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Preoperative risk Pulmonary

Dany-Michel Marcadet, Bruno Pavy, Gilles Bosser, Frédérique Claudot, Sonia Corone, Hervé Douard, Marie-Christine Iliou, Bénédicte Vergès-Patois, Pascal Amedro, Thierry Le Tourneau, Caroline Cueff, Taniela Avedian, Alain Cohen Solal, François Carré
The exercise test is performed routinely in cardiology; its main indication is the diagnosis of myocardial ischemia, evaluated along with the subject's pretest probability and cardiovascular risk level. Other criteria, such as analysis of repolarization, must be taken into consideration during the interpretation of an exercise test, to improve its predictive value. An exercise test is also indicated for many other cardiac diseases (e.g. rhythm and conduction disorders, severe asymptomatic aortic stenosis, hypertrophic cardiomyopathy, peripheral artery disease, hypertension)...
August 6, 2018: Archives of Cardiovascular Diseases
Ayhan Kaydu, Erhan Gokcek
BACKGROUND Pulmonary aspiration of the gastric contents is a serious perioperative complication. The aim of this study was to evaluate the efficacy of portable ultrasonography in the preoperative evaluation of the gastric contents of patients. The secondary aim was to examine the relationship between gastric antrum cross-sectional area and age and body mass index (BMI). MATERIAL AND METHODS This single-center, prospective, cross-sectional study included 120 patients who underwent surgery. Measurements the gastric antral cross-sectional areas and quantitative and qualitative measurements of the stomach were taken by ultrasonography guidance in all patients...
August 9, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Peter Michael Rodgers-Fischl
The Framingham Studies revealed diabetes mellitus (DM) predisposed subjects to a 2-8 fold increase in risk in developing heart failure (HF). Much less information is available about the reverse issue; namely is there an increased risk of developing DM in patients with HF.  We sought to determine if reversal/partial reversal of HF through aortic valve replacement would improve glycemic control in patients with DM at our institution.             Methods: Electronic medical records of 57 consecutive diabetic patients who underwent aortic valve replacement (AVR) at a medium sized academic medical center from May 2005 through May 2015 and had glycated hemoglobin (HbA1C) measuredbefore and after the procedure were retrospectively analyzed...
July 12, 2018: Heart Surgery Forum
Valentina Mantegazza, Annalisa Pasquini, Luciano Agati, Laura Fusini, Manuela Muratori, Paola Gripari, Sarah Ghulam Ali, Carlo Vignati, Antonio Luca Bartorelli, Cristina Ferrari, Francesco Alamanni, Mauro Pepi, Gloria Tamborini
MitraClip is a validated treatment for significant mitral regurgitation (MR) in high-risk patients. Aims of the study were to evaluate immediate changes in mitral valve (MV) geometry induced by MitraClip and correlations between baseline geometry and cardiac remodeling. Eighty patients who underwent MitraClip for primary (48%) or secondary (52%) MR were enrolled. Intraoperative transesophageal echocardiographic 3D images were acquired immediately before and after the procedure for MV annulus (MVA) morphology analysis...
July 4, 2018: American Journal of Cardiology
Wentong Zhang, Xiaofei Liu, Hongyan Cheng, Zhaojie Yang, Guiyu Zhang
The aim of this study was to assess the major risk factors for venous thromboembolism (VTE) in Chinese patients with ovarian cancer and to explore optimal methods of prophylaxis and treatment.A retrospective analysis of patients from Qilu Hospital of Shandong University was conducted from January 1, 2014, to January 1, 2017. We analyzed 388 patients who underwent surgery with a final diagnosis of ovarian cancer, of whom 35 developed VTE. Risk factors for preoperative and postoperative VTE were investigated...
August 2018: Medicine (Baltimore)
Alexander J Kurdi, Benjamin A Voss, Tony H Tzeng, Steve L Scaife, Mouhanad M El-Othmani, Khaled J Saleh
Current literature regarding complications following total joint arthroplasty have primarily focused on patients with osteoarthritis (OA), with less emphasis on the trends and in-hospital outcomes of rheumatoid arthritis (RA) patients undergoing these procedures. The purpose of this study is to analyze the outcomes and trends of RA patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA) compared to OA patients. Data from the Nationwide Inpatient Sample from 2006 to 2011 was extracted using the International Classification of Diseases, Ninth Revision codes for patients that received a TKA or THA...
July 2018: American Journal of Orthopedics
Annelotte C M van Bommel, Kay Schreuder, Renske K Veenstra, Kelly M de Ligt, Marie-Jeanne T F D Vrancken Peeters, John H Maduro, Sabine Siesling, Marc A M Mureau
BACKGROUND: Immediate breast reconstruction (IBR) may improve quality of life of patients receiving mastectomy. However, a significant hospital variation exists in the use of IBR due to various reasons. To better understand this variation, the present study investigated preoperative information provision to patients and personal opinions of surgical oncologists and plastic surgeons towards potential contra-indications for IBR. METHODS: An online survey (35 questions) was developed including questions on respondent demographics, information provision to the patient about IBR and potential contra-indications by IBR technique...
July 31, 2018: Annals of Plastic Surgery
Azeem T Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The main objective of this article was to investigate the impact of discharge destination on postdischarge outcomes following an elective 1- to 2-level posterior lumbar fusion (PLF) for degenerative pathology. BACKGROUND DATA: Discharge to an inpatient care facility may be associated with adverse outcomes as compared with home discharge. MATERIALS AND METHODS: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to query for patients undergoing PLFs using Current Procedural Terminology (CPT) codes (22612, 22630, and 22633)...
July 31, 2018: Clinical Spine Surgery
Alix Marhic, Bassel Dakhil, Gaëtan Plantefeve, Rym Zaimi, Viorel Oltean, Patrick Bagan
OBJECTIVES: The benefits of a rehabilitation programme before lung surgical resection for cancer remain to be defined. The purpose of this observational study was to assess the efficacy of preoperative rehabilitation and postoperative rehabilitation on short- and long-term outcomes in patients who were at high operative risk. METHODS: Between January 2010 and December 2012, 20 consecutive non-operable patients (16 men and 4 women, mean age 66 years) with clinical N0 lung cancer were included...
July 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Christian Lopez Ramos, Michael G Brandel, Robert C Rennert, Arvin R Wali, Jeffrey A Steinberg, David R Santiago-Dieppa, Brittany N Burton, Jeffrey S Pannell, Scott E Olson, Alexander A Khalessi
BACKGROUND: Hospital readmission is a key surgical quality metric associated with financial penalties and higher healthcare costs. We examined clinical risk factors and postoperative complications associated with 30-day unplanned hospital readmissions after cranial neurosurgery. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011-2016 for adult patients that underwent a cranial neurosurgical procedure...
July 24, 2018: World Neurosurgery
Jayalaxmi Shripati Aihole, Aruna Gowdra, Deepak Javaregowda, Vinay Jadhav, M Narendra Babu, Ravidra Sahadev
Background: Congenital diaphragmatic hernia (CDH) is a complex developmental defect having a multifactorial etiology; i majority of cases (~80%), the cause is not known. Survival rates for patients with CDH have increased over the past decade with early prenatal detection and better postnatal management including surgery. Clinical profile and the outcome of 83 CDH neonates were studied and analyzed over a period of 12 years in our institute. Aims and Objectives: The clinical study was to analyze the clinical profile and outcome of CDH among the neonates in a tertiary care referral neonatal and pediatric center in Karnataka, India...
July 2018: Journal of Indian Association of Pediatric Surgeons
Raymond Sroka, Emmanuel M Gabriel, Danna Al-Hadidi, Steven J Nurkin, Richard D Urman, Timothy D Quinn
The objective of this retrospective analysis was to describe the development and implementation of an anesthesiologist-led multidisciplinary committee to evaluate high-risk surgical patients in order to improve surgical appropriateness. The study was conducted in an anesthesia preoperative evaluation clinic at an academic comprehensive cancer center. One hundred sixty-seven high-risk surgical patients with cancer-related diagnoses were evaluated and discussed at a High-Risk Committee (HRC) meeting to determine surgical appropriateness and optimize perioperative care...
July 23, 2018: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
Tal Geva, Barbara Mulder, Kimberlee Gauvreau, Sonya V Babu-Narayan, Rachel Wald, Kelsey Hickey, Andrew J Powell, Michael A Gatzoulis, Anne Marie Valente
Background -Risk factors for adverse clinical outcomes have been identified in patients with repaired tetralogy of Fallot (rTOF) before pulmonary valve replacement (PVR). However, pre-PVR predictors for post-PVR sustained ventricular tachycardia (VT) and death have not been identified. Methods -Patients with rTOF enrolled in the INDICATOR cohort-a 4-center international cohort study- who had a comprehensive preoperative evaluation and subsequently underwent PVR were included. Pre-procedural clinical, electrocardiogram, cardiovascular magnetic resonance (CMR), and postoperative outcome data were analyzed...
July 20, 2018: Circulation
Isabelle Ruchonnet-Metrailler, Sylvain Blanchon, Samuel Luthold, Barbara E Wildhaber, Peter C Rimensberger, Constance Barazzone-Argiroffo, Valérie A Mc Lin
Liver transplantation (LT) is associated with high post-operative morbidity, despite excellent survival rates. With this retrospective study, we report the incidence of early and late pulmonary complications (PC) after LT, identify modifiable risk factors for PC and analyzed the role of PC in post-operative ventilation duration and hospital length of stay. In a series of 79 children (0-16 years) with LT over a 12 years period, early (<3 months post-LT) and/or late (>3 months post-LT) PC occurred in 68 patients (86%)...
July 17, 2018: Pediatric Transplantation
Jean B Guerrier, Zachary C Dietch, Bruce D Schirmer, Peter T Hallowell
PURPOSE: Laparoscopic sleeve gastrectomy (LSG) has rapidly gained popularity as a single-stage operation for the treatment of morbid obesity, as patients undergoing LSG have been shown to achieve similar weight loss and resolution of obesity-related comorbidities in comparison to those undergoing Roux-en-Y gastric bypass (RYGB), the "gold standard" bariatric operation. Although LSG poses fewer technical challenges than RYGB, little is known about differences in short-term outcomes among patients undergoing LSG and RYGB...
July 16, 2018: Obesity Surgery
Carlos M Mery, Rodrigo Zea-Vera, Martin A Chacon-Portillo, Huirong Zhu, William B Kyle, Iki Adachi, Jeffrey S Heinle, Charles D Fraser
BACKGROUND: Contemporary outcomes of complete atrioventricular septal defect (CAVSD) repair, particularly for defects with associated abnormalities, is unclear. The goal of this study is to report an all-inclusive experience of CAVSD repair using a consistent surgical approach. METHODS: All patients undergoing CAVSD repair between 1995 and 2016 at our institution were included. Patients were divided into 2 groups: isolated and complex (tetralogy of Fallot (TOF), aortic arch repair, double outlet right ventricle (DORV), and total anomalous pulmonary venous return (TAPVR))...
July 13, 2018: Annals of Thoracic Surgery
François-René Roustan, Fabien Lareyre, Imad Bentellis, Romain Haider, Stéphanie Torrino, Jacques Sedat, Laetitia Albano, Elixène Jean-Baptiste, Juliette Raffort, Matthieu Durand
Angioplasty with or without stenting has become a well-established procedure to treat transplant renal artery stenosis (TRAS). We evaluated our experience on postoperative outcomes following the intervention and identified potential predictive factors of TRAS recurrence. Consecutive patients who underwent endovascular treatment of TRAS were retrospectively reviewed. The study end points were the technical success, 30-day postoperative complications, and the estimated glomerular filtration rate (eGFR). Thirty-two patients underwent endovascular treatment for TRAS...
January 1, 2018: Angiology
Yun Chen, Guorong Wu, Ruichun Wang, Junping Chen
OBJECTIVE: Postoperative pulmonary complications (PPCs) can contribute to increased mortality and prolonged hospital stay in surgical patients with gastric cancer (GC). This study aimed to investigate potential risk factors for PPCs in elderly GC patients following elective laparoscopic gastrectomy. METHODS: Eligible consecutive elderly GC patients (aged over 65 years) who were scheduled to undergo elective laparoscopic gastrectomy were enrolled in this study. The demographic, clinicopathological characteristics and laboratory variables were compared in patients with or without PPCs within postoperative 30 days...
July 12, 2018: Current Pharmaceutical Design
Matthew S Agam, Michelle A Wedemeyer, Bozena Wrobel, Martin H Weiss, John D Carmichael, Gabriel Zada
OBJECTIVE Pituitary adenomas (PAs) are benign neoplasms that are frequently encountered during workup for endocrinopathy, headache, or visual loss. Transsphenoidal surgery remains the first-line approach for PA resection. The authors retrospectively assessed complication rates associated with transsphenoidal PA resection from an institutional database. METHODS A retrospective analysis of 1153 consecutive transsphenoidal pituitary adenoma resections performed at the Keck Hospital of USC between November 1992 and March 2017 was conducted...
June 1, 2018: Journal of Neurosurgery
Wen-Song Liu, Yong Jiang, Dong Zhang, Long-Qing Shi, Dong-Lin Sun
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients. METHODS: From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups...
July 1, 2018: Surgical Innovation
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