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Post operative morbidity myocardial infarction

Philipp Kolat, Patricia Guttenberger, Michael Ried, Julia Kapahnke, Assad Haneya, Christof Schmid, Claudius Diez
BACKGROUND:  Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. MATERIAL AND METHODS:  Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU...
May 1, 2018: Thoracic and Cardiovascular Surgeon
Derrick O Acheampong, Philip Paul, Shanice Guerrier, Percy Boateng, I Michael Leitman
OBJECTIVE: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012...
April 27, 2018: Journal of Surgical Education
Márcio Madeira, Sara Ranchordás, Paulo Oliveira, Tiago Nolasco, Marta Marques, Luis Bruges, José Calquinha, Miguel Sousa Uva, Miguel Abecasis, José Pedro Neves
INTRODUCTION: Left heart disease is the most common cause of pulmonary hypertension (PH), and when present is associated with higher surgical risk. OBJECTIVES: Analyze the effect of PH severity on morbidity, early and late mortality in patients with pulmonary artery systolic pressure (PASP) over 30mmHg that underwent valvular heart surgery. METHODS: Retrospective observational study including all patients with PH, defined as PASP>30 mmHg that underwent isolated valvular heart surgery, between 2007 and 2016...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Sungho Lim, Michael J Javorski, Pegge M Halandras, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: Through-knee amputation (TKA) is a rare amputation performed in <2% of all major lower extremity amputations in the United States. Despite biomechanical benefits and improved rehabilitation compared with above-knee amputation (AKA), TKA has largely been abandoned by vascular surgeons because of concerns for poor wound healing. The purpose of this study was to evaluate surgical outcomes of TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012 was queried using Current Procedural Terminology codes indicating AKA and TKA...
March 19, 2018: Journal of Vascular Surgery
Narjeet S Khurmi, Yu-Hui Chang, D Eric Steidley, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Amit K Mathur
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of post-liver transplant death, and variable care patterns may affect outcomes. We aimed to describe epidemiology and outcomes of inpatient CVD care across U.S. hospitals. METHODS: Using a merged dataset from the 2002-2011 Nationwide Inpatient Sample and the American Hospital Association Annual Survey, we evaluated liver transplant patients admitted primarily with myocardial infarction (MI), stroke (CVA), congestive heart failure (CHF), dysrhythmias, cardiac arrest (CA), or malignant hypertension...
March 15, 2018: Liver Transplantation
Elsa Limura, Pasquale Giordano
AIM: To present our single institution and surgeon's complex abdominal wall reconstructions (CAWR) experience with Permacol™ mesh through a non-randomized study. PATIENTS AND METHOD: Data of 51 consecutive patients were prospectively collected between 2003 and 2015. Patients had a median of 3 comorbidities (range 0-10) and 68% were Center for Disease Control class II-IV. The mean previous repair was 1.3 (range, 0-12), and 25 (44%) had a mesh in situ. The median defect size was 625 cm2 ...
October 2017: World Journal of Surgery
Hannah Cheng, Reshmi Udesh, Amol Mehta, Parthasarathy D Thirumala
STUDY OBJECTIVE: To examine the risk of perioperative stroke on in-hospital morbidity and mortality in staged coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) procedures. DESIGN: The National Inpatient Sample (NIS) database was used to extract data on all patients who underwent staged CABG CEA procedures. They were identified using the ICD-9 (International Classification of Diseases, Ninth Revision-Clinical Modification) diagnosis and procedure codes...
June 2017: Journal of Clinical Anesthesia
Ghulam Hussain, Mirza Ahmad Raza Baig, Abdul Ghaffar, Sara Zaheer, Hafiz Muhammad Azam Raheel, Sehrish Khalid
OBJECTIVE: To assess the impact of body mass index on early outcomes of coronary artery bypass grafting in terms of morbidity and mortality. METHODS: This retrospective comparative study was conducted at Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan, and comprised data of patients who underwent isolated coronary artery bypass grafting from December 2007 to December 2015. Analysis of variance and chi-square test were used for analysis of groups formed on the basis of body mass index...
April 2017: JPMA. the Journal of the Pakistan Medical Association
Tristen T Chun, Manuel Garcia-Toca, James F Eng, Jeffrey Slaiby, Edward J Marcaccio, William G Cioffi, Daithi S Heffernan
BACKGROUND: Despite advances in perioperative care, the rate of cardiac events in vascular patients remains high. We have previously shown that infections in trauma patients are associated with higher rates of subsequent cardiac complications, likely due to the additive effect of a second hit of an infection following the trauma. The aim of this study was to investigate whether there is an association between postoperative infections and subsequent cardiac events in vascular patients...
May 2017: Annals of Vascular Surgery
Hassan Al-Thani, Ayman El-Menyar, Noora Al-Thani, Mohammad Asim, Ahmed Hussein, Ahmed Sadek, Ahmed Sharaf, Amr Fares
BACKGROUND: To investigate the clinical characteristics, surgical interventions, and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications, and outcomes were analyzed...
May 2017: Annals of Vascular Surgery
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
March 2017: Journal of Surgical Oncology
Kirsten S Evonuk, Sumanth D Prabhu, Martin E Young, Tara M DeSilva
The incidence of cognitive impairment in cardiovascular disease (CVD) patients has increased, adversely impacting quality of life and imposing a significant economic burden. Brain imaging of CVD patients has detected changes in the hippocampus, a brain region critical for normal learning and memory. However, it is not clear whether adverse cardiac events or other associated co-morbidities impair cognition. Here, using a murine model of acute myocardial ischemia/reperfusion (I/R), where the coronary artery was occluded for 30min followed by reperfusion, we tested the hypothesis that acute myocardial infarction triggers impairment in cognitive function...
March 2017: Brain, Behavior, and Immunity
Barnaby C Reeves, Katie Pike, Chris A Rogers, Rachel Cm Brierley, Elizabeth A Stokes, Sarah Wordsworth, Rachel L Nash, Alice Miles, Andrew D Mumford, Alan Cohen, Gianni D Angelini, Gavin J Murphy
BACKGROUND: Uncertainty about optimal red blood cell transfusion thresholds in cardiac surgery is reflected in widely varying transfusion rates between surgeons and cardiac centres. OBJECTIVE: To test the hypothesis that a restrictive compared with a liberal threshold for red blood cell transfusion after cardiac surgery reduces post-operative morbidity and health-care costs. DESIGN: Multicentre, parallel randomised controlled trial and within-trial cost-utility analysis from a UK NHS and Personal Social Services perspective...
August 2016: Health Technology Assessment: HTA
Metesh Acharya, Leanne Harling, Marco Moscarelli, Hutan Ashrafian, Thanos Athanasiou, Roberto Casula
BACKGROUND: Minimal-access aortic valve replacement (MAAVR) may reduce post-operative blood loss and transfusion requirements, decrease post-operative pain, shorten length stay and enhance cosmesis. This may be particularly advantageous in overweight/obese patients, who are at increased risk of post-operative complications. Obese patients are however often denied MAAVR due to the perceived technical procedural difficulty. This retrospective analysis sought to determine the effect of BMI on post-operative outcomes in patients undergoing MAAVR...
April 27, 2016: Journal of Cardiothoracic Surgery
Nikita Lakomkin, Vasanth Sathiyakumar, Ashley C Dodd, A Alex Jahangir, Paul S Whiting, William T Obremskey, Manish K Sethi
PURPOSE: As US healthcare expenditures continue to rise, there is significant pressure to reduce the cost of inpatient medical services. Studies have estimated that over 70% of routine labs may not yield clinical benefits while adding over $300 in costs per day for every inpatient. Although orthopaedic trauma patients tend to have longer inpatient stays and hip fractures have been associated with significant morbidity, there is a dearth of data examining pre-operative labs in predicting post-operative adverse events in these populations...
June 2016: Injury
Sharven Taghavi, Vishnu Ambur, Senthil Jayarajan, John Gaughan, Yoshiya Toyoda, Elizabeth Dauer, Lars Ola Sjoholm, Abhijit Pathak, Thomas Santora, Amy J Goldberg
INTRODUCTION: Lung transplant patients require a high degree of immunosuppression, which can impair wound healing when surgical procedures are required. We hypothesized that because of impaired healing, lung transplant patients requiring gastrostomy tubes would have better outcomes with open gastrostomy tube (OGT) as compared to percutaneous endoscopic gastrostomy tube (PEG). METHODS: The National Inpatient Sample (NIS) Database (2005-2010) was queried for all lung transplant recipients requiring OGT or PEG...
February 2016: Annals of Medicine and Surgery
J Nagendran, M D Moore, C M Norris, A Khani-Hanjani, M M Graham, D H Freed, J Nagendran
The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m(-)(2)). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI: <20, 20-24.9, 25-29.9, 30-<34.9 and ⩾35). Patient characteristics were analyzed by analysis of variance and χ(2) analyses...
April 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
A Velescu, A Clará, M Cladellas, J Peñafiel, E Mateos, S Ibañez, M Mellado
OBJECTIVES: Pre-operative anemia has been associated with increased post-operative morbidity and mortality in elective cardiac surgery, but its association with post-operative mortality after open or endovascular surgery for critical limb ischemia (CLI) is not well established. The aim of this study was to evaluate the relationship between pre-operative anemia and mortality in surgery for CLI. MATERIALS AND METHODS: A retrospective study of 403 consecutive patients (mean age = 73; 73% male) undergoing open (n = 191, 47%) or endovascular (n = 212, 53%) surgery for CLI between 2005 and 2013 was performed...
April 2016: European Journal of Vascular and Endovascular Surgery
Mohammed Ashrafi, Stephen Ball, Abid Ali, Iraj Zeynali, Vittorio Perricone
INTRODUCTION: Stroke remains a major cause of morbidity and mortality after cardiac surgery affecting 2% of patients. Extra-cranial carotid artery disease has been implicated in the aetiology of post cardiac surgery stroke. The aim of the study was to evaluate and compare the morbidity and mortality in patients undergoing cardiac surgery with or without staged carotid endarterectomy (CEA) in a tertiary referral centre. METHODS: A 5 year retrospective study was performed...
February 2016: International Journal of Surgery
Marc Najjar, Isaac George, Hirokazu Akashi, Takashi Nishimura, Halit Yerebakan, Linda Mongero, James Beck, Stephen C Hill, Hiroo Takayama, Mathew R Williams
BACKGROUND: Del Nido (DN) cardioplegia, a calcium-free, hyperkalemic solution containing lidocaine and magnesium has been developed to help reduce intracellular calcium influx and the resulting myocyte damage in the immediate postischemic period following cardiac arrest. DN cardioplegia has been used for pediatric cardiac surgery but its use in complex reoperative surgery has not been studied. We specifically report the outcomes of patients undergoing reoperative cardiac surgery after previous coronary artery bypass grafting with a patent internal mammary artery (IMA)...
November 26, 2015: Journal of Cardiothoracic Surgery
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