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Safety in cardiac surgery

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https://www.readbyqxmd.com/read/28934975/right-anterolateral-thoracotomy-an-attractive-alternative-to-repeat-sternotomy-for-high-risk-patients-undergoing-reoperative-mitral-and-tricuspid-valve-surgery
#1
Hailong Cao, Qing Zhou, Fudong Fan, Yunxing Xue, Jun Pan, Dongjin Wang
BACKGROUND: Reoperative cardiac valve surgery via sternotomy is associated with a substantial morbidity and mortality. This study evaluated the right anterolateral thoracotomy for high-risk patients undergoing mitral and tricuspid valve redo procedures. METHODS: Out of a series of 173 patients undergoing redo cardiac valve surgery, 24 patients were reoperative via the right anterolateral thoracotomy as the high-risk group on the basis of the proximity of the heart and great vessels to the sternum and the presence and location of patent bypass grafts...
September 21, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28930917/shock-2017-military-supplement-an-overview-of-two-human-trials-of-perfluorocarbon-emulsions-in-non-cardiac-surgery
#2
Donat R Spahn, Peter E Keipert
Perfluorochemicals (PFCs) constitute one class of artificial oxygen carriers that are being produced completely synthetically. One formulation that has been evaluated extensively in clinical trials is a 60% w/v perflubron-based emulsion. Efficacy and safety of this perflubron emulsion was evaluated in a Phase 2 and a large prospective randomized Phase 3 multicenter European study, which collectively included a total of 639 patients. Perflubron emulsion was highly successful in improving organ function, reversing physiologic transfusion triggers and in reducing the need for allogeneic blood transfusions...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28911292/a-retrospective-observational-study-of-patients-with-dilated-cardiomyopathy-undergoing-non-cardiac-surgery
#3
K A Cook, P A MacIntyre, J R McAlpine
The perioperative risks and factors associated with adverse cardiac outcomes in patients with dilated cardiomyopathy undergoing non-cardiac surgery are unknown. Interrogation of the Nelson Hospital transthoracic echocardiogram database identified 127 patients with dilated cardiomyopathy who satisfied the study criteria and underwent non-cardiac surgery between June 1999 and July 2013. Demographic and clinical data along with postoperative death within 30 days or a major adverse cardiac event were retrieved and analysed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28903139/percutaneous-coronary-intervention-vs-coronary-artery-bypass-grafting-in-patients-with-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#4
Daniele Giacoppo, Roisin Colleran, Salvatore Cassese, Antonio H Frangieh, Jens Wiebe, Michael Joner, Heribert Schunkert, Adnan Kastrati, Robert A Byrne
Importance: In patients with left main coronary artery (LMCA) stenosis, coronary artery bypass grafting (CABG) has been the standard therapy for several decades. However, some studies suggest that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative. Objective: To compare the long-term safety of PCI with drug-eluting stent vs CABG in patients with LMCA stenosis. Data Sources: PubMed, Scopus, EMBASE, Web of Knowledge, and ScienceDirect databases were searched from December 18, 2001, to February 1, 2017...
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#5
RANDOMIZED CONTROLLED TRIAL
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28889818/efficacy-and-safety-of-recombinant-tissue-plasminogen-activator-for-venous-thrombosis-after-paediatric-heart-surgery
#6
Lindsey B Justice, David P Nelson, Joseph Palumbo, Jaclyn Sawyer, Manish N Patel, Jonathan W Byrnes
OBJECTIVE: Reports in the literature of treatment with recombinant tissue plasminogen activator following cardiac surgery are limited. We reviewed our experience to provide a case series of the therapeutic use of tissue plasminogen activator for the treatment of venous thrombosis in children after cardiac surgery. The data describe the morbidity, mortality, and clinical outcomes of tissue plasminogen activator administration for treatment of venous thrombosis in children following cardiac surgery...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28872484/effect-of-xenon-anesthesia-compared-to-sevoflurane-and-total-intravenous-anesthesia-for-coronary-artery-bypass-graft-surgery-on-postoperative-cardiac-troponin-release-an-international-multicenter-phase-3-single-blinded-randomized-noninferiority-trial
#7
Jan Hofland, Alexandre Ouattara, Jean-Luc Fellahi, Matthias Gruenewald, Jean Hazebroucq, Claude Ecoffey, Pierre Joseph, Matthias Heringlake, Annick Steib, Mark Coburn, Julien Amour, Bertrand Rozec, Inge de Liefde, Patrick Meybohm, Benedikt Preckel, Jean-Luc Hanouz, Luigi Tritapepe, Peter Tonner, Hamina Benhaoua, Jan Patrick Roesner, Berthold Bein, Luc Hanouz, Rob Tenbrinck, Ad J J C Bogers, Bert G Mik, Alain Coiffic, Jochen Renner, Markus Steinfath, Helga Francksen, Ole Broch, Assad Haneya, Manuella Schaller, Patrick Guinet, Lauren Daviet, Corinne Brianchon, Sebastien Rosier, Jean-Jacques Lehot, Hauke Paarmann, Julika Schön, Thorsten Hanke, Joachym Ettel, Silke Olsson, Stefan Klotz, Amir Samet, Giedrius Laurinenas, Adrien Thibaud, Mircea Cristinar, Olivier Collanges, François Levy, Rolf Rossaint, Ana Stevanovic, Gereon Schaelte, Christian Stoppe, Nora Ait Hamou, Sarah Hariri, Astrid Quessard, Aude Carillion, Hélène Morin, Jacqueline Silleran, David Robert, Anne-Sophie Crouzet, Kai Zacharowski, Christian Reyher, Sonja Iken, Nina C Weber, Marcus Hollmann, Susanne Eberl, Giovanni Carriero, Daria Collacchi, Alessandra Di Persio, Olivier Fourcade, Stefan Bergt, Angela Alms
BACKGROUND: Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models. METHODS: In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance...
September 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28859061/is-the-new-zealand-early-warning-score-useful-following-cardiac-surgery
#8
Kevin Niall Peek, Michael Gillham
AIMS: The rate of medical emergency team (MET) calling among post-cardiac surgery patients is unknown. We set out to determine what the call frequency would be if MET activation occurred in every instance that the early warning score (EWS) breached our local threshold, what the outcome was for these patients and what the calling rate might be if the proposed New Zealand EWS (NZEWS) system was implemented with 100% adherence. METHODS: The clinical records of 400 consecutive post-cardiac surgery patients were examined...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28855450/clinical-implication-of-transaortic-mitral-pannus-removal-during-repeat-cardiac-surgery-for-patients-with-mechanical-mitral-valve
#9
Byungjoon Park, Kiick Sung, Pyo Won Park
BACKGROUND: This study aimed to evaluate the safety and feasibility of transaortic mitral pannus removal (TMPR).Methods and Results:Between 2004 and 2016, 34 patients (median age, 57 years; 30 women) with rheumatic disease underwent pannus removal on the ventricular side of a mechanical mitral valve through the aortic valve during reoperation. The median time interval from the previous surgery was 14 years. TMPR was performed after removal of the mechanical aortic valve (n=21) or diseased native aortic valve (n=11)...
August 31, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28851292/combined-spinal-epidural-anesthesia-for-cesarean-delivery-in-a-patient-with-cor-triloculare-biventriculare
#10
Yuan Han, Zhenfeng Zhang, Qingchun Sun, Ke Ding, Liu Han, Mengmeng Dong, Yifan Xu, Lei Ge
BACKGROUND: Cor triloculare biventriculare accounts for approximately 0.31% of cases of congenital heart disease (CHD). Moreover, people with cor triloculare biventriculare always have shorter life spans, and cases of gestation are rare. There have been various related reports of cor triloculare biventriculare in recent years. CASE PRESENTATION: We described an emergency cesarean section of a 30-year-old, 38-weeks-pregnant woman suffering from cardiac insufficiency and fetal distress...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28835834/supraventricular-arrhythmias-in-patients-with-adult-congenital-heart-disease
#11
Carina Blomström Lundqvist, Tatjana S Potpara, Helena Malmborg
An increasing number of patients with congenital heart disease survive to adulthood; such prolonged survival is related to a rapid evolution of successful surgical repairs and modern diagnostic techniques. Despite these improvements, corrective atrial incisions performed at surgery still lead to subsequent myocardial scarring harbouring a potential substrate for macro-reentrant atrial tachycardia. Macroreentrant atrial tachycardias are the most common (75 %) type of supraventricular tachycardia (SVT) in patients with adult congenital heart disease (ACHD)...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#12
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28822540/life-threatening-complications-and-mortality-of-minimally-invasive-pectus-surgery
#13
André Hebra, Robert E Kelly, Marcelo M Ferro, Mustafa Yüksel, Jose Ribas M Campos, Donald Nuss
The prevalence and type of life-threatening complications related to the minimally invasive repair of pectus excavatum (MIRPE) and bar removal are unknown and underreported. The purpose of this communication is to make surgeons aware of the risk of these life threatening complications as well as the modifications which have been developed to prevent them. METHODS: Data related to life-threatening complications of Pectus Excavatum (PE) patients was obtained from four sources: 1. A survey of Chest Wall International Group (CWIG) surgeons who specialize in repairing congenital chest wall malformations, 2...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#14
Shawna M Kettyle, Nikhil L Chervu, Appajosula Sarada Rao, Salaam Sadi, David Majure, Jack A Sava, Laura S Johnson
the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28821525/point-of-care-washing-of-allogeneic-red-blood-cells-for-the-prevention-of-transfusion-related-respiratory-complications-war-prc-a-protocol-for-a-multicenter-randomised-clinical-trial-in-patients-undergoing-cardiac-surgery
#15
Matthew A Warner, Ian J Welsby, Phillip J Norris, Christopher C Silliman, Sarah Armour, Erica D Wittwer, Paula J Santrach, Laurie A Meade, Lavonne M Liedl, Chelsea M Nieuwenkamp, Brian Douthit, Camille M van Buskirk, Phillip J Schulte, Rickey E Carter, Daryl J Kor
INTRODUCTION: The transfusion-related respiratory complications, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are leading causes of transfusion-related morbidity and mortality. At present, there are no effective preventive strategies with red blood cell (RBC) transfusion. Although mechanisms remain incompletely defined, soluble biological response modifiers (BRMs) within the RBC storage solution may play an important role. Point-of-care (POC) washing of allogeneic RBCs may remove these BRMs, thereby mitigating their impact on post-transfusion respiratory complications...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#16
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#17
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28790268/-perioperative-care-of-low-cardiac-output-syndrome
#18
Hiroki Kato, Yoshiro Matsui
Low cardiac syndrome( LOS) is the imbalance of the oxygen supply and demand at the tissue due to reduced oxygen supply by decreased cardiac function. The causes of the cardiac dysfunction are insufficient cardioplegia, elongation of aortic clamp or cardiopulmonary bypass (CPB) duration, incomplete revascularization, and so on. The preventions of LOS are myocardial protections intraoperatively. The most important myocardial protection is to accomplish more quickly, accurately and safety to operation. And today, cardioplegia is essential for surgery requiring CPB...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28782157/initial-clinical-experiences-with-novel-diagonal-ecls-system-in-pediatric-cardiac-patients
#19
Yildiz Okan, Haydin Sertac, Ozturk Erkut, Kasar Taner, Onan I Selen, Altin H Firat, Cine Nihat, Ayyildiz Pelin, Erkan Halime, Guzeltas Alper
Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012...
August 2017: Artificial Organs
https://www.readbyqxmd.com/read/28770972/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#20
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
August 2, 2017: Cochrane Database of Systematic Reviews
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