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Postoperative troponin

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https://www.readbyqxmd.com/read/30333293/-postoperative-abnormal-liver-function-in-children-with-heart-surgery
#1
Lian Duan, Guohuang Hu, Meng Jiang, Chengliang Zhang
To investigate the incidence of postoperative abnormal liver function test (aLFT) for the children with heart surgery, and to analyze the clinical characteristics and risk factors.
 Methods: A total of 143 children younger than 18 years old who underwent heart surgery in 2017 were enrolled in this study. The liver function were examined one day preoperation and consecutive 5 days after operation. The clinical data of perioperative period were recorded and the risk factors for aLFT were analyzed.
 Results: There were 43/143 (30%) cases had aLFT, including 5/143 (3...
September 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/30308542/who-is-a-high-risk-surgical-patient
#2
Somnath Bose, Daniel Talmor
PURPOSE OF REVIEW: Timely identification of high-risk surgical candidates facilitate surgical decision-making and allows appropriate tailoring of perioperative management strategies. This review aims to summarize the recent advances in perioperative risk stratification. RECENT FINDINGS: Use of indices which include various combinations of preoperative and postoperative variables remain the most commonly used risk-stratification strategy. Incorporation of biomarkers (troponin and natriuretic peptides), comprehensive objective assessment of functional capacity, and frailty into the current framework enhance perioperative risk estimation...
October 10, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/30300173/mild-perioperative-hypothermia-and-myocardial-injury-a-retrospective-cohort-analysis
#3
Yehoshua N Schacham, Barak Cohen, Gausan R Bajracharya, Michael Walters, Nicole Zimmerman, Guangmei Mao, Marianne A Tanios, Daniel I Sessler
BACKGROUND: We tested the primary hypothesis that final intraoperative esophageal temperature is associated with increased odds of a composite of in-hospital all-cause mortality and myocardial injury within 7 days after noncardiac surgery. Secondary exposures were time-weighted average intraoperative temperature and area <37°C threshold. METHODS: Myocardial injury was defined by postoperative fourth-generation troponin T ≥0.03 ng/mL apparently due to cardiac ischemia...
October 8, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30253969/effect-of-fast-cardioplegic-arrest-induced-by-adenosine-on-cardiac-troponin-levels-after-heart-valve-surgery
#4
Amr A Abdelwahab, Mohab Sabry, Hatem A Elshora, Amr A Arafat
BACKGROUND: Cellular injury is not avoidable with current cardioplegic solutions. The effect of adenosine on reducing cardiac injury post-surgery is controversial. The objective of the current study is to evaluate the effect of fast cardioplegic arrest induced by adenosine on high sensitive cardiac troponin I after heart valve surgery. METHODS: Forty-five patients with rheumatic heart diseases underwent heart valve surgery using conventional approach through median sternotomy...
September 12, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/30236234/association-between-preoperative-ambulatory-heart-rate-and-postoperative-myocardial-injury-a-retrospective-cohort-study
#5
K S Ladha, W S Beattie, G Tait, D N Wijeysundera
BACKGROUND: Resting heart rate is well established as a predictor of morbidity and mortality in the general population. However, the relationship between preoperative heart rate and perioperative outcomes, specifically myocardial injury, is unclear. METHODS: This retrospective cohort study included patients undergoing elective major non-cardiac surgery from 2008 to 2014 at a multisite healthcare system. The exposure was ambulatory heart rate measured during the outpatient preoperative clinic visit, whereas the outcome of interest was myocardial injury (peak postoperative troponin I concentration >30 ng L-1 )...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30233710/effects-of-atrial-fibrillation-on-complications-and-prognosis-of-patients-receiving-emergency-pci-after-acute-myocardial-infarction
#6
Yingchun Zhang, Lingzhi Zhang, Hongzhi Zheng, Hongfen Chen
The effects of atrial fibrillation on complications and prognosis of patients receiving emergency percutaneous coronary intervention after acute myocardial infarction (AMI) were investigated. Eighty AMI patients treated with interventional vascular recanalization in the Affiliated Hospital of Weifang Medical University (Weifang, China) from July 2015 to October 2016 were selected, including 40 patients complicated with atrial fibrillation before operation (control group) and 40 patients without atrial fibrillation before operation (observation group)...
October 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/30217798/uncommon-cause-of-chest-pain-in-a-postoperative-spinal-patient
#7
Rajesh Dwivedi
An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones...
September 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/30198925/elevated-presepsin-is-associated-with-perioperative-major-adverse-cardiovascular-and-cerebrovascular-complications-in-elevated-risk-patients-undergoing-noncardiac-surgery-the-leukocytes-and-cardiovascular-perioperative-events-study
#8
Jessica Handke, Anna S Scholz, Hans-Jörg Gillmann, Henrike Janssen, Sarah Dehne, Christoph Arens, Laura Kummer, Florian Uhle, Markus A Weigand, Johann Motsch, Jan Larmann
BACKGROUND: Perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) are incompletely understood, and risk prediction is imprecise. Atherogenic leukocytes are crucial in cardiovascular events. However, it is unclear if surgical interventions affect leukocyte counts or activation status. Therefore, we investigated whether noncardiac surgery in patients with elevated cardiovascular risk is associated with changes in atherogenic leukocyte subsets and if these changes are related to perioperative MACCEs...
September 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30194978/postoperative-serum-troponin-trends-in-infants-undergoing-cardiac-surgery
#9
Jennifer A Su, S Ram Kumar, Hesham Mahmoud, Michael E Bowdish, Omar Toubat, John C Wood, Grace C Kung
Troponin-I (TN-I) levels are elevated following pediatric cardiac surgery with speculation that particular patterns may have prognostic significance. There is lack of procedure-specific data regarding postoperative TN-I levels in infants undergoing cardiac surgery. We hypothesized that TN-I elevation varies with type of surgery and persistent elevation predicts poor prognosis. We prospectively measured serial TN-I levels (preoperatively, 4, 8, 12, 24, and 48hours postoperatively) in 90 infants (age < 1 year) undergoing cardiac surgery: off cardiopulmonary bypass (CPB) (n = 15), on CPB (n = 43), and on CPB with ventricular incision (CPB with ventricular incision; n = 32)...
September 6, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30184029/is-preoperative-clopidogrel-resistance-a-predictor-of-bleeding-and-risks-in-patients-undergoing-emergency-cabg-surgery
#10
Mehmet Kizilay, Zeynep Aslan, Unsal Vural, Ahmet Yavuz Balci, Ahmet Arif Aglar, Sahin Yilmaz
OBJECTIVE: The aims of this study were to determine whether the detection of preoperative clopidogrel resistance in patients undergoing cardiac surgery while using clopidogrel could play a guiding role in the prediction of postoperative excessive bleeding, transfusion requirements, and risks and to provide clinically significant data. METHODS: Two hundred and twenty-two patients [median age: 59.4 (38-83) years; 38 females] undergoing emergency and elective coronary artery bypass graft (CABG) surgeries in our clinic were evaluated prospectively...
July 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/30177102/troponin-i-is-not-a-predictor-of-early-cardiovascular-morbidity-in-liver-transplant-recipients
#11
R Główczyńska, J Raszeja-Wyszomirska, M Janik, K Kostrzewa, M Zygmunt, H Zborowska, M Krawczyk, M Galas, G Niewińsk, M Krawczyk, K Zieniewicz, P Milkiewicz, G Opolski
BACKGROUND: Cardiovascular events (CVE) might occur in 20% to 70% of liver transplant recipients, and major CVE are associated with poor long-term survival. Overall, the ability to identify patients at the highest risk of death after liver transplantation (LT) has been improved. Abnormal pretransplant troponin I (TnI) level is regarded as one of predictors of postoperative CVE. We evaluated the number of early CVE after LT and the impact of pretransplant TnI on cardiovascular morbidity...
September 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30168305/transit-time-flow-measurement-and-high-frequency-ultrasound-epi-cardiac-imaging-to-guide-coronary-artery-bypass-surgery
#12
Daniel Wendt, Sharaf-Eldin Shehada, Fanar Mourad, Rene Machulla, Ender Demircioglu, Philipp Marx, Aydin Demircioglu, Konstantinos Tsagakis, Matthias Thielmann, Heinz G Jakob, Mohamed El Gabry
BACKGROUND: Transit-time flow measurement (TTFM) should be routinely used in CABG surgery to verify graft function. Most recently, a 2D high-frequency-ultrasound (HF-US) epi-cardiac imaging probe has been released (MiraQTM, Medistim, Oslo, Norway), which allows to evaluate the cannulation/clamping site of the aorta morphologically and to evaluate the completed anastomosis. We aimed to evaluate the use of TTFM and HF-US on surgical strategy during CABG surgery. METHODS: A total of 65 consecutive patients undergoing CABG surgery were evaluated...
August 29, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/30095548/association-of-pre-operative-troponin-levels-with-major-adverse-cardiac-events-and-mortality-after-noncardiac-surgery-a-systematic-review-and-meta-analysis
#13
Jian-Tong Shen, Miao Xu, Yan Wu, Shi-Hong Wen, Xiang Li, Bing-Cheng Zhao, Wen-Qi Huang
BACKGROUND: Circulating cardiac troponin levels are powerful predictors of prognosis in many clinical settings, but their association with outcomes after noncardiac surgery is unclear. OBJECTIVES: The aim of this systematic review was to summarise current evidence on the association of pre-operative troponin elevation with postoperative major adverse cardiac events (MACE) and mortality in patients undergoing noncardiac surgery. DESIGN: Systematic review of observational studies with meta-analysis...
November 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/30092431/open-repair-for-juxtarenal-aortic-aneurysm-short-and-long-term-results
#14
Alessandro Desole, Alessandra Ferrari, Federico Tosato, Domenico Milite
BACKGROUND: The recent technological evolution has also allowed for the treatment of juxtarenal aortic aneurysm (JAA) with an endovascular technique, but short- and long-term results must be compared with the results of open treatment, which is the gold standard. In this study, we analyzed the short- and long-term results of open surgical treatment (open repair) in patients with JAA in our series. METHODS: From January 2006 to December 2016, 155 patients were treated for JAA with open repair; the data were analyzed retrospectively...
August 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30081729/myocardial-protection-in-on-pump-coronary-artery-bypass-grafting-surgery-analysis-of-the-effectiveness-of-the-use-of-retrograde-celsior-%C3%A2
#15
José López-Menéndez, Javier Miguelena, Carlos Morales, Francisco Callejo, Jacobo Silva
BACKGROUND: We analyzed the adequacy of the myocardial protection achieved with a single dose of retrograde crystalloid Celsior®, compared with an accepted standard (microplegia), in on-pump coronary artery bypass grafting surgery (CABG). METHODS: This was a retrospective comparative clinical study conducted in a single institution that included all the patients operated on who had elective isolated on-pump CABG, from March 2006 to June 2014. We evaluated maximum postoperative troponin T (TnT) as a marker of myocardial damage, adjusted for possible confounders using propensity score matching...
October 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/30064376/high-sensitivity-troponin-t-release-profile-in-off-pump-coronary-artery-bypass-grafting-patients-with-normal-postoperative-course
#16
Wen Ge, Chang Gu, Chao Chen, Wangwang Chen, Zhengqiang Cang, Yuliang Wang, Chennan Shi, Yangyang Zhang
BACKGROUND: The aim of the study was to investigate the high-sensitivity troponin T (hs-TnT) release profile in off-pump coronary artery bypass grafting (OPCABG) patients with normal postoperative course. METHODS: From January 2015 to October 2016, 398 consecutive OPCABG patients who had normal postoperative courses were enrolled. Blood samples for hs-TnT were collected at several time points and the comparisons among different time points grouped by various factors were further analyzed...
July 31, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/30056521/neonatal-myocardial-perfusion-in-right-ventricle-dependent-coronary-circulation-clinical-surrogates-and-role-of-troponin-i-in-postoperative-management-following-systemic-to-pulmonary-shunt-physiology
#17
Dennis H VanLoozen, Kenneth A Murdison, Anastasios C Polimenakos
Right ventricle dependent coronary circulation (RVDCC) in pulmonary atresia with intact ventricular septum (PA/IVS) is associated with significant mortality risk in the immediate post-operative period following the initial stage of surgical palliation. Prognosis remains guarded during the interstage period towards conversion to the superior cavopulmonary shunt physiology. Current literature is scarce regarding this specific patient population. Cardiac troponin-I is widely used as a marker of coronary ischemia in adults, but its use for routine monitoring of neonatal myocardial tissue injury due to supply/demand perfusion mismatch is, yet to be determined...
October 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/30045799/-application-evaluation-of-failure-mode-and-effect-analysis-in-optimization-of-vascular-recanalization-process
#18
Xiuhong Zhou, Xinping Du, Kuan Wang, Guoxing Zuo, Sheng Hu, Jinhong Xue, Dandan Yuan, Jiaojiao Du
OBJECTIVE: To investigate the clinical application and effect evaluation of failure mode and effect analysis (FMEA) in the optimization of vascular recanalization in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 389 STEMI patients admitted to the emergency department of the Fifth Central Hospital in Tianjin from January 2014 to January 2015 were served as the control group, and 398 STEMI patients admitted to the chest pain center of the Fifth Central Hospital in Tianjin from January 2016 to October 2017 were served as the experimental group...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/30026138/rapid-ventricular-pacing-for-neurovascular-surgery-a-study-on-cardiac-and-cerebral-effects
#19
Vera Saldien, Tom Schepens, Katrien Van Loock, Gaelle Vermeersch, Davina Wildemeersch, Viviane Van Hoof, Frank De Belder, Johan Bosmans, Marcel Vercauteren, Tomas Menovsky
BACKGROUND AND OBJECTIVE: Intraoperative rupture of a cerebral aneurysm during neurosurgery can be a devastating event that increases perioperative morbidity and mortality. Rapid ventricular pacing (RVP) is a technique to obtain flow arrest for short periods of time during dissection or rupture of the aneurysm. The objective of this study was to evaluate the neurological and cardiac effects of repetitive periods of RVP during cerebrovascular surgery. METHODS: Data from patients who underwent repetitive RVP during craniotomy for cerebrovascular disorders were retrospectively analyzed from a single-center medical records database (Cegeka Medical Health Care Systems)...
July 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30023436/blunt-rupture-of-the-thoracic-duct-after-severe-thoracic-trauma
#20
Samuel R Brown, Carlos Fernandez, Robert Bertellotti, Juan Antonio Asensio
A 53-year-old man was admitted to our trauma center after sustaining thoracoabdominal injuries, secondary to a rear-end motor vehicle collision. As he stepped out of his vehicle, he was struck by a tractor trailer at 55 mph. The following were the initial vital signs on his arrival: heart rate 140 beats/min, blood pressure 142/80 mm Hg, respiratory rate 28 breaths/min, temperature 36.8°C, and oxygen saturation 93%. The Glasgow Coma Scale score was 15 and the Injury Severity Score was 59. He was evaluated and resuscitated per the advanced trauma life support protocols...
2018: Trauma surgery & acute care open
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