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https://www.readbyqxmd.com/read/29457560/prophylactic-intra-aortic-balloon-counterpulsation-before-surgical-myocardial-revascularization-in-patients-with-acute-myocardial-infarction
#1
Philippe Grieshaber, Tobias Schneider, Lukas Oster, Coskun Orhan, Peter Roth, Bernd Niemann, Andreas Böning
INTRODUCTION: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study aimed to specifically describe the effect of pIABC on outcomes of patients with acute myocardial infarction (AMI) undergoing CABG. METHODS: In 178 of 484 AMI patients (non-ST-segment elevation myocardial infarction [NSTEMI] or ST-segment elevation myocardial infarction [STEMI] ≤5 days before surgery) without cardiogenic shock who underwent CABG between 2008 and 2013, pIABC was initiated preoperatively...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#2
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456049/six-month-outcomes-after-high-risk-coronary-artery-bypass-graft-surgery-and-preoperative-intra-aortic-balloon-counterpulsation-use-an-inception-cohort-study
#3
Edward Litton, Frances Bass, Anthony Delaney, Graham Hillis, Silvana Marasco, Shay McGuinness, Paul S Myles, Christopher M Reid, Julian A Smith
OBJECTIVE: To inform the design of a pivotal randomized controlled trial of prophylactic intra-aortic balloon counterpulsation (IABC) in patients undergoing coronary artery bypass graft (CABG) at high risk of postoperative low cardiac output syndrome (LCOS). DESIGN: Inception cohort study. SETTING: A total of 13 established cardiac centers in Australia, Canada, New Zealand, and the United Kingdom. PARTICIPANTS: Adult patients were eligible for inclusion if they were listed for CABG surgery and had 2 or more LCOS risk factors (low ejection fraction, severe left main coronary artery disease, redo sternotomy, unstable angina)...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29455964/polytetrafluoroethylene-conduits-versus-homografts-for-right-ventricular-outflow-tract-reconstruction-in-infants-and-young-children-an-institutional-experience
#4
Christopher W Mercer, Shawn C West, Mahesh S Sharma, Masahiro Yoshida, Victor O Morell
OBJECTIVE: Our institution uses a valved polytetrafluoroethylene conduit as an alternative to homografts. The objective of this study was to investigate the performance of bicuspid valved polytetrafluoroethylene conduits used for right ventricular outflow tract reconstruction in children aged less than 2 years and to evaluate risk factors for earlier conduit explant. METHODS: We performed an Institutional Review Board-approved retrospective chart review of all patients aged less than 2 years who underwent surgical right ventricular outflow tract reconstruction with a bicuspid valved polytetrafluoroethylene conduit or homograft conduit from July 2004 to December 2014...
January 31, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29454717/superior-approach-for-supracardiac-total-anomalous-pulmonary-venous-connection
#5
Rong Liufu, Guocheng Shi, Fang Zhu, Yongmei Guan, Zhaohui Lu, Weimin Chen, Zhongqun Zhu, Huiwen Chen
BACKGROUND: Studies on the outcomes of surgical repair for supracardiac total anomalous pulmonary venous connection through the superior approach are uncommon. METHODS: From January 2004 to January 2016, 198 patients with supracardiac total anomalous pulmonary venous connection underwent side-to-side anastomosis between the common pulmonary vein and left atrium through the superior approach. Kaplan-Meier curve was used to demonstrate the survival estimates. Cox proportional hazard model and competing risk regression model were used to identify risk factors for death and postoperative pulmonary venous obstruction...
February 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29454380/quality-of-life-satisfaction-and-outcomes-after-ministernotomy-versus-full-sternotomy-isolated-aortic-valve-replacement-quality-avr-study-protocol-for-a-randomised-controlled-trial
#6
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29452832/delayed-endovascular-aortic-repair-is-associated-with-reduced-in-hospital-mortality-in-patients-with-blunt-thoracic-aortic-injury
#7
Christina L Marcaccio, Ryan P Dumas, Yanlan Huang, Wei Yang, Grace J Wang, Daniel N Holena
OBJECTIVE: The traditional approach to stable blunt thoracic aortic injury (BTAI) endorsed by the Society for Vascular Surgery is early (<24 hours) thoracic endovascular aortic repair (TEVAR). Recently, some studies have shown improved mortality in stable BTAI patients repaired in a delayed manner (≥24 hours). However, the indications for use of delayed TEVAR for BTAI are not well characterized, and its overall impact on the patient's survival remains poorly understood. We sought to determine whether delayed TEVAR is associated with a decrease in mortality compared with early TEVAR in this population...
February 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29452784/abdominal-aortic-aneurysm-sex-differences
#8
REVIEW
Christina Villard, Rebecka Hultgren
OBJECTIVE: Abdominal aortic aneurysm (AAA) predominantly affects an elderly male population. Even so, AAA appears more detrimental in women, who experience a higher risk of aneurysm rupture and a worse outcome after surgery than men. Why women are privileged from yet are worse off once affected has been attributed to an effect of sex hormones. This review summarizes the knowledge of sex differences in AAA and addresses the changes in the aneurysm wall from a gender perspective. METHOD: Standard reporting guidelines set by the PRISMA Group were followed to identify studies examining AAA from a gender perspective...
March 2018: Maturitas
https://www.readbyqxmd.com/read/29452395/mini-extracorporeal-circulation-technology-conventional-bypass-and-prime-displacement-in-isolated-coronary-and-aortic-valve-surgery-a-propensity-matched-in-hospital-and-survival-analysis
#9
Priyadharshanan Ariyaratnam, Lindsay A Mclean, Alexander Cale, Mubarak A Chaudhry, Ajith Vijayan, Neil Richards, Martin A Jarvis, Yama Haqzad, Dumbor Ngaage, Michael E Cowen, Mahmoud Loubani
OBJECTIVES: Conventional cardiopulmonary bypass is the most commonly used means of artificial circulation in cardiac surgery. However, it suffers from the effects of haemodilution and activation of inflammatory/coagulation cascades. Prime displacement (PD) can offset haemodilution and Mini-Extracorporeal Technology (MIECT) can offset both. So far, no study has compared all of these modalities together; hence, we compared the outcomes of these 3 modalities at our institution. METHODS: This was a retrospective analysis of our cardiac surgical database...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29452370/blood-cardioplegia-for-cardiac-surgery-in-acute-myocardial-infarction-rat-experiments-with-two-widely-used-solutions
#10
Andreas Boening, Lena Assling-Simon, Martina Heep, Kerstin Boengler, Bernd Niemann, Julia Schipke, Christian Mühlfeld, Philippe Grieshaber
OBJECTIVES: Blood cardioplegia (BCP) can be used in different ways to protect the heart from ischaemia-reperfusion injury during cardiac surgery. Because there could be differences between warm and cold intermittent cardioplegia with or without warm reperfusion, we investigated the influence of 2 blood cardioplegia solutions on cardiac function, metabolism and infarct size in stable and infarcted rat hearts. METHODS: The hearts of 32 male Wistar rats were excised and inserted into a blood-perfused isolated heart apparatus...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29452357/del-nido-cardioplegia-in-adult-cardiac-surgery-beyond-single-valve-surgery
#11
Wan Kee Kim, Hong Rae Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
OBJECTIVES: In recent years, the use of del Nido (DN) cardioplegia has been reported in single-valve surgery or isolated coronary artery bypass surgery with acceptable outcomes. The reports of its use in more complex adult cardiac procedures, however, have been scarce. METHODS: We enrolled a total of 149 adult patients who underwent heart valve surgery with the use of DN cardioplegia between May 2014 and December 2016. For a benchmark comparison, 892 patients who underwent cardiac valve surgery with blood cardioplegia during the same period served as controls...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29452118/long-term-outcome-of-interrupted-arch-repair-with-direct-anastomosis-and-homograft-augmentation-patch
#12
Mohammed Mohsin Uzzaman, Natasha E Khan, Ben Davies, John Stickley, Timothy J Jones, William J Brawn, David J Barron
BACKGROUND: We analysed outcomes of IAA repair using a standardised technique in order to interpret the role of the arch repair on late outcomes in this complex and heterogeneous group. METHODS: Single institution study from 1988-2015. 120 cases of IAA were divided into four groups: IAA with VSD (iVSD, n=38), IAA with Norwood/DKS (iNor, n=41), IAA with Truncus (iTruncus, n=24) and miscellaneous group (iMisc, n=17). Arch repair performed using a standard technique of direct anastomosis with homograft patch augmentation...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29448828/role-of-terminal-warm-blood-cardioplegia-in-complex-congenital-heart-surgery
#13
Pribadi Wiranda Busro, Harvey Romolo, Sudigdo Sastroasmoro, Jusuf Rachmat, Mohammad Sadikin, Anwar Santoso, Cindy Elfira Boom, Suhendro Suwarto, Ahmad Aulia Jusuf
Introduction Myocardial protection is vital to ensure successful open heart surgery. Cardioplegic solution is one method to achieve good myocardial protection. Inevitably, ischemia-reperfusion injury occurs with aortic crossclamping. Histidine-tryptophan-ketoglutarate solution is a frequently used cardioplegia for complex congenital heart surgery. We postulated that addition of terminal warm blood cardioplegia before removal of the aortic crossclamp might improve myocardial protection. Method A randomized controlled trial was conducted on 109 cyanotic patients aged, 1 to 5 years who underwent complex biventricular repair...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29447780/nonprimary-pci-at-hospitals-without-cardiac-surgery-on-site-consistent-outcomes-for-all
#14
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/29447379/acute-exercise-is-not-cardioprotective-and-may-induce-apoptotic-signalling-in-heart-surgery-a-randomized-controlled-trial
#15
Benedikte T Smenes, Fredrik H Bækkerud, Katrine H Slagsvold, Erlend Hassel, Martin Wohlwend, Maria Pinho, Morten Høydal, Ulrik Wisløff, Øivind Rognmo, Alexander Wahba
OBJECTIVES: During open-heart surgery, the myocardium experiences ischaemia-reperfusion injury. A single bout of moderate, 30-min exercise induces preconditioning and protects the heart from ischaemia-reperfusion injury in rats, but this has never been investigated in humans. We aimed to investigate whether 1 bout of moderate exercise 24 h prior to surgery protects against mitochondrial and cardiac damage. METHODS: Patients scheduled for elective coronary artery bypass were eligible for this pilot study...
February 13, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29445600/chronic-type-b-residual-after-type-a-what-i-would-do
#16
Martin Czerny, Maximilian Kreibich, Julia Morlock, Stoyan Kondov, Johannes Scheumann, Holger Schröfel, Fabian A Kari, Tim Berger, Matthias Siepe, Friedhelm Beyersdorf, Bartosz Rylski
" The major goal of surgery for acute type A aortic dissection is to have an alive patient. " This motto still remains the most important directive. However, also depending onto the extent of the underlying pathology and consecutively depending onto the extent of primary surgery, there is and will be need for additional classical surgical or interventional treatment sooner or later during follow-up in a substantial number of patients having had surgery for acute type A aortic dissection. This article shall guide the interested reader through the underlying mechanisms as well as treatment options in patients with chronic type B "residual" after type A repair and shall finally suggest preventive strategies to reduce the occurrence of this pathology to a minimum...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29444580/-our-experience-with-left-sided-retroperitoneal-approach-to-resection-of-abdominal-aortic-aneurysm
#17
B Čertík, V Třeška, J Moláček, M Čechura, R Šulc, K Houdek
INTRODUCTION: At most vascular surgery departments, transperitoneal approach predominates in resections of the aortic aneurysms. For difficult reconstructions of the aorta in the visceral segment, a left flank retroperitoneal approach is used most frequently. METHOD: The authors retrospectively evaluate the left retroperitoneal approach in the management of abdominal aortic aneurysms during a 10-year period. From the total number of 445 operated patients, the left-sided retroperitoneal approach was used in 23 cases...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29443351/reinforcement-of-suture-lines-with-aortic-eversion-in-aortic-replacement
#18
Erhan Kaya
BACKGROUND: In this study, we describe the technique of eversion of the native aortic tissue to prevent suture line complications, and report on our results with this technique. METHODS: A total of 42 patients who were operated on due to aortic aneurysm were retrospectively assessed. In all patients, an aortic segment of approximately 2 cm, which was left both distally and proximally, was everted to form a double-layer lumen and the grafts were anastomosed. Postoperative outcomes and long-term follow-up results were assessed...
January 16, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29442340/aortic-valve-replacement-using-autologous-pericardium-single-centre-experience-with-the-ozaki-technique
#19
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/29441169/perioperative-stroke-pathophysiology-and-management
#20
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
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