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Cardiopulmonary bypass

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https://www.readbyqxmd.com/read/29332913/early-extubation-in-the-operating-room-after-congenital-open-heart-surgery
#1
Takuma Fukunishi, Norihiko Oka, Takeshi Yoshii, Kensuke Kobayashi, Nobuyuki Inoue, Tetsuya Horai, Tadashi Kitamura, Hirotsugu Okamoto, Kagami Miyaji
Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29332409/high-dose-ulinastatin-improves-postoperative-oxygenation-in-patients-undergoing-aortic-valve-surgery-with-cardiopulmonary-bypass-a-retrospective-study
#2
Ka-Young Rhee, Tae-Yun Sung, Ju Deok Kim, Hyun Kang, Nazri Mohamad, Tae-Yop Kim
Objective To determine whether pre-treatment with high-dose ulinastatin provides enhanced postoperative oxygenation in patients who have undergone aortic valve surgery with moderate hypothermic cardiopulmonary bypass (CPB). Methods Patients who underwent aortic valve surgery with moderate hypothermic CPB were retrospectively evaluated. In total, 94 of 146 patients were included. The patients were classified into one of two groups: patients in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered during CPB (Group U, n = 38) and patients in whom ulinastatin was not administered (Group C, n = 56)...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29332153/vasoactive-inotropic-score-as-a-predictor-of-morbidity-and-mortality-in-adults-after-cardiac-surgery-with-cardiopulmonary-bypass
#3
Yumiko Yamazaki, Koji Oba, Yoshiro Matsui, Yuji Morimoto
PURPOSE: The vasoactive-inotropic score (VIS) is a scale showing the amount of vasoactive and inotropic support. Recently, it was suggested that the VIS after cardiac surgery predicts morbidity and mortality in infants. The purpose of this study was to evaluate the VIS at the end of surgery as a predictor of morbidity and mortality in adult cardiac surgery. METHODS: A retrospective cohort study of 129 adult cardiac surgery patients was performed at a university hospital...
January 13, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#4
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29326843/risk-of-acute-kidney-injury-in-patients-randomized-to-a-restrictive-versus-liberal-approach-to-red-blood-cell-transfusion-in-cardiac-surgery-a-substudy-protocol-of-the-transfusion-requirements-in-cardiac-surgery-iii-noninferiority-trial
#5
Amit X Garg, Nadine Shehata, Shay McGuinness, Richard Whitlock, Dean Fergusson, Ron Wald, Chirag Parikh, Sean M Bagshaw, Boris Khanykin, Alex Gregory, Summer Syed, Gregory M T Hare, Meaghan S Cuerden, Kevin E Thorpe, Judith Hall, Subodh Verma, Pavel S Roshanov, Jessica M Sontrop, C David Mazer
Background: When safe to do so, avoiding blood transfusions in cardiac surgery can avoid the risk of transfusion-related infections and other complications while protecting a scarce resource and reducing costs. This protocol describes a kidney substudy of the Transfusion Requirements in Cardiac Surgery III (TRICS-III) trial, a multinational noninferiority randomized controlled trial to determine whether the risk of major clinical outcomes in patients undergoing planned cardiac surgery with cardiopulmonary bypass is no greater with a restrictive versus liberal approach to red blood cell transfusion...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29323076/familial-biatrial-cardiac-myxoma-with-glandular-elements-a-rare-entity-with-review-of-literature
#6
Devajit Nath, Sudheer Arava, Ruma Ray, Amol Kumar Bhoje, Rachit Saxena, Shiv Kumar Chaudhary
Cardiac myxomas are benign neoplasm of the heart with an incidence of 0.3%. Glandular cardiac myxomas are very rare and accounts for less than 3% of all cardiac myxomas. Here, we report a case of familial glandular cardiac myxoma in a 35 year old male who complained of exertional dyspneoa and weakness of right side of body on clinical presentation. Associated features of Carney's complex were not present. Family history revealed presence of cardiac myxoma in younger brother and sister. Transthoracic echocardiography detected biatrial myxoma...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29320309/isocapnic-buffering-phase-a-useful-indicator-of-exercise-endurance-and-prognosis-in-patients-with-coronary-artery-disease
#7
Yun-Shan Yen, Daniel Chiung Jui Su, Kuo-Shu Yuan, Po-Wei Chen, Julie Chi Chow, Willy Chou
OBJECTIVES: The significance of the isocapnic buffering (IB) phase - the period between the first ventilatory threshold (1stVT) and respiratory compensation point (RCP) - has not been adequately established in patients. This study aimed to determine the clinical significance of the IB phase in coronary artery disease (CAD) patients. METHODS: This retrospective study included data of sixty-two CAD patients after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) performed in a single medical center between 2010-2014...
January 10, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29317969/pulse-pressure-analysis-to-guide-intraoperative-phlebotomy-prior-to-cardiac-surgery
#8
Brian Schloss, Dmitry Tumin, Aymen Naguib, Julie Rice, Mark Galantowicz, Joseph D Tobias
Background: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. Methods: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO2) using near-infrared spectroscopy (NIRS)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29313150/alfieri-stitch-for-temporary-severe-functional-mitral-regurgitation-after-aortic-valve-replacement
#9
Yoshihisa Morimoto, Takaki Sugimoto
The outcome in functional mitral regurgitation after aortic valve replacement is unclear. A frail 82-year-old woman with severe aortic valve regurgitation and mild to moderate functional mitral valve regurgitation (NYHA functional class III) was referred to our clinic. In consideration of her frail condition, aortic valve replacement without mitral surgery was performed. She had hemodynamic instability and difficulty to wean off cardiopulmonary bypass caused by severe functional mitral valve regurgitation with left ventricular dilatation...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29312714/off-vs-on-pump-coronary-artery-bypass-graft-surgery-on-hospital-outcomes-in-134-117-octogenarians
#10
Umberto Benedetto, Gianni D Angelini, Massimo Caputo, Dmitriy N Feldman, Luke K Kim, Christopher Lau, Antonino Di Franco, Leonard N Girardi, Mario Gaudino
Background: In octogenarian patients there is a potential for more tangible clinical benefits from off-pump coronary artery bypass (OPCAB) compared to conventional coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) (COCAB). We aimed to investigate whether, compared to COCAB, OPCAB is associated with better operative outcomes in octogenarians by analyzing the Nationwide Inpatient Sample (NIS) databases 2003-2011. Methods: Of the 134,117 discharge records from 797 hospitals analyzed of patients aged ≥80 years undergoing first time isolated CABG from 2003 to 2011, 70...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310938/evaluation-of-the-clinical-utility-of-transesophageal-echocardiography-and-invasive-monitoring-to-assess-right-ventricular-function-during-and-after-pulmonary-endarterectomy
#11
Thomas P Sullivan, James E Moore, Andrew A Klein, David P Jenkins, Lynne K Williams, Andrew Roscoe, Wendy Tsang
OBJECTIVE: Patients undergoing pulmonary endarterectomy (PEA) have impaired right ventricular function. The authors sought to assess the clinical utility of commonly used perioperative echocardiographic and right heart catheter measurements in patients undergoing PEA. DESIGN: A single-center prospective observational study. SETTING: The study was conducted in a quaternary care cardiac surgical center in the United Kingdom. PARTICIPANTS: Patients undergoing PEA between April 2015 and January 2016...
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29310555/mechanical-circulatory-support-for-the-failing-fontan-conversion-to-assisted-single-ventricle-circulation-preliminary-observations
#12
Syed M Peer, Kristopher B Deatrick, Thomas J Johnson, Jonathan W Haft, Francis D Pagani, Richard G Ohye, Edward L Bove, Alvaro Rojas-Peña, Ming-Sing Si
BACKGROUND: Mechanical circulatory support (MCS) of a failing Fontan circulation remains challenging. We hypothesized that MCS can be provided by converting the Fontan circulation into a mechanically assisted single ventricle parallel circulation (MASVC). METHODS: A porcine model of functionally univentricular circulation was created under cardiopulmonary bypass (CPB) by performing an atrial septectomy, tricuspid valvectomy, and interrupting antegrade pulmonary blood flow...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29310468/lidocaine-dose-response-effect-on-postoperative-cognitive-deficit-meta-analysis-and-meta-regression
#13
Mohammad Reza Habibi, Valiollah Habibi, Ali Habibi, Aria Soleimani
The true influence of the perioperative intravenous lidocaine on the development of postoperative cognitive deficit (POCD) in coronary artery bypass grafting (CABG) remains controversial. The principal aim is to undertake a meta-regression to determine whether moderator variables mediate the relationship between lidocaine and POCD. Areas covered: We searched the Web of Science, PubMed database, Scopus and the Cochrane Library database (up to June 2017) and systematically reviewed a list of retrieved articles...
January 9, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29309315/predicting-heparin-responsiveness-in-children-before-cardiopulmonary-bypass-a-retrospective-cohort-study
#14
Sayaka Nakamura, Osami Honjo, Lynn Crawford-Lean, Celeste Foreman, Minako Sano, James D O'Leary
BACKGROUND: Inadequate or excess administration of unfractionated heparin for cardiopulmonary bypass (CPB) can cause significant harm. Age-dependent differences in the pharmacodynamics and pharmacokinetics of heparin contribute to increased variability of heparin responsiveness in children. The aims of the current study were to (1) examine the correlation between predicted and observed heparin responsiveness in children before CPB measured using the Hemostasis Management System (HMS) Plus (Medtronic, Minneapolis, MN), (2) describe age-specific reference intervals for heparin sensitivity index (HSI) observed in children, and (3) test predictive models of HSI using preoperative clinical and laboratory data...
January 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29305679/decreased-coronary-arteriolar-response-to-kca-channel-opener-after-cardioplegic-arrest-in-diabetic-patients
#15
Yuhong Liu, Victoria Cole, Isabella Lawandy, Afshin Ehsan, Frank W Sellke, Jun Feng
We have recently found that diabetes is associated with the inactivation of the calcium-activated potassium channels (KCa) in endothelial cells, which may contribute to endothelial dysfunction in diabetic patients at baseline. In the current study, we further investigated the effects of diabetes on coronary arteriolar responses to the small (SK) and intermediate (IK) KCa opener NS309 in diabetic and non-diabetic patients and correlated that data with the changes in the SK/IK protein expression/distribution in the setting of cardioplegic ischemia and reperfusion (CP) and cardiopulmonary bypass (CPB)...
January 5, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29305251/cardiac-arrest-during-pregnancy-ongoing-clinical-conundrum-an-expert-review
#16
REVIEW
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305143/bleeding-complications-after-use-of-novel-oral-anticoagulants-in-patients-undergoing-cardiac-surgery
#17
Kambiz Hassan, Nikolai Bayer, Friederike Schlingloff, Martin Oberhoffer, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
BACKGROUND: To analyze the results of open-heart surgery and bleeding complications after administration of novel oral anticoagulants (NOAC). METHODS: We investigated 81 consecutive patients (age: 74 [IQR 68, 78] years) who underwent open-heart operations at our institution between July 2014 and June 2016. All patients presented for surgery while on NOAC therapy: 37 had Rivaroxaban (45.7%), 35 Apixaban (43.2%) and 9 Dabigatran (11.1%). The calculated risk, using the European System for Cardiac Operative Risk Evaluation II, was 3...
January 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29304201/short-term-outcomes-of-minimally-invasive-mitral-valve-repair-a-propensity-matched-comparison
#18
Qing Wang, Wang Xi, Yang Gao, Hua Shen, Jie Min, Jie Yang, Shiguan Le, Yufeng Zhang, Zhinong Wang
OBJECTIVES: We aimed to investigate the effect of minimally invasive mitral valve repair on early pulmonary function and haemodynamics, as well as its short-term efficacy. METHODS: From March 2012 to July 2015, 78 cases of minimally invasive mitral valve repair and 89 cases of conventional mitral valve repair were included in this study, with 67 well-matched pairs of patients identified by a propensity score matching, who were divided into the conventional sternotomy group and the right minithoracotomy group (the RT group)...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29303608/histidine-metabolism-after-bretschneider-cardioplegia-in-cardiac-surgical-patients
#19
J K Teloh, L Ansorge, M Petersen, E Demircioglu, I N Waack, S Brauckmann, H Jakob, D-S Dohle
Bretschneider (histidine-tryptophan-ketoglutarate) solution with its high histidine concentration (198 mM) is one of many cardioplegic solutions, which are routinely used for cardiac arrest. The aim of this study was to evaluate the physiological biochemical degradation of administered histidine to histamine and its major urinary metabolite N methylimidazole acetic acid. A total number of thirteen consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in the prospective observational designed study at the Department of Thoracic and Cardiovascular Surgery between 04/2016 and 06/2016...
January 5, 2018: Physiological Research
https://www.readbyqxmd.com/read/29302952/letter-to-the-editor-thrombocytopenia-after-sutureless-aortic-valve-implantation-does-it-really-matter
#20
G Santarpino, F Vogt
Despite the limited clinical relevance of thrombocytopenia after bioprosthetic aortic valve replacement (AVR), the postoperative depletion of platelet count continues to attract the attention of many authors. The development of thrombocytopenia has been evaluated either in patients receiving a sutureless bioprosthesis (1,2) or in those undergoing transcatheter aortic valve implantation, where cardiopulmonary bypass bears little or no relation to this phenomenon (3). Recently, Sánchez et al. (1) have published their findings on this topic, but their limited experience with the devices used makes their study of doubtful interest...
July 2017: Journal of Heart Valve Disease
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