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Cardiac surgery

Esther Gil-Barrionuevo, José Maria Balibrea, Enric Caubet, Oscar Gonzalez, Ramón Vilallonga, José Manuel Fort, Andrea Ciudin, Manel Armengol
INTRODUCTION: Pheochromocytomas are infrequent tumors arised from the chromaphine cells of the adrenal sympathetic system. The excess of circulating catecholamines may lead to different cardiovascular disorders from silent alterations of the myocardial conduction to different forms of cardiomyopathy. The onset as cardiogenic shock is exceptional. PRESENTATION OF CASE: A 35-year-old male, with a known history of acute myopericarditis of unknown origin which debuted as acute pulmonary edema, was admitted with dyspnea in the context of a new heart failure episode with pulmonary edema...
June 27, 2018: International Journal of Surgery Case Reports
Adam J Kingeter, Karthik Raghunathan, Sibyl H Munson, David K Hayashida, Xuan Zhang, Sloka Iyengar, Martin Bunke, Andrew D Shaw
PURPOSE: Albumin is widely used during and after on-pump cardiac surgery, although it is unclear whether this therapy improves clinical outcomes. METHODS: This observational study utilized the Cerner Health Facts® database (a large HIPAA-compliant clinical-administrative database maintained by Cerner Inc., USA) to identify a cohort of 6,188 adults that underwent on-pump cardiac surgery for valve and/or coronary artery procedures between January 2001 and March 2013...
July 13, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Huan Hsu, Hui-Chin Lai, Tsun-Jui Liu
Robot-assisted coronary artery bypass graft [robot-assisted (coronary artery bypass grafting (CABG)] surgery is the latest treatment for coronary artery disease. However, the surgery extensively affects cardiac and pulmonary function, and the risk factors associated with peri-operative morbidity, including prolong mechanical ventilation (PMV), have not been fully examined. In this retrospective cohort study, a total of 382 patients who underwent robot-assisted internal mammary artery harvesting with mini-thoracotomy direct-vision bypass grafting surgery (MIDCABG) from 2005 to 2012 at our tertiary care hospital were included...
July 13, 2018: Heart and Vessels
Daniel Bolliger, Joachim M Erb
No abstract text is available yet for this article.
June 20, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Maria Schubert, Roger Schürch, Soenke Boettger, David Garcia Nuñez, Urs Schwarz, Dominique Bettex, Josef Jenewein, Jasmina Bogdanovic, Marina Lynne Staehli, Rebecca Spirig, Alain Rudiger
BACKGROUND: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case...
July 13, 2018: BMC Health Services Research
Ilaria Girolami, Albino Eccher, Eliana Gilioli, Luca Novelli, Gioia Di Stefano, Matteo Brunelli, Luca Cima
Mesothelial/monocytic incidental cardiac excrescence (MICE) is a benign lesion composed of histiocytes and mesothelial cells, usually found during cardiac surgery. To date, no more than 50 cases are reported in literature, and pathogenesis is still unclear even if different theories have been proposed. Here we report a case of MICE encountered during aortic valve replacement with typical histological features and extensive immunohistochemical investigation. To date, little information is available about the pathogenesis of MICE...
June 10, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Diogo Sobreira-Fernandes, Laetitia Teixeira, Tiago S Lemos, Liliana Costa, Manuela Pereira, António C Costa, Paula S Couto
STUDY OBJECTIVE: To determine the incidence, risk factors, and predictors of survival of perioperative cardiac arrests (PCAs) occurring in patients who underwent non-cardiac and non-obstetric surgery from January 2008 to May 2015 at a tertiary hospital; determine the incidence and risk factors of anesthesia-related PCA. DESIGN: Retrospective observational study. SETTING: Operating room and postoperative recovery area. PATIENTS: Sixty-two PCA cases from an anesthesia database of 122,289 anesthetics...
July 10, 2018: Journal of Clinical Anesthesia
Fei Xu, Qian Wang, Sipeng Chen, Hushan Ao, Jun Ma
STUDY OBJECTIVE: Dexmedetomidine is widely used during surgery. Recent studies have demonstrated that dexmedetomidine administered perioperatively is associated with lower postoperative mortality and complications in patients undergoing cardiac surgery. DESIGN: This study was designed to investigate the effects of dexmedetomidine during cardiac surgery in Chinese patients. PATIENTS/INTERVENTIONS: We conducted a retrospective review of 1477 consecutive patients who underwent cardiac surgery at our institution...
July 10, 2018: Journal of Clinical Anesthesia
Koji Tamai, Christopher Wang, Patrick Heindel, Permsak Pahpolak, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To demonstrate the relationship between perioperative use of catheters and the incidence of surgical site infection (SSI) after cervical spine surgery, after adjusting for patient's age, severity of comorbidity, surgical approach, and use of instrumentation. SUMMARY OF BACKGROUND DATA: Although the association between SSI and the use of arterial catheters (ACs) or central venous catheters (CVCs) is established in cardiac surgery, the relation in the cervical spine was not well elucidated...
July 12, 2018: Spine
Rachel S Bronheim, Eric K Oermann, David S Bronheim, John M Caridi
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To determine the ability of Revised Cardiac Risk Index (RCRI) to predict adverse cardiac events following posterior lumbar decompression (PLD). SUMMARY OF BACKGROUND DATA: PLD is an increasingly common procedure used to treat a variety of degenerative spinal conditions. The RCRI is used to predict risk for cardiac events following non-cardiac surgery. There is a paucity of literature that directly addresses the relationship between RCRI and outcomes following PLD, specifically, the discriminative ability of the RCRI to predict adverse post-operative cardiac events...
July 12, 2018: Spine
Kanav Sharma, Barbara Slawski
Chronic kidney disease (CKD) is common in patients scheduled for surgery and increases the risk of postoperative acute kidney injury, major adverse cardiac events, and death. Acute kidney injury is a common complication of cardiac and noncardiac surgery and negatively affects both short- and long-term outcomes. If we can detect underlying CKD and other risk factors for acute kidney injury before surgery, we may in theory be able to give preventive therapies and improve perioperative outcomes.
July 2018: Cleveland Clinic Journal of Medicine
K Van der Spuy, M Crowther, M Nejthardt, F Roodt, J Davids, J Roos, E Cloete, T Pretorius, G Davies, J Van der Walt, C Van der Westhuizen, M Flint, J Swanevelder, B Biccard
BACKGROUND: Hypertension is common, affecting over one billion people worldwide. In sub-Saharan Africa, hypertensive disease not only affects the older population but is becoming increasingly prevalent in younger individuals. In South Africa (SA), >30% of the adult population has hypertension, making it the single most common cardiovascular risk factor and the predominant contributor to cardiovascular disease and mortality. Elevated blood pressure is the most common perioperative comorbidity encountered in non-cardiac surgical patients, with an overall prevalence of 20 - 25%, and it remains poorly controlled in low- and middle-income countries...
June 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Andrey Khozhenko, Massimo Lamperti, Sergio Terracina, Federico Bilotta
Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review...
July 11, 2018: Journal of Neurosurgical Anesthesiology
Laurent G Glance, Eric Faden, Richard P Dutton, Stewart J Lustik, Yue Li, Michael P Eaton, Andrew W Dick
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The 2014 American College of Cardiology Perioperative Guideline recommends risk stratifying patients scheduled to undergo noncardiac surgery using either: (1) the Revised Cardiac Index; (2) the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator; or (3) the Myocardial Infarction or Cardiac Arrest calculator. The aim of this study is to determine how often these three risk-prediction tools agree on the classification of patients as low risk (less than 1%) of major adverse cardiac event...
July 12, 2018: Anesthesiology
XianXiu Chen, Cheng-Li Lin, Yuan-Chih Su, Kuan-Fei Chen, Shih-Wei Lai, Sung-Tai Wei, Ching-Tien Peng, Cheng-Di Chiu, Shwn-Huey Shieh, Chun-Chung Chen
OBJECTIVE Although no benefits of extracranial-intracranial (EC-IC) bypass surgery in preventing secondary stroke have been identified previously, the outcomes of initial symptomatic ischemic stroke and stenosis and/or occlusion among the Asian population in patients with or without bypass intervention have yet to be discussed. The authors aimed to evaluate the subsequent risk of secondary vascular disease and cardiac events in patients with and without a history of this intervention. METHODS This retrospective nationwide population-based Taiwanese registry study included 205,991 patients with initial symptomatic ischemic stroke and stenosis and/or occlusion, with imaging data obtained between 2001 and 2010...
June 1, 2018: Journal of Neurosurgery
Carina Benstoem, Bleilevens Christian, Borchardt Ralf, Stoppe Christian, Goetzenich Andreas, Autschbach Ruedriger, Breuer Thomas
PURPOSE: Cardiac surgery with the use of extracorporeal circulation is associated with a significant risk for gaseous microemboli (GME) despite excellent surgical techniques and highest operative standards. GME are associated with postoperative neurocognitive dysfunction and negative clinical outcome. This study determines whether oxygenator design has influence on perioperative outcome after cardiac surgery. METHODS: Three different oxygenator models with integrated arterial filter (HiliteAF 7000, Fusion Affinity, and Synthesis) were retrospectively evaluated in 55 patients undergoing elective cardiac surgery with the use of extracorporeal circulation...
July 11, 2018: Annals of Thoracic and Cardiovascular Surgery
Alexander D Blandford, Newton B Wiggins, Waseem Ansari, Catherine J Hwang, Bruce L Wilkoff, Julian D Perry
PURPOSE: To discover oculofacial plastic surgeon practice patterns for cautery selection in the setting of implantable electronic devices and present guidelines based on a review of current literature. METHODS: A 10-Question web-based survey was sent to the email list serve of the American Society of Ophthalmic Plastic and Reconstructive Surgery to determine surgeon cautery preference in the setting of various implantable electronic devices and comfort level with the guidelines for cautery selection in their practice or institution...
July 1, 2018: European Journal of Ophthalmology
Yoshitsugu Nakamura, Sam Emmanuel, Fumiaki Shikata, Chihiro Shirai, Yujiro Ito, Miho Kuroda
OBJECTIVE: To investigate whether radial artery pressure is a reliable surrogate measure of central arterial pressure as approximated by femoral artery pressure in minimally invasive cardiac surgery with retrograde perfusion via femoral cannulation. METHOD: Fifty-two consecutive patients undergoing minimally invasive cardiac surgery were prospectively included in this study. Cardiopulmonary bypass was established via a femoral artery cannulation and femoral vein...
July 1, 2018: International Journal of Artificial Organs
Tomas D Tannvik, Audun E Rimehaug, Nils K Skjaervold, Idar Kirkeby-Garstad
This study assesses positional changes in cardiac power output and stroke work compared with classic hemodynamic variables, measured before and after elective coronary artery bypass graft surgery. The hypothesis was that cardiac power output was altered in relation to cardiac stunning. The study is a retrospective analysis of data from two previous studies performed in a tertiary care university hospital. Thirty-six patients scheduled for elective coronary artery bypass graft surgery, with relatively preserved left ventricular function, were included...
July 2018: Physiological Reports
Thathya V Ariyaratne, Zanfina Ademi, Molla Huq, Franklin Rosenfeldt, Stephen J Duffy, Bonny Parkinson, Cheng-Hon Yap, Julian Smith, Baki Billah, Bryan P Yan, Angela L Brennan, Lavinia Tran, Christopher M Reid
BACKGROUND: There are limited economic evaluations comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for multi-vessel coronary artery disease (MVCAD) in contemporary, routine clinical practice. OBJECTIVE: The aim was to perform a cost-effectiveness analysis comparing CABG and PCI in patients with MVCAD, from the perspective of the Australian public hospital payer, using observational data sources. METHODS: Clinical data from the Melbourne Interventional Group (MIG) and the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) registries were analysed for 1022 CABG (treatment) and 978 PCI (comparator) procedures performed between June 2009 and December 2013...
July 12, 2018: Applied Health Economics and Health Policy
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