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Aortic surgery anesthesia

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https://www.readbyqxmd.com/read/29036976/-comparison-of-perioperative-serum-thrombomodulin-levels-in-patients-underwent-off-pump-coronary-artery-bypass-grafting-with-and-without-cardiogenic-shock
#1
L Zhang, C Wang, T X Gu, C M Lu, Z W Wang
Objective: To observe the perioperative changes of serum thrombomodulin in patients with and without cardiogenic shock undergoing off-pump coronary artery bypass grafting surgery. Methods: A total of 66 patients with coronary artery disease who underwent off-pump coronary artery bypass grafting surgery between June and December 2015 in our hospital were included in this study.The patients were divided into non-cardiogenic shock group (n=51) and shock group (n=15) according to the absence or presence of cardiogenic shock...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#2
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28911827/single-site-robot-assisted-laparoscopic-staging-surgery-for-presumed-clinically-early-stage-ovarian-cancer
#3
Ji Geun Yoo, Woo Jin Kim, Keun Ho Lee
STUDY OBJECTIVE: To present the demonstration of Robotic-assisted laparoendoscopic single-site(R-LESS) staging surgery in presumed clinically early stage ovarian cancer. DESIGN: A step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING: A university hospital. INTERVENTION: A 29-year-old woman was referred from a local clinic for an 8x6cm sized left ovarian tumor suggesting malignancy...
September 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#4
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28893433/effects-of-remote-ischemic-preconditioning-in-patients-with-concentric-myocardial-hypertrophy-a-randomized-controlled-trial-with-molecular-insights
#5
Young Song, Jong Wook Song, Sak Lee, Ji-Hae Jun, Young-Lan Kwak, Jae-Kwang Shim
BACKGROUND: Efficacy of remote ischemic preconditioning (RIPC) for cardioprotection in cardiac surgery is controversial. We aimed to evaluate the clinical and molecular effects of RIPC on the concentrically hypertrophied myocardium. METHODS: Seventy-two aortic stenosis patients receiving aortic valve replacement (AVR) under sevoflurane anesthesia were randomly allocated to RIPC (3cycles of 5-min inflation [300mmHg] and deflation on the left arm) or control (deflated cuff placement) group...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#6
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887255/forced-air-warming-in-patients-undergoing-endovascular-procedures-comparison-between-two-thermal-blanket-models
#7
Frederico L J Monteiro, Helio Halpern, Fernando Bortoli, Lucia Kataoka, Cristina Marumo, Mariângela Ribeiro, Matheus Castellassi, Cynthia Mendes, Nelson Wolosker
STUDY OBJECTIVE: The purpose of this study was to compare the efficiency between two thermal blanket models: the upper blanket and the underbody blanket in patient heating and hypothermia prevention during endovascular surgery. DESIGN: Prospective randomized study SETTING: Operating room PATIENTS: 50 patients, ASA 2-4 physical status, receiving endovascular surgery repair of infrarenal abdominal aortic aneurysm or lower limb angioplasty by endovascular technique were studied...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887248/positive-impact-of-an-aortic-center-designation
#8
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Brad Johnson, Karl A Illig, Bruce Zwiebel, Lawrence S Grundy, Robert Hooker, Christiano Caldeira, Martin A Back, Murray L Shames
BACKGROUND: In January 2015, we created a multidisciplinary Aortic Center with the collaboration of Vascular Surgery, Cardiac Surgery, Interventional Radiology, Anesthesia and Hospital Administration. We report the initial success of creating a Comprehensive Aortic Center. METHODS: All aortic procedures performed from January 1, 2015 until December 31, 2016 were entered into a prospectively collected database and compared with available data for 2014. Primary outcomes included the number of all aortic related procedures, transfer acceptance rate, transfer time, and proportion of elective/emergent referrals...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28860786/risk-factors-and-early-outcomes-of-acute-renal-injury-after-thoracic-aortic-endograft-repair-for-type-b-aortic-dissection
#9
Songyuan Luo, Huanyu Ding, Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become an emerging treatment modality for acute type B aortic dissection (TBAD) patients in recent years. The risk factors and impacts of acute kidney injury (AKI) after percutaneous TEVAR, however, have not been widely established. METHODS: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28852473/evaluation-of-operating-room-reverse-trendelenburg-positioning-and-its-effect-on-postoperative-hypoxemia-aspiration-and-length-of-stay-a-retrospective-study-of-consecutive-patients
#10
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Tamara Antonaccio, Elisha A Chance, Gregory S Huang, Gregory Szmaj, Kristen Calabro, Cynthia Bishop, Tyson T Schrickel
BACKGROUND: In 2014, this group published an investigation of surgical patients from 2012 who had substantial rates of postoperative hypoxemia (POH) and perioperative pulmonary aspiration (POPA). Therefore, we investigated whether intraoperative reverse Trendelenburg positioning (RTP) decreases POH and POPA rates. METHODS: Consecutive ASA I-IV surgical patients who had preoperative pulmonary stability requiring general anesthesia with endotracheal intubation were evaluated...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#11
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28828046/modern-use-of-echocardiography-in-transcatheter-aortic-valve-replacement-an-up-date
#12
Cristina Caldararu, Serban Balanescu
Echocardiography is the cornerstone in the diagnosis of any valvular heart disease. The accurate diagnosis of aortic stenosis, the left ventricle function and the other heart valves evaluation are currently done by ultrasound alone. Prosthetic valve choice and dimensions prior to implantation can be done solely by proper use of echocardiography. The emergence of new methods to cure aortic stenosis such as trans-catheter aortic valve replacement (TAVR) emphasized the diagnostic value of cardiac ultrasound. The usefulness of echocardiography in TAVR can be divided in the baseline assessment (common to patients treated by conventional surgery), intra-procedural guidance of valve deployment and post-procedural follow-up...
December 2016: Mædica
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#13
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#14
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#15
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28697490/the-influence-of-blood-pressure-on-fetal-aortic-distensibility-an-animal-validation-study
#16
Christoph Wohlmuth, Kenneth J Moise, Ramesha Papanna, Ciprian Gheorghe, Anthony Johnson, Yisel Morales, Helena M Gardiner
BACKGROUND/AIMS: Aortic distension waveforms describe the change in diameter or cross-sectional area over the cardiac cycle. We aimed to validate the association of aortic fractional area change (AFAC) with blood pressure (BP) in a fetal lamb model. METHODS: Four pregnant ewes underwent open fetal surgery under general anesthesia at 107-120 gestational days. A 4-Fr catheter was introduced into the fetal femoral artery and vein, or the carotid artery and jugular vein...
July 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28673782/percutaneous-closure-of-periprosthetic-paravalvular-leaks-a-viable-alternative-to-surgery
#17
Ana Isabel Azevedo, Pedro Braga, Alberto Rodrigues, Lino Santos, Bruno Melica, José Ribeiro, Francisco Sampaio, Ricardo Fontes-Carvalho, Marlene Fonseca, Adelaide Dias, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: Paravalvular leak (PVL) is a possible complication after prosthetic valve implantation. PVL can cause significant symptoms of congestive heart failure and/or hemolysis. Medical therapy is palliative and reoperation has a high mortality rate. Percutaneous transcatheter closure is a promising alternative for symptomatic patients at high surgical risk. We aim to review the efficacy and safety of percutaneous PVL closure in a consecutive series of patients referred to our center...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#18
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28642176/microsurgical-bypass-training-rat-model-part-2-anastomosis-configurations
#19
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Pooneh Mokhtari, Sirin Gandhi, Arnau Benet
BACKGROUND: Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal pre-clinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. OBJECTIVE: We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28583731/risk-factors-for-postoperative-delirium-in-patients-undergoing-vascular-surgery
#20
REVIEW
George C Galyfos, Georgios E Geropapas, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Postoperative delirium (PODE) remains a common complication after vascular surgery procedures although the exact pathogenesis remains unclear, mainly because of its multifactorial character. The aim of this systematic review was to evaluate pooled data on potential risk factors for PODE in patients undergoing vascular surgery procedures. METHODS: A systematic literature review was conducted conforming to established criteria to identify eligible articles published from 1990 to 2016...
September 2017: Journal of Vascular Surgery
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