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https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#1
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29176374/intraoperative-vasoplegia-methylene-blue-to-the-rescue
#2
Sharon L McCartney, Lorent Duce, Kamrouz Ghadimi
PURPOSE OF REVIEW: To evaluate the efficacy, dosing, and safety of methylene blue (MTB) in perioperative vasoplegic syndrome (VS). RECENT FINDINGS: Vasoplegic syndrome is a state of persistent hypotension with elevated cardiac output, low filling pressures, and low systemic vascular resistance (SVR). It occurs in up to 25% of patients undergoing cardiac surgery with cardiopulmonary bypass, can last up to 72 h, and is associated with a high mortality rate. MTB has been found to increase SVR and decrease vasopressor requirements in vasoplegic syndrome by inhibiting nitric oxide synthase, thus limiting the generation of nitric oxide, while inhibiting activation of soluble guanylyl cyclase and preventing vasodilation...
November 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29168552/predictors-of-post-operative-atrial-fibrillation-in-patients-undergoing-isolated-coronary-artery-bypass-grafting
#3
Iwona Gorczyca-Michta, Kamil Michta, Edward Pietrzyk, Beata Wożakowska-Kapłon
BACKGROUND: Post-operative atrial fibrillation (POAF) is the most common cardiac arrhythmia occurring after coronary artery bypass grafting (CABG). Arrhythmia leads to prolonged hospitalization and may have impact on both short-term and long-term prognoses. AIM: The aim of this paper was the evaluation of the incidence of POAF in patients after CABG as well as the identification of its predictors. METHODS: The study was performed on 791 patients (selected from a group of 1031 patients who underwent CABG in the Clinical Department of Cardiology in years 2009-2011) who did not suffer from atrial fibrillation (AF) prior to isolated CABG...
November 23, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29155115/transtentorial-distortion-syndrome-a-consistent-complication-following-lateral-and-fourth-ventricular-shunting-in-adults
#4
Claudia L Craven, Irene Baudracco, Simon D Thompson, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
BACKGROUND: Complex hydrocephalus affecting lateral and fourth ventricles separately is occasionally managed with CSF diversion via supra- and infra-tentorial ventricular catheters. The optimal configuration to reduce complications is currently unknown in adults. We describe a consistently similar clinical presentation of patients with complex hydrocephalus and a fourth ventricle separately drained by infra-tentorial shunt insertion. METHODS: A retrospective single centre case series...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29132702/neutrophil-lymphocyte-ratio-prognostic-impact-in-heart-surgery-early-outcomes-and-late-survival
#5
Shuli Silberman, Ulfat Abu-Yunis, Rachel Tauber, Linda Shavit, Tal Grenader, Daniel Fink, Daniel Bitran, Ofer Merin
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery. Receiver-operating-characteristic was used to determine the cutoff value for elevated NLR. Multivariate regression was used to determine the predictive value of preoperative NLR on clinical outcomes...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29126782/feasibility-and-limitations-of-mitral-valve-repair-with-or-without-left-ventricular-reconstruction-in-non-ischemic-dilated-cardiomyopathy
#6
Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
BACKGROUND: Although non-transplant surgical interventions for non-ischemic dilated cardiomyopathy (NIDCM) are relatively effective, their feasibility and limitations have not been fully elucidated. The aim of this study was to define the feasibility and limitations of mitral valve repair, with or without surgical ventricular reconstruction for patients with NIDCM in terms of postoperative low cardiac output syndrome (LOS). METHODS: Twenty non-transplant candidates (aged 57±13 years) with NIDCM and significant mitral regurgitation had undergone mitral valve repair combined with submitral procedures...
November 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29124521/successful-peritoneal-dialysis-using-a-percutaneous-tube-for-peritoneal-drainage-in-an-extremely-low-birth-weight-infant-a-case-report
#7
Satoshi Yokoyama, Takayuki Nukada, Yuka Ikeda, Shigeto Hara, Akira Yoshida
BACKGROUND: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Several reports have described successful PD in these infants, but no guideline-based evidence concerning indications for renal replacement therapy in ELBW infants are currently available. Here, we report on our experience with PD in an ELBW infant with AKI resulting from septic shock...
November 9, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29119483/low-level-laser-therapy-for-xerostomia-in-primary-sj%C3%A3-gren-s-syndrome-a-randomized-trial
#8
Tania Fidelix, Adriano Czapkowski, Sergio Azjen, Adagmar Andriolo, Pedro Horvath Neto, Virgínia Trevisani
To evaluate the effectiveness of low-level laser therapy (LLLT) in the treatment of xerostomia in primary Sjögren's syndrome (SS), a randomized clinical trial of patients with dry mouth symptoms associated with primary SS receiving care at a university hospital was conducted. Sixty-six patients were randomly assigned with a 1:1 allocation ratio to receive LLLT (laser group, n = 33) or placebo treatment (placebo group, n = 33). Patients in the laser group received LLLT twice a week for 6 weeks, for a total of 12 treatment sessions...
November 9, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29116972/low-cardiac-output-syndrome-after-adult-cardiac-surgery-predictive-value-of-peak-systolic-global-longitudinal-strain
#9
Philippe Amabili, Sabeha Benbouchta, Laurence Roediger, Marc Senard, Marie Bernard Hubert, Anne-Françoise Donneau, Jean-François Brichant, Gregory A Hans
BACKGROUND: Peak systolic global longitudinal strain (GLS) is increasingly used to quantify left ventricular systolic function. The primary objective of this study was to assess whether GLS obtained during intraoperative transesophageal echocardiogram, performed before cardiopulmonary bypass, improves the prediction of postoperative low cardiac output syndrome (LCOS) after adult cardiac surgery. METHODS: GLS from 275 patients undergoing on-pump cardiac surgery was calculated retrospectively using two-dimensional- speckle tracking echocardiography (aCMQ module from Qlab software version 10...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29107824/antimicrobial-photodynamic-therapy-apdt-and-photobiomodulation-pbm-660nm-in-a-dog-with-chronic-gingivostomatitis
#10
Paula Abreu Villela, Naiá de Carvalho de Souza, Juliana Durigan Baia, Marco Antonio Gioso, Ana Cecília Corrêa Aranha, Patrícia Moreira de Freitas
Chronic gingivostomatitis in dogs is an inflammatory syndrome of the oral cavity, which treatment and control of concomitant periodontitis allow healing in most of the cases. In the presence of recurrent lesions, invasive methods are necessary to treat lesions and pain. As a conservative adjuvant method, photobiomodulation (PBM) with low power laser is able to promote reduction of tissue pain and tissue inflammation besides increasing vascularization and healing, restoring the normal function of the irradiated organ in a shorter time...
October 28, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#11
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVE: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy...
November 2, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#12
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29092123/bileaflet-foldoplasty-in-barlow%C3%A2-s-disease
#13
Zain Khalpey, Badi Rawashdeh, Toshinobu Kazui, Scott Lick
Mitral valve repair is a feasible and preferable option for the treatment of Barlow's disease. Complex valve repair techniques, in contrast, often lead to increased cross-clamp times and low cardiac output syndrome. A simple, fast, and reproducible foldoplasty technique to reduce anterior and posterior mitral leaflet heights may improve coaptation and reduce mitral regurgitation. Accordingly, herein are described minimally invasive, successful trans-septal and robotic approaches for a bileaflet foldoplasty technique in two patients with Barlow's disease...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29055710/remote-ischemic-preconditioning-in-high-risk-cardiovascular-surgery-patients-a-randomized-controlled-trial
#14
Nicole S Coverdale, Andrew Hamilton, Dimitri Petsikas, R Scott McClure, Paul Malik, Brian Milne, Tarit Saha, David Zelt, Peter Brown, Darrin M Payne
Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery. The intervention consisted of 3 cycles of RIPC on the upper limb for 5 minutes alternated with 5 minutes of rest. A sham intervention was performed on the control group. Patients were recruited who were undergoing (1) high-risk cardiac or vascular surgery or (2) cardiac or vascular surgery and were at high risk of ischemic complications...
September 11, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29047417/levosimendan-for-patients-with-severely-reduced-left-ventricular-systolic-function-and-or-low-cardiac-output-syndrome-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#15
Filippo Sanfilippo, Joshua B Knight, Sabino Scolletta, Cristina Santonocito, Federico Pastore, Ferdinando L Lorini, Luigi Tritapepe, Andrea Morelli, Antonio Arcadipane
BACKGROUND: Previous studies have shown beneficial effects of levosimendan in high-risk patients undergoing cardiac surgery. Two large randomized controlled trials (RCTs), however, showed no advantages of levosimendan. METHODS: We performed a systematic review and meta-analysis (MEDLINE and Embase from inception until March 30, 2017), investigating whether levosimendan offers advantages compared with placebo in high-risk cardiac surgery patients, as defined by preoperative left ventricular ejection fraction (LVEF) ≤ 35% and/or low cardiac output syndrome (LCOS)...
October 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28977199/risk-factors-for-delayed-extubation-after-ventricular-septal-defect-closure-a-prospective-observational-study
#16
Divyakant Parmar, Ketav Lakhia, Pankaj Garg, Kartik Patel, Ritesh Shah, Jigar Surti, Jigar Panchal, Himani Pandya
OBJECTIVE: The objective of our study was to determine the feasibility of early extubation and to identify the risk factors for delayed extubation in pediatric patients operated for ventricular septal defect closure. METHODS: A prospective, observational study was carried out at our Institute. This study involved consecutive 135 patients undergoing ventricular septal defect closure. Patients were extubated if feasible within six hours after surgery. Based on duration of extubation, patients were divided two groups: Group 1= extubation time ≤ 6 hours, Group 2= extubation time >6 hours...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28962507/minimal-access-versus-conventional-aortic-valve-replacement-a-meta-analysis-of-propensity-matched-studies
#17
Sharaf-Eldin Shehada, Yacine Elhmidi, Fanar Mourad, Daniel Wendt, Mohamed El Gabry, Jaroslav Benedik, Matthias Thielmann, Heinz Jakob
Conventional aortic valve replacement (CAVR) via a full sternotomy is the standard surgical approach for aortic valve replacement. Minimal access aortic valve replacement (MAAVR) is commonly performed via a partial sternotomy and a right minithoracotomy. Such procedures aim not only to reduce the invasiveness but to offer the same quality, safety and results of the conventional approach. Our goal was to compare both procedures by performing a meta-analysis of reports with risk adjustment that performed a propensity-matched analysis...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28955074/internal-mammary-artery-flow-in-different-racial-groups-of-pakistan
#18
Mudassir Iqbal Dar, Asim Hassan Dar, Mansoor Ahmed, Abdul Haseeb, Muhammad Bilal
OBJECTIVE: To find out any differences in free flow of internal mammary artery among different ethnic groups. METHODS: This observational, cross-sectional study was conducted at the Civil Hospital, Karachi, from January 2013 to December 2015, and comprised patients who underwent coronary artery bypass grafting. The participants were divided into 5 groups, i.e. Sindhi, Muslim migrants from India, Punjabi, Pathan and Balochi patients. Free flow of internal mammary artery was measured immediately after harvesting within a syringe, and its flow was measured in 30 seconds...
October 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28887708/long-term-clinical-results-of-acute-myocardial-infarction-at-the-left-main-trunk-requiring-percutaneous-cardiopulmonary-support
#19
Takashi Yamauchi, Takafumi Masai, Kenji Fujii, Yoshiki Sawa, Shinya Shirai, Mitsunori Kamigaki, Naofumi Itou
The clinical results of patients with acute myocardial infarction (AMI) at the left main trunk (LMT) remain unclear, especially in cases requiring percutaneous cardiopulmonary support (PCPS). Twenty seven cases of AMI at the LMT requiring emergent PCPS were retrospectively investigated. These 27 patients were aged 44-83 years (65.6 ± 8.6 years) and 20 (81.5%) were men. Peak creatine kinase (CK) leakage ranged from 538 to 34,010 IU/l (13,553 ± 7656 IU/l). Eight (29.6%) patients were discharged without mechanical support...
December 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#20
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
September 7, 2017: Pediatric Cardiology
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