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Cardiac surgery

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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437748/rational-and-timely-haemostatic-interventions-following-cardiac-surgery-coagulation-factor-concentrates-or-blood-bank-products
#2
Mariann Tang, Christian Fenger-Eriksen, Per Wierup, Jacob Greisen, Jørgen Ingerslev, Vibeke Hjortdal, Benny Sørensen
BACKGROUND: Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery...
April 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#3
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437263/a-randomised-trial-to-evaluate-preoperative-oral-carbohydrate-administration-on-insulin-resistance-in-off-pump-coronary-artery-bypass-patients
#4
Bora Lee, Sarah Soh, Jae-Kwang Shim, Ha Y Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. OBJECTIVE: We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#5
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
February 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28435644/immunohistochemical-diagnosis-of-primary-cardiac-leiomyosarcoma-in-a-latin-american-patient
#6
Ruben Blachman-Braun, Carlos Manuel Aboitiz-Rivera, Alberto Aranda-Fraustro, Adrián Ransom-Rodríguez, Mario Enrique Baltazares-Lipp, Jorge Manuel Catrip-Torres, Jesús Octavio Martínez-Reding
Primary cardiac malignancies are rare entities. Although sarcomas enclosed the main group of malignant heart neoplasms, primary cardiac leiomyosarcomas are extremely rare and constitutes less than 8% of cardiac tumors. Leiomyosarcoma usually originates from the pulmonary veins and have a worm-like shaped structure. In this article, we present a case of a 40-year-old Hispanic man diagnosed with a cardiac tumor who underwent surgical resection, during pathological examination the tissue samples were consistent with a malignancy of mesenchymal origin that contained irregular bundles of spindle cells...
March 24, 2017: Rare Tumors
https://www.readbyqxmd.com/read/28435322/spinal-anesthesia-after-intraoperative-cardiac-arrest-during-general-anesthesia-in-an-infant
#7
Emmett E Whitaker, Veronica Miler, Jason Bryant, Stephanie Proicou, Rama Jayanthi, Joseph D Tobias
Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. During the subsequent anesthetic care, spinal anesthesia was offered as an alternative to general anesthesia...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28435302/in-situ-detection-of-chlamydia-pneumoniae-c-trachomatis-and-cytokines-among-cardiovascular-diseased-patients-from-the-amazon-region-of-brazil
#8
Larissa S Freitas, Núbia Caroline C Almeida, Maria Alice Freitas Queiroz, Marcelo M Zaninotto, Hellen T Fuzii, Alfredo Ribeiro-Silva, Antonio Cr Vallinoto, Marluísa Og Ishak, Juarez As Quaresma, Ricardo Ishak
BACKGROUND: Chronic coronary artery disease has been associated, as a consequence of the local inflammatory reaction with previous or persistent infection with Chlamydia pneumoniae, which led to the investigation of the association of cardiovascular disease and previous infection with C. trachomatis and the role of cytokine profile (in situ) markers in the vascular system tissues. METHODS: Sixty-nine biopsies were collected for immunohistochemical analysis for the presence of IL-6, IL-8, TNF-α, IFN-γ, TGF-β, and IL-10, in 16 fragments from atheromatous plaques, 32 aorta fragments, and 21 valve fragments, using a tissue microarray technique for paraffin embedded tissues...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28434633/echocardiographic-evaluation-of-left-ventricular-mass-index-in-children-with-hypospadias-after-hormonal-stimulation-with-topical-testosterone-a-randomized-controlled-trial
#9
Elisabeth Campos de Andrade, Kelly Christina de Castro Paiva, Sarah da Silva Guedes, Mariana Lima C Souza, Marina Novellino Pereira, Laura Pimenta Miana, André Avarese de Figueiredo, José de Bessa, José Murillo B Netto
INTRODUCTION: Testosterone is often used in the preoperative period of hypospadias surgery. Previous studies have demonstrated the presence of androgen receptors in cardiac myocytes that can modulate the phenotype. The use of supraphysiological doses of androgens can lead to toxicity on the heart muscle and, in some cases, to left ventricular hypertrophy. This randomized double blind controlled clinical trial aims to evaluate the effect of topical testosterone on left ventricular mass index in boys with hypospadias...
April 10, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28434533/performance-of-fixed-heart-rate-increment-targets-of-20-vs-30-beats-per-minute-for-exercise-rehabilitation-prescription-in-outpatients-with-heart-failure
#10
Jennifer L Reed, Angelica Z Blais, Marja-Leena Keast, Andrew L Pipe, Robert D Reid
BACKGROUND: Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated...
February 2, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28434264/exploring-effects-of-remote-ischemic-preconditioning-in-a-pig-model-of-hypothermic-circulatory-arrest
#11
Johanna Herajärvi, Tuomas Anttila, Elitsa Y Dimova, Tuomas Laukka, Mikko Myllymäki, Henri Haapanen, Benjamin A Olenchock, Hannu Tuominen, Ulla Puistola, Peeter Karihtala, Kai Kiviluoma, Peppi Koivunen, Vesa Anttila, Tatu Juvonen
OBJECTIVES: During aortic and cardiac surgery, risks for mortality and morbidity are inevitable. Surgical setups involving deep hypothermic circulatory arrest (DHCA) are effective to achieve organ protection against ischemic injury. The aim of this study was to identify humoural factors mediating additive protective effects of remote ischemic preconditioning (RIPC) in a porcine model of DHCA. DESIGN: Twenty-two pigs were randomized into the RIPC group (n = 11) and the control group (n = 11)...
April 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28434140/radiation-therapy-for-recurrent-cardiac-undifferentiated-pleomorphic-sarcoma-after-three-operations
#12
Kazunobu Hirooka, Masahiro Oonuki, Susumu Manabe, Daisuke Hiraoka, Takashi Yasukawa, Keiko Suzuki
We report the case of a 57-year-old female suffering from recurrent malignant undifferentiated pleomorphic sarcoma of the left atrium. Metastasis to the posterior mediastinum was detected upon first presentation. Incomplete resections were carried out twice before mitral valve replacement was finally performed. The tumor recurred 16 months later and was treated with radiation therapy, which has proved to be effective in bringing about tumor regression for 2 years, to date. The patient has survived for 7 years since the first surgery...
April 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433357/brain-natriuretic-peptide-and-n-terminal-pro-brain-natriuretic-peptide-confirmed-the-prognostic-accuracy-in-pediatric-cardiac-surgery-time-for-their-inclusion-in-prediction-risk-models
#13
EDITORIAL
Massimiliano Cantinotti, Aldo Clerico
No abstract text is available yet for this article.
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433218/cardiac-arrhythmia-after-open-thoracoabdominal-aortic-aneurysm-repair
#14
Ahmet Dolapoglu, Irina V Volguina, Matt D Price, Susan Y Green, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Cardiac arrhythmias commonly arise after cardiac surgery and are associated with poor prognosis. In thoracoabdominal aortic aneurysm (TAAA) repair, these complications are poorly understood. We assessed characteristics, incidence, outcomes, and potential predictors of postoperative arrhythmia (PA) after open TAAA repair. METHODS: From 2010 to 2014, 403 consecutive open TAAA replacement operations were performed in patients without preoperative cardiac rhythm abnormalities at a single tertiary center...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433204/-post-operative-visual-loss-after-cervical-laminectomy-in-prone-position
#15
Kumar Naren Chandra, Meghraj Kundan
Postoperative visual loss is a rare and devastating complication. The estimated incidence is 0.01-1% after non ocular surgery. It has been reported after spine, cardiac and head and neck surgeries. We report a patient who was operated for cervical laminectomy in prone position and complained of loss of vision in one eye postoperatively. He was thoroughly investigated after visual loss. The case was diagnosed as central retinal artery occlusion (CRAO) of the left eye. Here we consider the potential etiological factors causing this unilateral loss of vision and try to suggest strategies to reduce the incidence of the complication in spinal surgery...
April 19, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28432158/risk-score-for-cardiac-surgery-in-active-left-sided-infective-endocarditis
#16
Carmen Olmos, Isidre Vilacosta, Gilbert Habib, Luis Maroto, Cristina Fernández, Javier López, Cristina Sarriá, Erwan Salaun, Salvatore Di Stefano, Manuel Carnero, Sandrine Hubert, Carlos Ferrera, Gabriela Tirado, Afonso Freitas-Ferraz, Carmen Sáez, Javier Cobiella, Juan Bustamante-Munguira, Cristina Sánchez-Enrique, Pablo Elpidio García-Granja, Cecile Lavoute, Benjamin Obadia, David Vivas, Ángela Gutiérrez, José Alberto San Román
OBJECTIVE: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery. METHODS: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#17
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28431809/pilot-study-of-changes-in-presepsin-concentrations-compared-with-changes-in-procalcitonin-and-c-reactive-protein-concentrations-after-cardiovascular-surgery
#18
Junichi Saito, Eiji Hashiba, Akio Mikami, Tomoyuki Kudo, Hidetomo Niwa, Kazuyoshi Hirota
OBJECTIVE: The authors investigated the presepsin-concentration profile after cardiac surgery compared with those of procalcitonin (PCT) and C-reactive protein (CRP). DESIGN: A single-center, prospective, observational clinical study. SETTING: Hirosaki University Hospital. PARTICIPANTS: Patients who underwent cardiovascular surgery without preoperative infection and end-stage kidney disease requiring dialysis. The patients also were subdivided into 2 groups with respect to the use of cardiopulmonary bypass (CPB)...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28431770/aortic-stenosis-and-non-cardiac-surgery-a-systematic-review-and-meta-analysis
#19
Chun Shing Kwok, Rodrigo Bagur, Muhammad Rashid, Ronit Lavi, Mario Cibelli, Mark A de Belder, Neil Moat, David Hildick-Smith, Peter Ludman, Mamas A Mamas
BACKGROUND: Aortic stenosis (AS) poses a perioperative management dilemma to physicians looking after patients who require non-cardiac surgery. The objective of this review is to investigate mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery. METHODS: We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28431719/mitral-valve-necrosis-after-cardiac-surgery-using-gelatin-resorcinol-formaldehyde-glue
#20
Yuki Tanaka, Tadashi Kitamura, Yurie Miyata, Kagami Miyaji
We present a rare case of mitral regurgitation with anterior mitral leaflet perforation associated with gelatin-resorcinol-formaldehyde (GRF) glue. We performed mitral valve replacement for anterior mitral leaflet perforation occurred 7 years after aortic valve replacement and abscess cavity repair using GRF glue. Long-term follow-up is needed for patients who have undergone surgeries using GRF glue or BioGlue (CryoLife, Inc, Kennesaw, GA) because of the possibility of late complications. In particular, when an eccentric mitral regurgitation is observed after aortic root surgery using GRF glue or BioGlue, anterior mitral leaflet perforation should be considered...
May 2017: Annals of Thoracic Surgery
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