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https://www.readbyqxmd.com/read/28229199/-coronary-artery-disease-interventional-and-operative-therapeutic-options-after-cardiac-arrest
#1
M Behnes, K Mashayekhi, M Borggrefe, I Akin
Coronary artery disease (CAD) represents a common structural cause for developing cardiac arrest in older patients, whereas in young adults cardiac arrest is more often caused by cardiomyopathies and cardiac channelopathies. A structural heart disease is known in almost 50% of patients prior to cardiac arrest. The present review outlines current interventional and operative therapeutic options for patients surviving cardiac arrest. The focus is on associations between epidemiological data on the incidence of malignant arrhythmias causing cardiac arrest depending on the presence or absence of CAD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#2
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28197053/large-in-transient-left-ventricular-thrombus-due-to-anabolic-steroid-induced-cardiomyopathy
#3
Feridoun Sabzi, Reza Faraji
The presence of small or moderate size thrombosis is not uncommon in left ventricle (LV) as results of basic co-moribund disease, but huge LV thrombosis that protrudes to aortic valve in the LV outflow tract (LVOT) tract is an exceptionally rare phenomenon. We report a 34-year-old bodybuilder athlete with cardiomyopathy and massive LV thrombosis. The thrombosis extended to LVOT and protruded through the aortic valve in systole and posed a high risk of systemic emboli. The patient underwent open heart surgery, and the clot was removed...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28174212/drug-eluting-stents-versus-bare-metal-stents-in-acute-myocardial-infarction-with-cardiogenic-shock
#4
Jakob Ledwoch, Georg Fuernau, Steffen Desch, Ingo Eitel, Christian Jung, Suzanne de Waha, Janine Poess, Steffen Schneider, Gerhard Schuler, Karl Werdan, Uwe Zeymer, Holger Thiele
OBJECTIVES: The aim of the present study was to assess the outcome of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) receiving drug-eluting stents (DES) compared with bare-metal stents (BMS). Data comparing these two stent technologies in AMI with CS were limited. METHODS: A total of 783 patients with AMI and CS undergoing early revascularisation were included in the randomised Intra-aortic Balloon Pump in Cardiogenic Shock II trial (n=600) and the associated registry (n=183)...
February 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28167082/hemodynamic-support-for-ventricular-tachycardia-ablation
#5
REVIEW
Chandrasekar Palaniswamy, Marc A Miller, Vivek Y Reddy, Srinivas R Dukkipati
This review discusses the role of hemodynamic support for catheter ablation of unstable ventricular tachycardia, using commercially available mechanical circulatory support devices (intra-aortic balloon pump, Impella, TandemHeart, extracorporeal membrane oxygenation) and analyzes the published clinical experience of the safety and efficacy of these devices during ventricular tachycardia ablation. Appropriate selection of patients, device-specific characteristics, and hemodynamic monitoring is also discussed...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28153551/current-and-future-percutaneous-strategies-for-the-treatment-of-acute-and-chronic-heart-failure
#6
Ignacio J Amat-Santos, Luis H Varela-Falcón, William T Abraham
The prevalence of heart failure (HF) has risen in parallel with improved survival in patients after a myocardial infarction and an aging population worldwide. In recent years, new percutaneous therapies have been developed to complement current established treatments for acute/decompensated and chronic HF and minimize risks. In acute presentations, the failure of medical treatment is no longer the end of the road in refractory circulatory shock; the use of mechanical circulatory support devices may be the next milestone in well-resourced health settings...
January 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28117180/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-as-an-adjunct-to-acls-in-non-traumatic-cardiac-arrest-a-review-of-key-concepts-physiology-current-evidence-and-future-directions
#7
James Daley, Jonathan James Morrison, John Sather, Lisa Hile
Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28111968/first-high-risk-percutaneous-coronary-intervention-under-use-of-the-ivac2l-system-in-germany
#8
Alexander Samol, Stefanie Schmidt, Melanie Zeyse, Stefanie Dürrwald, Marcus Wiemer
Percutaneous coronary intervention of complex stenoses is becoming more and more of an alternative to coronary bypass surgery. Nevertheless, complications can occur and lead to the need for circulatory support and/or emergency surgery. Circulatory support devices like the intra-aortic balloon pump showed only low benefit in patients' outcome. Devices with higher cardiac output necessitate more complex implantation procedures. We report the case of the first successful use of a transfemoral pulsatile ventricular assist device with up to 2 l additional cardiac output during high-risk percutaneous coronary intervention in a 74-year-old man with complex stenosis...
January 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#9
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28098650/was-the-intraaortic-balloon-pumping-under-venoarterial-extracorporeal-membrane-oxygenation-really-effective-in-reducing-the-mortality-of-cardiogenic-patients
#10
Toshinobu Yamagishi, Tomoko Sakatani, Yukihiro Kitamura, Masahiro Kashiura
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096836/coronary-artery-spasm-following-on-pump-coronary-artery-bypass-grafting-with-20-months-follow-up
#11
Adam R Kowalówka, Marcin Malinowski, Magdalena Onyszczuk, Marek Deja
We report on a 69-year-old woman who demonstrated native coronary artery and grafted vessel spasm following on-pump coronary artery bypass grafting (CABG). Despite intraaortic balloon pump (IABP) insertion, electrocardiogram (ECG) abnormalities did not disappear. Emergency coronary angiography (CAG) was performed. The patient was successfully treated with systemic and intracoronary injection of vasodilator agents. ECG changes disappeared, with normalized and stable hemodynamic function. Intraaortic balloon pump was maintained for 48 h...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28079812/the-efficacy-of-elastomeric-patient-control-module-when-connected-to-a-balloon-pump-for-postoperative-epidural-analgesia-a-randomized-noninferiority-trial
#12
RANDOMIZED CONTROLLED TRIAL
Myung Hwa Kim, Yon Hee Shim, Min-Soo Kim, Yang-Sik Shin, Hyun Joo Lee, Jeong Soo Lee
When considering the principles of a pain control strategy by patients, reliable administration of additional bolus doses is important for providing the adequate analgesia and improving patient satisfaction. We compared the efficacy of elastomeric patient-control module (PCM) with conventional PCM providing epidural analgesia postoperatively.A noninferiority comparison was used. Eighty-six patients scheduled for open upper abdominal surgery were randomized to use either an elastomeric or conventional PCM connected to balloon pump...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#13
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#14
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28065768/ventricular-septal-defect-complicating-st-elevation-myocardial-infarctions-a-call-for-action
#15
Vikas Singh, Alex P Rodriguez, Parth Bhatt, Carlos E Alfonso, Rahul Sakhuja, Igor F Palacios, Ignacio Inglessis-Azuaje, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
BACKGROUND: Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain a major contributor to mortality. METHODS: We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28057952/direct-thrombin-inhibitor-resistance-and-possible-mechanisms
#16
Maria Cardinale, Michael Ha, Michael H Liu, David P Reardon
Objective: To report 3 cases in which doses of bivalirudin higher than commonly used in clinical practice were required in order to achieve therapeutic anticoagulation as monitored by the activated partial thromboplastin time (aPTT). Case Summary: The medical records of 3 patients who required large doses of bivalirudin to remain therapeutic were thoroughly reviewed. In all 3 patients, bivalirudin was initiated at a rate appropriate for the patients' renal function and titrated using a nurse-driven protocol with recommended dose adjustments based on aPTT...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28044253/transvenous-inoue-balloon-aortic-valvuloplasty-with-intra-aortic-balloon-pump-in-treating-cardiogenic-shock-due-to-critical-calcific-aortic-stenosis
#17
Yoshihito Sakata
A 90-year-old female with severe peripheral vascular disease developed cardiogenic shock (CS) due to critical aortic stenosis (AS). The balloon aortic valvuloplasty was emergently performed via transvenous and transseptal antegrade approach (ante-BAV), which saved arterial accesses for intra-aortic balloon pump (IABP) and enabled us to use the Inoue balloon. The IABP augmented systemic perfusions and controlled left heart filling pressures. Multiple times of inflations with stepwisely increased balloon diameters were performed under IABP support (ante-Inoue-BAV + IABP), resulting in remarkable improvements both in clinical and hemodynamic conditions...
January 2, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28043662/a-novel-risk-score-model-for-prediction-of-contrast-induced-nephropathy-after-emergent-percutaneous-coronary-intervention
#18
Kai-Yang Lin, Wei-Ping Zheng, Wei-Jie Bei, Shi-Qun Chen, Sheikh Mohammed Shariful Islam, Yong Liu, Lin Xue, Ning Tan, Ji-Yan Chen
BACKGROUND: A few studies developed simple risk model for predicting CIN with poor prognosis after emergent PCI. The study aimed to develop and validate a novel tool for predicting the risk of contrast-induced nephropathy (CIN) in patients undergoing emergent percutaneous coronary intervention (PCI). METHODS: 692 consecutive patients undergoing emergent PCI between January 2010 and December 2013 were randomly (2:1) assigned to a development dataset (n=461) and a validation dataset (n=231)...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040758/stent-valve-implantation-in-conventional-redo-aortic-valve-surgery-to-prevent-patient-prosthesis-mismatch
#19
Enrico Ferrari, Giorgio Franciosi, Sara Clivio, Francesco Faletra, Marco Moccetti, Tiziano Moccetti, Giovanni Pedrazzini, Stefanos Demertzis
OBJECTIVES: The goal was to show the technical details, feasibility and clinical results of balloon-expandable stent valve implantation in the aortic position during conventional redo open-heart surgery in selected obese patients with a small aortic prosthesis and severe patient-prosthesis mismatch. METHODS: Two symptomatic overweight patients (body mass index of 31 and 38), each with a small aortic prosthesis (a 4-year-old, 21-mm Hancock II biological valve and a 29-year-old, 23-mm Duromedic mechanical valve), increased transvalvular gradients (59/31 and 74/44 mmHg) and a reduced indexed effective orifice area (0...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040188/effect-of-early-initiation-of-mechanical-circulatory-support-on-survival-in-cardiogenic-shock
#20
Mir B Basir, Theodore L Schreiber, Cindy L Grines, Simon R Dixon, Jeffrey W Moses, Brijeshwar S Maini, Akshay K Khandelwal, E Magnus Ohman, William W O'Neill
The role and timing of percutaneous mechanical circulatory support (MCS) devices in the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) are not well understood. We sought to evaluate patient characteristics and predictors of outcomes in patients presenting with AMICS supported with an axial flow percutaneous MCS device; 287 consecutive unselected patients enrolled in the catheter-based ventricular assist device registry presenting with AMICS who underwent percutaneous coronary intervention (PCI) were included in this analysis...
December 18, 2016: American Journal of Cardiology
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