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Quality of life in cardiac surgery

Jack H Boyd, Vedant S Pargaonkar, David H Scoville, Ian S Rogers, Takumi Kimura, Shigemitsu Tanaka, Ryotaro Yamada, Michael P Fischbein, Jennifer A Tremmel, Robert Scott Mitchell, Ingela Schnittger
BACKGROUND: Left anterior descending artery myocardial bridges (MBs) range from clinically insignificant incidental angiographic findings to a potential cause of sudden cardiac death. Within this spectrum, a group of patients with isolated, symptomatic, and hemodynamically significant MBs despite maximally tolerated medical therapy exist for whom the optimal treatment is controversial. We evaluated supraarterial myotomy, or surgical unroofing, of the left anterior descending MBs as an isolated procedure in these patients...
October 1, 2016: Annals of Thoracic Surgery
Kimberly Giraud, Megan Pontin, Linda D Sharples, Paul Fletcher, Tim Dalgleish, Allaina Eden, David P Jenkins, Alain Vuylsteke
Introduction: Post-operative delirium remains a significant problem, particularly in the older surgical patient. Previous evidence suggests that the provision of supplementary visual feedback about ones environment via the use of a mirror may positively impact on mental status and attention (core delirium diagnostic domains). We aimed to explore whether use of an evidence-based mirrors intervention could be effective in reducing delirium and improving post-operative outcomes such as factual memory encoding of the Intensive Care Unit (ICU) environment in older cardiac surgical patients...
2016: Frontiers in Aging Neuroscience
Sten Lyager Nielsen
Transcatheter mitral valve (MV) intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation (MR) in patients considered to be inoperable or at high operative risk for surgical MV surgery. In primary mitral regurgitation, surgical repair is the standard of care. Transcatheter edge-to-edge MV repair with the MitraClip system has the largest clinical experience to date, and offers a sustained clinical benefit in selected surgical high-risk patients. Surgery for secondary MR remains a challenge...
October 13, 2016: Scandinavian Cardiovascular Journal: SCJ
Maria G Takousi, Stefanie Schmeer, Irene Manaras, Christoforos D Olympios, Georgios Makos, Nicholas A Troop
OBJECTIVE: To conduct a systematic review and meta-analysis to summarize evidence and determine the impact of coronary revascularization (CR) on cardiac patients' Health-Related Quality of Life (HRQoL), highlighting factors that may affect this outcome in patients. METHODS: A systematic search of Medline (Pubmed), EMBASE, Cochrane Library, Sciverse (Science Direct and Scopus) and PsycInfo was conducted to identify studies published from January 2000 to December 2012...
August 23, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Mohammad Diab, Rajdeep Bilkhu, Gopal Soppa, Nadine McGale, Shashivadan P Hirani, Stanton P Newman, Marjan Jahangiri
No abstract text is available yet for this article.
June 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Katherine L Brown, Christina Pagel, Rhian Brimmell, Kate Bull, Peter Davis, Rodney C Franklin, Aparna Hoskote, Natasha Khan, Warren Rodrigues, Sara Thorne, Liz Smith, Linda Chigaru, Martin Utley, Jo Wray, Victor Tsang, Andrew Mclean
BACKGROUND: Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance. METHODS: As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients...
September 29, 2016: Cardiology in the Young
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
Laurent Macle, John Cairns, Kori Leblanc, Teresa Tsang, Allan Skanes, Jafna L Cox, Jeff S Healey, Alan Bell, Louise Pilote, Jason G Andrade, L Brent Mitchell, Clare Atzema, David Gladstone, Mike Sharma, Subodh Verma, Stuart Connolly, Paul Dorian, Ratika Parkash, Mario Talajic, Stanley Nattel, Atul Verma
The Canadian Cardiovascular Society (CCS) Atrial Fibrillation (AF) Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in AF management. This 2016 Focused Update deals with: (1) the management of antithrombotic therapy for AF patients in the context of the various clinical presentations of coronary artery disease; (2) real-life data with non-vitamin K antagonist oral anticoagulants; (3) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (4) digoxin as a rate control agent; (5) perioperative anticoagulation management; and (6) AF surgical therapy including the prevention and treatment of AF after cardiac surgery...
October 2016: Canadian Journal of Cardiology
Kensuke Kobayashi, Yukio Suto, Okihiko Akashi, Yoshihito Sakata, Yasufumi Hayama, Junichi Kon, Osamu Chino
We report a case of pericardial fenestration in a patient with myocardial metastasis and cardiac tamponade after surgery for esophageal cancer. A 66-year-old man had been suffering from orthopnea, hypotension and general malaise due to cardiac tamponade and heart failure. Esophagectomy was performed with substernal gastric tube reconstruction for advanced esophageal carcinoma. Nine months after the operation, heart failure developed, and myocardial and pericardial metastasis was subsequently detected. Subxiphoidal pericardiocentesis was abandoned due to the substernal gastric tube, and pericardial fenestration was performed through a small left anterior thoracotomy at the 5th intercostal space...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Alexander Kulik
PURPOSE OF REVIEW: Despite the benefits of surgical coronary revascularization, patients continue to be at risk for ischemic events in the years that follow coronary artery bypass graft surgery (CABG), mandating the role for postoperative secondary preventive therapy. The purpose of this review was to present a summary on the subject of secondary prevention after CABG, including an overview of a recently published scientific statement, and highlight the newest studies in the field. RECENT FINDINGS: Aspirin and statin therapy continue to be the mainstay of secondary prevention after CABG, although newer antiplatelet and lipid-lowering medicines are being actively studied for their potential benefits...
November 2016: Current Opinion in Cardiology
Hui-Shan Lin, J N Watts, N M Peel, R E Hubbard
BACKGROUND: As the population ages, increasing numbers of older adults are undergoing surgery. Frailty is prevalent in older adults and may be a better predictor of post-operative morbidity and mortality than chronological age. The aim of this review was to examine the impact of frailty on adverse outcomes in the 'older old' and 'oldest old' surgical patients. METHODS: A systematic review was undertaken. Electronic databases from 2010 to 2015 were searched to identify articles which evaluated the relationship between frailty and post-operative outcomes in surgical populations with a mean age of 75 and older...
2016: BMC Geriatrics
John W Hammon
No abstract text is available yet for this article.
2016: Seminars in Thoracic and Cardiovascular Surgery
Heyman Luckraz, Kumaresan Nagarajan, Akis Chnaris, Parminderjit Kaur Jayia, Israr Muhammed, Sophia Mahboob, Alan Nevill
Cardiac surgery has become established in octogenarians over the past decade. This study assessed the quality of life (QOL) and survival in patients undergoing various cardiac procedures at various time intervals postoperative. Patients older than 80 years at the time of their cardiac procedure were initially included (n = 427). Patients were grouped according to the time interval from their operations namely as within 3 years postoperative (Group A), 3-5 years postoperative (Group B), and older than 5 years postoperative (Group C)...
2016: Seminars in Thoracic and Cardiovascular Surgery
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
Mark D Huffman, Kunal N Karmali, Mark A Berendsen, Adin-Cristian Andrei, Jane Kruse, Patrick M McCarthy, S C Malaisrie
BACKGROUND: People with atrial fibrillation (AF) often undergo cardiac surgery for other underlying reasons and are frequently offered concomitant AF surgery to reduce the frequency of short- and long-term AF and improve short- and long-term outcomes. OBJECTIVES: To assess the effects of concomitant AF surgery among people with AF who are undergoing cardiac surgery on short-term and long-term (12 months or greater) health-related outcomes, health-related quality of life, and costs...
August 22, 2016: Cochrane Database of Systematic Reviews
Barnaby C Reeves, Katie Pike, Chris A Rogers, Rachel Cm Brierley, Elizabeth A Stokes, Sarah Wordsworth, Rachel L Nash, Alice Miles, Andrew D Mumford, Alan Cohen, Gianni D Angelini, Gavin J Murphy
BACKGROUND: Uncertainty about optimal red blood cell transfusion thresholds in cardiac surgery is reflected in widely varying transfusion rates between surgeons and cardiac centres. OBJECTIVE: To test the hypothesis that a restrictive compared with a liberal threshold for red blood cell transfusion after cardiac surgery reduces post-operative morbidity and health-care costs. DESIGN: Multicentre, parallel randomised controlled trial and within-trial cost-utility analysis from a UK NHS and Personal Social Services perspective...
August 2016: Health Technology Assessment: HTA
Suzanne V Arnold, Philip G Jones, Larry A Allen, David J Cohen, Timothy J Fendler, Jonathan E Holtz, Sanjeev Aggarwal, John A Spertus
BACKGROUND: A left ventricular assist device (LVAD) improves survival and quality of life for many, but not all, patients with end-stage heart failure who are ineligible for transplantation. We sought to evaluate the frequency of poor outcomes using a novel composite measure that integrates quality of life with mortality. METHODS AND RESULTS: Within the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) national registry, poor outcome was defined as death or an average Kansas City Cardiomyopathy Questionnaire <45 during the year after LVAD (persistently limiting heart failure symptoms and poor quality of life)...
August 2016: Circulation. Heart Failure
Shogo Yokose, Takashi Miura, Koji Hashizume, Youichi Hisata, Kazuki Hisatomi, Kazuyoshi Tanigawa, Kiyoyuki Eishi
PURPOSE: We evaluated the outcomes of open heart surgery and long-term quality of life for patients 85 years and older. METHODS: We enrolled 46 patients 85 years and older who underwent cardiac and thoracic aortic surgery between May 1999 and November 2012. Long-term assessment was performed for 43 patients; three patients who died in the hospital were excluded. Patient conditions were assessed before surgery, 6 months and 12 months after surgery, and during the late period regarding the need for nursing care, degree of independent living, and living willingness...
August 10, 2016: Annals of Thoracic and Cardiovascular Surgery
Ivo W Soliman, Jos F Frencken, Linda M Peelen, Arjen J C Slooter, Olaf L Cremer, Johannes J van Delden, Diederik van Dijk, Dylan W de Lange
BACKGROUND: Prognostic factors for the combination of long-term survival and health-related quality of life (HRQoL) after intensive care unit (ICU) stay have not yet been studied. Our aim was to assess whether early acute kidney injury (eAKI), AKI occurring on the first day of ICU admission, is an independent predictor of this combined one-year outcome. METHODS: We included all patients admitted to the mixed ICU of the University Medical Centre Utrecht between July 2009 and April 2013, excluding patients with chronic dialysis, cardiac surgery, and length of stay shorter than 24 hours...
2016: Critical Care: the Official Journal of the Critical Care Forum
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