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Postoperative troponin

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...
August 7, 2018: European Journal of Anaesthesiology
A Desole, A Ferrari, F Tosato, D Milite
INTRODUCTION: The recent technological evolution has also allowed for the treatment of juxtarenal abdominal aortic aneurysms (JAA) with an endovascular technique but short and long-term results must be compared with the results of open treatment that is the gold standard. In this study we analyzed the short and long term results of open surgical treatment (OR) 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
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...
August 7, 2018: Therapeutic Advances in Cardiovascular Disease
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
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...
July 28, 2018: Pediatric Cardiology
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
Vera Saldien, Tom Schepens, Katrien Van Loock, Gaelle Vermeersch, Davina Wildemeersch, Viviane Van Hoof, Frank De Belder, Johan Bosmans, Marcel Vercauteren, Tomas Menovsky
BACKGROUND: 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. OBJECTIVE: 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 different cerebrovascular disorders were retrospectively analysed from a single-centre medical records database (Cegeka Medical Health Care Systems)...
July 16, 2018: World Neurosurgery
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
Martin Christmann, Alexandra Wipf, Hitendu Dave, Daniel Quandt, Oliver Niesse, Markus Deisenberg, Martin Hersberger, Oliver Kretschmar, Walter Knirsch
OBJECTIVE: To find risk factors for a complicated early postoperative course after arterial switch operation (ASO) in neonates with d-transposition of the great arteries (dTGA). In addition to anatomical and surgical parameters, the predictive value of early postoperative troponin T (TnT) values in correlation to the early postoperative course after ASO is analyzed. METHODS: Seventy-nine neonates (57 (72%) male) with simple dTGA treated by ASO between 2009 and 2016 were included in the analysis...
July 17, 2018: Congenital Heart Disease
Fernando R Altermatt, Ghislaine C Echevarría, René F de la Fuente, Ricardo Baeza, Marcela Ferrada, Juan C de la Cuadra, Marcia A Corvetto
BACKGROUND: Perioperative myocardial ischemia is common among patients undergoing hip fracture surgery. Our aim is to evaluate the efficacy of perioperative continuous lumbar plexus block in reducing the risk of cardiac ischemic events of elderly patients undergoing surgery for hip fractures, expressed as a reduction of ischemic events per subject. METHODS: Patients older than 60 years, ASA II-III, with risk factors for or known coronary artery disease were enrolled in this randomized controlled study...
July 14, 2018: Revista Brasileira de Anestesiologia
Dingxu Gong, Lin Zhang, Ying Zhang, Fang Wang, Xianliang Zhou, Hansong Sun
OBJECTIVES: Aldehyde dehydrogenase 2 activity is associated with cardioprotection. Individuals carrying an East Asian variant of the ALDH2 genotype (ALDH2*2) have significantly reduced aldehyde dehydrogenase 2 activity. No previous studies have determined the effect of the ALDH2*2 genotype on cardioprotective results after coronary artery bypass grafting (CABG). METHODS: In total, 207 patients who underwent selective off-pump CABG were prospectively enrolled. Their baseline characteristics and clinical results were collected...
July 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Dianne E C van Beek, Iwan C C van der Horst, A Fred de Geus, Massimo A Mariani, Thomas W L Scheeren
PURPOSE: Low serum albumin (SA) is a prognostic factor for poor outcome after cardiac surgery. The aim of this study was to estimate the association between pre-operative SA, early post-operative SA and postoperative myocardial injury. METHODS: This single center cohort study included adult patients undergoing cardiac surgery during 4 consecutive years. Postoperative myocardial damage was defined by calculating the area under the curve (AUC) of troponin (Tn) values during the first 72 h after surgery and its association with SA analyzed using linear regression and with multivariable linear regression to account for patient related and procedural confounders...
June 6, 2018: Journal of Critical Care
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
Hannan Dalyanoglu, Arash Mehdiani, Jan Philipp Minol, Nihat Firat Sipahi, Hug Aubin, Udo Boeken, Alfred Müller, Hisaki Makimoto, Artur Lichtenberg, Bernhard Korbmacher
Postoperative, new-onset atrial fibrillation (POAF) is one of the most common complications after cardiosurgical procedures. Vernakalant has been reported to be effective in the conversion of POAF. The aim of this study was to evaluate the efficacy and safety of vernakalant for atrial fibrillation after cardiac operations, and to investigate predictors for the success of vernakalant treatment. Patients and Methods: Post-cardiac surgery patients with new-onset of atrial fibrillation (AF) were consecutively enrolled in this study...
May 25, 2018: Heart Surgery Forum
Asmâa Biaz, Mohammed Drissi, Aissam El Maataoui, Samira El Machtani Idrissi, Sanae Bouhsain, Abdellah Dami, Abdellatif Boulahya, Zohra Ouzzif
Introduction: This prospective study was conducted at the Laboratoy of Biochemistry of the HMIMV, Rabat, over a period of 1 year. It aimed to analyse the kinetics of troponin lc (cTnl) after on-pump cardiac surgery in order to establish threshold values for the diagnosis of perioperative myocardial infarction. Methods: The study included 58 patients who had undergone on-pump valvular surgery or on-pump coronary artery bypass surgery. These patients were separated into 3 groups according to their clinical and electrical evolution as well as their laboratory tests (cTnI) during the immediate post-operative period...
2018: Pan African Medical Journal
Kimberly A Johnston, Angela J Westover, Alvaro Rojas-Pena, Jonathan W Haft, John M Toomasian, Thomas Johnson, Deborah A Buffington, H David Humes
Leukocyte activation during cardiopulmonary bypass (CPB) promotes a systemic inflammatory response that contributes to organ injury and postoperative organ dysfunction. A leukocyte modulatory device (L-MOD) for use during (and after) CPB to limit leukocyte-mediated organ injury was tested in a preclinical model. Twenty-two pigs underwent 180 minutes of CPB and 5 hours postoperative observation. Pigs received no intervention (group 1, n = 9), 3 hours of therapy by incorporation of L-MOD into the CPB circuit (group 2, n = 6), or 8 hours of therapy using a femoral venovenous L-MOD circuit during and after CPB (group 3, n = 7)...
May 23, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
E Coetzee, B M Biccard, R A Dyer, N D Meyersfeld, C Chishala, B M Mayosi
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) is a newly recognised entity identified as an independent risk factor associated with increased 30-day all-cause mortality. MINS increases the risk of death in the perioperative period by ~10-fold. More than 80% of patients with MINS are asymptomatic, so the majority of diagnoses are missed. Awareness of MINS is therefore important for perioperative physicians. OBJECTIVES: To investigate the incidence of MINS after elective elevated-risk non-cardiac surgery at Groote Schuur Hospital, Cape Town, South Africa (SA)...
April 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Giovanna Lurati Buse, Braden Manns, Andre Lamy, Gordon Guyatt, Carisi A Polanczyk, Matthew T V Chan, Chew Yin Wang, Juan Carlos Villar, Alben Sigamani, Daniel I Sessler, Otavio Berwanger, Bruce M Biccard, Rupert Pearse, Gerard Urrútia, Wojciech Szczeklik, Ignacio Garutti, Sadeesh Srinathan, German Malaga, Valsa Abraham, Clara K Chow, Michael J Jacka, Maria Tiboni, Gareth Ackland, Danielle Macneil, Robert Sapsford, Martin Leuwer, Yannick Le Manach, Philip J Devereaux
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) is a mostly asymptomatic condition that is strongly associated with 30-day mortality; however, it remains mostly undetected without systematic troponin T monitoring. We evaluated the cost and consequences of postoperative troponin T monitoring to detect MINS. METHODS: We conducted a model-based cost-consequence analysis to compare the impact of routine troponin T monitoring versus standard care (troponin T measurement triggered by ischemic symptoms) on the incidence of MINS detection...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Firmin Kamber, Eckhard Mauermann, Esther Seeberger, Lorenz Guerke, Christian Mueller, Daniel Bolliger, Giovanna A L Lurati Buse
BACKGROUND: Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES: In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels...
May 9, 2018: European Journal of Anaesthesiology
W L Hu, Y Z Chen, J H Wang, X L Hao, D X Zhai, H Y Sun, X S Zhao
Objective: Perioperative myocardial infarction remains a severe complication in non-cardiac surgery and is one of the major causes of death. Cardiac troponin (cTn) I elevation is associated with short-term and long-term mortality. The aim of the study was to assess the proportion rate of cTnI elevation and its clinical characteristics among patients admitted for orthopaedic surgery with or without cardiovascular events. Methods: This is a retrospective study including 27 744 patients aged 50 years or older who admitted for orthopaedic surgery from 2009-2015 in Beijing Jishuitan Hospital...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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