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https://www.readbyqxmd.com/read/29223684/thromboelastometry-as-guidance-for-blood-management-in-patients-undergoing-cardiac-surgery
#1
C Sarrais Polo, A Alonso Morenza, J Rey Picazo, L Álvarez Mercadal, R Beltrao Sial, C Aguilar Lloret
OBJECTIVE: Thromboelastometry is a viscoelastometric method for haemostasis testing in a whole blood sample. The aim of this study was to assess the results of using thromboelastometry as guidance for blood management in cardiac surgery, postoperative adverse events and ICU stay. MATERIAL AND METHOD: Analytical and comparative non-randomised quasi-experimental prospective study with a retrospective control group. The inclusion criteria for the 80 patients were: patients undergoing cardiac surgery who had had prior cardiac surgery, endocarditis surgery or aortic arch surgery...
December 6, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29223438/-bringing-on-the-light-in-a-complex-clinical-scenario-optical-coherence-tomography-guided-discontinuation-of-antiplatelet-therapy-in-cancer-patients-with-coronary-artery-disease-protect-oct-registry
#2
Cezar A Iliescu, Mehmet Cilingiroglu, Dana E Giza, Oscar Rosales, Jake Lebeau, Israel Guerrero-Mantilla, Juan Lopez-Mattei, Juhee Song, Guillherme Silva, Pranav Loyalka, Andre R M Paixao, Syed Wamique Yusuf, Emerson Perin, Vernon H Anderson, Konstantinos Marmagkiolis
BACKGROUND: Cancer patients with recently placed drug-eluting stents (DESs) often require premature dual antiplatelet therapy (DAPT) discontinuation for cancer-related procedures. Optical coherence tomography (OCT) can identify risk factors for stent thrombosis such as stent malapposition, incomplete strut coverage and in-stent restenosis and may help guide discontinuation of DAPT. METHODS: We conducted a single-center prospective study in cancer patients with recently placed (1-12 months) DES who required premature DAPT discontinuation...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222766/electrical-velocimetry-for-non-invasive-monitoring-of-the-closure-of-the-ductus-arteriosus-in-preterm-infants
#3
Ana Rodríguez Sánchez de la Blanca, M Sánchez Luna, N González Pacheco, M Arriaga Redondo, N Navarro Patiño
Closure of a patent ductus arteriosus (PDA) in preterm infants modifies cardiac output and induces adaptive changes in the hemodynamic situation. The present study aims to analyze those changes, through a non-invasive cardiac output monitor based on blood electrical velocimetry, in preterm babies. A prospective observational study of preterm infants with a gestational age of less than 28 weeks, and a hemodynamic significant PDA, requires intravenous ibuprofen or surgical closure. All patients were monitored with electrical velocimetry before treatment and through the following 72 h...
December 8, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29220756/the-impact-of-sustained-new-onset-atrial-fibrillation-on-mortality-and-stroke-incidence-in-critically-ill-patients-a-retrospective-cohort-study
#4
Takuo Yoshida, Shigehiko Uchino, Taisuke Yokota, Tomoko Fujii, Shoichi Uezono, Masanori Takinami
PURPOSE: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients. MATERIAL AND METHODS: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29216946/-diagnostic-significance-of-urinary-neutrophil-gelatin-enzyme-related-lipid-delivery-protein-and-kidney-injury-molecule-1-in-acute-kidney-injury-after-cardiac-operation-with-cardiopulmonary-bypass-operation-in-children
#5
Yupeng Wen, Zongxiao Li, Cheng Chang, Peng Zhang, Yang Lyu
OBJECTIVE: To investigate the diagnostic value of urinary neutrophil gelatin enzyme-related lipid delivery protein (NGAL) and kidney injury molecule-1 (KIM-1) in the acute kidney injury (AKI) after cardiopulmonary bypass (CPB) operation in children with non-cyanotic congenital heart disease (CHD). METHODS: A retrospective analysis was conducted. 200 CPB undergoing cardiac surgery in children with non-cyanotic CHD admitted to Tianjin Children's Hospital from June 2015 to May 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29214375/review-surgical-treatment-of-giant-coronary-aneurysms-in-pediatric-patients-with-kawasaki-disease
#6
Masami Ochi
In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential...
December 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29212513/cardiac-amyloidosis-is-prevalent-in-older-patients-with-aortic-stenosis-and-carries-worse-prognosis
#7
João L Cavalcante, Shasank Rijal, Islam Abdelkarim, Andrew D Althouse, Michael S Sharbaugh, Yaron Fridman, Prem Soman, Daniel E Forman, John T Schindler, Thomas G Gleason, Joon S Lee, Erik B Schelbert
BACKGROUND: Non-invasive cardiac imaging allows detection of cardiac amyloidosis (CA) in patients with aortic stenosis (AS). Our objective was to estimate the prevalence of clinically suspected CA in patients with moderate and severe AS referred for cardiovascular magnetic resonance (CMR) in age and gender categories, and assess associations between AS-CA and all-cause mortality. METHODS: We retrospectively identified consecutive AS patients defined by echocardiography referred for further CMR assessment of valvular, myocardial, and aortic disease...
December 7, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29211216/cardiac-surgery-in-jehovah-s-witness-patients-experience-of-a-brazilian-tertiary-hospital
#8
Felipe Homem Valle, Fernando Pivatto, Bruna Sessim Gomes, Tanara Martins de Freitas, Vanessa Giaretta, Miguel Gus
INTRODUCTION: The outcomes of Jehovah's Witness (JW) patients submitted to open heart surgery may vary across countries and communities. The aim of this study was to describe the morbidity and mortality of JW patients undergoing cardiac surgery in a tertiary hospital center in Southern Brazil. METHODS: A case-control study was conducted including all JW patients submitted to cardiac surgery from 2008 to 2016. Three consecutive surgical non-JW controls were matched to each selected JW patient...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29209927/hydroxocobalamin-for-the-treatment-of-cardiac-surgery-associated-vasoplegia-a-case-series
#9
Pranav R Shah, Penny S Reynolds, Nirvik Pal, Daniel Tang, Harry McCarthy, Bruce D Spiess
PURPOSE: Vasoplegia is a clinical syndrome marked by severe arteriolar vasodilatation, hypotension, and low systemic vascular resistance refractory to multiple vasopressor treatment. We report our experience with hydroxocobalamin (B12) infusion as a potential rescue adjunct for refractory vasoplegia during cardiopulmonary bypass (CPB). METHODS: We performed a retrospective chart review of 33 patients undergoing cardiac surgery between 1 January 2013 and 31 December 2015, who were given intravenous B12 for refractory hypotension during, or immediately following, CPB...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29208472/role-of-transglutaminase-2-in-a1-adenosine-receptor-and-%C3%AE-2-adrenoceptor-mediated-pharmacological-pre-and-post-conditioning-against-hypoxia-reoxygenation-induced-cell-death-in-h9c2-cells
#10
Falguni S Vyas, Carl P Nelson, John M Dickenson
Pharmacologically-induced pre- and post-conditioning represent attractive therapeutic strategies to reduce ischaemia/reperfusion injury during cardiac surgery and following myocardial infarction. We have previously reported that transglutaminase 2 (TG2) activity is modulated by the A1 adenosine receptor and β2-adrenoceptor in H9c2 cardiomyoblasts. The primary aim of this study was to determine the role of TG2 in A1 adenosine receptor and β2-adrenoceptor-induced pharmacological pre- and post-conditioning in the H9c2 cells...
December 2, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29207816/non-catheter-related-perioperative-superior-vena-cava-syndrome-following-surgical-vsd-closure-role-of-transesophageal-echocardiography
#11
Tanveer Singh Kundra, Divya Gopal, Manasa Dhananjaya
Unintentional iatrogenic surgical complications can complicate the operative and postoperative courses of paediatric cardiac surgery patients. Unless recognized and treated early, it's possible, these complications may lead to a prolonged hospital stay, increased treatment cost, morbidity, and even death. Ventricular Septal Defect (VSD) is the most common congenital heart defect in children, occurring in 50% of all children with congenital heart disease and in 20% as an isolated lesion. Herein, we discuss the development of Superior Vena Cava (SVC) syndrome following surgical repair of VSD in a nine-month-old child...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29207365/thirty-day-outcomes-in-100-consecutive-patients-undergoing-transfemoral-aortic-valve-replacement-with-the-portico-valve-on-an-all-comer-basis
#12
Silvia Mas-Peiro, Mariuca Vasa-Nicotera, Helge Weiler, Nestoras Papadopoulos, Roberta De Rosa, Andreas M Zeiher, Stephan Fichtlscherer
OBJECTIVES: Transcatheter heart valves such as the self-expandable Portico valve (St. Jude Medical) are being developed to overcome limitations of first-generation devices. Since clinical experience with this valve is still limited in a real-world setting, we investigated its use on an all-comer basis. METHODS: Between October 2015 and October 2016, a total of 100 consecutive patients assessed for transcatheter aortic valve replacement (TAVR) and found suitable for the Portico valve were included...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#13
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29205502/intraoperative-thermographic-imaging-to-assess-myocardial-distribution-of-del-nido-cardioplegia
#14
Prashant Rao, Jack B Keenan, Taufiek K Rajab, Alice Ferng, Samuel Kim, Zain Khalpey
We describe the intraoperative non-invasive use of an infrared (IR) camera to monitor Del Nido cardioplegia delivery in patients undergoing cardiac surgery. Thermal pictures were taken pre- and post-cardioplegia and at timed points after arrest, and compared to readings from a transseptal temperature probe. There was good concordance between the transseptal probe and the IR camera temperature readings. This non-invasive technique, which assesses cardioplegic distribution, may help to determine when additional doses of Del Nido cardioplegia are required during periods of cardioplegic arrest...
December 3, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29203501/effect-of-a-newly-designed-observation-response-and-discharge-chart-in-the-post-anaesthesia-care-unit-on-patient-outcomes-a-quasi-expermental-study-in-australia
#15
Maryann Street, Nicole M Phillips, Mohammadreza Mohebbi, Bridie Kent
OBJECTIVES: This study aimed to evaluate whether use of a discharge criteria tool for nursing assessment of patients in Post Anaesthesia Care Unit (PACU) would enhance nurses' recognition and response to patients at-risk of deterioration and improve patient outcomes. METHODS: A prospective non-randomised pre-post intervention study was conducted in three hospitals in Australia. Participants were adults undergoing elective surgery before (n=723) and after (n=694) implementation of the Post-Anaesthetic Care Tool (PACT)...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#16
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201178/analgesic-therapy-improves-arterial-endothelial-function-following-non-cardiovascular-surgery-a-randomized-placebo-controlled-trial
#17
Meng-Jun Wu, Meng-Chang Yang, Long-Qing Ran, Su-Mei Wei, Wen-Lai Zhou, Yong-Sheng Gou, Hai Yu
Pain subsequent to non-cardiac surgery may affect the endothelial function, which in turn contributes to myocardial injury (MI). The present study examined whether effective pain control is able to improve the postoperative endothelial function. Patients (n=160) undergoing laparoscopic cholecystectomy were randomly assigned into two groups, treated with tramadol analgesic or saline (placebo) following surgery. On preoperative day 1 (baseline) and postoperatively at 2 h, 1 day and 5 days, pain was assessed on a visual analogue scale (VAS), and B-mode ultrasound was used to measure brachial endothelium-dependent flow-mediated dilation (FMD) and nitroglycerin-induced dilation...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29199541/impact-of-temperature-on-the-narcotrend-index-during-hypothermic-cardiopulmonary-bypass-in-children-with-sevoflurane-anesthesia
#18
Nils Dennhardt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Alexander Horke, Sebastian Tiedge, Martin Boehne, Robert Sümpelmann
BACKGROUND: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. OBJECTIVE: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29198262/medical-missions-for-the-provision-of-paediatric-cardiac-surgery-in-low-and-middle-income-countries
#19
Frank J Molloy, Nguyenvu Nguyen, Marisa Mize, Gavin Wright, Cecilia St George-Hyslop, Maura O'Callaghan, Emma Scanlan, William M Novick
This review will outline the role of visiting cardiac surgical teams in low- and middle-income countries drawing on the collective experience of the authors in a wide range of locations. Requests for assistance can emerge from local programmes at a beginner or advanced stage. However, in all circumstances, careful pre-trip planning is necessary in conjunction with clinical and non-clinical local partners. The clinical evaluation, surgical procedures, and postoperative care all serve as a template for collaboration and education between the visiting and local teams in every aspect of care...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198131/early-detection-of-cardiac-surgery%C3%A2-associated-acute-kidney-injury-by-microrna-21
#20
P Arvin, H R Samimagham, H Montazerghaem, M Khayatian, H Mahboobi, F Ghadiri Soufi
We tested the hypothesis whether microRNA-21 (miR-21) can detect CSA-AKI earlier than serum creatinine (sCr). A total of 103 patients scheduled to undergo cardiac surgery. CSA-AKI was defined as sCr > 0.3 mg/dl 24 h after surgery. The patients were divided into two groups according to whether or not developing AKI after surgery. Serum and urinary miR-21 were measured prior to, and 6, 12 and 24 h after surgery. Baseline serum and urinary levels of miR-21 in AKI group were lower than in non-AKI group. Moreover, the levels of miR-21 were significantly lower 6 h after surgery for serum, and 6 and 12 h after surgery for urine samples than those before surgery in AKI group...
2017: Bratislavské Lekárske Listy
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