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Tracheotomy cardiac surgery

Konrad Paczkowski, Ireneusz Haponiuk, Maciej Chojnicki, Grażyna Brzezińska-Rajszys
An iatrogenic aneurysm of an innominate artery is an extremely rare complication, especially in children. Nevertheless, this pathology was diagnosed in a child given palliative care with chronic respiratory insufficiency and a history of encephalitis requiring permanent ventilation at home via a tracheal tube.A nine-year-old girl with colitis ulcerosa and a history of hemorrhagic encephalitis, with chronic home ventilation therapy, was admitted in an emergency setting because of massive bleeding from the upper respiratory tract and the area surrounding the tracheotomy...
2016: Heart Surgery Forum
Xian-Yue Wang, Wen-Peng Dong, Guang Tong, Sheng-Hui Bi, Ben Zhang, Hua Lu, Xiao-Wu Wang, Wei-da Zhang
OBJECTIVE: To investigate the protective effects of high-dose ulinastatin on the vital organs in patients undergoing total arch replacement for type A aortic dissection. METHODS: Between September 2014 and March 2016, 66 patients with type A aortic dissection underwent total arch replacement at our center. Thirty-six of the patients received ulinastatin treatment at 300 000 U/8 h from admission to 3 days postoperatively and at 300 000 U/2 h during cardiopulmonary bypass surgery (UTI group), and the other 30 patients did not receive perioperative ulinastatin treatment (control group)...
August 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Koji Hashizume, Mizuki Sumi, Kazuyoshi Tanigawa, Takashi Miura, Seiji Matsukuma, Ichiro Matsumaru, Kiyoyuki Eishi
OBJECTIVE: We report the use of the elephant trunk technique at all anastomotic sites in acute type A aortic dissection surgery. METHODS: Artificial graft carrying a 2-mm short elephant trunk were prepared for both distal and proximal anastomotic sites. Subjects were 82 patients with acute type A aortic dissection who underwent surgery using this procedure between March 2009 and August 2015. The mean age was 69.6 ±10.7 years( range, 43~89 years). Seventeen patients( 20...
April 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Yosuke Inoue, Kenji Minatoya, Tatsuya Oda, Tatsuya Itonaga, Yoshimasa Seike, Hiroshi Tanaka, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: An entry located at aortic arch in acute type A aortic dissection (AAAD) is uncommon. It remains controversial whether or not aggressive primary entry resection should be routinely performed in such patients. We have adopted an aggressive strategy of entry site resection, including total arch replacement (TAR) in patients with arch tears. The purpose of this study was to investigate the efficacy of our surgical management approach, using aggressive primary entry resection...
September 2016: European Journal of Cardio-thoracic Surgery
Yongzhong Fan, Jundan Cai, Chaojun Yan
The aim of this study was to explore the application value of technical improvements of difficult tracheotomy. Percutaneous dilatational tracheotomy kit combined with traditional surgical tracheotomy was performed on seven patients with various types of difficult tracheotomy surgery from Jan. 2011 to Mar. 2013 in our hospital. The indicators, such as difficulty degree and intraoperative peripheral oxygen saturation changes of each patient, were assessed and analyzed. The average operating time was 20 min (from the beginning of skin incision to the implantation of the tracheal tube), and the time from cutting out tracheal cartilage rings to completely implanting tracheal tube was with 2 min; the intraoperative oxygen saturation degrees were all above 92 %...
December 2015: Indian Journal of Surgery
Yan Qiu, Jing Lin, Yang Yang, Jing Zhou, Li-Na Gong, Zhen Qin, Lei Du
BACKGROUND: It was believed that inflammatory response induced by cardiopulmonary bypass (CPB) was blamed for complications after cardiac surgery. To improve the outcome, many pharmacological interventions have been applied to attenuate inflammatory response during CPB. The objective of this study was to investigate the effect of ulinastatin (urinary trypsin inhibitor [UTI]) on outcome after CPB surgery. METHODS: Totally, 208 patients undergoing elective valves replacement between November 2013 and September 2014 were divided into Group U (n = 70) and Group C (n = 138) based on they received UTI or not...
December 5, 2015: Chinese Medical Journal
Hong Qian, Wei Meng, Jia Hu, Zheng-hua Xiao, Zhi Fang, Yang Li, Jun Gu, Ming-hua Zhong, Hong-wei Zhang, Er-yong Zhang
OBJECTIVE: To evaluate the early and mid-outcomes of proximal aorta reconstruction for type A aortic dissection (AAD) patients without intimal tear in aortic arch, and assess the safety and efficacy of this surgical strategy. METHODS: From January 2010 to February 2013, there were 23 AAD patients without intimal tear in the aortic arch received proximal aorta reconstruction surgery. Clinical data of these patients were analyzed retrospectively, the mean age was (48...
July 2015: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
Kevin Pilarczyk, Guenter Marggraf, Michaela Dudasova, Ender Demircioglu, Valerie Scheer, Heinz Jakob, Fabian Dusse
OBJECTIVE: To assess the impact of timing of percutaneous dilatational tracheotomy (PDT) on incidence of deep sternal wound infections (DSWI) after cardiac surgery with median sternotomy. DESIGN: Retrospective study between 2003 and 2013. SETTING: Single-center university hospital. PARTICIPANTS: Eight hundred seventy-nine patients after cardiac surgery with extracorporeal circulation and median sternotomy. INTERVENTIONS: PDT using the Ciaglia-technique with direct bronchoscopic guidance...
December 2015: Journal of Cardiothoracic and Vascular Anesthesia
Mutsuhito Kikura, Yuji Suzuki, Taiga Itagaki, Tsunehisa Sato, Junko Nishino
Vocal cord paralysis after tracheal intubation is rare. It causes severe hoarseness and aspiration, and delays recovery and discharge. Arytenoid cartilage dislocation and recurrent nerve paralysis are main causes of vocal cord paralysis. Physical stimulation of the tracheal tube as well as patient and surgical characteristics also contribute. Vocal cord paralysis occurs in 1 (0.07%) of 1,500 general surgery patients and on the left side in 70% of cases. It is associated with surgery/anesthesia time (two-fold, 3-6 hours; 15-fold, over 6 hours), age (three-fold, over 50 years), and diabetes mellitus or hypertension (two-fold)...
January 2015: Masui. the Japanese Journal of Anesthesiology
Eyad Musallam
We sought to conduct a systematic review to evaluate the predictors of surgical site infection (SSI) after cardiac surgery. We included published, peer-reviewed, English-language, retrospective and prospective studies identified in a search of Medline, CINAHL, and PubMed from 2005 and through February 20, 2012. The studies involved adults (age >18 years) undergoing cardiac surgery (defined by ICD-9 codes) and could be of any study design, in English, published within last 7 years, with data collection taking place in United States within last 10 years...
September 2014: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Stacey A Skoretz, Terrence M Yau, Joan Ivanov, John T Granton, Rosemary Martino
Following cardiovascular (CV) surgery, prolonged mechanical ventilation of >48 h increases dysphagia frequency over tenfold: 51 % compared to 3-4 % across all durations. Our primary objective was to identify dysphagia frequency following CV surgery with respect to intubation duration. Our secondary objective was to explore characteristics associated with dysphagia across the entire sample. Using a retrospective design, we stratified all consecutive patients who underwent CV surgery in 2009 at our institution into intubation duration groups defined a priori: I (≤ 12 h), II (>12 to ≤ 24 h), III (>24 to ≤ 48 h), and IV (>48 h)...
December 2014: Dysphagia
Jad Jabbour, Timothy Martin, David Beste, Thomas Robey
IMPORTANCE The clinical course and outcomes of pediatric vocal fold immobility (VFI) vary widely in the literature, and follow-up in these patients varies accordingly. A better understanding of the natural history of pediatric VFI is crucial to improved management. OBJECTIVE To characterize the natural history of pediatric VFI, including symptoms and rates of resolution and surgical intervention. DESIGN, SETTING, AND PARTICIPANTS Retrospective review at an academically affiliated private pediatric otolaryngology practice in a metropolitan area of all patients seen between July 15, 2001, and September 1, 2012, with a diagnosis of complete or partial VFI...
May 2014: JAMA Otolaryngology—Head & Neck Surgery
Guang-fa Zhu, Di-jia Wang, Shuang Liu, Ming Jia, Shi-jie Jia
BACKGROUND: Although noninvasive positive pressure ventilation (NPPV) has been successfully used for various kinds of acute respiratory failure, the data are limited regarding its application in postoperative respiratory failure after cardiac surgery. Therefore, we conducted a prospective randomized control study in a university surgical intensive care unit to evaluate the efficacy and safety of NPPV in the treatment of acute respiratory failure after cardiac surgery, and explore the predicting factors of NPPV failure...
December 2013: Chinese Medical Journal
Chiu-Hsia Chang, Fan-Yen Lee, Chin-Chou Wang, Ying-Ni Chen, Hsin-Chu Chen, Huei-Ling Hung, Meng-Chih Lin, Shih-Feng Liu
BACKGROUND: Numerous studies have documented an obesity paradox that overweight of Caucasian patients has better prognosis after cardiac surgery. This study is to examine Asian patients' BMI to see whether an obesity paradox exists in DMV after cardiac surgery. METHODS: A retrospective study consisted of 428 patients after cardiac surgery from January 2006 to December 2010 in the medical center of Taiwan. The Asian BMI was divided into 3 groups: under-normal weight patients (BMI < 24; n = 165), overweight patients (BMI 24 to <27; n = 130), and obese patients (BMI ≥ 27; n = 133)...
2013: TheScientificWorldJournal
Koichi Suehiro, Katsuaki Tanaka, Tadashi Matsuura, Tomoharu Funao, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
OBJECTIVE: To determine if increases in discrepancy between ScvO2 and SvO2 (ScvO2 - SvO2 = ΔSO2) during surgery in cardiac surgery patients can predict postoperative complications. DESIGN: Prospective, observational study. SETTING: University hospital. PARTICIPANTS: One hundred two patients undergoing cardiac surgery were enrolled. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Central venous oxygen saturation (ScvO2) and mixed venous oxygen saturation (SvO2) values during surgery automatically were collected...
June 2014: Journal of Cardiothoracic and Vascular Anesthesia
Ibrahim J Alibrahim, Mohamad S Kabbani, Riyadh Abu-Sulaiman, Ali Al-Akhfash, Khalid A Mazrou
OBJECTIVE: To investigate the incidence, timing indications and outcome of tracheotomy in children who underwent cardiac surgeries. METHODS: All pediatric cardiac patients (under 14 years of age) who underwent cardiac surgeries and required tracheotomy from November 2000 to November 2010 were reviewed. The data were collected and reviewed retrospectively. RESULTS: Sixteen children underwent tracheotomy after cardiac surgery. Fifteen of these cases had surgery for congenital heart disease, and one had surgery for an acquired rheumatic mitral valve disease...
July 2012: Journal of the Saudi Heart Association
Hiroyuki Kamiya, Nadine Tanzeem, Payam Akhyari, Anabel Pedraza, Klaus Kallenbach, Artur Lichtenberg, Matthias Karck
BACKGROUND: The aims of this study are (1) to investigate the occurrence rate of postoperative complications in patients ≥ 80 years old after cardiac surgery and (2) to elucidate the impact of the most common postoperative complications on mortality. METHODS: Between January 1998 and December 2007, 649 patients aged over 80 years received isolated first-time coronary artery bypass graft (CABG), isolated aortic valve replacement (AVR) or a combination of both in our institute...
2014: Annals of Thoracic and Cardiovascular Surgery
S Lu, X Sun, T Hong, S Yang, K Song, H Lai, C Wang
AIM: This study aimed to evaluate the results of modified surgical strategies of total arch replacement using a four-branched arch graft, stented elephant trunk, and innovative organ protection method for acute type A aortic dissection. METHODS: Between August 2011 and December 2011, 21 patients with acute type A aortic dissection underwent modified total arch replacement using the four-branched arch graft technique. All 21 patients had emergency surgery. Five patients had undergone previous aortic or cardiac surgery...
August 2015: Journal of Cardiovascular Surgery
Antje-Christin Deppe, Elmar Kuhn, Maximilian Scherner, Ingo Slottosch, Oliver Liakopoulos, Georg Langebartels, Yeong-Hoon Choi, Thorsten Wahlers
BACKGROUND: Percutaneous dilatational tracheotomy (PDT) is a common procedure. Coagulation disorders represent a relative contraindication for PDT and, therefore, normalization of hemostasis parameters is recommended. Especially patients undergoing cardiac surgery after valve replacement and with any kind of assist device need to require an adequate anticoagulation. This study investigated the impact of impaired hemostasis as a risk factor for bleeding complications retrospectively. METHODS: Patients who underwent PDT (November 2007 to November 2010) were stratified into a high-risk (HR) and low-risk (LR) group in regard to bleeding complications...
April 2013: Thoracic and Cardiovascular Surgeon
Branka Maldini, Zdenko Novotny, Renata Letica-Brnadić, Ana Brkljacić, Dubravka Bartolek
This clinical report describes an emergency case of a 49-year-old man, ASA E III status, with clinical symptoms of acute abdomen and ileus, who was scheduled for urgent surgery. Predictors of difficult intubation (Mallampati test Class III, short thyro-mental (< 6 cm) and sterno-mental distance (<10 cm) with limited mouth opening (inter-incisor gap < 3 cm) were associated with significant comorbidity (rheumatoid arthritis, heart disease, obesity (body mass index 32.6 kg m-2), cervical spine mobility and generalized vascular disease)...
September 2012: Acta Clinica Croatica
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