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Cardiac Surgery, Thoracic Surgery, Vascular Surgery

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https://www.readbyqxmd.com/read/30508866/german-heart-surgery-report-2017-the-annual-updated-registry-of-the-german-society-for-thoracic-and-cardiovascular-surgery
#1
Andreas Beckmann, Renate Meyer, Jana Lewandowski, Michael Frie, Andreas Markewitz, Wolfgang Harringer
Based on a longtime voluntary registry, founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all cardiac, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during the year 2017 are analyzed. In 2017, a total of 179,337 procedures were submitted to the registry, and 101,728 were summarized as heart surgery procedures in the narrower sense. About 16.8% of these patients were at least 80 years old, resulting in an increase of 1...
December 3, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/30460254/mechanical-ventilation-management-during-cardiothoracic-surgery-an-open-challenge
#2
REVIEW
Elena Bignami, Francesco Saglietti, Antonio Di Lullo
Mechanical ventilation during surgery is a highly complex procedure, particularly in cardiothoracic surgery, where patients need to undergo substantial hemodynamic management, involving large fluid exchanges and pharmacological manipulation of vascular resistance, as well as direct manipulation of the lungs themselves. Cardiothoracic surgery is burdened by a high rate of postoperative pulmonary complication (PPC), comorbidity, and mortality. Recent trials have examined various techniques to preserve lung function, although consensus on best practice has yet to be reached...
October 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/30366687/prospective-trial-of-low-fidelity-deliberate-practice-of-aortic-and-coronary-anastomoses-tecog-002
#3
John R Spratt, Melissa Brunsvold, David Joyce, Tom Nguyen, Mara Antonoff, Gabriel Loor
OBJECTIVE: We sought to examine the feasibility of a home practice curriculum of vascular anastomosis in cardiovascular surgery using a low-fidelity simulation platform and to examine its effectiveness in skill acquisition in senior surgical trainees. DESIGN: We organized a multicenter prospective randomized study of senior residents and fellows, who were oriented to a low-fidelity cardiac simulator and an 8-week curriculum of independent practice of aortic and coronary anastomosis...
October 23, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/30365170/surgical-ligation-of-patent-ductus-arteriosus-in-a-dorper-sheep
#4
Jennifer L Halleran, Ryan D Baumwart, Danielle R Dugat, Robert N Streeter, Heidi Phillips
OBJECTIVE: To report the diagnosis and treatment of a companion dorper wether with patent ductus arteriosus (PDA). STUDY DESIGN: Case report. ANIMAL: An 8-month-old dorper wether presented to its primary care veterinarian for a persistent cough and was referred for suspected heart failure on the basis of physical examination and thoracic radiography. A PDA was diagnosed on echocardiography. METHODS: The sheep underwent cardiac catheterization and angiogram to measure pulmonary arterial and right ventricular (RV) pressures, identify the morphology of the PDA, and determine whether an intravascular occlusion of the PDA was feasible...
October 26, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/30310021/-imaging-diagnosis-and-interventional-radiology-for-thoracic-surgery
#5
Kei Takase
Recent introduction of multidetector-row computed tomography(MDCT) with more than 64 scanners enabled high-speed scanning in wide range of the body. Electrocardiogram (ECG) gated scanning and 4-dimensional imaging provides precise evaluation of cardiac and vascular diseases. Fine vascular structures such as the artery of Adamkiewicz can be visualized due to improved spatial and temporal resolution of CT and magnetic resonance imaging(MRI). Interventional radiology also plays important roles in combination with surgical treatment...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/30217710/length-of-stay-after-thoracic-endovascular-aortic-repair-depends-on-indication-and-acuity
#6
Nathan Belkin, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Venkat Kalapatapu, Michael A Golden, Ronald M Fairman, Rachel R Kelz, Grace J Wang
BACKGROUND: Length of stay (LOS) is a commonly used metric to optimize value in medical care. Although pathways have been developed for some procedures in vascular surgery to reduce LOS, they do not yet exist for thoracic endovascular aortic repair (TEVAR). The purpose of this study is to identify and define the risk factors for prolonged LOS in patients undergoing TEVAR to facilitate pathway development. METHODS: We included TEVAR patients in the National Surgical Quality Improvement Program database from 2005 to 2015...
September 11, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30094212/off-pump-coronary-artery-bypass-surgery-with-bilateral-internal-thoracic-arteries-the-leipzig-experience
#7
Piroze M Davierwala, Sergey Leontyev, Jens Garbade, Sven Lehmann, David Holzhey, Martin Misfeld, Michael A Borger
Background: Contrasting results of recent randomized controlled trials (RCTs) comparing off-pump and on-pump coronary artery bypass graft (CABG) surgery, as well as the lack of evidence for any survival benefit of bilateral internal thoracic artery (ITA) grafting over single ITA use, has intensified the debate about the role of the off-pump technique and bilateral ITA use in CABG surgery. We therefore investigated our 15-year experience in off-pump CABG with bilateral ITA grafting and evaluated temporal trends in preoperative characteristics and postoperative outcomes...
July 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29959499/-hybrid-operating-theater
#8
REVIEW
T Fuchs-Buder, N Settembre, D Schmartz
A hybrid suite is an operating theater with imaging equipment equivalent to that used in an angiography suite with computed tomography (CT) and magnetic resonance imaging (MRI). They are often situated outside the operating room area and typically serve as multifunctional rooms designed to support a variety of catheter-based endovascular procedures and open surgery to be performed in the same location. The possibility to perform these in the same location facilitates the combination of both approaches to so-called hybrid procedures...
July 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29921605/evolution-of-validated-biomarkers-and-intraoperative-parameters-in-the-development-of-postoperative-ards
#9
Hemang Yadav, Adam Bartley, Sheila Keating, Laurie A Meade, Philip J Norris, Rickey E Carter, Ognjen Gajic, Daryl J Kor
BACKGROUND: Patients who develop ARDS from medical or traumatic causes typically present after the inciting event has already occurred. Postoperative ARDS is unique in that the inciting insult potentially responsible for ARDS is known ahead of time, which provides an opportunity to study the early pathophysiology of ARDS. The objective of this study was to better understand the early pathophysiology of postoperative ARDS through a temporal analysis of key biomarkers of interest. METHODS: We performed a case-control study of adults undergoing elective thoracic, aortic vascular, or cardiac surgery, which placed them at increased risk of developing postoperative ARDS...
November 2018: Respiratory Care
https://www.readbyqxmd.com/read/29850131/the-feasibility-and-safety-of-off-pump-coronary-bypass-surgery-in-emergency-revascularization
#10
Hyun-Chel Joo, Young-Nam Youn, Byung-Chul Chang, Kyung-Jong Yoo
Background: The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) in emergency revascularization remains controversial despite its widespread use. The aim of our study was to examine the applicability and safety of OPCAB in patients who were indicated for emergency surgery. Methods: This single-center study reviewed the indication, operative data, and early and long-term outcomes of 113 patients (mean age, 67.2±9.0 years; logistic EuroSCORE, 14...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29738368/antiapoptotic-effect-of-%C3%AE-1-blockers-in-ascending-thoracic-aortic-smooth-muscle-cells-the-role-of-hsp70-expression
#11
Ioannis K Rizos, James N Tsoporis, Ioannis K Toumpoulis, Vasileios Salpeas, Shehla Izhar, Angelos G Rigopoulos, Eleftherios A Sakadakis, Thomas G Parker
Heat shock proteins (HSPs) play an important role in the cellular adaptation to stress, a requisite for cell survival. The aortic wall appears to be a target for increased expression of HSPs during surgical stress. We aimed to define the expression and function of aortic HSP70 in 31 patients with normal ascending thoracic aortic diameter who underwent aortic valve replacement due to aortic valve stenosis and in 35 patients with dilated ascending thoracic aorta who underwent replacement of an ascending thoracic aortic aneurysm...
August 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29714043/vasomotion-as-an-oscillatory-sign-of-functional-impairment-in-the-human-internal-thoracic-artery-a-study-based-on-risk-factors-and-vessel-reactivity
#12
Diogo A Fonseca, Pedro E Antunes, Manuel J Antunes, Maria Dulce Cotrim
NEW FINDINGS: What is the central question of this study? Vasomotion has been viewed as a rhythmic oscillation of the vascular tone that is physiologically important for optimal tissue perfusion. Also, it has been studied primarily in the microcirculation. However, the precise underlying mechanisms and the physiological significance remain unknown. What is the main finding and its importance? Vasomotion is not specific to the microcirculation, as shown by our findings. In human arteries from patients undergoing cardiac surgery, an increased incidence was associated with endothelial dysfunction settings...
July 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#13
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#14
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29688940/robotic-beating-heart-totally-endoscopic-coronary-artery-bypass-in-higher-risk-patients-can-it-be-done-safely
#15
COMPARATIVE STUDY
Husam H Balkhy, Sarah Nisivaco, Hiroto Kitahara, Mackenzie McCrorey, Brooke Patel
OBJECTIVE: Patients with a high Society of Thoracic Surgeons (STS) predicted risk of mortality undergoing coronary artery bypass surgery are known to have worse outcomes. Less invasive approaches have been shown to improve morbidity and mortality for these patients. In this study, we examined perioperative outcomes in higher-risk patients undergoing robotic totally endoscopic beating heart coronary artery bypass surgery. METHODS: The STS predicted risk of mortality was reviewed for patients undergoing robotic totally endoscopic beating heart coronary artery bypass surgery at our institution between January 2013 and May 2017...
March 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29627015/spinal-cord-infarction-clinical-and-imaging-insights-from-the-periprocedural-setting
#16
Nicholas L Zalewski, Alejandro A Rabinstein, Karl N Krecke, Robert D Brown, Eelco F M Wijdicks, Brian G Weinshenker, Derrick A Doolittle, Eoin P Flanagan
OBJECTIVE: Describe the range of procedures associated with spinal cord infarction (SCI) as a complication of a medical/surgical procedure and define clinical and imaging characteristics that could be applied to help diagnose spontaneous SCI, where the diagnosis is often less secure. METHODS: We used an institution-based search tool to identify patients evaluated at Mayo Clinic, Rochester, MN from 1997 to 2016 with a periprocedural SCI. We performed a descriptive analysis of clinical features, MRI and other laboratory findings, and outcome...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29562425/-feasibility-and-efficacy-of-transcatheter-closure-of-anastomotic-leakage-after-aortic-surgery-using-amplatzer-vascular-plug-%C3%A2
#17
W H Wu, L J Huang, J Z Pu, X Y Huang, X Pu, Y Ning, X Wang
Objective: To investigate the feasibility and efficacy of transcatheter closure of anastomotic leakage after aortic surgery using Amplatzer Vascular Plug Ⅲ (AVP Ⅲ). Methods: A retrospective analysis was performed in 5 patients with anastomotic leakage after aortic surgery, who underwent transcatheter closure in our hospital from January to June 2017 using AVP Ⅲ. Surgeries were performed in 3 cases of Standford type A dissection, 1 case of ascending aortic aneurysm and 1 case of persistent truncus.There were 3 males,and age was (43...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29562073/association-of-frailty-with-failure-to-rescue-after-low-risk-and-high-risk-inpatient-surgery
#18
Rupen Shah, Kristopher Attwood, Shipra Arya, Daniel E Hall, Jason M Johanning, Emmanuel Gabriel, Anthony Visioni, Steven Nurkin, Moshim Kukar, Steven Hochwald, Nader N Massarweh
Importance: Failure to rescue (FTR), or death after a potentially preventable complication, is a nationally endorsed, publicly reported quality measure. However, little is known about the impact of frailty on FTR, in particular after low-risk surgical procedures. Objective: To assess the association of frailty with FTR in patients undergoing inpatient surgery. Design, Setting, and Participants: This study assessed a cohort of 984 550 patients undergoing inpatient general, vascular, thoracic, cardiac, and orthopedic surgery in the National Surgical Quality Improvement Program between January 1, 2005, and December 31, 2012...
May 16, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29519377/a-multidisciplinary-approach-on-the-perioperative-antithrombotic-management-of-patients-with-coronary-stents-undergoing-surgery-surgery-after-stenting-2
#19
REVIEW
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29507790/hyperthermic-intrathoracic-chemotherapy-after-extended-pleurectomy-and-decortication-for-malignant-pleura-mesothelioma-an-observational-study-on-outcome-and-microcirculatory-changes
#20
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
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