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cardiac wound

Francesca Forini, Giuseppina Nicolini, Claudia Kusmic, Romina D'Aurizio, Milena Rizzo, Mario Baumgart, Marco Groth, Stefano Doccini, Giorgio Iervasi, Letizia Pitto
Thyroid hormone (T3) dyshomeostasis in the cardiac ischemia-reperfusion (IR) setting negatively impacts on mitochondria function and extracellular matrix remodeling. The modulation of cardiac miRNAs may represent the underlying molecular mechanisms, but a systems biology perspective investigating this critical issue in depth is still lacking. A rat model of myocardial IR, with or without an early short-term T3-replacement, was used to predict putative T3-dependent miRNA-gene interactions targeted to mitochondria quality control and wound healing repair...
September 14, 2018: Scientific Reports
Tim Montrief, Alex Koyfman, Brit Long
INTRODUCTION: Coronary artery bypass graft (CABG) surgery remains a high-risk procedure, and many patients require emergency department (ED) management for complications after surgery. OBJECTIVE: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post-CABG surgery complications. DISCUSSION: While there has been a recent decline in all cardiac revascularization procedures, there remains over 200,000 CABG surgeries performed in the United States annually, with up to 14% of these patients presenting to the ED within 30 days of discharge with post-operative complications...
September 8, 2018: American Journal of Emergency Medicine
Martin Simek, Adam Chudoba, Roman Hajek, Patrick Tobbia, Martin Molitor, Petr Nemec
Deep sternal wound infection is a challenging aspect of modern cardiac surgery. The considerable mortality rate, devastating morbidity and, negative impact on long-term survival has driven cardiac and plastic surgeons to seek a more advantageous treatment solution. This review summarizes progress in the field of deep sternal wound infection treatment after cardiac surgery. Emphasis is placed on outcomes analysis of contemporary treatment strategy based on negative pressure wound therapy followed by sternotomy wound reconstruction, and its comparison with conventional treatment modalities used afore...
September 14, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Nathaniel H Greene, Edmund H Jooste, Dylan P Thibault, Amelia S Wallace, Alice Wang, David F Vener, Roland A Matsouaka, Marshall L Jacobs, Jeffrey P Jacobs, Kevin D Hill, Warwick A Ames
BACKGROUND: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to perceived benefits of less postoperative sedation and a lower risk for accidental extubation. This study sought to describe the practice of nasal intubation in the pediatric population undergoing cardiopulmonary bypass surgery and assess the risks/benefits of a nasal route against an oral one...
September 5, 2018: Anesthesia and Analgesia
Marek Zubrzycki, Andreas Liebold, Christian Skrabal, Helmut Reinelt, Mechthild Ziegler, Ewelina Perdas, Maria Zubrzycka
Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain...
2018: Journal of Pain Research
Stephanie L C Scofield, Christopher R Daniels, Suman Dalal, Jonathan A Millard, Mahipal Singh, Krishna Singh
AIMS: β-adrenergic receptor (β-AR) stimulation increases extracellular levels of ubiquitin (UB), and exogenous UB plays an important role in β-AR-stimulated myocardial remodeling with effects on heart function, fibrosis and myocyte apoptosis. Cardiac fibroblasts are vital for maintaining the normal function of the heart, and in the structural remodeling of the heart in response to injury. Here we hypothesized that extracellular UB modulates cardiac fibroblast phenotype and function via its interaction with CXC chemokine receptor type 4 (CXCR4)...
September 5, 2018: Life Sciences
Sulakshana Balachandran, Linda Denehy, Annemarie Lee, Colin Royse, Alistair Royse, Doa El-Ansary
BACKGROUND: Despite a paucity of evidence, patients following cardiac surgery via median sternotomy are routinely prescribed sternal precautions that restrict upper limb and trunk movements, with the rationale of reducing postoperative sternal complications such as sternal wound dehiscence, instability, infection and/or pain. The primary aim of this study was to measure motion at the sternal edges during dynamic upper limb and trunk tasks to better inform future sternal precautions and optimise postoperative recovery...
June 27, 2018: Heart, Lung & Circulation
Hiroaki Aida, Satoru Kagaya
Cardiac trauma is one of the most lethal injuries. We reported 7 patients with cardiac injuries who underwent surgical repair. They were 4 men and 3 women with a mean age of 64 years. The mechanisms of injuries were blunt trauma by traffic accident in 5 patients and penetrating trauma in 2 patients. The injured cardiac chambers were the right atrium in 2, the right ventricle in 2, the right ventricle and the ascending aorta in 1,the left atrium in 1 and the left ventricle in 1 patient. The wounds of all patients were repaired by direct suture closure...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
William M Brigode, Michael Masteller, Rishi Chaudhuri, Ryan Sullivan, Amir Vafa
This study was performed to assess our institution's experience with stab injuries to the posterior mediastinal box. We examine the value of performing CT of the chest and esophagram in conjunction with a chest X-ray (CXR) over performing CXR(s) alone in evaluating this group of patients. We performed a retrospective study covering a 10-year period consisting of patients with stab wounds to the posterior mediastinal box. Age, gender, and injury severity score as demographic data points were collected. CXR, CT, and esophagram results; identified injuries; and subsequent interventions were analyzed...
August 1, 2018: American Surgeon
Thomas Pech, Alexander Kania, Wiebke Fehlberg, Jörg C Kalff, Klaus-Jürgen Walgenbach, Kay-Hendrik Busch
BACKGROUND: After median sternotomy in cardiac surgery, deep sternal wound infections develop in 0.8 - 8% of patients, resulting in prolonged hospital stay and increased morbidity and mortality. Our treatment strategy combines radical surgical debridement, removal of extraneous material and reconstruction of large and deep defects by a pedicled M. latissimus dorsi flap. With retrospective analysis of patient characteristics and pre- und perioperative data we could identify risk factors in regard to proper wound healing and bleeding complications...
August 2018: Zentralblatt Für Chirurgie
Merry L Lindsey, Mira Jung, Andriy Yabluchanskiy, Presley L Cannon, Rugmani Padmanabhan Iyer, Elizabeth R Flynn, Kristine Y DeLeon-Pennell, Fritz M Valerio, Courtney L Harrison, Crystal M Ripplinger, Michael E Hall, Yonggang Ma
Aims: Macrophage phagocytosis of dead cells is a prerequisite for inflammation resolution. Because CXCL4 induces macrophage phagocytosis in vitro, we examined the impact of exogenous CXCL4 infusion on cardiac wound healing and macrophage phagocytosis following myocardial infarction (MI). Methods and Results: CXCL4 expression significantly increased in the infarct region beginning at day 3 post-MI, and macrophages were the predominant source. Adult male C57BL/6J mice were subjected to coronary artery occlusion, and MI mice were randomly infused with recombinant mouse CXCL4 or saline beginning at 24 h post-MI by mini-pump infusion...
August 29, 2018: Cardiovascular Research
Mona Ramadan, Ahmed Abdelgawad, Ahmed Elshemy, Emad Sarawy, Aly Emad, Mahmoud Mazen, Ahmed Abdel Aziz
Objective: It is unknown whether adequacy of diabetic control, measured by hemoglobin A1c, is a predictor of adverse outcomes after coronary artery bypass grafting. Methods: From December 2013 to November 2015, 80 consecutive patients underwent primary isolated CABG surgery at national heart institute, their data were prospectively collected and they were classified according to their HbA1c level into two groups, Group (A): Forty patients with fair glycemic control (HbA1c below or equal to 7%), Group (B): Forty patients with poor glycemic control (HbA1c above 7%)...
June 2018: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
Patrick R Vargo, Robert J Steffen, Faisal G Bakaeen, Suparna Navale, Edward G Soltesz
BACKGROUND: A survival benefit for obese patients has been observed in various medical and surgical populations. We examined the effect of obesity on outcomes after cardiac surgery from a large national database. METHODS: A total of 6 648 334 adult patients were identified from the Nationwide Inpatient Sample who underwent cardiac surgery between 1998 and 2011, of who 598 450 were obese. Multivariable regression analysis and propensity score matching were used for comparisons of outcomes and costs...
August 29, 2018: Journal of Cardiac Surgery
Peter Roth, Jenna Stella, Bernd Niemann, Philippe Grieshaber, Rainer Roehrig, Andreas Böning
BACKGROUND:  To examine if fibrin-coated collagen fleece (Tachosil) interferes with bone and wound healing when it is used on the cut surface of the sternum after median sternotomy. METHODS:  A total of 25 patients with osteoporotic sternal disorders were treated with fibrin-coated collagen fleece at the cut surface of the sternum after median sternotomy (therapy group). We compared the occurrence of impaired wound healing and sternal instability, reoperation rate, and 30-day mortality with a control group of 25 case-matched patients...
August 28, 2018: Thoracic and Cardiovascular Surgeon
Rakan I Nazer, Khalid A Alburikan, Anhar Ullah, Ali M Albarrati, Mazen Hassanain
Background Surgical site infections can have a significant impact on cardiac surgical outcome. The liver plays an important role in infection prevention. This study aimed to retrospectively determine whether transient postoperative liver dysfunction after coronary bypass surgery increased surgical site infections. Methods A modified version of the Schindl scoring scale for liver dysfunction was adapted to objectively quantify transient liver dysfunction in the first 7 days after on-pump coronary artery bypass grafting...
July 2018: Asian Cardiovascular & Thoracic Annals
Jorinde Aw Polderman, Violet Farhang-Razi, Susan Van Dieren, Peter Kranke, J Hans DeVries, Markus W Hollmann, Benedikt Preckel, Jeroen Hermanides
BACKGROUND: In the perioperative period, dexamethasone is widely and effectively used for prophylaxis of postoperative nausea and vomiting (PONV), for pain management, and to facilitate early discharge after ambulatory surgery.Long-term treatment with steroids has many side effects, such as adrenal insufficiency, increased infection risk, hyperglycaemia, high blood pressure, osteoporosis, and development of diabetes mellitus. However, whether a single steroid load during surgery has negative effects during the postoperative period has not yet been studied...
August 28, 2018: Cochrane Database of Systematic Reviews
Sheryl A Zelenitsky, Divna Calic, Rakesh C Arora, Hilary P Grocott, Ted M Lakowski, Ryan Lillico, Robert E Ariano
This study characterizes the pharmacodynamics of antimicrobial prophylaxis and sternal wound infections following cardiac surgery. Duration of surgery and cefazolin plasma concentration during wound closure were independently associated with surgical site infection at 30 days. Furthermore, duration of surgery >346 minutes and total cefazolin closure concentration <104 mg/L were significant thresholds for an increased risk of infection. This study provides new data that informs dosing strategies for effective AP in patients undergoing cardiac surgery with cardiopulmonary bypass...
August 27, 2018: Antimicrobial Agents and Chemotherapy
Si Li, Bai-Yun Tang, Bao Zhang, Cui-Ping Wang, Wen-Bo Zhang, Song Yang, Jia-Bin Chen
BACKGROUND: Valvular heart disease is one of the most frequent and challenging heart diseases worldwide. The incidence of complications and cardiothoracic surgical intensive care unit (CSICU) readmission after cardiac valve surgery is high. Because CSICU readmission is costly and adversely impacts the quality life, reducing the risk of CSICU readmission has become one of the main focuses of health care. OBJECTIVE: To explore the risk factors for CSICU readmission and to establish a risk prediction model for CSICU readmission in heart valve surgical patients...
August 24, 2018: Heart & Lung: the Journal of Critical Care
Vivek A Wadhawa, Kartik G Patel, Chirag P Doshi, Jigar K Shah, Jaydip A Ramani, Pankaj D Garg, Sudhir H Adalti, Yashpal R Rana, Himani M Pandya, Vijay Gupta
OBJECTIVE: One of the major challenges faced in minimally invasive pediatric cardiac surgery is cannulation strategy for cardiopulmonary bypass. Central aortic cannulation through the same incision has been the usual strategy, but it has the disadvantage of cluttering of the operative field. We hereby present the results of femoral cannulation in minimally invasive pediatric cardiac surgery in terms of adequacy and safety. METHODS: From January 2013 to June 2016, 200 children (122 males) with mean ± SD age of 9...
July 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Yong Liu, Haitao Xiao, Xiaoxue Liu, Chang Cao, Junliang Wu, Bing Yao, Yuan Chen, Xuewen Xu
Objective: To investigate the effectiveness of internal mammary artery perforator (IMAP) propeller flap repair combined with radiotherapy for chest keloid in female patients. Methods: Between January 2015 and December 2016, 15 female patients with chest keloids were treated, aged 28-75 years (mean, 45.2 years). The keloid disease duration was 1-28 years (median, 6 years). The causes of disease included secondary keloid caused by folliculitis in 7 cases, cardiac surgery in 4 cases, skin abrasion in 2 cases, mosquito bite in 1 case, and unknown etiology in 1 case...
September 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
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