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chronic thromboembolism

Masami Takagaki, Hiroki Yamaguchi, Naoko Ikeda, Kaori Takeda, Fumihito Kasai, Kiyotaka Yahagi, Shunji Kanzaki, Shinichi Mitsuyama, Tasuku Kadowaki, Toru Kotani
We present the cases of eight patients (mean age 75 years; EuroSCORE II 17.0 ± 22.0) who underwent post-cardiotomy venovenous extracorporeal membrane oxygenation (ECMO) without heparinization due to serious bleeding. Three liver cirrhosis, two chronic hemodialysis, three redo sternotomy, and two urgent surgery cases were included. Respiratory ECMO Survival Prediction score was - 5.1 ± 4.2 (estimated survival rate: approximately 30%). Mean ECMO duration was 14 days with 9 circuit exchanges. Five patients were weaned from ECMO and three were discharged alive at 90 days (survival 37...
August 17, 2018: General Thoracic and Cardiovascular Surgery
Dong Kyu Oh, Jong-Min Song, Duk-Woo Park, Sang Young Oh, Jin-Sook Ryu, Jaewon Lee, Sang Do Lee, Jae Seung Lee
BACKGROUND: Although guidelines have recommended that patients with chronic thromboembolic pulmonary hypertension (CTEPH) should be managed by a multidisciplinary team (MDT), there is a lack of clinical data indicating that the MDT improves CTEPH management. OBJECTIVES: The study aimed to identify the effect of an MDT on CTEPH management. METHODS: We divided the study period into pre-MDT and post-MDT eras and compared the implementation rates of major diagnostic and therapeutic procedures...
August 13, 2018: Heart & Lung: the Journal of Critical Care
Andrzej Labyk, Dominik Wretowski, Sabina Zybińska-Oksiutowicz, Aleksandra Furdyna, Katarzyna Ciesielska, Dorota Piotrowska-Kownacka, Olga Dzikowska -Diduch, Barbara Lichodziejewska, Andrzej Biederman, Piotr Pruszczyk, Marek Roik
BACKGROUND: Approximately a quarter of patients with advanced sarcoidosis develop pulmonary hypertension (PH), which affects their prognosis. We report unusual case of confirmed chronic thromboembolic pulmonary hypertension (CTEPH) in a patient with stage IV sarcoidosis successfully treated with balloon pulmonary angioplasty (BPA). CASE PRESENTATION: A 65 years old male with a history of colitis ulcerosa, and pulmonary sarcoidosis diagnosed in 10 years before, on long term oral steroids, with a history of deep vein thrombosis and acute pulmonary embolism chronically anticoagulated was referred to our center due to severe dyspnea...
August 16, 2018: BMC Pulmonary Medicine
Mohammad Davoodi, Boshra Rezvankhah, Keivan Gohari Moghadam, Amir Pejman Hashemi Taheri
BACKGROUND AND AIMS: The risk of pulmonary thromboembolism (PTE) in patients with exacerbated chronic obstructive pulmonary disease (e-COPD) is higher than in non-COPD states. This study aimed to evaluate the prevalence and the parameters that are critical for finding the incidence of PTE in patients with e-COPD. METHODS: This cross-sectional study was performed on 68 consecutive patients with the e-COPD, referred to the Pulmonary Disease Department at the Shariati Hospital in Tehran between 2013 and 2014...
August 15, 2018: Advances in Respiratory Medicine
Xiaomao Fan, Qihang Yao, Yunpeng Cai, Fen Miao, Fangmin Sun, Ye Li
Atrial fibrillation (AF) is one of the most common sustained chronic cardiac arrhythmia in elderly population, associated with a high mortality and morbidity in stroke, heart failure, coronary artery disease, systemic thromboembolism, etc. The early detection of AF is necessary for averting the possibility of disability or mortality. However, AF detection remains problematic due to its episodic pattern. In this paper, a multi-scaled fusion of deep convolutional neural network (MSCNN) is proposed to screen out AF recordings from single lead short ECG recordings...
August 7, 2018: IEEE Journal of Biomedical and Health Informatics
Prateek Pophali, Pedro Horna, Terra L Lasho, Christy M Finke, Rhett P Ketterling, Naseema Gangat, David Nagorney, Ayalew Tefferi, Mrinal M Patnaik
In a 28-year period, 39 (7%) patients with chronic myelomonocytic leukemia (CMML) (median age 66 years, 64% male) underwent a splenectomy at our institution. Primary indications for splenectomy were refractory thrombocytopenia (36%), progressive spleen related symptoms (33%), emergent splenectomy for splenic rupture (21%), refractory anemia (8%) and prior to allogenic stem cell transplant (3%). Eleven (28%) patients had anemia at the time of splenectomy, of which 3 (27%) were autoimmune. The median time to splenectomy from CMML diagnosis was 6 months (0-40); peri-operative morbidity and mortality rates were 43% and 13%, while the median post-splenectomy survival was 25 months (11-38)...
August 13, 2018: American Journal of Hematology
Tatsuro Ibe, Hiroshi Wada, Kenichi Sakakura, Miyuki Ito, Yusuke Ugata, Kei Yamamoto, Yousuke Taniguchi, Shin-Ichi Momomura, Hideo Fujita
Recently, long-term outcomes of pre-capillary pulmonary hypertension (PH) have been improved, whereas morbidity and mortality are still high because of right-sided heart failure (HF). Right-sided HF is closely related to right ventricular (RV) function and hemodynamics such as RV stroke work index (RVSWI). However, the association between RVSWI and long-term outcomes in pre-capillary PH has not been well investigated. The aims of this study were to compare clinical characteristics between low RVSWI and high RVSWI and to investigate the association between low RVSWI and long-term outcomes in patients with pre-capillary PH...
August 11, 2018: International Heart Journal
Yvonne M Ende-Verhaar, Wilbert B van den Hout, Harm Jan Bogaard, Lilian J Meijboom, Menno V Huisman, Petr Symersky, Anton Vonk-Noordegraaf, Frederikus A Klok
BACKGROUND: The median diagnostic delay of chronic thromboembolic pulmonary hypertension (CTEPH) is 14 months, which may affect prognosis. We aimed to explore healthcare utilisation of patients diagnosed with CTEPH after acute pulmonary embolism (PE) and to identify causes of diagnostic delay. METHODS: We collected all data of patient's symptoms, medical specialist's referrals and ordered diagnostic tests to reconstruct the clinical pathways of 40 patients referred to the VU University Medical Center Amsterdam (VUMC, the Netherlands) for CTEPH treatment...
August 12, 2018: Journal of Thrombosis and Haemostasis: JTH
Panagiotis Karyofyllis, Dimitris Tsiapras, Varvara Papadopoulou, Michael D Diamantidis, Paraskevi Fotiou, Eftychia Demerouti, Vassilis Voudris
Pulmonary hypertension (PH), a serious disorder with a high morbidity and mortality rate, is known to occur in a number of unrelated systemic diseases. β-Thalassaemia, among other haematological disorders, develop PH which is not an infrequent finding and worsens the prognosis. Haemolysis, iron overload and hypercoagulable state are among the main pathogenetic mechanisms. Haemoglobinopathies and congenital haemolytic anaemia constitute a unique patients population more predisposed to developing chronic thromboembolic pulmonary hypertension (CTEPH)...
August 7, 2018: Journal of Thrombosis and Thrombolysis
O V Kamenskaya, I Y Loginova, A M CHernyavskiy, D V Khabarov, V V Lomivorotov
AIM: to study lung diffusion capacity and efficiency of pulmonary ventilation in patients with chronic thromboembolic pulmonary hypertension (CTEPH) depending on the severity of pulmonary hypertension. MATERIALS AND METHODS: The study included 139 patients with CTEPH. The parameters of body plethysmography, lung diffusion capacity, efficiency of pulmonary ventilation and their interrelation with results of angiopulmonography were assessed. RESULTS: Patients were divided according to systolic pulmonary artery pressure (SPAP): group 1 - < 50, group 2 - 50-80, group 3 - > 80 mm Hg...
July 2018: Kardiologiia
S G Kanorskiy
Conducting anticoagulant therapy for atrial fibrillation, combined with diabetes mellitus and/or chronic kidney disease, can create certain difficulties for practicing doctors due to a simultaneous increase in the risk of thromboembolic and hemorrhagic complications. The presence of diabetes mellitus and renal dysfunction can influence the results of antithrombotic therapy in patients with atrial fibrillation. The review provides information on the differences in efficacy and safety of individual oral anticoagulants in the prevention of thromboembolic complications of atrial fibrillation in patients with diabetes mellitus, impaired renal function...
2018: Kardiologiia
Katharine L Cheung, Beth A Bouchard, Mary Cushman
Chronic kidney disease (CKD) affects 30 million Americans and is associated with approximately a two-fold increased risk of venous thromboembolism (VTE). There is a graded increased risk of VTE across declining kidney function, as measured by estimated glomerular filtration rate (eGFR) and albuminuria. When patients with end-stage kidney disease (ESKD) experience VTE they are more likely than the general population to be hospitalized and they have a higher mortality. The incidence and consequences of VTE may also differ depending on the cause of kidney disease...
July 31, 2018: Thrombosis Research
Yasaman Kavousi, Ziad Al Adas, Efstathios Karamanos, Nicole Kennedy, Loay S Kabbani, Judith C Lin
BACKGROUND: Risk factors for chronic venous disease (CVD) have been widely reported in population health management. However, predisposing factors associated with patients treated for advanced stages of CVD have yet to be established. We examined the demographics and risk factors associated with advanced clinical presentation of CVD for patients referred for vein ablation. METHODS: Retrospective analysis of our institutional Vascular Quality Initiative Varicose Vein Registry included endovenous laser treatment and radiofrequency ablation procedures at our tertiary institution, community hospital, and outpatient vein clinic between January 2015 and December 2016...
July 28, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Quentin Binet, Catherine Lambert, Cedric Hermans
INTRODUCTION: Venous malformations (VM) are congenital slow-flow vascular malformations. A common complication is localized intravascular coagulopathy (LIC), which results from chronic, localized, intraluminal activation and consumption of clotting factors and is characterized by elevated D-dimer and, in severe cases, decreased fibrinogen levels. Therapeutic options include anti-coagulation by Low Molecular Weight Heparin (LMWH) which has been reported to improve pain, decrease thrombosis, improve laboratory parameters and reduce hemorrhagic complications...
August 2018: Thrombosis Research
Ai-Li Li, Zhen-Guo Zhai, Ya-Nan Zhai, Wan-Mu Xie, Jun Wan, Xin-Cao Tao
Right ventricular (RV) function is a significantly important factor in the determination of the prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) patients. Speckle-tracking echocardiography (STE) is an angle-independent new technique for quantifying myocardial deformation that is capable of providing data on multiple parameters including longitudinal and transverse information of the myocardium. In the present study, we aimed to study the advantages of STE-derived parameters in identifying RV dysfunction in CTEPH patients...
July 30, 2018: International Journal of Cardiovascular Imaging
Sidra Khalid, Samin Yasar, Aariez Khalid, Timothy Pp Spiro, Abdo Haddad, Hamed Daw
Background Ibrutinib is a Bruton's tyrosine kinase inhibitor, which is United States Food and Drug Administration (FDA)-approved for chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenström's macroglobulinemia. Ibrutinib is associated with atrial fibrillation and bleeding events. Our aim is to determine the management of prior atrial fibrillation when starting ibrutinib, as well as ibrutinib-induced atrial fibrillation. Our focus is on which rate and rhythm control strategies to use and decisions regarding the use of antiplatelet and anticoagulation agents...
May 29, 2018: Curēus
Alexandra Grosse, Claudia Grosse, Irene Lang
PURPOSE: The aim of this study was to evaluate the vascular and parenchymal CT imaging findings, including vessel and cardiac chamber diameter measurements, in patients newly diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH). The CT imaging findings were correlated with hemodynamic measurements and patient outcome. METHODS: Vascular and parenchymal CT findings were assessed on retrospectively ECG-gated MDCT angiography scans in 76 patients newly diagnosed with CTEPH...
2018: PloS One
Keshav Menon, Patrick D Sutphin, Sonja Bartolome, Sanjeeva P Kalva, Takeshi Ogo
Chronic thromboembolic pulmonary hypertension (CTEPH) is a debilitating but potentially reversible complication of chronic pulmonary thromboembolic disease characterized by progressive right heart dysfunction secondary to pulmonary arterial stenosis or occlusion. Balloon pulmonary angioplasty (BPA) has recently emerged as an alternative intervention for non-surgical candidates with CTEPH. Modern reperfusion angioplasty techniques relieve sequela of chronic pulmonary hypertension, ameliorate right ventricular failure, and improve functional status...
June 2018: Cardiovascular Diagnosis and Therapy
Katia Hidemi Nishiyama, Sachin S Saboo, Yuki Tanabe, Dany Jasinowodolinski, Michael J Landay, Fernando Uliana Kay
Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of venous thromboembolic disease. Differently from other causes of pulmonary hypertension, CTEPH is potentially curable with surgery (thromboendarterectomy) or balloon pulmonary angioplasty. Imaging plays a central role in CTEPH diagnosis. The combination of techniques such as lung scintigraphy, computed tomography and magnetic resonance angiography provides non-invasive anatomic and functional information. Conventional pulmonary angiography (CPA) with right heart catheterization (RHC) is considered the gold standard method for diagnosing CTEPH...
June 2018: Cardiovascular Diagnosis and Therapy
John K Bartoli-Abdou, Jignesh P Patel, Rosa Xie, Olubanke Dzahini, Bipin Vadher, Alison Brown, Lara N Roberts, Raj K Patel, Roopen Arya, Vivian Auyeung
Background: Anticoagulation control with vitamin-K antagonists (VKAs) in patients with atrial fibrillation (AF) or venous thromboembolism (VTE) can be measured using time in therapeutic range (TTR), where TTR >65% is considered good and low TTR may be associated with low adherence. Methods: This cross-sectional observational study compared illness beliefs, treatment beliefs, and treatment satisfaction of patients with TTR >75% and TTR <50% using validated tools to determine their association with TTR...
July 2018: Research and Practice in Thrombosis and Haemostasis
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