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Myocardial infarction and surgery

Andrea Garatti, Alessandro Parolari, Alberto Canziani, Eugenio Mossuto, Andrea Daprati, Ali Abu Farah, Daniele Brugnetti, Marco Ranucci, Lorenzo Menicanti
AIMS: Despite several studies reporting a higher mortality rate for women undergoing isolated coronary artery bypass graft (CABG) surgery, this issue has not been completely clarified. The aim of the current study was to determine if sex differences in CABG surgery affect adjusted operative results and operative mortality. METHODS: Between January 2005 and December 2012, 3756 consecutive patients (3009 men and 747 women) underwent isolated CABG at our institution...
June 16, 2018: Journal of Cardiovascular Medicine
Antonio Klasan, Philipp Dworschak, Thomas J Heyse, Dominik Malcherczyk, Christian D Peterlein, Karl F Schüttler, Matthias Lahner, Bilal Farouk El-Zayat
BACKGROUND: Knee and hip replacement surgery are still the mainstay therapy for osteoarthritis. In spite of the improvement of techniques and implants, anemia is a relatively common complication, with transfusion rates of up to 23% in some centers. OBJECTIVE: The purpose of the study was to determine a correlation of transfusions to complications including infection since this topic is still being debated or even disputed in the literature. METHODS: This is a level III, single center retrospective observational cohort study of 2760 unilateral primary knee and hip replacements...
June 2, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Charelle M Carter-Brooks, Angela L Du, Kristine M Ruppert, Anna L Romanova, Halina M Zyczynski
OBJECTIVES: ERAS protocols were developed for colorectal surgery to hasten post-op recovery. Variations of the protocol are being adopted for gynecologic procedures despite limited population and procedure-specific outcome data. Our objective was to evaluate if implementation of an ERAS pathway would facilitate reduced length of admission in an urogynecology population. MATERIALS AND METHODS: In this retrospective analysis of patients undergoing pelvic floor reconstructive surgery by 7 female pelvic medicine and reconstructive surgeons we compared same day discharge, length of admission and post-op complications before and after implementation of an ERAS pathway at a tertiary-care hospital...
June 15, 2018: American Journal of Obstetrics and Gynecology
Sorin J Brener, Venkatesh Alapati, Doris Chan, Akanibo Da-Wariboko, Yousef Kaid, Yevgeniy Latyshev, Amr Moussa, Chockalingham A Narayanan, John P O'Laughlin, Amol Raizada, Gautam Verma, Terrence J Sacchi
BACKGROUND: Short-term outcome after percutaneous coronary intervention (PCI) has improved dramatically, but the association between clinical or angiographic characteristics and long-term outcome remains less well described. The SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) II score has been designed to overcome the limitations of the purely angiographic SYNTAX I score by including clinical parameters and comorbidities. It has not been tested extensively in "real-world" PCI patients, outside of randomized clinical studies...
June 15, 2018: Journal of Invasive Cardiology
Scott L Parker, Ahilan Sivaganesan, Silky Chotai, Matthew J McGirt, Anthony L Asher, Clinton J Devin
OBJECTIVE Hospital readmissions lead to a significant increase in the total cost of care in patients undergoing elective spine surgery. Understanding factors associated with an increased risk of postoperative readmission could facilitate a reduction in such occurrences. The aims of this study were to develop and validate a predictive model for 90-day hospital readmission following elective spine surgery. METHODS All patients undergoing elective spine surgery for degenerative disease were enrolled in a prospective longitudinal registry...
June 15, 2018: Journal of Neurosurgery. Spine
P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. METHODS: In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries...
June 9, 2018: Lancet
Raisuke Iijima, Norihiro Kougame, Hidehiko Hara, Masao Moroi, Masato Nakamura
BACKGROUND: The aim of this study was to investigate whether drug-coated balloon (DCB) treatment is effective for de novo coronary lesions that are unsuitable for drug-eluting stent (DES) implantation.Methods and Results:This retrospective study included 118 de novo lesions that were not suitable for DES implantation. Of the lesions, 40% was treated because of very small vessel disease. Patients with planned non-cardiac surgery and at high bleeding risk were 3% and 19%, respectively, and lesions that easily develop stent fracture comprised 26%...
June 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Jeffrey L Carson, Simon J Stanworth, John H Alexander, Nareg Roubinian, Dean A Fergusson, Darrell J Triulzi, Shaun G Goodman, Sunil V Rao, Carolyn Doree, Paul C Hebert
BACKGROUND: Several new trials evaluating transfusion strategies in patients with cardiovascular disease have recently been published, increasing the number of enrolled patients by over 30%. The objective was to evaluate transfusion thresholds in patients with cardiovascular disease. METHODS: We conducted an updated systematic review of randomized trials that compared patients assigned to maintain a lower (restrictive transfusion strategy) or higher (liberal transfusion strategy) hemoglobin concentration...
June 2018: American Heart Journal
Kenji Nakatsuma, Hiroki Shiomi, Takeshi Morimoto, Hirotoshi Watanabe, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Koh Ono, Satoshi Shizuta, Takeshi Kimura
Aims: To evaluate the influence of a history of cancer on clinical outcomes in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI). Methods and Results: In the CREDO-Kyoto PCI/coronary bypass grafting (CABG) Registry Cohort-2, there were 12,180 CAD patients who received PCI with stents. There were 1109 patients with a history of cancer (cancer group), and 11,071 patients without cancer (non-cancer group). The cumulative 5-year incidences of cardiac death and heart failure (HF) hospitalization were significantly higher in the cancer group than in the non-cancer group (12...
April 20, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
Suman L Sood, Dunlei Cheng, Margaret Ragni, Craig M Kessler, Doris Quon, Amy D Shapiro, Nigel S Key, Marilyn J Manco-Johnson, Adam Cuker, Christine Kempton, Tzu-Fei Wang, M Elaine Eyster, Philip Kuriakose, Annette von Drygalski, Joan Cox Gill, Allison Wheeler, Peter Kouides, Miguel A Escobar, Cindy Leissinger, Sarah Galdzicka, Marshall Corson, Crystal Watson, Barbara A Konkle
Men with hemophilia were initially thought to be protected from cardiovascular disease (CVD), but it is now clear that atherothrombotic events occur. The primary objective of the CVD in Hemophilia study was to determine the prevalence of CVD and CVD risk factors in US older men with moderate and severe hemophilia and to compare findings with those reported in age-comparable men in the Atherosclerosis Risk in Communities (ARIC) cohort. We hypothesized if lower factor levels are protective from CVD, we would see a difference in CVD rates between more severely affected and unaffected men...
June 12, 2018: Blood Advances
Mehmet Kaplan, Anil Karaagac, Tolga Can, Sahin Yilmaz, Mehmet Inanc Yesilkaya, Adlan Olsun, Hakki Aydogan
BACKGROUND: Hypothermia is a method of myocardial protection in cardiac surgery. This protection occurs by decreasing the metabolic demands, however, it creates susceptibility to various problems. In this study, we investigated patients operated on under normothermia (at the patient's own temperature) and hypothermia for postoperative differences. METHODS: The study was conducted between June 2015 and September 2016 with 167 patients. The patients were divided into two groups in accordance with our routine clinical practice: the normothermic group (native temperature goup; intraoperative body temperature ≥ 34°C), and the hypothermic group intraoperative body temperature  < 34°C - ≥ 28°C)...
April 18, 2018: Heart Surgery Forum
Michael M Kheir, Timothy L Tan, Jaiben George, Carlos A Higuera, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk of failing surgical treatment for periprosthetic joint infection (PJI) is imperative to allow medical optimization and targeted prevention. The purpose of this study was to create a preoperative prognostic calculator for PJI treatment by assessing a patient's individual risk for treatment failure based on many preoperative variables. METHODS: A retrospective review was performed of 1438 PJIs, treated at 2 institutions from 2000 to 2014...
April 30, 2018: Journal of Arthroplasty
Barbara E Stähli, Manfred B Wischnewsky, Philipp Jakob, Roland Klingenberg, Slayman Obeid, Dik Heg, Lorenz Räber, Stephan Windecker, Marco Roffi, François Mach, Baris Gencer, David Nanchen, Peter Jüni, Ulf Landmesser, Christian M Matter, Thomas F Lüscher, Willibald Maier
BACKGROUND: This study sought to investigate the predictive value of the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes (ACS). The ACEF score (age/left ventricular ejection fraction +1 [if creatinine > 176 μmol/L]) has been established in patients evaluated for coronary artery bypass surgery. Data on its predictive value in all-comer ACS patients undergoing percutaneous coronary intervention are scarce. METHODS: A total of 1901 patients prospectively enrolled in the Swiss ACS Cohort were included in the analysis...
June 1, 2018: International Journal of Cardiology
Till Hoffmann, Alexander Assmann, Angelika Dierksen, Elisabeth Roussel, Sebastian Ullrich, Artur Lichtenberg, Alexander Albert, Stephan Sixt
OBJECTIVES: Although off-label use of recombinant activated factor VII against refractory bleeding is incorporated in current guideline recommendations, safety concerns persist predominantly with respect to thromboembolic complications. We analyzed the safety and efficacy of recombinant activated factor VII at a very low dose in cardiosurgical patients with refractory bleeding. METHODS: This prospective study includes 1180 cardiosurgical patients at risk of bleeding...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
Takuma Yamasaki, Yuichi Matsuzaki, Yu Hohri, Takeshi Hiramatsu
Ventricular septal rupture with ventricular free wall dissection is an extremely rare complication after inferior myocardial infarction, and the optimal surgical strategy remains unclear because of the limited number of survival cases. Electrocardiography-synchronized contrast computed tomography was performed before surgery to identify the dissected area and to set up a surgical strategy. We report on modified double patch repair with ventricular wall dissection exclusion, which might be effective for preventing residual shunt and maintaining cardiac function...
June 5, 2018: Annals of Thoracic Surgery
Tomo Ando, Emmanuel Akintoye, Anthony A Holmes, Alexandros Briasoulis, Mohit Pahuja, Hisato Takagi, Theodore Schreiber, Cindy L Grines, Luis Afonso
It is unknown if transcatheter aortic valve implantation (TAVI) is a safe alternative to surgical aortic valve replacement (SAVR) in patients <65 years old. Data from the National Inpatient Sample database were utilized. Patients from 2011 to 2015, ages 18 to 64 years old (inclusive) who underwent TAVI and SAVR were included. Patients who underwent SAVR and who also received a concomitant nonaortic valve surgery were excluded. A propensity score analysis was used. A total of 18,970 (528 TAVI and 18,442 SAVR) patients were identified...
April 24, 2018: American Journal of Cardiology
Asmâa Biaz, Mohammed Drissi, Aissam El Maataoui, Samira El Machtani Idrissi, Sanae Bouhsain, Abdellah Dami, Abdellatif Boulahya, Zohra Ouzzif
Introduction: This prospective study was conducted at the Laboratoy of Biochemistry of the HMIMV, Rabat, over a period of 1 year. It aimed to analyse the kinetics of troponin lc (cTnl) after on-pump cardiac surgery in order to establish threshold values for the diagnosis of perioperative myocardial infarction. Methods: The study included 58 patients who had undergone on-pump valvular surgery or on-pump coronary artery bypass surgery. These patients were separated into 3 groups according to their clinical and electrical evolution as well as their laboratory tests (cTnI) during the immediate post-operative period...
2018: Pan African Medical Journal
Alex Gu, Chapman Wei, Camilla M Maybee, Shane A Sobrio, Matthew P Abdel, Peter K Sculco
BACKGROUND: Total knee arthroplasty (TKA) utilization is increasing in older Americans. The incidence of chronic obstructive pulmonary disease (COPD) has been steadily rising over the past few decades. In particular, COPD is being increasingly more common in patients undergoing revision TKA. The aim of this study is to identify the impact of COPD on postoperative complications for patients undergoing revision TKA. METHODS: A retrospective cohort study was conducted using data collected through the American College of Surgeons National Quality Improvement Program Database...
May 14, 2018: Journal of Arthroplasty
Natasha Corballis, Sujay Chadran, Neil Mangrolia, Kashif Ashraf, Toomas Sarev, Alisdair Ryding
A chronically persistent left atrial pseudoaneurysm is a rare complication of valvular surgery, trauma, myocardial infarction and endocaritis but this is the first known description of a chronic pseudoaneurysm as a complication of coronary rupture during percutaneous coronary intervention (PCI). We report computed tomography images depicting this in the case of elective PCI in an 81-year-old gentleman for limiting angina.
May 2018: Oxford Medical Case Reports
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