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hepatitis C cardiac surgery

Maurizio Domanin, Giovanni Romagnoni
No abstract text is available yet for this article.
April 14, 2016: Thoracic and Cardiovascular Surgeon
Maude Gagné-Loranger, Louis Lacombe, Frédéric Pouliot, Vincent Fradet, François Dagenais
OBJECTIVES: The natural history of renal cell carcinoma (RCC) with tumour thrombus extending at or above the hepatic veins is dismal. Different surgical approaches have been described including cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest. We here report our experience in terms of surgical techniques and outcomes on 41 consecutive patients presenting an RCC extending to the hepatic veins or the right atrium. A surgical decision-making algorithm is discussed. METHODS: Retrospective review of 41 patients operated for RCC extending in the retrohepatic vena cava (extent level III-IV) between 2000 and 2015...
August 2016: European Journal of Cardio-thoracic Surgery
Jun Sasaki, John C Dykes, Lisa J Sosa, Jane L Salvaggio, Milagros D Tablante, Jorge Ojito, Danyal M Khan, Robert L Hannan, Anthony F Rossi, Redmond P Burke, Gil Wernovsky
OBJECTIVES: Children with functional single ventricle undergoing the Fontan operation consume considerable resources. The purpose of this study is to evaluate pre- and intraoperative risk factors for longer hospital stay and to describe the perioperative course at a single institution over a 15-year period. DESIGN: Retrospective cohort study. SETTING: A single pediatric cardiac ICU. PATIENTS: All consecutive patients undergoing a first-time Fontan operation from 2000 to 2014...
May 2016: Pediatric Critical Care Medicine
Z-C Liu, X-F Lu, H Yang, H-D Liu, X Song, S-L Ning, Y-F Xu, Y-X Chen
OBJECTIVE/BACKGROUND: To evaluate the effectiveness of double banding/ligation of hepatic arteries in treating patients with hepatic hereditary hemorrhagic telangiectasia (HHHT). METHODS: From January 2004 to December 2013, 35 patients were diagnosed with HHHT, among whom 11 woman and two men with a mean ± SD age of 44 ± 9 years were treated by double hepatic artery banding/ligation for cardiac insufficiency and/or portal hypertension. The outcomes were evaluated prospectively by measuring clinical manifestations, imaging features, liver and cardiac function, pulmonary arterial systolic pressure, and post-operative complications...
April 2016: European Journal of Vascular and Endovascular Surgery
Oda Bratland Østerdal, Pirjo-Riitta Salminen, Stina Jordal, Haakon Sjursen, Øystein Wendelbo, Rune Haaverstad
OBJECTIVES: Intravenous drug users have a high risk of infective endocarditis and reduced survival. Cardiac surgery may be recommended for these patients, but redo surgery is controversial. This study describes the characteristics and outcomes of intravenous drug users accepted for surgery during a 12-year period. METHODS: This retrospective study included 29 injecting drug users treated with valve surgery for endocarditis between January 2001 and December 2013 at a tertiary academic centre...
May 2016: Interactive Cardiovascular and Thoracic Surgery
Thomas R Ziegler, Addison K May, Gautam Hebbar, Kirk A Easley, Daniel P Griffith, Nisha Dave, Bryan R Collier, George A Cotsonis, Li Hao, Traci Leong, Amita K Manatunga, Eli S Rosenberg, Dean P Jones, Gregory S Martin, Gordon L Jensen, Harry C Sax, Kenneth A Kudsk, John R Galloway, Henry M Blumberg, Mary E Evans, Paul E Wischmeyer
OBJECTIVE: To determine whether glutamine (GLN)-supplemented parenteral nutrition (PN) improves clinical outcomes in surgical intensive care unit (SICU) patients. SUMMARY BACKGROUND DATA: GLN requirements may increase with critical illness. GLN-supplemented PN may improve clinical outcomes in SICU patients. METHODS: A parallel-group, multicenter, double-blind, randomized, controlled clinical trial in 150 adults after gastrointestinal, vascular, or cardiac surgery requiring PN and SICU care...
April 2016: Annals of Surgery
Maria Restrepo, A Colleen Crouch, Christopher M Haggerty, Jarek Rossignac, Timothy C Slesnick, Kirk R Kanter, Ajit P Yoganathan
BACKGROUND: A Fontan Y-shaped graft using a commercially available aortoiliac graft has been used to connect the inferior vena cava (IVC) to the pulmonary arteries. This modification of the Fontan procedure seeks to improve hepatic flow distribution (HFD) to the lungs. However, patient-specific anatomical restrictions might limit the space available for graft placement. Altering the superior vena cava (SVC) positioning is hypothesized to provide more space for an optimal connection, avoiding caval flow collision...
January 2016: Annals of Thoracic Surgery
Wouter G Morshuis, Robert A F de Lind van Wijngaarden, Charles Kik, Ad J J C Bogers
In a 76-year-old female undergoing coronary artery bypass surgery, a persistent left hepatic vein was observed. Draining of this vein into the coronary sinus is an extremely rare embryological malformation and this is the first case to be reported as a solitary malformation in absence of other cardiac malformations.
November 2015: Journal of Cardiac Surgery
W C Hsieh, P C Chen, G George, G Tinica, F-C Corciova
OBJECTIVE: Current cardiac risk assessments such as EuroSCORE II and the STS-Score do not take liver dysfunction into account. The purpose of this study was to evaluate the prevalence and post-operative morbidity risk factors following cardiac surgery of patients with chronic viral hepatitis. PATIENTS AND METHODS: The study group consisted of 105 patients with documented chronic viral hepatitis who were subject to elective cardiac surgery from 2001 to 2012. Subjects were evaluated for pre-operative liver dysfunction according to the MELD score...
2015: European Review for Medical and Pharmacological Sciences
Laura Sophie Gansera, Edgar Eszlari, Oliver Deutsch, Walter Benno Eichinger, Brigitte Gansera
OBJECTIVES: To discuss the dilemma of adequate decision making in patients with intravenous drug abuse and recurrent valve prosthesis infections or in patients with positive HIV or hepatitis C status. Ethical, social, and economic considerations, not only in terms of technical feasibility but also in terms of unpromising results and aspects of resources, are discussed. Thoughts are presented about the legitimation of cardiac surgery centers refusing to perform surgery in high-risk patients with HIV or hepatitis C infections...
January 2016: Thoracic and Cardiovascular Surgeon
Matthew C L Keith, Xian-Liang Tang, Yukichi Tokita, Qian-Hong Li, Shahab Ghafghazi, Joseph Moore Iv, Kyung U Hong, Brandon Elmore, Alok Amraotkar, Brian L Ganzel, Kendra J Grubb, Michael P Flaherty, Gregory Hunt, Bathri Vajravelu, Marcin Wysoczynski, Roberto Bolli
BACKGROUND: There is mounting interest in using c-kit positive human cardiac stem cells (c-kit(pos) hCSCs) to repair infarcted myocardium in patients with ischemic cardiomyopathy. A recent phase I clinical trial (SCIPIO) has shown that intracoronary infusion of 1 million hCSCs is safe. Higher doses of CSCs may provide superior reparative ability; however, it is unknown if doses >1 million cells are safe. To address this issue, we examined the effects of 20 million hCSCs in pigs. METHODS: Right atrial appendage samples were obtained from patients undergoing cardiac surgery...
2015: PloS One
Monica M Dua, Jordan M Cloyd, Francois Haddad, Ramin E Beygui, Jeffrey A Norton, Brendan C Visser
INTRODUCTION: Primary hepatic sarcomas are uncommon malignant neoplasms; prognostic features, natural history, and optimal management of these tumors are not well characterized. PRESENTATION OF CASE: This report describes the management of a 51-year-old patient that underwent a right trisectionectomy for a large hepatic mass found to be a liver sarcoma on pathology. He subsequently developed tumor emboli to his lungs and was discovered to have cardiac intracavitary metastases from his primary tumor...
2014: International Journal of Surgery Case Reports
Yong Chiat Wong, Yi Yang Lai, Mui Hong Tan, Chuen Seng Tan, Jian Wu, Lewis Zheng Jie Zeng, Jia Lu, Shabbir Moochhala
Traumatic injury remains a major cause of morbidity and mortality worldwide, and patients who survived the initial insult are susceptible to an overwhelming inflammatory dysfunction that will lead to acute coagulopathy of trauma (ACOT) and subsequently multiple organ dysfunction syndrome (MODS). Multiple organ dysfunction syndrome-related scoring systems, although they measure organ dysfunction, present clinical markers, and single-cytokine estimates are unable to predict accurately the events of MODS in the clinical setting to aid risk stratification...
February 2015: Shock
Daniel A Cox, Salil Ginde, James S Tweddell, Michael G Earing
BACKGROUND: Symptoms associated with hepatitis C infection often do not develop until an advanced stage of liver disease. Prior to 1992, reliable testing for hepatitis C was unavailable, resulting in potential patient exposure during cardiopulmonary bypass. As the hepatitis C prevalence in our center was unknown, a screening protocol for patients who underwent surgery prior to 1992 was developed. METHODS: Patients evaluated in the Wisconsin Adult Congenital Heart Disease program who underwent surgery prior to 1992 were screened for hepatitis C as part of their initial clinical evaluation...
October 2014: World Journal for Pediatric & Congenital Heart Surgery
Dominic Emerson, Kendal Endicott, Richard Amdur, Gregory Trachiotis
BACKGROUND: Approximately 2-4 million individuals are chronically infected with hepatitis C (HCV) in the United States. Though several studies have previously examined short and mid-term outcomes for patients with cirrhosis requiring cardiac surgery, no study to date has examined the long-term outcomes of individuals chronically infected with HCV. METHODS: A retrospective review of 75 patients with HCV and/or HIV infection who underwent cardiac surgery between 1999 and 2011 was undertaken...
August 2016: Journal of Cardiovascular Surgery
Marcos Coutinho Schechter, Eduardo Della Valle Prezzi, Gustavo Cabral, Eduardo Souza Martins Fernandes, Arthur Oswaldo de Abreu Vianna
Pulmonary artery catheter is frequently used to monitor patients during liver transplantation. Recently developed less invasive methods for estimating cardiac output and pulmonary capillary wedge pressure together with the failure of randomized studies to demonstrate reduced mortality in pulmonary artery catheter-monitored patients, has restricted its applicability. Pulmonary artery rupture by pulmonary artery catheter is a rare, but dangerous complication. The purpose of this report is to describe a pulmonary artery rupture caused by monitorization with a pulmonary artery catheter, reviewing the clinical approach and discussing hemodynamic monitoring with the pulmonary artery catheter during liver transplantation...
June 2009: Revista Brasileira de Terapia Intensiva
Ioannis Dimarakis, Stuart Grant, Rebecca Corless, Theodore Velissaris, Martin Prince, Ben Bridgewater, George Asimakopoulos
Increasing prevalence of hepatic disease is likely to translate in a growing number of patients with significant hepatic disease requiring cardiac surgery. Available cardiac risk stratification models do not address the risk associated with hepatic disease. However, weighted mean mortality rates based on previous studies of cardiac surgery in patients with hepatic disease demonstrate operative mortality rates that range from 9.88% (standard deviation [SD] 9.69) for patients in Child-Turcotte-Pugh (CTP) class A cirrhosis to 69...
February 2015: Thoracic and Cardiovascular Surgeon
S B Han, M S Gwak, S J Choi, J S Ko, G S Kim, H J Son, J C Shin
BACKGROUND: Hypothermia (core temperature <35°C) causes multiple physiologic disturbances, including coagulopathy and cardiac dysfunction. Patients undergoing liver transplantation are at risk of inadvertent hypothermia and might be more vulnerable to its adverse effects. We sought to identify the factors contributing to hypothermia during living-donor liver transplantation (LDLT), which have not yet been studied in depth. METHODS: Medical records of 134 recipients who underwent adult-to-adult LDLT were reviewed...
April 2014: Transplantation Proceedings
A Christine Argento, Anthony Kim, Melissa Knauert-Brown, Daniel Boffa, Mark D Siegel, Behrouz Jafari, Jonathan T Puchalski
BACKGROUND: Pleural effusions may result from intra-abdominal processes and sometimes present with dramatic clinical consequences. We present 2 cases of recurrent hydrothorax requiring surgical repair of diaphragmatic defects and describe when surgery may be the best treatment modality. PATIENT 1: : A 63-year-old man with end-stage renal disease requiring peritoneal dialysis presented with dyspnea on exertion that progressed to cardiac arrest. He was found to have a tension hydrothorax that was initially stabilized with thoracentesis and tube thoracostomy...
April 2014: Journal of Bronchology & Interventional Pulmonology
E Jason Abel, R Houston Thompson, Vitaly Margulis, Jennifer E Heckman, Megan M Merril, Oussama M Darwish, Laura-Maria Krabbe, Stephen A Boorjian, Bradley C Leibovich, Christopher G Wood
BACKGROUND: Surgery for renal cell carcinoma (RCC) patients with inferior vena cava (IVC) thrombus above the hepatic veins is technically complex and associated with an increased risk of perioperative morbidity and mortality. However, minimal data exist that describe contemporary perioperative outcomes at major referral centers or the prognostic factors associated with poor outcomes. OBJECTIVE: To determine the preoperative predictors of major complications and 90-d mortality after surgery in RCC patients who have IVC thrombus above the hepatic veins...
September 2014: European Urology
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