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Safety in cardiac surgery

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https://www.readbyqxmd.com/read/29344822/novel-oral-anticoagulants-in-the-preoperative-period-a-meta-analysis
#1
Hua He, Bingbing Ke, Yan Li, Fuheng Han, Xiaodong Li, Yujie Zeng
The purpose of this study is to evaluate the efficacy and safety of novel oral anticoagulant (NOAC) versus warfarin therapy in patients undergoing different operations. We performed a systematic review of MEDLINE, EMBASE, Cochrane Controlled Trials Register, and reports presented at scientific meetings. The efficacy and safety of NOACs during the perioperative period was compared to that using warfarin. Of the 2652 studies initially reviewed, we identified 9 that included 15,880 patients for the meta-analysis...
January 17, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#2
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29333595/implanted-closed-loop-gastric-electrical-stimulation-clges-system-with-sensor-based-feedback-safely-limits-weight-regain-at-24%C3%A2-months
#3
S Morales-Conde, I Alarcón Del Agua, L Busetto, F Favretti, M Anselmino, G M Rovera, M Socas-Macias, A Barranco-Moreno, R Province-Azalde, A J Torres
BACKGROUND: Weight regain following bariatric surgery is not uncommon. Safe, effective weight loss treatment up to 1 year has been reported with the closed-loop gastric electrical stimulation (CLGES) system. Continuous recording of eating and activity behavior by onboard sensors is one of the novel features of this closed-loop electrical stimulation therapy, and may provide improved long-term weight maintenance by enhancing aftercare. METHODS: Four centers participating in a 12-month prospective multicenter randomized study monitored all implanted participants (n = 47) up to 24 months after laparoscopic implantation of a CLGES system...
January 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29332420/activated-factor-7-versus-4-factor-prothrombin-complex-concentrate-for-critical-bleeding-post-cardiac-surgery
#4
Sarah L Mehringer, Zachary Klick, Jonathan Bain, Elizabeth B McNeely, Sreekumar Subramanian, Lawrence J Pass, Davis Drinkwater, V Seenu Reddy
BACKGROUND: Recombinant and plasma-derived factor products, such as activated factor seven (rFVIIa) and four-factor prothrombin complex concentrate (4-factor PCC), have been used off-label for bleeding after cardiac surgery, but little evidence has been published regarding their efficacy and safety. OBJECTIVE: To determine whether there is a difference in chest tube output in patients who have received 4-factor PCC or rFVIIa for critical postoperative bleeding associated with cardiovascular surgery...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29329825/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-in-patients-with-pure-aortic-regurgitation-and-advanced-heart-failure
#5
Gabriele Pesarini, Mattia Lunardi, Anna Piccoli, Leonardo Gottin, Daniele Prati, Valeria Ferrero, Roberto Scarsini, Aldo Milano, Alberto Forni, Giuseppe Faggian, Flavio Ribichini
Results of transcatheter aortic valve implantation (TAVI) for treatment of severe noncalcific isolated aortic regurgitation (AR) complicated by advanced heart failure or cardiogenic shock has been previously reported only in isolated case reports. Current self-expanding transcatheter aortic valves are designed to treat aortic valve stenosis, and have also been implanted in cases of severe AR due to degenerated bioprosthesis and in very few cases of native aortic valves. We report 13 consecutive inoperable patients with noncalcific, pure AR, and advanced heart failure treated with emergency percutaneous transfemoral implantation with self-expandable CoreValves at our institution between July 2012 and September 2017...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29319633/risk-factors-for-healthcare-associated-infections-after-pediatric-cardiac-surgery
#6
Takeshi Hatachi, Kazuya Tachibana, Yu Inata, Yuji Tominaga, Aiko Hirano, Miyako Kyogoku, Kazue Moon, Yoshiyuki Shimizu, Kanako Isaka, Muneyuki Takeuchi
OBJECTIVES: Healthcare-associated infections after pediatric cardiac surgery are significant causes of morbidity and mortality. We aimed to identify the risk factors for the occurrence of healthcare-associated infections after pediatric cardiac surgery. DESIGN: Retrospective, single-center observational study. SETTING: PICU at a tertiary children's hospital. PATIENTS: Consecutive pediatric patients less than or equal to 18 years old admitted to the PICU after cardiac surgery, between January 2013 and December 2015...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29309707/safety-and-effectiveness-of-selective-carotid-angioplasty-prior-to-cardiac-surgery-a-single-centre-matched-case-control-study
#7
Zahra Hasani, Rudolf W M Keunen, Dénes L J Tavy, Arne Mosch, Barry B Mook-Kanamori, Sebastiaan F T M De Bruijn, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Eric Teeuws, Jan van Alphen, Hans van Overhagen, Frank E E Treurniet, Lucas van Dijk, Paulien M van Kampen
OBJECTIVES: Reducing the rate of postoperative stroke after cardiac surgery remains challenging, especially in patients with occlusive cerebrovascular disease. Angioplasty in all patients with high-grade carotid artery stenosis has not been shown to be effective in reducing the post-surgical stroke rate. In this study, we present the initial results of a different approach using selective carotid angioplasty only in patients with poor intracranial collaterals. METHODS: We conducted a single-centre study to assess the safety of this procedure...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29300963/no-touch-aorta-robot-assisted-atrial-septal-defect-repair-via-two-ports
#8
Norihiko Ishikawa, Go Watanabe, Tatsuya Tarui
OBJECTIVES: Atrial septal defect (ASD) repairs have been successfully performed on arrested hearts with robotic assistance. The present study assessed the feasibility, safety, and efficacy of totally endoscopic cardiac surgery using a no-touch aorta technique for ASD via only 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS). METHODS: Between May 2014 and June 2016, 8 consecutive patients underwent TROCS for ASD using the da Vinci surgical system (Intuitive Surgical Inc...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29289366/comparison-of-endoaortic-and-transthoracic-aortic-clamping-in-less-invasive-mitral-valve-surgery
#9
Cristina Barbero, Ralph Krakor, Mohamed Bentala, Filip Casselman, Pascal Candolfi, Jacques Goldstein, Mauro Rinaldi
BACKGROUND: Less-invasive mitral valve surgery has become a widespread procedure in recent years, although mode of perfusion and aortic clamping are still debated questions. The aim of this study was to compare the results between transthoracic aortic clamping (TTC) and endoaortic clamping (EAC) in a multicenter, retrospective study. METHODS: Data from 3 centers experienced in both TTC and EAC were retrospectively analyzed. Five hundred consecutive patients undergoing less-invasive mitral valve surgery received either TTC (n = 250) or EAC (n = 250)...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29288807/major-inpatient-surgeries-and-in-hospital-mortality-in-new-south-wales-public-hospitals-in-australia-a-state-wide-retrospective-cohort-study
#10
Wei Du, Nicholas Glasgow, Paul Smith, Archie Clements, Art Sedrakyan
BACKGROUND: Surgical interventions save lives and are important focus for health services research worldwide. Investigating variation in postoperative mortality may improve understanding of unwarranted variations and promote safety and quality in surgical care. We aimed to evaluate trends of in-hospital mortality rates among adult inpatients receiving major elective surgeries and determine the variation in mortality among New South Wales (NSW) public hospitals. MATERIALS AND METHODS: In this study, we used the all-inclusive population-based NSW Admitted Patient Data from July 2001 to June 2014...
December 27, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29286568/utilization-of-frozen-plasma-cryoprecipitate-and-recombinant-factor-viia-for-children-with-hemostatic-impairments-an-audit-of-transfusion-appropriateness
#11
Lani Lieberman, Yulia Lin, Christine Cserti-Gazdewich, Qi Long Yi, Jacob Pendergrast, Wendy Lau, Jeannie Callum
BACKGROUND: Blood transfusions and fractionated products are not without risk and may lead to acute and long-term adverse events. The objective of this study was to evaluate the appropriateness of usage of frozen plasma (FP), cryoprecipitate (CRYO), and recombinant factor VIIa (rVIIa) in a pediatric setting. METHODS: All orders for FP, CRYO, and rVIIa were prospectively audited over 6 weeks. Data collected included demographics, laboratory values, indication, and adverse reactions...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29284860/effect-of-locally-administered-dexmedetomidine-as-adjuvant-to-levobupivacaine-in-supraclavicular-brachial-plexus-block-double-blind-controlled-study
#12
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#13
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29277548/outcomes-of-video-assisted-minimally-invasive-cardiac-myxoma-resection
#14
Giacomo Bianchi, Rafik Margaryan, Enkel Kallushi, Alfredo Giuseppe Cerillo, Pier Andrea Farneti, Angela Pucci, Marco Solinas
BACKGROUND: Myxomas are the most frequent cardiac tumours. Their diagnosis requires prompt removal. In our centre, for valve surgery we use a minimally invasive approach. Here, we report our experience of cardiac myxoma removal through right lateral mini-thoracotomy (RLMT) with particular focus on its feasibility, efficacy and patient safety. METHODS: Between February 2006 and January 2017, 30 consecutive patients (aged 66±12.6years, range 35-83 years) underwent atrial myxoma resection through video-assisted RLMT...
December 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29276625/epicardial-delivery-of-autologous-atrial-appendage-micrografts-during-coronary-artery-bypass-surgery-safety-and-feasibility-study
#15
Annu Nummi, Tuomo Nieminen, Tommi Pätilä, Milla Lampinen, Miia L Lehtinen, Sari Kivistö, Miia Holmström, Erika Wilkman, Kari Teittinen, Mika Laine, Juha Sinisalo, Markku Kupari, Esko Kankuri, Tatu Juvonen, Antti Vento, Raili Suojaranta, Ari Harjula
Background: The atrial appendages are a tissue reservoir for cardiac stem cells. During on-pump coronary artery bypass graft (CABG) surgery, part of the right atrial appendage can be excised upon insertion of the right atrial cannula of the heart-lung machine. In the operating room, the removed tissue can be easily cut into micrografts for transplantation. This trial aims to assess the safety and feasibility of epicardial transplantation of atrial appendage micrografts in patients undergoing CABG surgery...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29275827/simulation-and-deliberate-practice-in-a-porcine-model-for-congenital-heart-surgery-training
#16
Constantine D Mavroudis, Constantine Mavroudis, Jeffrey P Jacobs, William M DeCampli, James S Tweddell
BACKGROUND: Surgeons in training for congenital cardiac surgery face considerable challenges owing to procedure complexity, closely scrutinized outcomes, and a steep learning curve. Simulation methods have been initiated in other surgical specialties, but have yet to be established for congenital cardiac surgery trainees. The purpose of this study was to assess high-fidelity simulation as a method to train and improve skills of resident trainees learning critical components of index congenital cardiac surgical procedures...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29250266/intravenous-sotalol-reintroducing-a-forgotten-agent-to-the-electrophysiology-therapeutic-arsenal
#17
REVIEW
Syeda Atiqa Batul, Rakesh Gopinathannair
Sotalol is a racemic mixture possessing beta-blocker and class III anti arrhythmic properties. Approved by US food and drug administration (FDA) since 2009 based on its bioequivalence with oral sotalol, clinicians are less familiar with the potential uses of the intravenous form despite its re-launch in United States in 2015. Available literature suggests that intravenous sotalol in recommended doses can be safely administered in adult and pediatric population achieving rapid reliable therapeutic plasma concentration and without additional proarrhythmic effects when compared to its oral form as well as other antiarrhythmic medications...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29242018/current-practice-in-cytoreductive-surgery-and-hipec-for-metastatic-peritoneal-disease-spanish-multicentric-survey
#18
Rafael Morales-Soriano, Neus Esteve-Pérez, Juan José Segura-Sampedro, Pedro Cascales-Campos, Pedro Barrios
INTRODUCTION: Radical Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), has been proposed as the current standard of treatment for metastatic peritoneal disease by several tumors. Despite its widely utilization, there seems to be a great variability in their organization, clinical practice, and safety among centers. AIM OF THE STUDY: To obtain updated information on clinical practice in different perioperative areas of the CRS-HIPEC...
December 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29232303/totally-endoscopic-cardiac-surgery-for-atrial-septal-defect-repair-on-beating-heart-without-robotic-assistance-in-25-patients
#19
Quang-Huy Dang, Ngoc-Thanh Le, Cong-Huu Nguyen, Dac-Dai Tran, Do-Hung Nguyen, Trung-Hieu Nguyen, Thi-Hai-Linh Ngo
OBJECTIVE: The aim of the study was to investigate the effectivity and safety of totally endoscopic cardiac surgery without robotic assistance for atrial septal defect (ASD) closure on beating hearts. METHODS: Twenty-five patients (adults/children: 15/10) underwent ASD closure using nonrobotically assisted totally endoscopic approach on beating heart. Three 5-mm trocars and one 12-mm trocar were used, only the superior vena cava is snared, filling the pleural and pericardial cavities with CO2, and the heart was beating during the surgery...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29229621/stem-cell-therapy-for-congenital-heart-disease-a-systematic-review
#20
REVIEW
Diamantis I Tsilimigras, Evangelos K Oikonomou, Demetrios Moris, Dimitrios Schizas, Konstantinos P Economopoulos, Konstantinos S Mylonas
BACKGROUND: Congenital heart disease (CHD) constitutes the most prevalent and heterogeneous group of congenital anomalies. Although surgery remains the gold standard treatment modality, stem cell therapy has been gaining ground as a complimentary or alternative treatment option in certain types of CHD. The aim of this study was to present the existing published evidence and ongoing research efforts on the implementation of stem cell-based therapeutic strategies in CHD. METHODS: A systematic review was conducted by searching Medline, ClinicalTrials...
December 12, 2017: Circulation
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