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https://www.readbyqxmd.com/read/29452285/risk-factors-for-perioperative-morbidity-in-spine-surgeries-of-different-complexities-a-multivariate-analysis-of-1009-consecutive-patients
#1
M Farshad, D E Bauer, C Wechsler, C Gerber, A Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: To identify predictive risk factors for peri- and early post-operative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29450741/utility-of-cardiac-computed-tomography-scanning-in-the-diagnosis-and-pre-operative-evaluation-of-patients-with-infective-endocarditis
#2
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29447780/nonprimary-pci-at-hospitals-without-cardiac-surgery-on-site-consistent-outcomes-for-all
#3
Matthew J Czarny, Julie M Miller, Daniel Q Naiman, Chao-Wei Hwang, Rani K Hasan, Cynthia C Lemmon, Thomas Aversano
BACKGROUND: The CPORT-E trial showed the noninferiority of nonprimary percutaneous coronary intervention (PCI) at hospitals without cardiac surgery on-site (SoS) compared with hospitals with SoS for 6-week mortality and 9-month major adverse cardiac events (MACE). However, target vessel revascularization (TVR) was increased at non-SoS hospitals. Therefore, we aimed to determine the consistency of the CPORT-E trial findings across the spectrum of enrolled patients. METHODS: Post hoc subgroup analyses of 6-week mortality and 9-month MACE, defined as the composite of death, Q-wave myocardial infarction, or TVR, were performed...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447344/the-balance-between-short-term-and-long-term-outcomes-of-bilateral-internal-thoracic-artery-skeletonization-in-coronary-artery-bypass-surgery-a-propensity-matched-cohort-study
#4
Janet M C Ngu, Ming Hao Guo, David Glineur, Diem Tran, Fraser D Rubens
OBJECTIVES: There is growing interest in the use of bilateral internal thoracic arteries (BITAs) for myocardial revascularization. This study sought to compare the balance between early benefits and long-term outcomes of skeletonized or non-skeletonized conduits and to determine whether differences in outcomes are affected by other patient risk factors. METHODS: BITAs were used in 1504 cases with either SK or NSK conduits. Propensity matching was completed using 22 covariates identifying 441 pairs of patients...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29446256/using-a-vancomycin-pbpk-model-in-special-populations-to-elucidate-case-based-clinical-pk-observations
#5
Chie Emoto, Trevor N Johnson, Brooks T McPhail, Alexander A Vinks, Tsuyoshi Fukuda
Simultaneous changes in several physiological factors may contribute to the large pharmacokinetic (PK) variability of vancomycin. This study was designed to systematically characterize the effects of multiple physiological factors to the altered PK of vancomycin observed in special populations. A vancomycin physiologically based pharmacokinetic (PBPK) model was developed as a PK simulation platform to quantitatively assess the effects of changes in physiologies to the PK profiles. The developed model predicted the concentration-time profiles in healthy adults and diseased patients...
February 15, 2018: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/29445263/noncompaction-cardiomyopathy-and-heterotaxy-syndrome
#6
Hugo R Martinez, Stephanie M Ware, Marcus S Schamberger, John J Parent
Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by compact and trabecular layers of the left ventricular myocardium. This cardiomyopathy may occur with congenital heart disease (CHD). Single cases document co-occurrence of LVNC and heterotaxy, but no data exist regarding the prevalence of this association. This study sought to determine whether a non-random association of LVNC and heterotaxy exists by evaluating the prevalence of LVNC in patients with heterotaxy. In a retrospective review of the Indiana Network for Patient Care, we identified 172 patients with heterotaxy (69 male, 103 female)...
September 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/29442340/aortic-valve-replacement-using-autologous-pericardium-single-centre-experience-with-the-ozaki-technique
#7
Oliver Reuthebuch, Luca Koechlin, Ulrich Schurr, Martin Grapow, Jens Fassl, Friedrich S Eckstein
OBJECTIVE: To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD: Between September 2015 and May 2017 30 patients (20 males, mean ± standard deviation age 66.83 ± 10.55 years) suffering from aortic stenosis (AS, n = 7), aortic regurgitation (AR, n = 12), or a combination of both (AS/AR, n = 11) were assigned for an Ozaki procedure...
February 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29442199/multisite-cardiac-resynchronization-therapy-for-traditional-and-non-traditional-indications
#8
Avishag Laish-Farkash, Sharon Bruoha, Vladimir Khalameizer, Chaim Yosefy, Yoav Michowitz, Mahmoud Suleiman, Amos Katz
PURPOSE: Multisite cardiac resynchronization therapy (MSCRT) with dual-vein left ventricular (LV) pacing has theoretical advantages over conventional CRT in faster and more physiological LV activation. We aimed to define indications, feasibility, safety, acute, and long-term results of MSCRT. METHODS: All patients implanted with MSCRT during 2008-2014 in a single center were reviewed and analyzed. RESULTS: Thirty-nine patients (90% CRT-defibrillators, 64 ± 9 years, 85% male, 74% ischemic etiology) were included...
February 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29441818/comparative-effectiveness-and-harms-of-intraoperative-transesophageal-echocardiography-in-noncardiac-surgery-a-systematic-review
#9
Ashraf Fayad, Sasha Shillcutt, Massimiliano Meineri, Terrence D Ruddy, Mohammed Toseef Ansari
Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29441169/perioperative-stroke-pathophysiology-and-management
#10
REVIEW
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29440154/outcomes-comparison-of-different-surgical-strategies-for-the-management-of-severe-aortic-valve-stenosis-study-protocol-of-a-prospective-multicentre-european-registry-e-avr-registry
#11
Francesco Onorati, Riccardo Gherli, Giovanni Mariscalco, Evaldas Girdauskas, Eduardo Quintana, Francesco Santini, Marisa De Feo, Sandro Sponga, Piergiorgio Tozzi, Mohamad Bashir, Andrea Perrotti, Aniello Pappalardo, Vito Ruggieri, Giuseppe Santarpino, Mauro Rinaldi, Silva Ronaldo, Francesco Nicolini
INTRODUCTION: Traditional and transcatheter surgical treatments of severe aortic valve stenosis (SAVS) are increasing in parallel with the improved life expectancy. Recent randomised controlled trials (RCTs) reported comparable or non-inferior mortality with transcatheter treatments compared with traditional surgery. However, RCTs have the limitation of being a mirror of the predefined inclusion/exclusion criteria, without reflecting the 'real clinical world'. Technological improvements have recently allowed the development of minimally invasive surgical accesses and the use of sutureless valves, but their impact on the clinical scenario is difficult to assess because of the monocentric design of published studies and limited sample size...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29435832/myocardial-injury-in-elderly-patients-after-abdominal-surgery
#12
Shun Huang, WenPing Peng, Ning Yang, Tao Yu, Hong Yuan Cui, Jing Yong Xu, Qi An, Hua Yang, Yan Nan Liu, Zhe Li, Ming Zhang Zuo
BACKGROUND: The development of sensitive myocardial-specific cardiac biomarkers allows for detection of very small amounts of myocardial injury or necrosis. Myocardial injury (MI) as a prelude of the serious perioperative complication myocardial infarction, should be paid more attention, especially in elderly susceptible patients. Myocardial injury after abdominal surgery in elderly patients has not been described yet. The objectives of this study were to identify the incidence, predictors, characteristics and the impact of MI on outcome in elderly patients underwent abdominal surgery...
February 12, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29435809/body-mass-index-predicts-insulin-sensitivity-during-cardiac-surgery-a-prospective-observational-study
#13
Yosuke Nakadate, Hiroaki Sato, Tamaki Sato, Takumi Codere-Maruyama, Takashi Matsukawa, Thomas Schricker
PURPOSE: Taking into account the previously described link between body weight and diabetes mellitus (DM) in non-surgical patients, and the understanding that the degree of intraoperative insulin resistance is a predictor of adverse clinical outcomes, we investigated the relationship between body mass index (BMI) and insulin sensitivity during cardiac surgery. METHODS: We prospectively enrolled 400 patients scheduled for elective cardiac surgery and divided them into groups based on the presence or absence of type-2 DM...
February 12, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29434090/determinants-and-long-term-outcomes-of-percutaneous-coronary-interventions-vs-surgery-for-multivessel-disease-according-to-clinical-presentation
#14
Sung-Jin Hong, Byeong-Keuk Kim, Sanghoon Shin, Yongsung Suh, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
BACKGROUND: The long-term outcome of percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG), particularly for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), remains controversial.Methods and Results:We retrospectively analyzed 2,827 patients (stable coronary artery disease [SCAD], n=1,601; NSTE-ACS, n=1,226) who underwent either PCI (n=1,732) or CABG (n=1,095). The 8-year composite of cardiac death and myocardial infarction (MI) was compared between PCI and CABG before and after propensity matching...
February 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29433600/development-and-preliminary-testing-of-the-brief-developmental-assessment-an-early-recognition-tool-for-children-with-heart-disease
#15
Jo Wray, Katherine L Brown, Deborah Ridout, Monica Lakhanpaul, Liz Smith, Angie Scarisbrick, Sara O'Curry, Aparna Hoskote
Introduction Neurodevelopmental abnormalities are common in children with CHD and are the highest-priority concerns for parents and professionals following cardiac surgery in childhood. There is no additional routine monitoring of development for children with CHD in the United Kingdom; hence, neurodevelopmental concerns may be detected late, precluding early referral and intervention. METHODS: An early recognition tool - the "Brief Developmental Assessment" - was developed using quality improvement methodology involving several iterations and rounds of pilot testing...
February 13, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29432891/estimation-of-achievable-oxygen-consumption-following-transfusion-with-rejuvenated-red-blood-cells
#16
Amudan J Srinivasan, Kyle Kausch, Collin Inglut, Alan Gray, Matthew Landrigan, Jessica L Poisson, Jacob N Schroder, Ian J Welsby
OBJECTIVE: Erythrocyte storage induces a non-physiological increase in hemoglobin-oxygen affinity (quantified by low p50, the oxygen tension at 50% hemoglobin saturation), which can be restored through biochemical rejuvenation. The objective was to mathematically model the impact of transfusing up to three standard allogeneic units or rejuvenated units on oxygen delivery (DO 2 ) and oxygen consumption (VO 2 ). METHODS: Oxygen dissociation curves were generated from AS-1 RBC leukoreduced units (n = 7) before and after rejuvenation following manufacturer's instructions...
February 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29429912/denosumab-versus-zoledronic-acid-in-bone-disease-treatment-of-newly-diagnosed-multiple-myeloma-an-international-double-blind-double-dummy-randomised-controlled-phase-3-study
#17
Noopur Raje, Evangelos Terpos, Wolfgang Willenbacher, Kazuyuki Shimizu, Ramón García-Sanz, Brian Durie, Wojciech Legieć, Marta Krejčí, Kamel Laribi, Li Zhu, Paul Cheng, Douglas Warner, G David Roodman
BACKGROUND: Multiple myeloma is characterised by monoclonal paraprotein production and osteolytic lesions, commonly leading to skeletal-related events (spinal cord compression, pathological fracture, or surgery or radiotherapy to affected bone). Denosumab, a monoclonal antibody targeting RANKL, reduces skeletal-related events associated with bone lesions or metastases in patients with advanced solid tumours. This study aimed to assess the efficacy and safety of denosumab compared with zoledronic acid for the prevention of skeletal-related events in patients with newly diagnosed multiple myeloma...
February 8, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29429638/association-between-intraoperative-hypotension-and-30-day-mortality-major-adverse-cardiac-events-and-acute-kidney-injury-after-non-cardiac-surgery-a-meta-analysis-of-cohort-studies
#18
Wan-Jie Gu, Bai-Ling Hou, Joey S W Kwong, Xin Tian, Yue Qian, Yin Cui, Jing Hao, Ju-Chen Li, Zheng-Liang Ma, Xiao-Ping Gu
BACKGROUND: The association between intraoperative hypotension (IOH) and postoperative outcomes is not fully understood. We performed a meta-analysis to determine whether IOH is associated with increased risk of 30-day mortality, major adverse cardiac events (MACEs) and acute kidney injury (AKI) after non-cardiac surgery. METHODS: We searched PubMed and Embase through May 2016 to identify cohort studies that investigated the association between IOH and risk of 30-day mortality, MACEs, or AKI in adult patients after non-cardiac surgery...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29427974/time-of-day-is-not-associated-with-increased-rates-of-mortality-in-emergency-surgery-an-analysis-of-49-196-surgical-procedures
#19
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29427617/single-versus-multi-center-surgeons-risk-adjusted-coronary-artery-bypass-graft-procedural-outcomes
#20
A Laurie W Shroyer, William E Gioia, Muath Bishawi, Amelia S Wallace, Brian C Gulack, Ying Xian, Sean M O'Brien, Vinod H Thourani, Thomas V Bilfinger
BACKGROUND: Since 2010, 460+ hospital mergers have occurred in the United States rerouting historical coronary artery bypass graft [CABG] referral patterns. The goals of this study were: 1) to compare risk-adjusted CABG outcomes between single-center versus multi-center surgeons; and 2) for multi-center surgeons, to evaluate the risk-adjusted outcomes between their home (primary) versus satellite (secondary) hospitals. METHODS: Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, non-emergent, first-time CABG procedures (n = 543,403) performed in the United States between 2011 and 2014 were extracted across 1,120 centers and for 2,676 surgeons...
February 7, 2018: Annals of Thoracic Surgery
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