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adult and Pediatric cardiac surgery

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https://www.readbyqxmd.com/read/27901294/performance-of-functional-fibrinogen-thromboelastography-in-children-undergoing-congenital-heart-surgery
#1
Nischal K Gautam, Chunyan Cai, Olga Pawelek, Muhammad B Rafique, Davide Cattano, Evan G Pivalizza
BACKGROUND: Functional Fibrinogen assay of the Thromboelastography (FFTEG), a whole blood viscoelastic hemostatic assay, has been used to estimate fibrinogen levels in adult patients undergoing major surgery but its performance in pediatric patients undergoing cardiac surgery requires evaluation. In this study, we evaluate the correlation between FFTEG parameters and standard laboratory tests for fibrinogen and platelet counts before and after cardiopulmonary bypass in children undergoing repair for congenital heart disease...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27844091/preoperative-staphylococcus-aureus-carriage-and-risk-of-surgical-site-infection-after-cardiac-surgery-in-children-younger-than-1%C3%A2-year-a-pilot-cohort-study
#2
J Macher, C Gras Le Guen, A Chenouard, J M Liet, B Gaillard Le Roux, A Legrand, J Mahuet, E Launay, V Gournay, N Joram
Surgical site infections (SSI) increase length of stay, morbidity, mortality and cost of hospitalization. Staphylococcus aureus (SA) carriage is a known risk factor of SSI in adults, but its role in pediatrics remains uncertain. The main objective of this pilot prospective monocentric cohort study was to describe the prevalence of SA colonization in children under 1 year old before cardiac surgery. The secondary objectives were to compare the incidence of SSI and other nosocomial infections (NI) between preoperative carriers and non-carriers...
November 14, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27785879/intravascular-and-hybrid-intraoperative-stent-placement-for-baffle-obstruction-in-transposition-of-the-great-arteries-after-atrial-switch
#3
Joseph T Poterucha, Nathaniel W Taggart, Jonathan N Johnson, Bryan C Cannon, Allison K Cabalka, Donald J Hagler, Joseph A Dearani, Frank Cetta
OBJECTIVES: To report our experience with intravascular and hybrid intra-operative stent placement for baffle obstruction in patients with complete transposition of the great arteries (TGA) after the atrial switch (Mustard/Senning) operation. BACKGROUND: Venous baffle obstruction is a challenging complication after atrial switch operation in patients with TGA. Traditional treatment options include intravascular stenting or surgery. METHODS: A retrospective analysis of Mayo Clinic's electronic medical record was completed to identify consecutive pediatric and adult patients with TGA after atrial switch who underwent baffle stent implantation from 1994 to 2015...
October 27, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27785133/application-of-the-cardiocel-bovine-pericardial-patch-a-preliminary-report
#4
Michał Sobieraj, Edyta Cudak, Wojciech Mrówczyński, Tomasz K Nałęcz, Przemysław Westerski, Michał Wojtalik
INTRODUCTION: Animal pericardial patches are widely used in adult and pediatric cardiac surgery. A search is ongoing for a new material with optimal surgical properties that will reduce intraoperative bleeding and the occurrence of restenosis, calcification, and pseudoaneurysms in long-term observation. One product of interest is the CardioCel bovine pericardial patch. AIM: Evaluation of the short-term results of CardioCel bovine pericardial patch implantation during pediatric cardiac surgery...
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27780555/relation-of-left-atrial-size-to-atrial-fibrillation-in-patients-aged-%C3%A2-22%C3%A2-years
#5
Douglas Y Mah, Divya Shakti, Kimberlee Gauvreau, Steven D Colan, Mark E Alexander, Dominic J Abrams, David W Brown
Left atrial (LA) dilation has been shown to be associated with atrial fibrillation (AF) in the adult population, with some studies indicating that larger LAs are more prone to AF recurrence. The relation of LA size to AF in the pediatric and young adult population has not been investigated. In this study, all pediatric patients (aged ≤22 years) who presented to Boston Children's Hospital from January 2002 to December 2012 with AF were reviewed. Patients with significant congenital heart disease, cardiomyopathies, proven channelopathies, previous cardiac surgery, end-stage renal disease, or severe lung disease/cystic fibrosis were excluded...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27716703/strategies-for-blood-conservation-in-pediatric-cardiac-surgery
#6
Sarvesh Pal Singh
Cardiac surgery accounts for the majority of blood transfusions in a hospital. Blood transfusion has been associated with complications and major adverse events after cardiac surgery. Compared to adults it is more difficult to avoid blood transfusion in children after cardiac surgery. This article takes into account the challenges and emphasizes on the various strategies that could be implemented, to conserve blood during pediatric cardiac surgery.
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27645949/robert-lee-replogle-september-30-1931-may-9-2016
#7
Mark K Ferguson
The world of cardiothoracic surgery lost a friend and remarkable colleague on May 9, 2016. Robert L. Replogle, the 31st President of The Society of Thoracic Surgeons, died at the University of Chicago Medical Center after a brief illness, surrounded by his loving family. Known to his friends as "Rep," he will be remembered as an excellent pediatric and adult cardiac surgeon and as a visionary leader.
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27621853/sufficient-myocardial-protection-of-del-nido-cardioplegia-regardless-of-ventricular-mass-and-myocardial-ischemic-time-in-adult-cardiac-surgical-patients
#8
Ji Seong Kim, Jin Hee Jeong, Sin Ju Moon, Hyuk Ahn, Ho Young Hwang
BACKGROUND: Del Nido (DN) cardioplegic solution (CPS) has been widely used during pediatric cardiac surgery. However, its use in the field of adult cardiac surgery is not popular yet. We evaluated efficacy of DN cardioplegia in adult cardiac surgical patients. METHODS: Fifty-three adult patients (mean age, 54±16 years) who underwent cardiovascular surgery using DN cardioplegia were enrolled. Myocardial troponin I (TnI) level up to three days after surgery and early clinical outcomes were evaluated...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27618336/assessment-of-risk-factors-for-a-sustainable-on-table-extubation-program-in-pediatric-congenital-cardiac-surgery-5-year-experience
#9
Reena Khantwal Joshi, Neeraj Aggarwal, Mridul Agarwal, Veronique Dinand, Raja Joshi
OBJECTIVE: To delineate risk factors for failure of extubation in the operating room among pediatric cardiac surgery patients. DESIGN: Prospective, observational study. SETTING: Single center, tertiary care, teaching hospital. PARTICIPANTS: The study comprised 448 congenital cardiac surgery patients who were enrolled for intended extubation in the pediatric cardiac operating room over 5 years. INTERVENTIONS: The airways of enrolled patients were extubated in the operating room if predetermined suitability criteria were met...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27591466/intraoperative-goal-directed-hemodynamic-therapy-in-noncardiac-surgery-a-systematic-review-and-meta-analysis
#10
Javier Ripollés, Angel Espinosa, Eugenio Martínez-Hurtado, Alfredo Abad-Gurumeta, Rubén Casans-Francés, Cristina Fernández-Pérez, Francisco López-Timoneda, José María Calvo-Vecino
BACKGROUND: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. METHODS: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27590683/mortality-trends-in-pediatric-and-congenital-heart-surgery-an-analysis-of-the-society-of-thoracic-surgeons-congenital-heart-surgery-database
#11
Jeffrey P Jacobs, Xia He, John E Mayer, Erle H Austin, James A Quintessenza, Tom R Karl, Luca Vricella, Constantine Mavroudis, Sean M O'Brien, Sara K Pasquali, Kevin D Hill, S Adil Husain, David M Overman, James D St Louis, Jane M Han, David M Shahian, Duke Cameron, Marshall L Jacobs
BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). METHODS: Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27583584/protocolized-care-for-early-shock-resuscitation
#12
Matthew Goodwin, Kaori Ito, Arielle H Gupta, Emanuel P Rivers
PURPOSE OF REVIEW: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR. RECENT FINDINGS: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27573217/diagnosis-and-diagnostic-modalities-in-pediatric-patients-with-elevated-troponin
#13
Tyler H Harris, Jeffrey G Gossett
Care of adults with coronary artery disease focuses on troponins to rapidly move patients to catheterization. Troponins are increasingly drawn in children, but emergent catheterization may not be indicted. We sought to establish etiologies of troponin elevation and ascertain the yield of diagnostic tests, in this population. Retrospective review of patients from January 1, 2002, to December 31, 2011, who had any elevated troponin during the study period. Patients were excluded for recent cardiac surgery, "significant" congenital heart disease, if they were neonates in the NICU or were on ECMO...
December 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27559006/current-status-of-platelet-transfusion-in-pediatric-patients
#14
REVIEW
Steven R Sloan, Robert I Parker
Outside the neonatal period, most platelets that are transfused to pediatric patients are given to those who are thrombocytopenic secondary to malignancy and associated therapy and/or hematopoietic progenitor cell transplant, or to those with significant bleeding associated with surgery, especially cardiac surgery. Indications for platelet transfusion, doses, and other practices for children largely mimic adult platelet transfusion protocols because there are few pediatric-specific studies in this area. Pediatric platelet transfusion practices would benefit from focused pediatric research...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27559005/pediatric-patient-blood-management-programs-not-just-transfusing-little-adults
#15
REVIEW
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27541719/cardiac-embryology-and-molecular-mechanisms-of-congenital-heart-disease-a-primer-for-anesthesiologists
#16
Benjamin Kloesel, James A DiNardo, Simon C Body
Congenital heart disease is diagnosed in 0.4% to 5% of live births and presents unique challenges to the pediatric anesthesiologist. Furthermore, advances in surgical management have led to improved survival of those patients, and many adult anesthesiologists now frequently take care of adolescents and adults who have previously undergone surgery to correct or palliate congenital heart lesions. Knowledge of abnormal heart development on the molecular and genetic level extends and improves the anesthesiologist's understanding of congenital heart disease...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27537760/unrepaired-tetralogy-of-fallot-related-pathophysiologic-changes-reduce-systemic-clearance-of-etomidate-in-children
#17
Yang Shen, Mei-Hua Cai, Wei Ji, Jie Bai, Yue Huang, Ying Sun, Lin Lin, Jing Niu, Ma-Zhong Zhang
BACKGROUND: Pathophysiologic changes in children with congenital heart disease may alter the effect of drugs by influencing the pharmacokinetics (PK). Considering the limited literature that describes the PK of etomidate in pediatric patients, especially in those with tetralogy of Fallot (TOF), our aim was to characterize the PK of etomidate and explore the effects of TOF. METHODS: Twenty-nine pediatric patients (15 with TOF and 14 with normal cardiac anatomy) scheduled to undergo elective surgery under general anesthesia were recruited in the study...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27493092/efficacy-and-safety-of-fibrinogen-concentrate-in-surgical-patients-a-meta-analysis-of-randomized-controlled-trials
#18
Evgeny Fominskiy, Valeriy A Nepomniashchikh, Vladimir V Lomivorotov, Fabrizio Monaco, Chiara Vitiello, Alberto Zangrillo, Giovanni Landoni
OBJECTIVES: To investigate the efficacy and safety of fibrinogen concentrate (FC) in surgical patients. DESIGN: Meta-analysis of randomized controlled studies (RCTs). SETTING: Perioperative. PARTICIPANTS: Adult and pediatric surgical patients. INTERVENTIONS: A search of PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, Transfusion Evidence Library, Google Scholar, and the proceedings from major international anesthesiology meetings up to February 1, 2016 for RCTs that compared FC with placebo or other comparators...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27490600/near-infrared-spectroscopy-as-a-hemodynamic-monitor-in-critical-illness
#19
Nancy S Ghanayem, George M Hoffman
OBJECTIVES: The objectives of this review are to discuss the technology and clinical interpretation of near infrared spectroscopy oximetry and its clinical application in patients with congenital heart disease. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Near infrared spectroscopy provides a continuous noninvasive assessment of tissue oxygenation. Over 20 years ago, near infrared spectroscopy was introduced into clinical practice for monitoring cerebral oxygenation during cardiopulmonary bypass in adults...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27451052/del-nido-cardioplegia-in-low-risk-adults-undergoing-first-time-coronary-artery-bypass-surgery
#20
Gustavo E Guajardo Salinas, Roger Nutt, Gerardo Rodriguez-Araujo
OBJECTIVES: Single-dose del Nido cardioplegia has been used in the pediatric population for many years. Only a small amount of data exists about its use in adult cardiac surgery. We sought to compare the outcomes of all patients undergoing coronary artery bypass, using our 4:1 blood cardioplegia versus single-dose 1:4 del Nido cardioplegia, at our institution. METHODS: Data were retrospectively reviewed from all patients during 2 consecutive years (2013-2014). We switched our cardioplegia protocol from 4:1 blood cardioplegia to exclusively 1:4 single-dose del Nido cardioplegia in early 2014...
July 21, 2016: Perfusion
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