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https://www.readbyqxmd.com/read/29681959/levosimendan-in-patients-with-low-ejection-fraction-undergoing-cardiac-surgery
#1
Ewa M Kucewicz-Czech, Tomasz Maciejewski, Barbara Budziarz, Tadeusz Kołodziej, Kazimierz Kiermasz, Leszek Machej
Introduction: Significant impairment of left ventricular function causes low cardiac output syndrome in the immediate postoperative period in 3-14% of patients undergoing surgery, increasing the mortality 15-fold. Aim: To assess the use of levosimendan in patients undergoing cardiac surgery in 2016. Material and methods: The analysis included 14 patients: 3 (21.4%) women and 11 (78.6%) men aged 65.4 ±11.8 years. The mean value of left ventricular ejection fraction amounted to 20 ±6...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29677033/characterization-of-the-glucocorticoid-receptor-in-children-undergoing-cardiac-surgery
#2
Saul Flores, David S Cooper, Amy M Opoka, Ilias Iliopoulos, Sarah Pluckebaum, Matthew N Alder, Kelli A Krallman, Rashmi D Sahay, Lin Fei, Hector R Wong
OBJECTIVES: Postoperative administration of corticosteroids is common practice for managing catecholamine refractory low cardiac output syndrome. Since corticosteroid activity is dependent on the glucocorticoid receptor, we sought to characterize glucocorticoid receptor levels in children undergoing cardiac surgery and examined the association between glucocorticoid receptor levels and cardiovascular dysfunction. DESIGN: Prospective observational cohort study. SETTING: Large, tertiary pediatric cardiac center...
April 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29662808/critical-illness-related-corticosteroid-insufficiency-in-patients-with-low-cardiac-output-syndrome-after-cardiac-surgery
#3
You Jung Ok, Ju Yong Lim, Sung-Ho Jung
Background: Low cardiac output syndrome (LCOS) after cardiac surgery usually requires inotropes. In this setting, critical illness-related corticosteroid insufficiency (CIRCI) may develop. We aimed to investigate the clinical features of CIRCI in the presence of LCOS and to assess the efficacy of steroid treatment. Methods: We reviewed 28 patients who underwent a rapid adrenocorticotropic hormone (ACTH) test due to the suspicion of CIRCI between February 2010 and September 2014...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29662806/early-clinical-outcomes-of-tricuspid-valve-repair-with-a-tri-ad-annuloplasty-ring-in-comparison-with-the-outcomes-using-an-mc-3-ring
#4
Woohyun Jung, Jae Woong Choi, Ho Young Hwang, Kyung Hwan Kim
Background: We evaluated the early clinical outcomes of tricuspid valve annuloplasty (TAP) with the Tri-Ad annuloplasty ring for functional tricuspid regurgitation (TR). Methods: From January 2015 to March 2017, 36 patients underwent TAP with a Tri-Ad ring for functional TR. To evaluate the early clinical outcomes of TAP with the Tri-Ad ring, we conducted a propensity score-matched analysis comparing the Tri-Ad and MC3 tricuspid annuloplasty rings (n=34 in each group)...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#5
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628028/-disorders-associated-with-mild-cognitive-impairment-risk-factors-and-predictors
#6
Manuel Antón Jiménez, José Luis González Guerrero
Traditionally, cognitive impairment has been associated not only with ageing itself but also with concomitant comorbidities that interact in the disease continuum from the prodromic phases. Notable among these are delirium, nutritional alterations, balance and gait, infections and even a progressive incidence of neoplasms. However, with regard to diagnosis and staging, clinicians should perhaps remain especially alert to the possibility of pharmacological iatrogeny, which is not limited to psychopharmacological treatment...
June 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29618063/endoscopic-port-access-surgery-for-isolated-atrioventricular-valve-endocarditis
#7
Johan van der Merwe, Filip Casselman, Bernard Stockman, Apostolos Roubelakis, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
OBJECTIVES: Our goal was to report the clinical and echocardiographic outcomes of endoscopic port access surgery for isolated active and convalescent atrioventricular valve endocarditis (AVVE). METHODS: Our current surgical team performed endoscopic port access surgery in 66 consecutive patients with isolated AVVE (mean age, 65.5 ± 12.7 years, 37.9% women, mean EuroSCORE II 31.2 ± 24.9%, 45.5% prosthetic AVVE, Staphylococcus aureus 22.2%), between 1 May 2004 and 31 July 2015...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29573810/meta-analysis-of-trials-on-prophylactic-use-of-levosimendan-in-patients-undergoing-cardiac-surgery
#8
Ayman Elbadawi, Islam Y Elgendy, Marwan Saad, Michael Megaly, Amgad Mentias, Ahmed S Abuzaid, Hend I Shahin, Vinay Goswamy, Hesham Abowali, Barry London
BACKGROUND: The role of prophylactic levosimendan in patients undergoing cardiac surgery is controversial. METHODS: We performed a computerized search of Medline, Embase, and Cochrane databases through September 2017 for randomized trials evaluating the prophylactic use of levosimendan in patients undergoing cardiac surgery (ie, patients without low cardiac output syndrome). The main study outcome was mortality at 30 days. RESULTS: The final analysis included 16 randomized trials with total of 2,273 patients...
March 21, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29566803/conscious-sedation-versus-general-anesthesia-in-transcatheter-aortic-valve-replacement-the-german-aortic-valve-registry
#9
Oliver Husser, Buntaro Fujita, Christian Hengstenberg, Christian Frerker, Andreas Beckmann, Helge Möllmann, Thomas Walther, Raffi Bekeredjian, Michael Böhm, Costanza Pellegrini, Sabine Bleiziffer, Rüdiger Lange, Friedrich Mohr, Christian W Hamm, Timm Bauer, Stephan Ensminger
OBJECTIVES: The aims of this study were to report on the use of local anesthesia or conscious sedation (LACS) and general anesthesia in transcatheter aortic valve replacement and to analyze the impact on outcome. BACKGROUND: Transcatheter aortic valve replacement can be performed in LACS or general anesthesia. Potential benefits of LACS, such as faster procedures and shorter hospital stays, need to be balanced with safety. METHODS: A total of 16,543 patients from the German Aortic Valve Registry from 2011 to 2014 were analyzed, and propensity-matched analyses were performed to correct for potential selection bias...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29564979/levosimendan-for-perioperative-cardioprotection-myth-or-reality
#10
Elpidio Santillo, Monica Migale, Carlo Massini, Raffaele Antonelli Incalzi
BACKGROUND: Levosimendan is a calcium sensitizer drug causing increased contractility in the myocardium and vasodilation in the vascular system. It is mainly used for the therapy of acute decompensated heart failure. Several studies on animals and humans provided evidence of the cardioprotective properties of levosimendan including preconditioning and anti-apoptotic. In view of these favorable effects, levosimendan has been tested in patients undergoing cardiac surgery for the prevention or treatment of low cardiac output syndrome...
March 21, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29564463/multivariate-computational-analysis-of-biosensor-s-data-for-improved-cd64-quantification-for-sepsis-diagnosis
#11
U Hassan, R Zhu, R Bashir
Sepsis, as a leading cause of death worldwide, relies on systemic inflammatory response syndrome (SIRS) criteria for its diagnosis. SIRS is highly non-specific as it relies on monitoring of patients' vitals for sepsis diagnosis, which are known to change with many confounding factors. Changes in leukocyte counts and CD64 expression levels are known specific biomarkers of pro-inflammatory host response at the onset of sepsis. Recently, we have developed a biosensor chip that can enumerate the leukocyte counts and quantify the neutrophil CD64 expression levels from a drop of blood...
March 22, 2018: Lab on a Chip
https://www.readbyqxmd.com/read/29556346/non-invasive-electrical-impedance-tomography-for-multi-scale-detection-of-liver-fat-content
#12
Yuan Luo, Parinaz Abiri, Shell Zhang, Chih-Chiang Chang, Amir H Kaboodrangi, Rongsong Li, Ashish K Sahib, Alex Bui, Rajesh Kumar, Mary Woo, Zhaoping Li, René R Sevag Packard, Yu-Chong Tai, Tzung K Hsiai
Introduction: Obesity is associated with an increased risk of nonalcoholic fatty liver disease (NAFLD). While Magnetic Resonance Imaging (MRI) is a non-invasive gold standard to detect fatty liver, we demonstrate a low-cost and portable electrical impedance tomography (EIT) approach with circumferential abdominal electrodes for liver conductivity measurements. Methods and Results: A finite element model (FEM) was established to simulate decremental liver conductivity in response to incremental liver lipid content...
2018: Theranostics
https://www.readbyqxmd.com/read/29538053/prevention-of-low-cardiac-output-syndrome-after-pediatric-cardiac-surgery-a-double-blind-randomized-clinical-pilot-study-comparing-dobutamine-and-milrinone
#13
Anna Cavigelli-Brunner, Maja I Hug, Hitendu Dave, Oskar Baenziger, Christoph Buerki, Dominique Bettex, Vincenzo Cannizzaro, Christian Balmer
OBJECTIVES: Dobutamine and milrinone are commonly used after open-heart surgery to prevent or treat low cardiac output syndrome. We sought to compare efficacy and safety of these drugs in pediatric patients. DESIGN: Prospective, single-center, double-blinded, randomized clinical pilot study. SETTING: Tertiary-care university children's hospital postoperative pediatric cardiac ICU. PATIENTS: After written consent, 50 consecutive patients (age, 0...
March 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29537977/fulminant-myocarditis-characteristics-treatment-and-outcomes
#14
Giacomo Veronese, Enrico Ammirati, Manlio Cipriani, Maria Frigerio
Myocarditis is an inflammatory disease of the myocardium with a broad spectrum of clinical presentations, ranging from mild symptoms to severe heart failure. The course of patients with myocarditis is heterogeneous, varying from partial or full clinical recovery in few days to advanced low cardiac output syndrome requiring mechanical circulatory support or heart transplantation. Fulminant myocarditis (FM) is a peculiar clinical condition and is an acute form of myocarditis, whose main characteristic is a rapidly progressive clinical course with the need for hemodynamic support...
March 13, 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29531820/warm-blood-cardioplegia-versus-cold-crystalloid-cardioplegia-for-myocardial-protection-during-coronary-artery-bypass-grafting-surgery
#15
Paolo Nardi, Calogera Pisano, Fabio Bertoldo, Sara R Vacirca, Guglielmo Saitto, Antonino Costantino, Emanuele Bovio, Antonio Pellegrino, Giovanni Ruvolo
We retrospectively analyzed early results of coronary artery bypass grafting (CABG) surgery using two different types of cardioplegia for myocardial protection: antegrade intermittent warm blood or cold crystalloid cardioplegia. From January 2015 to October 2016, 330 consecutive patients underwent isolated on-pump CABG. Cardiac arrest was obtained with use of warm blood cardioplegia (WBC group, n  = 297) or cold crystalloid cardioplegia (CCC group, n  = 33), according to the choice of the surgeon. Euroscore II and preoperative characteristics were similar in both groups, except for the creatinine clearance, slightly lower in WBC group (77...
December 2018: Cell Death Discovery
https://www.readbyqxmd.com/read/29482650/intraoperative-milrinone-versus-dobutamine-in-cardiac-surgery-patients-a-retrospective-cohort-study-on-mortality
#16
Dorthe Viemose Nielsen, Christian Torp-Pedersen, Regitze Kuhr Skals, Thomas A Gerds, Zidryne Karaliunaite, Carl-Johan Jakobsen
BACKGROUND: Several choices of inotropic therapy are available and used in relation to cardiac surgery. Comparisons are necessary to select optimal therapy. In Denmark, dobutamine and milrinone are the two inotropic agents most commonly used to treat post-bypass low cardiac output syndrome. This study compares all-cause mortality with these drugs. METHODS: In a retrospective observational study we investigated 10,700 consecutive patients undergoing cardiac surgery from 1 April 2006 to 31 December 2013 at Aarhus and Aalborg University Hospitals in the Central and Northern Denmark Region...
February 26, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29470687/surgical-management-of-extensive-dissecting-thoracic-aortic-aneurysm-via-the-semi-clamshell-approach
#17
Hiroshi Furukawa, Takeshi Honda, Takahiko Yamasawa, Hisao Masaki, Kazuo Tanemoto
BACKGROUND: We retrospectively evaluated the initial clinical experience of the surgical management of extensive dissecting thoracic aortic aneurysm (TAA) via the semi-clamshell approach. METHODS: Thirteen patients (3 women and 10 men, mean age 67 ± 15 years) who underwent elective surgical intervention for extensive dissecting TAA via semi-clamshell approach in our institute between May 2007 and April 2017 participated in this study. Regarding surgical techniques, left thoracotomy with transverse sternotomy was initially performed via the third or fourth intercostal space following an incision from the right sternal borderline to the anterior axillary line on the left sternal borderline...
February 22, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29456049/six-month-outcomes-after-high-risk-coronary-artery-bypass-graft-surgery-and-preoperative-intra-aortic-balloon-counterpulsation-use-an-inception-cohort-study
#18
Edward Litton, Frances Bass, Anthony Delaney, Graham Hillis, Silvana Marasco, Shay McGuinness, Paul S Myles, Christopher M Reid, Julian A Smith
OBJECTIVE: To inform the design of a pivotal randomized controlled trial of prophylactic intra-aortic balloon counterpulsation (IABC) in patients undergoing coronary artery bypass graft (CABG) at high risk of postoperative low cardiac output syndrome (LCOS). DESIGN: Inception cohort study. SETTING: A total of 13 established cardiac centers in Australia, Canada, New Zealand, and the United Kingdom. PARTICIPANTS: Adult patients were eligible for inclusion if they were listed for CABG surgery and had 2 or more LCOS risk factors (low ejection fraction, severe left main coronary artery disease, redo sternotomy, unstable angina)...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29451075/short-term-outcomes-of-preoperative-intra-aortic-balloon-pump-use-in-patients-undergoing-adjunctive-coronary-endarterectomy-a-retrospective-observational-study
#19
Liangshan Wang, Xing Hao, Xiaomeng Wang, Chengxiong Gu, Hong Wang, Xiaotong Hou
BACKGROUND: Coronary artery bypass grafting (CABG) combined with coronary endarterectomy (CE) can be associated with high operative mortality and morbidity. An intra-aortic balloon pump (IABP) has been the most widely used mechanical circulatory support device during perfusion treatment. However, the benefits of preoperative IABP in CABG combined with CE remain unknown. We conducted a retrospective observational study to evaluate the efficacy of preoperative IABP therapy in patients undergoing adjunctive right coronary artery (RCA) endarterectomy...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29448828/role-of-terminal-warm-blood-cardioplegia-in-complex-congenital-heart-surgery
#20
Pribadi Wiranda Busro, Harvey Romolo, Sudigdo Sastroasmoro, Jusuf Rachmat, Mohammad Sadikin, Anwar Santoso, Cindy Elfira Boom, Suhendro Suwarto, Ahmad Aulia Jusuf
Introduction Myocardial protection is vital to ensure successful open heart surgery. Cardioplegic solution is one method to achieve good myocardial protection. Inevitably, ischemia-reperfusion injury occurs with aortic crossclamping. Histidine-tryptophan-ketoglutarate solution is a frequently used cardioplegia for complex congenital heart surgery. We postulated that addition of terminal warm blood cardioplegia before removal of the aortic crossclamp might improve myocardial protection. Method A randomized controlled trial was conducted on 109 cyanotic patients aged, 1 to 5 years who underwent complex biventricular repair...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
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