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Bypass surgery

K Karkouti, P Yip, C Chan, L Chawla, V Rao
Acute kidney after cardiac surgery is more common in anaemic patients, whereas haemolysis during cardiopulmonary bypass may lead to iron-induced renal injury. Hepcidin promotes iron sequestration by macrophages: hepcidin concentration is reduced by anaemia and increased by inflammation. We analysed the associations in 525 patients between pre-operative anaemia (haemoglobin < 130 g.l-1 in men and < 120 g.l-1 in women), intra-operative hepcidin concentration and acute kidney injury (dialysis or > 26...
March 12, 2018: Anaesthesia
Katja M Gist, David S Cooper, Julia Wrona, Sarah Faubel, Christopher Altmann, Zhiqian Gao, Bradley S Marino, Jeffrey Alten, Kristal M Hock, Tomoyuki Mizuno, Alexander A Vinks, Melanie S Joy, Michael F Wempe, Michael R Bennett, Stuart L Goldstein
BACKGROUND: Milrinone, an inotropic agent used ubiquitously in children after cardiac surgery, accumulates in acute kidney injury (AKI). We assessed if urinary AKI biomarkers are predictive of an increase in milrinone concentrations in infants after cardiac surgery. METHODS: Multicenter prospective pilot study of infants undergoing cardiac surgery. Urinary AKI biomarkers were measured in the urine at specific time intervals after cardiopulmonary bypass initiation...
April 2018: Therapeutic Drug Monitoring
(no author information available yet)
[This corrects the article DOI: 10.4103/jmas.JMAS_148_16].
April 2018: Journal of Minimal Access Surgery
M Gasser, M H Frank, A M Waaga-Gasser
Critical chronic ischemia in patients with underlying arterial occlusive disease requires vascular reconstructive surgery. The limited supply of suitable small-diameter autologous vascular grafts in many patients and obvious disadvantages of synthetic bypass material demand the development of clinically usable tissue-engineered blood vessel substitutes. Despite substantial progress in the field over the last two decades, their implementation into the clinical routine has been challenging. The limited replicative life span of human adult vascular cells and their slow rate of collagenous matrix production in vitro have posed important problems in the development of mechanically robust and biologically functional engineered grafts...
February 2018: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
Jung-Chien Chen, Nan-Yung Hsu, Wei-Jei Lee, Shu-Chun Chen, Kong-Han Ser, Yi-Chih Lee
BACKGROUND: Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated. OBJECTIVE: To validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Jared P Beller, Robert B Hawkins, J Hunter Mehaffey, Damien J LaPar, Irving L Kron, Leora T Yarboro, Gorav Ailawadi, Ravi K Ghanta
BACKGROUND: As a marker of myocardial injury, troponin level correlates with adverse outcomes following myocardial infarction (MI). We hypothesized that patients with higher preoperative troponin level would have increased morbidity and mortality following CABG. METHODS: A total of 1,272 patients underwent urgent or emergent, isolated CABG and had preoperative troponin measurements at our institution (2002-2016). Logistic regression assessed the risk-adjusted impact of peak troponin level on morbidity and mortality...
March 8, 2018: Annals of Thoracic Surgery
Jaime Ruiz-Tovar, Juan González, Alejandro García, Dennis Cesar Levano-Linares, Manuel Durán
No abstract text is available yet for this article.
March 8, 2018: Cirugía Española
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Luciana Teixeira de Siqueira, Marcela Silvestre Outtes Wanderley, Roberto Afonso da Silva, Adriana da Silva Andrade Pereira, José Luiz de Lima Filho, Álvaro Antônio Bandeira Ferraz
BACKGROUND: Obesity has been associated with the development of various types of cancer. Biomarker studies may provide molecular level knowledge of the factors involved in this association, improving clinical practice through new methods of prevention and treatment. PURPOSE: The present study aimed to analyze proteins found in the plasma of obese patients prior to and 6 months after bariatric surgery, using body mass index (BMI) and percentage total weight loss (%TWL) to evaluate, in a prospective manner, the effects of weight loss on the regulation of proteins related to the appearance of tumors...
March 10, 2018: Obesity Surgery
Uri Kaplan, Scott Penner, Forough Farrokhyar, Nicole Andruszkiewicz, Ruth Breau, Scott Gmora, Dennis Hong, Mehran Anvari
PURPOSE: Older age (> 60) has been considered a relative contraindication for bariatric surgery due to increased complication risk. This study examined the risks and benefits of bariatric surgery for patients older than 60 years in Canadian population. METHODS: This was a retrospective cohort study of the Ontario Bariatric Registry: a database recording peri-operative and post-operative outcomes of publicly funded bariatric surgeries across the province. Patients who completed 1 year follow-up, who underwent laparoscopic gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between January 2010 and May 2013, were divided into older (> 60) and younger (> 60) cohorts, and outcomes were compared...
March 10, 2018: Obesity Surgery
Otavio Berwanger, Eliana Vieira Santucci, Pedro Gabriel Melo de Barros E Silva, Isabella de Andrade Jesuíno, Lucas Petri Damiani, Lilian Mazza Barbosa, Renato Hideo Nakagawa Santos, Ligia Nasi Laranjeira, Flávia de Mattos Egydio, Juliana Aparecida Borges de Oliveira, Frederico Toledo Campo Dall Orto, Pedro Beraldo de Andrade, Igor Ribeiro de Castro Bienert, Carlos Eduardo Bosso, José Armando Mangione, Carisi Anne Polanczyk, Amanda Guerra de Moraes Rego Sousa, Renato Abdala Karam Kalil, Luciano de Moura Santos, Andrei Carvalho Sposito, Rafael Luiz Rech, Antônio Carlos Sobral Sousa, Felipe Baldissera, Bruno Ramos Nascimento, Roberto Rocha Corrêa Veiga Giraldez, Alexandre Biasi Cavalcanti, Sabrina Bernardez Pereira, Luiz Alberto Mattos, Luciana Vidal Armaganijan, Hélio Penna Guimarães, José Eduardo Moraes Rego Sousa, John Hunter Alexander, Christopher Bull Granger, Renato Delascio Lopes
Importance: The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain. Objective: To determine if periprocedural loading doses of atorvastatin decrease 30-day major adverse cardiovascular events (MACE) in patients with ACS and planned invasive management. Design, Setting, and Participants: Multicenter, double-blind, placebo-controlled, randomized clinical trial conducted at 53 sites in Brazil among 4191 patients with ACS evaluated with coronary angiography to proceed with a percutaneous coronary intervention (PCI) if anatomically feasible...
March 11, 2018: JAMA: the Journal of the American Medical Association
Julie D Lankiewicz, Tess Wong, Marilyn Moucharite
Surgical site infection incidence following coronary artery bypass graft surgery was observed across 27,296 procedures within a Medicare population. A facility-level case-control claims analysis demonstrated a significant 25% reduction (P = .04) in suspected surgical site infection at 90 days after coronary artery bypass graft surgery at facilities utilizing a single-patient-use electrocardiography cable and lead wire system.
March 7, 2018: American Journal of Infection Control
H Mason Hedberg, Alexander Trenk, Michael B Ujiki
BACKGROUND: Weight regain after Roux-en-Y gastric bypass affects up to 30% of individuals. A dilated gastrojejunostomy contributes to regain through decreased restriction. Endoscopic gastrojejunostomy revision is a safe alternative to revisional surgery. There is evidence that technique affects outcome, but the mechanical properties of various sutured repairs have not been evaluated. OBJECTIVE: To compare different suture patterns for endoscopic gastrojejunostomy revision using an ex vivo porcine model...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Andrew Schneider, Deborah A Hutcheon, Allyson Hale, Joseph A Ewing, Megan Miller, John D Scott
BACKGROUND: Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. OBJECTIVE: To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. SETTING: Regional referral center and teaching hospital...
February 2, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Paul S Pagel, Lonnie Dye, Brent T Boettcher, Julie K Freed
OBJECTIVE: Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Bryan D Hinck, Ricardo Miyaoka, James E Lingeman, Dean G Assimos, Brian R Matlaga, Rocky Pramanik, John Asplin, Benjamin Cohen, Manoj Monga
INTRODUCTION: To determine if markers of kidney injury correlate with urinary oxalate excretion. If so, such biomarkers might be early predictors of oxalate nephropathy. Gastric bypass surgery for obesity is known to be associated with postoperative hyperoxaluria, which can lead to urolithiasis and kidney damage. MATERIALS AND METHODS: Patients were recruited from four large academic centers > 6 months following completion of gastric bypass surgery. Patients provided a spot urine sample for analysis of three markers of kidney injury: 8-iso-Prostaglandin F2 α, N-acetyl- β -D-Glucosaminidase, and Neutrophil gelatinase-associated lipocalin...
February 2018: Canadian Journal of Urology
Renana Robinson, Jean Marc Weinstein, Carlos Cafri, Avital Avriel
Post-operative pulmonary complications in coronary artery bypass grafting (CABG) surgery are mostly reversible. We report a patient who developed pulmonary arterial hypertension (PAH) post-CABG and did not have pulmonary hypertension prior to surgery. PAH Group 1 was diagnosed after right and left heart catheterization. To the best of our knowledge, this is the only reported case of a patient developing PAH post-CABG surgery. This could be explained by immunological and/or haemostatic changes triggered by cardiopulmonary bypass...
March 10, 2018: ESC Heart Failure
Gianfranco Donatelli, Ludovica Guerriero, Fabrizio Cereatti, Kostantinos Arapis, Carmelisa Dammaro, Jean-Loup Dumont, David Fuks, Silvana Perretta
INTRODUCTION: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula. MATERIAL AND METHODS: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula...
March 9, 2018: Obesity Surgery
Zubaidah Nor Hanipah, Suriya Punchai, Stacy A Brethauer, Philip R Schauer, Ali Aminian
INTRODUCTION: While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution. METHODS: Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6...
March 9, 2018: Obesity Surgery
Hannu Kokki, Martin Maaroos, Sten Ellam, Jari Halonen, Ilkka Ojanperä, Merja Ranta, Veli-Pekka Ranta, Aleksandra Tolonen, Oscar Lindberg, Matias Viitala, Juha Hartikainen
PURPOSE: Cardiac surgery and conventional extracorporeal circulation (CECC) impair the bioavailability of drugs administered by mouth. It is not known whether miniaturized ECC (MECC) or off-pump surgery (OPCAB) affect the bioavailability in similar manner. We evaluated the metoprolol bioavailability in patients undergoing CABG surgery with CECC, MECC, or having OPCAB. METHODS: Thirty patients, ten in each group, aged 44-79 years, scheduled for CABG surgery were administered 50 mg metoprolol by mouth on the preoperative day at 8-10 a...
March 9, 2018: European Journal of Clinical Pharmacology
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