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Anticoagulation cardiac surgery

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https://www.readbyqxmd.com/read/29331555/preoperative-thromboelastographic-profile-of-patients-with-congenital-heart-disease-association-of-hypercoagulability-and-decreased-heparin-response
#1
Zhe Amy Fang, Rachel Bernier, Sirisha Emani, Sitaram Emani, Gregory Matte, James A DiNardo, David Faraoni, Juan C Ibla
OBJECTIVE: To describe the demographic and thromboelastographic characteristics of patients with congenital heart disease presenting with decreased heparin response before cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single institution, tertiary, academic, university hospital. PARTICIPANTS: The study comprised 496 pediatric and adult patients undergoing cardiac surgery for congenital heart disease...
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29327158/comparison-of-warfarin-requirements-in-post-cardiac-surgery-patients-valve-replacement-versus-non-valve-replacement
#2
Logan M Olson, Andrea M Nei, David L Joyce, Narith N Ou, Ross A Dierkhising, Scott D Nei
INTRODUCTION: Anticoagulation with warfarin affects approximately 140,000 post-cardiac surgery patients every year, yet there remains limited published data in this patient population. Dosing remains highly variable due to intrinsic risk factors that plague cardiac surgery candidates and a lack of diverse literature that can be applied to those who have undergone a cardiac surgery alternative to heart valve replacement (HVR). In the present study, our aim was to compare the warfarin requirements between HVR and non-HVR patients...
January 11, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29312771/low-grade-myxofibrosarcoma-in-the-right-ventricle-presenting-as-pulmonary-thromboembolism
#3
Jong Hui Suh, Do Yeon Kim, Jeong Seob Yoon, Eun Su Park, Chan Beom Park
We report an unusual malignant cardiac neoplasm that initially presented as pulmonary thromboembolism in a 78-year-old male. Despite anticoagulation, the pulmonary artery lesion progressed and a mass-like lesion developed in the right ventricular outflow tract. Venoarterial extracorporeal membrane oxygenation was applied before surgery due to the presence of severe right-side heart failure with pulmonary hypertension. A round mass was found in the right ventricle and separate lobulated masses were found in both pulmonary arteries, and these were consistent with low-grade myxofibrosarcoma...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29309597/effectiveness-of-adherence-to-a-preoperative-antiplatelet-and-anticoagulation-cessation-protocol-in-cardiac-surgery
#4
Richard van Valen, Menno van Gameren, Mostafa M Mokhles, Johanna J M Takkenberg, Maarten Ter Horst, Jan Hofland, Ad J J C Bogers
OBJECTIVES: Reduction of blood loss after cardiac surgery remains challenging. The effectiveness of adherence to a protocol on cessation of anticoagulants and platelet-inhibiting medications was investigated together with the influence of protocol violations on blood loss after surgery, use of blood products, surgical re-explorations and 30-day mortality. METHODS: Between 2009 and 2013, data were collected prospectively for all elective cardiac surgery procedures in adult patients (n = 1637)...
December 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29305143/bleeding-complications-after-use-of-novel-oral-anticoagulants-in-patients-undergoing-cardiac-surgery
#5
Kambiz Hassan, Nikolai Bayer, Friederike Schlingloff, Martin Oberhoffer, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
BACKGROUND: To analyze the results of open-heart surgery and bleeding complications after administration of novel oral anticoagulants (NOAC). METHODS: We investigated 81 consecutive patients (age: 74 [IQR 68, 78] years) who underwent open-heart operations at our institution between July 2014 and June 2016. All patients presented for surgery while on NOAC therapy: 37 had Rivaroxaban (45.7%), 35 Apixaban (43.2%) and 9 Dabigatran (11.1%). The calculated risk, using the European System for Cardiac Operative Risk Evaluation II, was 3...
January 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#6
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29287725/activated-protein-c-protects-against-pressure-overload-induced-hypertrophy-through-ampk-signaling
#7
Courtney Cates, Thomas Rousselle, Jinli Wang, Nanhu Quan, Lin Wang, Xu Chen, Likui Yang, Alireza R Rezaie, Ji Li
We found that the anticoagulant plasma protease, activated protein C (APC), stimulates the energy sensor kinase, AMPK, in the stressed heart by activating protease-activated receptor 1 (PAR1) on cardiomyocytes. Wild-type (WT) and AMPK-kinase dead (KD) transgenic mice were subjected to transverse aortic constriction (TAC) surgery. The results demonstrated that while no phenotypic differences can be observed between WT and AMPK-KD mice under normal physiological conditions, AMPK-KD mice exhibit significantly larger hearts after 4 weeks of TAC surgery...
December 26, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29240293/transvenous-pacemaker-implantation-after-the-bidirectional-glenn-operation-for-patients-with-complex-congenital-disease
#8
Danielle E Harake, Kevin M Shannon, Jamil A Aboulhosn, Jeremy P Moore
INTRODUCTION: The bidirectional Glenn operation for congenital heart disease produces anatomical constraints to conventional transvenous pacemaker implantation. An iliac approach, although not previously described in this population, is potentially a preferable alternative to a thoracotomy for epicardial pacing. METHODS AND RESULTS: A single-center retrospective review was performed for all patients that underwent transvenous pacemaker implantation following the bidirectional Glenn operation with partial biventricular repair...
December 14, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29224652/primary-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-surgical-support-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#9
MULTICENTER STUDY
Majed Afana, Hitinder S Gurm, Milan Seth, Kathleen M Frazier, Sheryl Fielding, Gerald C Koenig
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is being increasingly performed nationally at sites without on-site cardiac surgery; however, recent guidelines only provide a Class IIa recommendation for this practice. The state of Michigan has permitted PPCI without on-site surgery under a closely monitored system that mandates auditing of all procedures and quarterly feedback on quality and outcomes. This study sought to compare outcomes of patients undergoing PPCI at centers with and without on-site surgery in the state of Michigan...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29206646/argatroban-and-bivalirudin-for-perioperative-anticoagulation-in-cardiac-surgery
#10
Andreas Koster, David Faraoni, Jerrold H Levy
No abstract text is available yet for this article.
December 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#11
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29178294/advanced-cardiac-imaging-techniques-assist-in-characterizing-a-cardiac-mass-and-directing-management
#12
Chadi Ayoub, Sushil A Luis, Joseph J Maleszewski, Patricia A Pellikka
Advanced imaging techniques, including contrast echocardiography and CMR, provided valuable characterization and evaluation of a boy with an unusual cardiac mass. Imaging features assisted with differentiation of benign from malignant etiology and excluding thrombus. Accurate imaging techniques saved our patient risks associated with unnecessary surgery or anticoagulation. The ability to accurately define size serially assisted in guiding expectant management. He died from a noncardiac cause at age 28, and autopsy demonstrated a hamartoma of mature cardiac myocytes...
November 2017: Echocardiography
https://www.readbyqxmd.com/read/29171276/pericardial-effusion-following-cardiac-surgery-a-single-center-experience
#13
Hien Sinh Nguyen, Hung Doan-Thai Nguyen, Thang Duc Vu
Background Pericardial effusion is still a common postoperative complication after open heart surgery with cardiopulmonary bypass. Pericardial effusion significantly prolongs the hospital stay and associated costs as well as affecting overall outcomes after open heart surgery in Hanoi Heart Hospital, a tertiary hospital in Vietnam with an annual volume of 1000 patients. This study aimed to investigate the clinical presentation, incidence, and risk factors of postoperative pericardial effusion, which may ensure better prevention of pericardial effusion and improvement in surgical outcomes after open heart surgery...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29162159/pulsed-electron-avalanche-knife-peak-plasmablade%C3%A2-in-pacemaker-and-defibrillator-procedures
#14
Elif Kaya, Matthias Totzeck, Tienush Rassaf
BACKGROUND: The pulsed electron avalanche knife (PEAK) PlasmaBlade™ is an innovative electrosurgical device that uses a novel technology to cut tissues. It has been proven to be safe and feasible in ear, nose, and throat surgery, but there are only limited data concerning the use of PlasmaBlade™ instead of conventional electrocautery in cardiac implantable electronic device (CIED) procedures except for generator replacements. METHODS: We conducted a retrospective, single-center study with patients undergoing CIED surgery at our center between December 2015 and March 2017 and evaluate the feasibility and the clinical outcome of the PlasmaBlade™...
November 21, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29161419/incidence-of-postoperative-atrial-fibrillation-recurrence-in-patients-discharged-in-sinus-rhythm-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#15
Nicole Lowres, Georgina Mulcahy, Kai Jin, Robyn Gallagher, Lis Neubeck, Ben Freedman
Postoperative atrial fibrillation (POAF) is associated with increased stroke risk and mortality post-discharge. POAF is often considered transient; however, recurrence is likely under-recognized as symptoms are an unreliable guide. Surveillance post-discharge may identify asymptomatic POAF recurrences in patients discharged in sinus rhythm. Therefore, we performed a systematic review and meta-analysis of studies investigating POAF recurrence post-discharge, in patients with new-onset POAF following cardiac surgery who reverted to sinus rhythm prior to discharge...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#16
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#17
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
September 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29115650/spontaneous-rectus-sheath-hematoma-in-cardiac-in-patients-a-single-center-experience
#18
Ebubekir Gündeş, Durmuş Ali Çetin, Ulaş Aday, Hüseyin Çiyiltepe, Kamuran Cumhur Değer, Orhan Uzun, Aziz Serkan Senger, Erdal Polat, Mustafa Duman
BACKGROUND: This study presents the relationship between mortality and spontaneous rectus sheath hematoma (RSH) in inpatients receiving anticoagulant and antiaggregant treatment for cardiac pathology at cardiology and cardiovascular surgery clinics. METHODS: Within the scope of our study, the cases of 27 patients who were diagnosed with spontaneous RSH between January 2010 and December 2015 at Kartal Kosuyolu High Speciality Training and Research Hospital were retrospectively evaluated...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29104201/-cardiac-perforation-after-pacemaker-implantation-report-of-a-case
#19
Yuko Ohashi, Kazuhiro Ohkura, Ayano Yamada
A 71-year-old woman was diagnosed with sick sinus syndrome (SSS) upon her cardiogenic cerebral embolism and underwent pacemaker implantation. Active fixation leads were positioned at the right atrial appendage and ventricular septum. Twenty-one days later at her routine checkup, she was asymptomatic and there were no signs of cardiac tamponade or pacing failure. But echocardiography and computed tomography revealed a large amount of pericardial effusion due to the lead perforation. We performed open drainage because her anticoagulant could not be stopped for her history of cerebral infarction...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29099334/viscoelastic-monitoring-to-guide-hemostatic-resuscitation-in-liver-transplantation-surgery
#20
Kevin P Blaine, Tetsuro Sakai
Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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