkalla, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, Volkmar Falk
OBJECTIVE: In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. METHODS: Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90-98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23...
November 28, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27893054/outcomes-and-temporal-trends-of-inpatient-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-cardiac-surgery-in-the-united-states
#14
Kashish Goel, Tanush Gupta, Dhaval Kolte, Sahil Khera, Gregg C Fonarow, Deepak L Bhatt, Mandeep Singh, Charanjit S Rihal
Importance: There are concerns whether percutaneous coronary intervention (PCI) at centers without on-site cardiac surgery is safe outside of a tightly regulated research environment. Objective: To analyze the outcomes and temporal trends of inpatient PCI at centers without on-site cardiac surgery in an unselected and nationally representative population of the United States. Design, Setting, and Participants: A national inpatient sample (N = 6 912 232) was used to identify patients who underwent inpatient PCI in the United States from January 1, 2003, to December 31, 2012...
November 23, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27892891/atorvastatin-for-high-risk-statin-na%C3%A3-ve-patients-undergoing-noncardiac-surgery-the-lowering-the-risk-of-operative-complications-using-atorvastatin-loading-dose-load-randomized-trial
#15
Otavio Berwanger, Pedro G M de Barros E Silva, Roberto Ramos Barbosa, Dalton Bertolim Precoma, Estêvão Lanna Figueiredo, Ludhmila Abrahão Hajjar, Cleber Dario Pinto Kruel, Carolina Alboim, Adail Paixão Almeida, Marianna Deway Andrade Dracoulakis, Hugo Vargas Filho, Maria José Carvalho Carmona, Lília Nigro Maia, João Bosco de Oliveira Filho, Jose Francisco Kerr Saraiva, Rafael M Soares, Lucas Damiani, Denise Paisani, Alessandra A Kodama, Beatriz Gonzales, Dimas T Ikeoka, Philip J Devereaux, Renato D Lopes
: Preliminary evidence suggests that statins may prevent major perioperative vascular complications. METHODS: We randomized 648 statin-naïve patients who were scheduled for noncardiac surgery and were at risk for a major vascular complication. Patients were randomized to a loading dose of atorvastatin or placebo (80 mg anytime within 18hours before surgery), followed by a maintenance dose of 40 mg (or placebo), started at least 12hours after the surgery, and then 40 mg/d (or placebo) for 7days...
November 9, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27890407/postoperative-tachycardia-clinically-meaningful-or-benign-consequence-of-orthopedic-surgery
#16
Alana E Sigmund, Yixin Fang, Matthew Chin, Harmony R Reynolds, Leora I Horwitz, Ezra Dweck, Eduardo Iturrate
OBJECTIVE: To determine the clinical significance of tachycardia in the postoperative period. PATIENTS AND METHODS: Individuals 18 years or older undergoing hip and knee arthroplasty were included in the study. Two data sets were collected from different time periods: development data set from January 1, 2011, through December 31, 2011, and validation data set from December 1, 2012, through September 1, 2014. We used the development data set to identify the optimal definition of tachycardia with the strongest association with the vascular composite outcome (pulmonary embolism and myocardial necrosis and infarction)...
November 24, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27888052/non-steroidal-anti-inflammatory-drugs-and-clinical-outcomes-in-patients-undergoing-coronary-artery-bypass-surgery
#17
Flávio de Souza Brito, Rajendra H Mehta, Renato D Lopes, Ralf E Harskamp, B Daniel Lucas, Phillip J Schulte, Jean-Claude Tardif, John H Alexander
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in perioperative pain management of patients undergoing coronary artery bypass graft surgery. However, the association of periprocedural use of NSAIDs and clinical outcomes after coronary artery bypass graft is understudied. METHODS: We conducted a retrospective analysis using pooled data from 2 multicenter randomized controlled trials (PREVENT IV [n=3,014] and MEND-CABG II [n=3,023]). Rates of death; death or myocardial infarction; and death, myocardial infarction, or stroke in the 30 days following coronary artery bypass graft surgery were compared in patients using or not using perioperative NSAIDs...
November 22, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#18
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27884744/technical-description-of-oblique-lateral-interbody-fusion-at-l1-l5-olif25-and-at-l5-s1-olif51-and-evaluation-of-complication-and-fusion-rates
#19
Kamal R M Woods, James B Billys, Richard A Hynes
BACKGROUND: The OLIF procedure is aimed at mitigating some of the challenges seen with traditional ALIF and transpsoas LLIF and allows for interbody fusion at L1-S1. PURPOSE: To describe the OLIF technique and assess the complication and fusion rates. STUDY DESIGN: A retrospective cohort study. PATIENT SAMPLE: 137 patients who underwent the oblique lateral interbody fusion (OLIF) procedure. OUTCOME MEASURES: Adverse events within 6 months of surgery: Infection, symptomatic pseudarthrosis, hardware failure, vascular injury, perioperative blood transfusion, ureteral injury, bowel injury, renal injury, prolonged postoperative ileus (greater than 3 days), incisional hernia, pseudohernia, reoperation, neurological deficits (weakness, numbness, paresthesia), hip flexion pain, retrograde ejaculation, sympathectomy affecting lower extremities, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, and cerebrovascular accident...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#20
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
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