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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/29655951/acef-score-adapted-to-st-elevation-myocardial-infarction-patients-the-acef-stemi-score
#1
Martin Reindl, Sebastian Johannes Reinstadler, Christina Tiller, Markus Kofler, Markus Theurl, Nora Klier, Katherina Fleischmann, Agnes Mayr, Benjamin Henninger, Gert Klug, Bernhard Metzler
BACKGROUND: The age, creatinine and ejection fraction (ACEF) score has originally been developed for risk stratification of patients undergoing elective cardiac surgery. In patients with stable coronary artery disease treated by percutaneous coronary intervention (PCI), the prognostic accuracy of ACEF could be further improved by modifying the original scoring system (called "modified ACEF" or "ACEF-MDRD"). We aimed to specifically adapt the ACEF score for risk assessment of ST-elevation myocardial infarction (STEMI) patients...
April 6, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#2
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#3
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29628154/-severity-of-disease-scoring-systems-and-mortality-after-non-cardiac-surgery
#4
Pedro Videira Reis, Gabriela Sousa, Ana Martins Lopes, Ana Vera Costa, Alice Santos, Fernando José Abelha
BACKGROUND: Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. METHODS: Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI)...
April 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29624524/blood-pressure-coefficient-of-variation-and-its-association-with-cardiac-surgical-outcomes
#5
Sayuri P Jinadasa, Ariel Mueller, Varesh Prasad, Kathirvel Subramaniam, Thomas Heldt, Victor Novack, Balachundhar Subramaniam
BACKGROUND: Multiple studies completed in the ambulatory nonsurgical setting show a significant association between short- and long-term blood pressure variability and poor outcomes. However, perioperative blood pressure variability outcomes have not been well studied, especially in the cardiac surgical setting. In this study, we sought to assess whether systolic and mean arterial blood pressure variability were associated with 30-day mortality and in-hospital renal failure in patients undergoing cardiac surgery requiring cardiopulmonary bypass...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29617839/outcomes-of-aortic-valve-replacement-via-partial-upper-sternotomy-versus-conventional-aortic-valve-replacement-in-obese-patients
#6
Henryk A Welp, Isabell Herlemann, Sven Martens, Heinz Deschka
OBJECTIVES: Excellent outcomes after minimally invasive aortic valve replacement (mini-AVR) have been reported. Therefore, mini-AVR has become a popular treatment option in many cardiac surgery centres. However, whether obese patients particularly benefit from mini-AVR remains unclear. The aim of the present study was to evaluate outcomes of AVR performed through partial upper sternotomy compared to AVR through a full sternotomy (full-AVR) in obese patients. METHODS: We retrospectively reviewed the medical records of all patients who underwent isolated AVR at our institution, and 217 consecutive obese [body mass index (BMI) >30 kg/m2] patients were identified...
March 30, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29617495/early-clinical-results-of-perceval-sutureless-aortic-valve-in-139-patients-freeman-experience
#7
Syed Saleem Mujtaba, Simon Ledingham, Asif Raza Shah, Stephen Clark, Thasee Pillay, Stephan Schueler
OBJECTIVE: The aim of this retrospective study is to evaluate the safety and performance of the Perceval sutureless valve in patients undergoing aortic valve replacement. We report the 30-day clinical outcomes of 139 patients. METHODS: From January 2014 to December 2016, 139 patients underwent sutureless aortic valve replacement. Their operation notes, National Adult Cardiac Surgery Database and perioperative transoesophageal echocardiography findings were studied retrospectively...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#8
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
https://www.readbyqxmd.com/read/29611320/high-fibroblast-growth-factor-23-concentrations-in-experimental-renal-failure-impair-calcium-handling-in-cardiomyocytes
#9
Melissa Verkaik, Maarten Oranje, Desiree Abdurrachim, Max Goebel, Zeineb Gam, Jeanine J Prompers, Michiel Helmes, Pieter M Ter Wee, Jolanda van der Velden, Diederik W Kuster, Marc G Vervloet, Etto C Eringa
The overwhelming majority of patients with chronic kidney disease (CKD) die prematurely before reaching end-stage renal disease, mainly due to cardiovascular causes, of which heart failure is the predominant clinical presentation. We hypothesized that CKD-induced increases of plasma FGF23 impair cardiac diastolic and systolic function. To test this, mice were subjected to 5/6 nephrectomy (5/6Nx) or were injected with FGF23 for seven consecutive days. Six weeks after surgery, plasma FGF23 was higher in 5/6Nx mice compared to sham mice (720 ± 31 vs...
April 2018: Physiological Reports
https://www.readbyqxmd.com/read/29599072/preoperative-immobility-significantly-impacts-the-risk-of-postoperative-complications-in-bariatric-surgery-patients
#10
Rana M Higgins, Melissa Helm, Jon C Gould, Tammy L Kindel
BACKGROUND: Preoperative immobility in general surgery patients has been associated with an increased risk of postoperative complications. It is unknown if immobility affects bariatric surgery outcomes. OBJECTIVES: The aim of this study was to determine the impact of immobility on 30-day postoperative bariatric surgery outcomes. SETTING: This study took place at a university hospital in the United States. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures...
March 5, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29589379/results-and-factors-associated-with-adverse-outcome-after-tricuspid-valve-replacement
#11
Paweł Litwiński, Piotr Kołsut, Tadeusz Sitko, Tomasz Zieliński, Piotr Hoffman, Tomasz Hryniewiecki, Jacek Różański, Mariusz Kuśmierczyk
BACKGROUND: This retrospective analysis of patients with severe tricuspid valve disease, who underwent tricuspid valve replacement (TVR) for either tricuspid regurgitation or stenosis, represents an attempt to determine the factors that predict poor hospital and long-term survival. METHODS: The study population consisted of 86 patients, 65 female and 21 male, who underwent TVR with or without concomitant surgical procedures between 2000 and 2010 at our institution...
March 28, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29588078/pulsed-doppler-evaluation-of-renal-perfusion-during-pulsatile-extracorporeal-circulation-a-pilot-study
#12
B Carretero de la Encarnación, E Mateo Rodríguez, C S Romero García, M A Revert Ros
INTRODUCTION: Acute renal failure (ARF) after cardiac surgery is a risk factor associated with mortality and use of resources. Some studies have reported beneficial effects of pulsatile flow on cardiopulmonary bypass (CPB) on renal function. The aim of this study is to describe the echographic morphology of the renal arterial wave modifying the parameters of pulsatile CPB. MATERIAL AND METHOD: Descriptive study was performed on 10 patients without previous AFR and undergoing cardiac surgery with CPB...
March 24, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29581218/ripheart-remote-ischemic-preconditioning-for-heart-surgery-study-myocardial-dysfunction-postoperative-neurocognitive-dysfunction-and-1-year-follow-up
#13
Patrick Meybohm, Madeline Kohlhaas, Christian Stoppe, Matthias Gruenewald, Jochen Renner, Berthold Bein, Martin Albrecht, Jochen Cremer, Mark Coburn, Gereon Schaelte, Andreas Boening, Bernd Niemann, Michael Sander, Jan Roesner, Frank Kletzin, Haitham Mutlak, Sabine Westphal, Rita Laufenberg-Feldmann, Marion Ferner, Ivo F Brandes, Martin Bauer, Sebastian N Stehr, Andreas Kortgen, Maria Wittmann, Georg Baumgarten, Tanja Meyer-Treschan, Peter Kienbaum, Matthias Heringlake, Julika Schoen, Sascha Treskatsch, Thorsten Smul, Ewa Wolwender, Thomas Schilling, Georg Fuernau, Holger Bogatsch, Oana Brosteanu, Dirk Hasenclever, Kai Zacharowski
BACKGROUND: Remote ischemic preconditioning (RIPC) has been suggested to protect against certain forms of organ injury after cardiac surgery. Previously, we reported the main results of RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study, a multicenter trial randomizing 1403 cardiac surgery patients receiving either RIPC or sham-RIPC. METHODS AND RESULTS: In this follow-up paper, we present 1-year follow-up of the composite primary end point and its individual components (all-cause mortality, myocardial infarction, stroke and acute renal failure), in a sub-group of patients, intraoperative myocardial dysfunction assessed by transesophageal echocardiography and the incidence of postoperative neurocognitive dysfunction 5 to 7 days and 3 months after surgery...
March 26, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29580777/quality-of-life-after-cardiac-surgery-based-on-the-minimal-clinically-important-difference-concept
#14
Nathalie Grand, Jean Baptiste Bouchet, Paul Zufferey, Anne Marie Beraud, Sahar Awad, Fabricio Sandri, Salvator Campisi, Jean François Fuzellier, Serge Molliex, Marco Vola, Jerome Morel
BACKGROUND: Health-related quality of life (HRQOL) is an increasingly important issue in assessing the consequences of any surgical or medical intervention. Our study aimed to evaluate change in HRQOL 6 months after elective cardiac surgery and to identify specific predictors of poor HRQOL. METHODS: In this prospective, single-center study, HRQOL was evaluated before and 6 months after surgery using the SF-36 questionnaire and its two components: the physical component summary (PCS) and the mental component summary (MCS)...
March 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29577925/the-society-of-thoracic-surgeons-2018-adult-cardiac-surgery-risk-models-part-1-background-design-considerations-and-model-development
#15
David M Shahian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Liqi Feng, Xia He, Sean M O'Brien
BACKGROUND: The last published version of the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) risk models were developed in 2008 based on patient data from 2002 to 2006 and have been periodically recalibrated. In response to evolving changes in patient characteristics, risk profiles, surgical practice, and outcomes, STS has now developed a set of entirely new risk models for adult cardiac surgery. METHODS: New models were estimated for isolated coronary artery bypass grafting surgery (CABG, n = 439,092), isolated aortic or mitral valve surgery (n = 150,150), and combined valve + CABG (n = 81,588) procedures...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29577924/the-society-of-thoracic-surgeons-2018-adult-cardiac-surgery-risk-models-part-2-statistical-methods-and-results
#16
Sean M O'Brien, Liqi Feng, Xia He, Ying Xian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Fred H Edwards, David M Shahian
BACKGROUND: The Society of Thoracic Surgeons (STS) uses statistical models to create risk-adjusted performance metrics for Adult Cardiac Surgery Database (ACSD) participants. Because of temporal changes in patient characteristics and outcomes, evolution of surgical practice, and additional risk factors available in recent ACSD versions, completely new risk models have been developed. METHODS: Using July 2011 to June 2014 ACSD data, risk models were developed for operative mortality, stroke, renal failure, prolonged ventilation, mediastinitis /deep sternal wound infection (DSWI), reoperation, major morbidity or mortality composite, and prolonged postoperative length of stay (PLOS) or short PLOS among patients who underwent isolated coronary artery bypass grafting (CABG; n = 439,092), aortic or mitral valve surgery (n = 150,150), or combined valve + CABG (n = 81,588)...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29576786/malignant-hyperthermia-report-of-two-cases-with-a-neglected-complication-in-cardiac-surgery
#17
Mahdi Neshati, Manizheh Azadeh, Parinaz Neshati, Tyrone Burnett, Ryan Saenz, Bahman Karbasi, Ghader Shahmohammadi, Eskandar Nourizadeh, Mohsen Rostamzadeh
Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery. We herein report 2 cases of MH, graded as "very likely" or "almost certain" based on the MH clinical grading scale...
October 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29576405/a-propensity-matched-comparison-of-fenestrated-endovascular-aneurysm-repair-and-open-surgical-repair-of-pararenal-and-paravisceral-aortic-aneurysms
#18
Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
OBJECTIVE: This study investigated the outcomes of a current series of patients treated with fenestrated and branched endovascular aneurysm repair (F-BEVAR) or open surgical repair (OSR) for pararenal abdominal aortic aneurysms (pr-AAAs), including juxtarenal, suprarenal, and type IV thoracoabdominal aneurysms. This study compares the outcomes of these procedures from two high-volume centers without the bias induced by a learning curve. METHODS: All patients with pr-AAAs undergoing repair at two centers between January 2010 and June 2016 were included in a prospective database...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#19
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29566140/conventional-aortic-valve-replacement-in-2005-elderly-patients-a-32-year-experience
#20
Thierry Langanay, Simon Rouzé, Jacques Tomasi, Marie Aymami, Syed M Rehman, Amedeo Anselmi, Hervé Corbineau, Erwan Flécher, Yves Logeais, Alain Leguerrier, Jean-Philippe Verhoye
OBJECTIVES: Considering the good immediate results reported for transcatheter aortic valve implantation in high-risk patients, the role of conventional aortic valve replacement (AVR) is being questioned, especially in elderly patients. The aim of this study was to evaluate our long-term results of conventional AVR in octogenarians. METHODS: A total of 2005 patients aged ≥80 years underwent AVR for aortic stenosis in our institution between 1978 and 2011. Of these, 1009 (50%) patients had an associated extracardiac comorbidity and 650 (32%) patients had coronary lesions...
March 16, 2018: European Journal of Cardio-thoracic Surgery
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