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Adult Cardiac Surgery

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https://www.readbyqxmd.com/read/29158075/intermediate-care-unit-after-cardiac-surgery-impact-on-length-of-stay-and-outcomes
#1
Carlos Labata, Teresa Oliveras, Elisabet Berastegui, Xavier Ruyra, Bernat Romero, Maria-Luisa Camara, Maria-Soledad Just, Jordi Serra, Ferran Rueda, Marc Ferrer, Cosme García-García, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Current postoperative management of adult cardiac surgery often comprises transfer from the intensive care unit (ICU) to a conventional ward. Intermediate care units (IMCU) permit hospital resource optimization. We analyzed the impact of an IMCU on length of stay (both ICU and in-hospital) and outcomes (in-hospital mortality and 30-day readmissions) after adult cardiac surgery (IMCU-CS). METHODS: From November 2012 to April 2015, 1324 consecutive patients were admitted to a university hospital for cardiac surgery...
November 17, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29158060/meta-analysis-of-the-outcome-after-postcardiotomy-venoarterial-extracorporeal-membrane-oxygenation-in-adult-patients
#2
Fausto Biancari, Andrea Perrotti, Magnus Dalén, Mariapia Guerrieri, Antonio Fiore, Daniel Reichart, Angelo M Dell'Aquila, Giuseppe Gatti, Tero Ala-Kokko, Eeva-Maija Kinnunen, Tuomas Tauriainen, Sidney Chocron, Juhani K E Airaksinen, Vito G Ruggieri, Debora Brascia
OBJECTIVE: This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN: Systematic review of the literature and meta-analysis. SETTING: Multi-institutional study. PARTICIPANTS: Adult patients with acute heart failure immediately after cardiac surgery. INTERVENTIONS: VA-ECMO after cardiac surgery...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29156619/standard-vs-calorie-dense-immune-nutrition-in-haemodynamically-compromised-cardiac-patients-a-prospective-randomized-controlled-pilot-study
#3
Sergey Efremov, Vladimir Lomivorotov, Christian Stoppe, Anna Shilova, Vladimir Shmyrev, Michail Deryagin, Alexander Karaskov
BACKGROUND: The aim of study was to test the hypothesis that early enteral nutrition (EN) with calorie-dense and protein rich enteral formula improves enteral energy and protein delivery in critically ill cardiac patients. METHODS: Prospective randomized pilot study of 40 ventilated adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass receiving inotropic support postoperatively. Patients were to receive either standard isocaloric (1000 Kcal/L and 38 g/L protein) early EN (n = 20) or calorie-dense and protein-rich (1300 Kcal/L and 66...
November 20, 2017: Nutrients
https://www.readbyqxmd.com/read/29153787/the-society-of-thoracic-surgeons-national-database-2017-annual-report
#4
Jeffrey P Jacobs, David M Shahian, Richard S D'Agostino, Marshall L Jacobs, Benjamin D Kozower, Vinay Badhwar, Vinod H Thourani, Henning A Gaissert, Felix G Fernandez, Richard L Prager
The Society of Thoracic Surgeons (STS) National Database has three major component databases: the STS Adult Cardiac Surgery Database (ACSD), the STS Congenital Heart Surgery Database (CHSD), and the STS General Thoracic Surgery Database (GTSD). Beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article summarizes the status of the STS National Database as of October 2017 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2017 series "Outcomes Analysis, Quality Improvement, and Patient Safety...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29151493/surgical-treatment-of-coronary-to-pulmonary-artery-fistulas-in-adults
#5
Yangsin Lee, Yoshihiro Naruse, Keita Tanaka
Coronary to pulmonary artery fistulas (CPAFs) are abnormal communications between the coronary and pulmonary arteries. They are an uncommon congenital heart disease and usually remain asymptomatic until later in life. However, there is no consensus on their management. We present four adult patients who required surgery for coronary to pulmonary artery fistulas to illuminate this issue. The clinical presentations were variable depending on the anatomical features of coronary to pulmonary artery fistulas and the presence or absence of other cardiac diseases...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29151483/imaging-of-right-to-left-shunt-in-an-adult-patient-with-unroofed-coronary-sinus-with-persistent-left-superior-vena-cava
#6
Chieko Sakai, Tetsuhiro Yamano, Tomonori Miki, Akiko Otsuka, Yuzuko Kato, Michiyo Yamano, Takeshi Nakamura, Satoaki Matoba
A 54-year-old woman with a history of multiple cardiac surgeries suffered from hypoxemia caused by a right-to-left intra-cardiac shunt due to coronary sinus (CS) anomaly with persistent left superior vena cava (PLSVC). Both the contrast echocardiography and enhanced computed tomography (CT) provided conclusive diagnosis of this rare congenital anomaly, which was overlooked for a long time. However, an important diagnostic clue was left-arm injection of the contrast media. In the present case, previously performed enhanced CT with its routine manner, i...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29150036/thoracic-surgery-considerations-in-the-child-and-young-adult
#7
REVIEW
Marvin D Atkins, Stephanie Fuller
Vascular rings and slings may represent life-threatening compression of the esophagus and trachea. Such anatomic variants, although rare, are encountered by all thoracic surgeons in the scope of their practice at some time. The thoracic surgeon, whether treating such patients in the practice of congenital heart surgery, or in the practice of adult cardiac or thoracic surgery must have a requisite understanding of such anatomic variants, their diagnostic workup and radiologic interpretation, as well as their surgical management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#8
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#9
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#10
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#11
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29137577/postoperative-troponin-measurement-as-a-screening-tool-for-adverse-cardiac-events-in-adult-patients-undergoing-moderate-or-major-non-cardiac-surgery
#12
D Coric, N A Smith
Elevated troponin levels within three days of surgery are strongly linked to major adverse cardiac events (MACE). However, the value of screening with troponin measurements is controversial. The extent to which this is done in routine practice is uncertain. We examined the medical records of all patients ≥45 years of age undergoing moderate or major non-cardiac surgery in our tertiary referral hospital over a six-month period. We determined how many patients had a troponin (TnT) measurement recorded in the first three days postoperatively, how many of these were abnormal, and the occurrence of MACE within 30 days...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#13
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
September 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29134534/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-jcvsd-1-mission-and-history-of-jcvsd
#14
Shinichi Takamoto, Noboru Motomura, Hiroaki Miyata, Hiroyuki Tsukihara
The Japan Cardiovascular Surgery Database (JCVSD) was created in 2000 with the support of the Society of Thoracic Surgeons (STS). The STS database content was translated to Japanese using the same disease criteria and in 2001, data entry for adult cardiac surgeries was initiated online using the University Hospital Medical Information Network (UMIN). In 2008, data entry for congenital heart surgeries was initiated in the congenital section of JCVSD and preoperative expected mortality (JapanSCORE) in adult cardiovascular surgeries was first calculated using the risk model of JCVSD...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29132805/feasibility-of-the-use-of-transesophageal-echocardiography-as-a-surface-probe-for-puncturing-and-catheterization-of-the-internal-jugular-vein-a-randomized-controlled-pilot-study
#15
Yi Teng, Mengchan Ou, Hai Yu
OBJECTIVE: To compare the transesophageal echocardiography (TEE) probe as a surface probe with the vascular probe for guiding internal jugular vein (IJV) catheterization. DESIGN: Prospective, randomized, controlled pilot study. SETTING: University hospital. PARTICIPANTS: One hundred cardiac surgery patients, including 50 adult and 50 pediatric patients. INTERVENTIONS: Patients in the TEE probe group received right IJV catheterization using the TEE probe, while the vascular probe group used the vascular probe for catheterization...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#16
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
Background The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. Methods In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29129562/preoperative-use-of-oral-beta-adrenergic-blocking-agents-and-the-incidence-of-new-onset-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
REVIEW
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29128485/neutrophil-lymphocyte-and-platelet-counts-and-acute-kidney-injury-after-cardiovascular-surgery
#18
Chang-Hoon Koo, Dhong Eun Jung, Yoon Sang Park, Jungil Bae, Youn Joung Cho, Won Ho Kim, Jae-Hyon Bahk
OBJECTIVE: Postoperative low platelet count and perioperative high neutrophil/lymphocyte (N/L) ratio are associated with acute kidney injury (AKI) and mortality after cardiac surgery. The authors investigated whether (1) their combination neutrophil/lymphocyte × platelet (N/LP) ratio is an independent predictor of AKI and postoperative mortality and (2) whether the N/LP ratio increases predictive ability compared with the N/L ratio or platelet nadir. DESIGN: This was a retrospective and observational study...
August 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29126688/prediction-of-postoperative-blood-loss-using-thromboelastometry-in-adult-cardiac-surgery-cohort-study-and-systematic-review
#19
Michael I Meesters, David Burtman, Peter M van de Ven, Christa Boer
OBJECTIVE: The aim was to evaluate the predictive value of thromboelastometry for postoperative blood loss in adult cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective cohort study and systematic review of the literature. SETTING: A tertiary university hospital. PARTICIPANTS: 202 patients undergoing elective cardiac surgery. INTERVENTIONS: Thromboelastometry was performed before cardiopulmonary bypass and 3 minutes after protamine administration...
August 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29126680/anesthetic-and-perioperative-considerations-for-combined-heart-kidney-transplantation
#20
Santiago Mc Loughlin, Juan C Bianco, Ricardo G Marenchino
OBJECTIVE: To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: All consecutive HKT recipients aged 18 years and older. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After approval of the Institutional Review Board, the authors studied all consecutive adult patients who underwent HKT between January 2013 and July 2016...
September 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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