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Anticoagulation cardiac surgery

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https://www.readbyqxmd.com/read/28430913/prediction-of-adverse-events-after-catheter-based-procedures-in-adolescents-and-adults-with-congenital-heart-disease-in-the-impact-registry
#1
Ada C Stefanescu Schmidt, Aimee Armstrong, Kevin F Kennedy, David Nykanen, Jamil Aboulhosn, Ami B Bhatt
Aims: We sought to identify factors associated with major adverse events (MAE) after cardiac catheterization in adolescents and adults with congenital heart disease (CHD), and create the first model to individualize risk discussions in this growing population. Methods and results: Improving Pediatric and Adult Congenital Treatment (IMPACT), a National Cardiovascular Data Registry, contains congenital catheterization data from over 87 hospitals in the United States...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28414995/case-report-of-an-intracaval-leiomyomatosis-10-months-after-complete-hysterectomy
#2
Hannah Maria Schäfer, Andrej Isaak, Lorenz Gürke
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor, usually found in women with tumors of the reproductive organs, such as uterus myomatosous. Surgically, this case belies the call for sternotomy and two-stage surgery in caval IVL extending to the right atrium: we suggest one-stage median laparotomy as a minimal procedure with maximal benefit. PRESENTATION OF CASE: We present the case of a 60-year-old postmenopausal woman with suspected intravenous leiomyomatosis of the right internal iliac vein...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28388863/perioperative-coagulation-management-of-a-hemophilia-a-patient-during-cardiac-surgery
#3
Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, Kenichi A Tanaka
Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined...
April 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28341399/early-postoperative-blood-pressure-and-blood-loss-after-cardiac-surgery-a-retrospective-analysis
#4
Cagla Demirci, Florian Zeman, Christof Schmid, Bernhard Floerchinger
BACKGROUND: Increased blood loss after cardiac surgery is a risk factor for patient morbidity and mortality. Guidelines for postoperative haemodynamics management recommend normotensive blood pressure to avoid increased chest drain volumes. The aim of this study was to verify the correlation of early postoperative hypertension and blood loss in patients after cardiac surgery during the early postoperative period. METHODS: Postoperative mean blood pressure values and chest drain volumes of 431 patients were registered by an intensive care monitoring system during first 60minutes after intensive care admission...
March 22, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28339794/short-term-dabigatran-interruption-before-cardiac-rhythm-device-implantation-multi-centre-experience-from-the-re-ly-trial
#5
Vidal Essebag, Riccardo Proietti, David H Birnie, Jia Wang, James Douketis, Benoit Coutu, Ratika Parkash, Gregory Y H Lip, Stefan H Hohnloser, Andrew Moriarty, Jonas Oldgren, Stuart J Connolly, Michael Ezekowitz, Jeff S Healey
Aims: Cardiac implantable electronic device (CIED) surgery is commonly performed in patients with atrial fibrillation (AF). The current analysis was undertaken to compare peri-operative anticoagulation management, bleeding, and thrombotic events in AF patients treated with dabigatran vs. warfarin. Methods and results: This study included 611 patients treated with dabigatran vs. warfarin who underwent CIED surgery during the RE-LY trial. Among 201 warfarin-treated patients, warfarin was interrupted a median of 144 (inter-quartile range, IQR: 120-216) h, and 37 (18...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#6
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28298666/bivalirudin-as-an-alternative-anticoagulant-for-cardiopulmonary-bypass-during-adult-cardiac-surgery-a-change-in-practice
#7
Peter Gatt, Samuel Anthony Galea, Walter Busuttil, Charles Grima, Jeffrey Muscat, Yvette Farrugia
The referral of patients for open heart surgery, presenting with a history of heparin hypersensitivity instigated a multidisciplinary effort to find an alternative anticoagulant to heparin. The various options mentioned in the literature call for changes in the routine practice of open heart surgery on cardiopulmonary bypass. These changes involve mostly the perfusion setup and conduct on bypass and to a lesser extent the anesthetic and surgical practice. Nevertheless, the different professions involved in the cardiac surgical firm discussed the proposed changes in a multidisciplinary effort...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28283470/rheumatic-fever-with-severe-carditis-still-prevalent-in-the-south-west-pacific
#8
Taran Kaur Nandra, Nigel J Wilson, John Artrip, Bruno Pagis
Rheumatic heart disease (RHD) has a worldwide prevalence of 33 million cases and 270 000 deaths annually, making it the most common acquired heart disease in the world. There is a disparate global burden in developing countries. This case report aims to address the minimal RHD coverage by the international medical community. A Tahitian boy aged 10 years was diagnosed with advanced heart failure secondary to RHD at a local clinic. Previous, subtle symptoms of changes in handwriting and months of fever had gone unrecognised...
March 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#9
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28256020/left-atrial-anatomy-and-patient-related-factors-associated-with-adverse-outcomes-with-the-watchman-device-a-real-world-experience
#10
Shishir Murarka, Mohamad Lazkani, Soundos Moualla, Divya Ratan Verma, Ashish Pershad
OBJECTIVE: This study sought to identify patient and left atrial morphology specific factors associated with early complications for left atrial appendage occlusion with the Watchman™ (Boston Scientific, Natick, MA) device. BACKGROUND: Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation, however, long-term OAC compliance is poor. In randomized control trials, the Watchman™ device has demonstrated superiority over OAC with warfarin for all cause and cardiovascular mortality and hemorrhagic stroke...
April 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28249381/echocardiography-guided-pericardiocentesis-as-the-method-of-choice-for-treatment-of-significant-pericardial-effusion-following-cardiac-surgery-a-12-year-single-centre-experience
#11
Martin Kolek, Radim Brat
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis following cardiac surgery in Europe. The aim of the study was to review tertiary cardiac surgery centre experience with postoperative pericardial effusion (PE) diagnosis and treatment. METHODS: A total of 6830 patients underwent open-heart surgery at our centre between December 2004 and November 2016. Of these patients, 208 (3%) required pericardiocentesis for significant PE...
March 1, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28248604/middle-ear-obliteration-with-blind-sac-closure-of-the-external-auditory-canal-for-spontaneous-csf-otorrhea
#12
Shawn M Stevens, Ryan Crane, Myles L Pensak, Ravi N Samy
Outcome Objectives To (1) identify unique features of patients who underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal for spontaneous cerebrospinal fluid (CSF) otorrhea and (2) explore outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults treated for spontaneous cerebrospinal fluid otorrhea from 2007 through 2015 were reviewed and stratified into 2 groups based on the surgery performed: (1) 11 patients underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal and (2) 26 patients underwent other procedures...
March 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28243155/perioperative-care-in-an-adolescent-patient-with-heparin-induced-thrombocytopenia-for-placement-of-a-cardiac-assist-device-and-heart-transplantation-case-report-and-literature-review
#13
Mineto Kamata, Roby Sebastian, Patrick I McConnell, Daniel Gomez, Aymen Naguib, Joseph D Tobias
Heparin-induced thrombocytopenia (HIT) can cause life-threatening complications following the administration of heparin. Discontinuation of all sources of heparin exposure and the use of alternative agents for anticoagulation are necessary when HIT is suspected or diagnosed. We present the successful use of bivalirudin anticoagulation in an adolescent patient during cardiopulmonary bypass who underwent both placement of a left ventricular assist device and subsequent heart transplantation within a 36-hour period...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28242144/supplemental-antithrombin-is-effective-in-achieving-adequate-anticoagulation-in-infants-and-children-with-an-inadequate-response-to-heparin
#14
Mathew Lopez, Changyong Feng, Olga Vasilyeva, Michael P Eaton
OBJECTIVE: To demonstrate that supplemental antithrombin (AT) is effective in establishing adequate anticoagulation in infants and children with initially inadequate responses to heparin. DESIGN: Following institutional review board approval, a retrospective chart review was conducted on pediatric patients receiving AT during cardiac surgery requiring cardiopulmonary bypass. SETTING: A single institutional review in a hospital setting. PARTICIPANTS: Thirty-one pediatric patients with age ranging from 1 day to 36 months (median 12 weeks) receiving AT during the study period...
December 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#15
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28230634/platelet-dysfunction-in-critically-ill-patients
#16
Travis Hase, Sarah Sirajuddin, Patrick Maluso, Raksha Bangalore, Louis DePalma, Babak Sarani
Thrombelastography Platelet Mapping (TEG-PM) allows for measurement of maximal potential clot strength (MA) and strength from stimulation of arachidonic acid (MA-AA) and adenosine disphosphate (MA-ADP) receptors. This study was conducted to assess degree of platelet dysfunction in critically ill adult patients. A retrospective study of critically ill, adult, nontrauma patients in a medical/surgical ICU was conducted from August 2013 to September 2014. All patients who underwent TEG-PM were enrolled. Patients with intracerebral hemorrhage, following cardiac surgery, or without an APACHE II score were excluded...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#17
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28160375/heparin-versus-bivalirudin-for-non-primary-percutaneous-coronary-intervention-a-post-hoc-analysis-of-the-cport-e-trial
#18
Matthew J Czarny, Chao-Wei Hwang, Daniel Q Naiman, Cynthia C Lemmon, Rani K Hasan, Thomas Wang, Thomas Aversano
OBJECTIVES: To compare bivalirudin to heparin during non-primary percutaneous coronary intervention (PCI). BACKGROUND: The optimal anticoagulant to support PCI remains uncertain. METHODS: We performed a propensity score-based analysis comparing clinical outcomes of patients receiving heparin to those receiving bivalirudin during non-primary PCI. RESULTS: Of 18,867 patients in the Cardiovascular Patient Outcomes Research Team Non-Primary PCI (CPORT-E) trial, we selected 7,913 patients undergoing non-staged PCI of whom 57...
February 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28125808/coagulation-management-in-jersey-calves-an-ex-vivo-study
#19
Sabine Gröning, Judith Maas, Svenja van Geul, Rolf Rossaint, Ulrich Steinseifer, Oliver Grottke
OBJECTIVE: Jersey calves are frequently used as an experimental animal model for in vivo testing of cardiac assist devices or orthopedic implants. In this ex vivo study, we analyzed the coagulation system of the Jersey calves and the potential of human-based coagulation management to circumvent perioperative bleeding complications during surgery. Experimental Procedure: Blood from 7 Jersey calves was subjected to standard laboratory tests and thromboelastometry analysis. An ex vivo model of dilutional coagulopathy was used to study the effects of fibrinogen or prothrombin complex concentrate supplementation...
January 27, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28122567/is-there-a-correlation-between-late-re-exploration-after-cardiac-surgery-and-removal-of-epicardial-pacemaker-wires
#20
Ioannis Bougioukas, Ahmad Fawad Jebran, Marius Grossmann, Martin Friedrich, Theodor Tirilomis, Friedrich A Schoendube, Bernhard Christoph Danner
BACKGROUND: Re-exploration for bleeding accounts for increased morbidity and mortality after major cardiac operations. The use of temporary epicardial pacemaker wires is a common procedure at many departments. The removal of these wires postoperatively can potentially lead to a serious bleeding necessitating intervention. METHODS: From Jan 2011 till Dec 2015 a total of 4244 major cardiac procedures were carried out at our department. We used temporary epicardial pacemaker wires in all cases...
January 25, 2017: Journal of Cardiothoracic Surgery
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