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Safety in cardiac surgery

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https://www.readbyqxmd.com/read/29138794/noninvasive-cardiac-testing-vs-clinical-evaluation-alone-in-acute-chest-pain-a-secondary-analysis-of-the-romicat-ii-randomized-clinical-trial
#1
Samuel W Reinhardt, Chien-Jung Lin, Eric Novak, David L Brown
Importance: The incremental benefit of noninvasive testing in addition to clinical evaluation (history, physical examination, an electrocardiogram [ECG], and biomarker assessment) vs clinical evaluation alone for patients who present to the emergency department (ED) with acute chest pain is unknown. Objective: To examine differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) vs clinical evaluation alone...
November 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29134534/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-jcvsd-1-mission-and-history-of-jcvsd
#2
Shinichi Takamoto, Noboru Motomura, Hiroaki Miyata, Hiroyuki Tsukihara
The Japan Cardiovascular Surgery Database (JCVSD) was created in 2000 with the support of the Society of Thoracic Surgeons (STS). The STS database content was translated to Japanese using the same disease criteria and in 2001, data entry for adult cardiac surgeries was initiated online using the University Hospital Medical Information Network (UMIN). In 2008, data entry for congenital heart surgeries was initiated in the congenital section of JCVSD and preoperative expected mortality (JapanSCORE) in adult cardiovascular surgeries was first calculated using the risk model of JCVSD...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29132931/hybrid-surgical-versus-percutaneous-access-epicardial-ventricular-tachycardia-ablation
#3
Anthony Li, Justin Hayase, Duc Do, Eric Buch, Marmar Vaseghi, Olujimi A Ajijola, Carlos Macias, Yuliya Krokhaleva, Houman Khakpour, Noel G Boyle, Peyman Benharash, Reshma Biniwale, Kalyanam Shivkumar, Jason S Bradfield
BACKGROUND: There is limited experience of surgical epicardial access in the contemporary era of ventricular tachycardia ablation after prior cardiac surgery. OBJECTIVE: To describe our institutional experience with surgical epicardial access, the influence of surgical approach and compare outcomes to a propensity-matched percutaneous epicardial access control group. METHODS: A retrospective study of consecutive surgical epicardial VT ablation cases from a single center was performed...
November 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29132805/feasibility-of-the-use-of-transesophageal-echocardiography-as-a-surface-probe-for-puncturing-and-catheterization-of-the-internal-jugular-vein-a-randomized-controlled-pilot-study
#4
Yi Teng, Mengchan Ou, Hai Yu
OBJECTIVE: To compare the transesophageal echocardiography (TEE) probe as a surface probe with the vascular probe for guiding internal jugular vein (IJV) catheterization. DESIGN: Prospective, randomized, controlled pilot study. SETTING: University hospital. PARTICIPANTS: One hundred cardiac surgery patients, including 50 adult and 50 pediatric patients. INTERVENTIONS: Patients in the TEE probe group received right IJV catheterization using the TEE probe, while the vascular probe group used the vascular probe for catheterization...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29131449/mechanical-power-sheath-mediated-recanalization-and-lead-implantation-in-patients-with-venous-occlusion-technique-and-results
#5
Olivier A Witte, Ahmet Adiyaman, Marnix W van Bemmel, Jaap Jan J Smit, Abdul Ghani, Anand R Ramdat Misier, Arif Elvan, Peter Paul Hm Delnoy
INTRODUCTION: Chronic venous occlusion hampers lead revisions and upgrades in patients with a cardiac implantable electronic devices (CIEDs). This can make cardiothoracic surgery, venoplasty or contra-lateral implantation of leads with tunneling necessary. A technique using venous recanalization may be a preferred alternative. We assessed the efficacy and safety of this new technique. METHODS AND RESULTS: From 2009-2016 all consecutive patients planned for lead revision or upgrade with known chronic venous occlusion were studied...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29115202/risk-factors-for-hospital-associated-venous-thromboembolism-in-critically-ill-children-following-cardiothoracic-surgery-or-therapeutic-cardiac-catheterisation
#6
Christie M Atchison, Ernest Amankwah, Jean Wilhelm, Shilpa Arlikar, Brian R Branchford, Arabela Stock, Michael Streiff, Clifford Takemoto, Irmel Ayala, Allen Everett, Gary Stapleton, Marshall L Jacobs, Jeffrey P Jacobs, Neil A Goldenberg
BACKGROUND: Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. OBJECTIVE: The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. METHODS: We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St...
November 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29112023/behavior-of-anesthesiology-residents-in-a-situation-of-intravenous-route-occlusion-during-syringe-pump-use-in-a-simulated-intensive-care-unit
#7
Takayuki Kariya, Tetsuya Miyashita, Hitoshi Sato, Hiromasa Kawakami, Takahisa Goto
INTRODUCTION: Unintentional catecholamine flush caused by inappropriate release of an intravenous occlusion during use of a syringe pump in the intensive care unit (ICU) can have dangerous consequences in patients receiving critical care. We investigated whether anesthesiology residents understood how to deal with syringe pump occlusion in a simulated ICU setting. METHODS: We set up a mannequin that virtually simulated a sedated patient under mechanical ventilation after cardiac surgery, with epinephrine and dopamine being infused by syringe pumps to maintain blood pressure at 100/50 mm Hg...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29102688/beating-heart-mitral-valve-repair-using-a-novel-eptfe-cordal-implantation-device-prospective-trial
#8
James S Gammie, Krzysztof Bartus, Andrzej Gackowski, Michael N D'Ambra, Piotr Szymanski, Agata Bilewska, Mariusz Kusmierczyk, Boguslaw Kapelak, Jolanta Rzucidlo-Resil, Neil Moat, Alison Duncan, Rashmi Yadev, Steve Livesey, Paul Diprose, Gino Gerosa, Augusto D'Onofrio, Demetrio Pitterello, Paolo Denti, Giovanni La Canna, Michele De Bonis, Ottavio Alfieri, Judy Hung, Piotr Kolsut
BACKGROUND: We evaluated safety and performance of the Harpoon Mitral Valve Repair System (H-MVRS), a transesophageal echocardiographic-guided device designed to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on mitral leaflets in the beating heart. METHODS: In a prospective multicenter study, 30 consecutive patients with severe degenerative mitral regurgitation (MR) were treated with H-MVRS via small left thoracotomy. The primary (30 day) endpoint was successful implantation of cords with MR reduction to moderate or less...
October 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29092122/treatment-of-prosthetic-valve-thrombosis-with-bolus-dose-tenecteplase-an-experience-from-a-developing-country
#9
Rajesh Kumar Jha, Sandeep Bansal, H S Issar, Mayuresh Chaudhary, Sonu Sharma
BACKGROUND: Prosthetic valve thrombosis (PVT) in metallic prosthetic cardiac valves is not an uncommon condition, and has high mortality and morbidity. Although surgery is the traditional choice for PVT therapy, thrombolysis with newer agents has achieved good success rates. Many studies described in the western literature have used tissue plasminogen activators, while studies from developing countries have been largely based on the use of streptokinase and urokinase. Data regarding the use of newer agents such as tenecteplase are scant...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29058296/research-and-application-of-transnasal-transesophageal-echocardiography-probe
#10
Lei Wang, Jing Zhang, Shao-Ping Zheng, Lin He, Jing Wang, Xin-Fang Wang, Ming-Xing Xie
The intubation of conventional transesophageal echocardiography (TEE) probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed at the development of a special probe which could be inserted through the nasopharyngeal cavity into the esophagus to obtain the same high-quality echocardiography images as those obtained by conventional TEE and improve patients' experience. During the examination, the patients felt relaxed for a longer time and cooperated with the sonographers in the process of cardiac catheterization conducted in the surgery room or the intensive care unit (ICU), resulting in improved accuracy of the diagnosis and timely administration of appropriate treatment...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#11
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29045467/the-dose-of-hydroxyethyl-starch-6-130-0-4-for-fluid-therapy-and-the-incidence-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-matched-study
#12
Mona Momeni, Lompoli Nkoy Ena, Michel Van Dyck, Amine Matta, David Kahn, Dominique Thiry, André Grégoire, Christine Watremez
The safety of hydroxyethyl starches (HES) is still under debate. No studies have compared different dosing regimens of HES in cardiac surgery. We analyzed whether the incidence of Acute Kidney Injury (AKI) differed taking into account a weight-adjusted cumulative dose of HES 6% 130/0.4 for perioperative fluid therapy. This retrospective cohort study included all adult patients undergoing elective or emergency cardiac surgery with or without cardiopulmonary bypass. Exclusion criteria were patients on renal replacement therapy (RRT), cardiac trauma surgery, heart transplantation, patients with ventricular assist devices, subjects who required a surgical revision for bleeding and those whose medical records were incomplete...
2017: PloS One
https://www.readbyqxmd.com/read/29042864/recent-advances-in-pediatric-interventional-cardiology
#13
REVIEW
Seong-Ho Kim
During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates...
August 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29040454/to-fly-as-a-pilot-after-cardiac-surgery
#14
Thomas Syburra, Ed Nicol, Stuart Mitchell, Denis Bron, Ulrich Rosendahl, John Pepper
Aircrew are responsible for safe and reliable aircraft operations. Cardiovascular disease accounts for 50% of all pilot licences declined or withdrawn for medical reasons in Western Europe and is the most common cases of sudden incapacitation in flight. Aircrew retirement age is increasing (up to age 65) in a growing number of airlines and the burden of subclinical, but potentially significant, coronary atherosclerosis is unknown in qualified pilots above age 40. Safety considerations are paramount in aviation medicine, and the most dreaded cardiovascular complications are thromboembolic events and rhythm disturbances due to their potential for sudden incapacitation...
October 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29038286/allogeneic-mesenchymal-stem-cells-for-treatment-of-aki-after-cardiac-surgery
#15
Madhav Swaminathan, Mark Stafford-Smith, Glenn M Chertow, David G Warnock, Viken Paragamian, Robert M Brenner, François Lellouche, Alison Fox-Robichaud, Mohamed G Atta, Spencer Melby, Ravindra L Mehta, Ron Wald, Subodh Verma, C David Mazer
AKI after cardiac surgery remains strongly associated with mortality and lacks effective treatment or prevention. Preclinical studies suggest that cell-based interventions may influence functional recovery. We conducted a phase 2, randomized, double-blind, placebo-controlled trial in 27 centers across North America to determine the safety and efficacy of allogeneic human mesenchymal stem cells (MSCs) in reducing the time to recovery from AKI after cardiac surgery. We randomized 156 adult subjects undergoing cardiac surgery with evidence of early AKI to receive intra-aortic MSCs (AC607; n=67) or placebo (n=68)...
October 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29029526/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-disease-an-updated-meta-analysis-of-randomized-clinical-trials
#16
Lei Gao, Yuqi Liu, Zhijun Sun, Yabin Wang, Feng Cao, Yundai Chen
OBJECTIVES: To compare the safety and efficacy of percutaneous coronary intervention (PCI) using drug-eluting stent (DES) and coronary artery bypass graft (CABG) for the treatment of left main coronary artery (LMCA) disease. BACKGROUND: Several new randomized trials have recently examined the clinical outcomes of PCI and CABG in LMCA disease. However, the results of these studies were inconsistent. MATERIALS AND METHODS: We searched five online electronic databases to identify all the randomized clinical trials assessing the outcomes of PCI using DES and CABG in patients with LMCA...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29017778/patent-ductus-arteriosus-closure-in-preterms-less-than-2kg-surgery-versus-transcatheter
#17
Ozge Pamukcu, Aydin Tuncay, Nazmi Narin, Ali Baykan, Levent Korkmaz, Mustafa Argun, Abdullah Ozyurt, Suleyman Sunkak, Kazim Uzum
BACKGROUND: As new devices come into the market, percutaneous techniques improve and interventionalists become more experienced; percutaneous closure gets more common in preterms. In this study we aimed to compare efficacy and safety of Patent Ductus Arteriosus closure surgically versus transcatheter method in preterms <2kg. Best of our knowledge this study is the first one that compares outcomes of surgery and percutaneous Patent Ductus Arteriosus closure in preterms. METHODS & RESULTS: Between the dates July 1997 to October 2014 in our center Patent Ductus Arteriosus of 26 patients <2kg were closed percutaneously (Group A) and 31 less than 2kg operated (Group B)...
October 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29016813/epicardial-left-atrial-appendage-atriclip-occlusion-reduces-the-incidence-of-stroke-in-patients-with-atrial-fibrillation-undergoing-cardiac-surgery
#18
Etem Caliskan, Ayhan Sahin, Murat Yilmaz, Burkhardt Seifert, Ricarda Hinzpeter, Hatem Alkadhi, James L Cox, Tomas Holubec, Diana Reser, Volkmar Falk, Jürg Grünenfelder, Michele Genoni, Francesco Maisano, Sacha P Salzberg, Maximilian Y Emmert
Aims: Left atrial appendage (LAA) occlusion has emerged as an interesting alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). We report the safety, efficacy, and durability of concomitant device-enabled epicardial LAA occlusion during open-heart surgery. In addition to long-term follow-up, we evaluate the impact on stroke risk in this selected population. Methods and results: A total of 291 AtriClip devices were deployed epicardially in patients (mean CHA2DS2-VASc-Score: 3...
July 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016781/effectiveness-safety-and-long-term-outcomes-of-non-powered-mechanical-sheaths-for-transvenous-lead-extraction
#19
Andrzej Kutarski, Marek Czajkowski, Radoslaw Pietura, Bogdan Obszanski, Anna Polewczyk, Wojciech Jachec, Maciej Polewczyk, Krzysztof Mlynarczyk, Marcin Grabowski, Grzegorz Opolski
Aims: To analyse the effectiveness, safety and long-term outcomes of conventional non-powered mechanical systems for transvenous lead extraction (TLE) performed by experienced first operators. Outcomes were assessed according to lead location and type of operating room in which the procedure was performed. Methods and results: Data from 2049 patients (mean age: 65 years), with infectious (40%) or non-infectious (60%) indications, were analysed over a mean of 3...
August 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#20
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
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