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Safety in cardiac surgery

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https://www.readbyqxmd.com/read/28711585/global-outbreak-of-severe-mycobacterium-chimaera-disease-after-cardiac-surgery-a-molecular-epidemiological-study
#1
Jakko van Ingen, Thomas A Kohl, Katharina Kranzer, Barbara Hasse, Peter M Keller, Anna Katarzyna Szafrańska, Doris Hillemann, Meera Chand, Peter Werner Schreiber, Rami Sommerstein, Christoph Berger, Michele Genoni, Christian Rüegg, Nicolas Troillet, Andreas F Widmer, Sören L Becker, Mathias Herrmann, Tim Eckmanns, Sebastian Haller, Christiane Höller, Sylvia B Debast, Maurice J Wolfhagen, Joost Hopman, Jan Kluytmans, Merel Langelaar, Daan W Notermans, Jaap Ten Oever, Peter van den Barselaar, Alexander B A Vonk, Margreet C Vos, Nada Ahmed, Timothy Brown, Derrick Crook, Theresa Lamagni, Nick Phin, E Grace Smith, Maria Zambon, Annerose Serr, Tim Götting, Winfried Ebner, Alexander Thürmer, Christian Utpatel, Cathrin Spröer, Boyke Bunk, Ulrich Nübel, Guido V Bloemberg, Erik C Böttger, Stefan Niemann, Dirk Wagner, Hugo Sax
BACKGROUND: Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. METHODS: We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates...
July 12, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#2
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28690218/-comparative-study-between-cardiac-catheterization-intervention-therapy-and-transthoracic-small-incision-surgery-for-closure-of-congenital-atrial-septal-defect-by-domestic-occluder-with-echocardiographic-monitoring
#3
Xiaomei He, Lina Zhao, Xuejia Guo, Ning Zhang, Yuna Sun, Jun Wang, Zhen Wang, Gaiqin Liu
To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).
 Methods: A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively, and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery...
June 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28683983/sutureless-sorin-perceval-aortic-valve-implantation
#4
Steffen Pfeiffer, Theodor Fischlein, Giuseppe Santarpino
The sutureless Perceval aortic valve (Sorin Group, Saluggia, Italy) is a device increasingly used in many European cardiac surgery centers. Since the first reports evaluating implantation feasibility and valve safety in humans in 2007, an increasing amount of data have become available, including premarketing clinical results and experience in particular conditions. Overall, excellent performances have been demonstrated in hemodynamic outcomes, safety, and versatility of use. However, several questions remain unanswered, especially regarding long-term durability, risk for endocarditis, and the need for postoperative pacemaker implantation...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28676183/preclinical-efficacy-and-safety-of-kcnh2-g628s-gene-therapy-for-postoperative-atrial-fibrillation
#5
Zhao Liu, Julie A Hutt, Barur Rajeshkumar, Yoshihiro Azuma, Kailai L Duan, J Kevin Donahue
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common complication occurring after cardiac surgery. Multiple studies have shown significantly increased risks of stroke, myocardial infarction, and death associated with POAF. Current prophylaxis strategies are inadequate to eliminate this problem. We examined the preclinical efficacy and safety of KCNH2-G628S gene transfer to prevent POAF. METHODS: Domestic pigs received AdKCNH2-G628S by epicardial atrial gene painting and atrial pacemaker implantation for continuous-burst pacing to induce atrial fibrillation...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28675571/five-year-survival-after-surgery-in-nonagenarian-patients
#6
Roberto Fariña-Castro, Cristina Roque-Castellano, Joaquín Marchena-Gómez, Aurelio Rodríguez-Pérez
AIM: In countries with longer life expectancies, the nonagenarian population is increasing. Therefore, there is greater demand for healthcare, including surgical procedures. The aim of the present study was to determine the outcomes of surgery carried out on nonagenarians in terms of long-term survival after the procedure. METHODS: We carried out a cross-longitudinal study on a cohort of 159 nonagenarian patients, who underwent a non-cardiac, non-traumatic surgical procedure in our institution between January 1999 and December 2011...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28662711/repurposing-propranolol-as-a-drug-for-the-treatment-of-retinal-haemangioblastomas-in-von-hippel-lindau-disease
#7
Virginia Albiñana, Rosa María Jiménez Escribano, Isabel Soler, Luis Rodríguez Padial, Lucia Recio-Poveda, Karina Villar Gómez de Las Heras, Luisa María Botella
BACKGROUND: Von Hippel-Lindau (VHL) disease is a rare oncological disease with an incidence of 1:36,000, and is characterized by the growth of different types of tumours. Haemangioblastomas in the central nervous system (CNS) and retina, renal carcinoma and pheochromocytomas are the most common tumours. The absence of treatment for VHL leads to the need of repeated surgeries as the only option for these patients. Targeting VHL-derived tumours with drugs with reduced side effects is urgent to avoid repeated CNS surgeries...
June 29, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28645469/transcatheter-mitral-valve-repair-with-mitraclip-for-symptomatic-functional-mitral-valve-regurgitation
#8
REVIEW
Rodrigo Mendirichaga, Vikas Singh, Vanessa Blumer, Manuel Rivera, Alex P Rodriguez, Mauricio G Cohen, William W O'Neill, Sammy Elmariah
Transcatheter edge-to-edge mitral valve repair (TMVr) with MitraClip has proved to be safe and effective for high-risk surgical patients with severe symptomatic degenerative mitral regurgitation. There is paucity of data regarding its use in functional mitral regurgitation (FMR). The objective of this study was to evaluate the use of MitraClip in patients with symptomatic moderate or severe FMR and a high surgical risk. Medical libraries were systematically searched for studies assessing the use of MitraClip for patients with symptomatic moderate or severe FMR and a high surgical risk...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#9
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28629781/position-paper-for-the-evaluation-and-management-of-oral-status-in-patients-with-valvular-disease-groupe-de-travail-valvulopathies-de-la-soci%C3%A3-t%C3%A3-fran%C3%A3-aise-de-cardiologie-soci%C3%A3-t%C3%A3-fran%C3%A3-aise-de-chirurgie-orale-soci%C3%A3-t%C3%A3-fran%C3%A3-aise-de-parodontologie-et-d-implantologie
#10
REVIEW
Sarah Millot, Philippe Lesclous, Marie-Laure Colombier, Loredana Radoi, Clément Messeca, Mathieu Ballanger, Jean-Luc Charrier, Philippe Tramba, Stéphane Simon, Alain Berrebi, Fabien Doguet, Emmanuel Lansac, Christophe Tribouilloy, Gilbert Habib, Xavier Duval, Bernard Iung
Oral health is of particular importance in patients with heart valve diseases because of the risk of infective endocarditis. Recommendations for antibiotic prophylaxis before dental procedures have been restricted, but the modalities of oral evaluation and dental care are not detailed in guidelines. Therefore, a multidisciplinary working group reviewed the literature to propose detailed approaches for the evaluation and management of buccodental status in patients with valvular disease. Simple questions asked by a non-dental specialist may draw attention to buccodental diseases...
June 16, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#11
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28616214/high-dose-hydroxocobalamin-for-vasoplegic-syndrome-causing-false-blood-leak-alarm
#12
Wisit Cheungpasitporn, John Hui, Kianoush B Kashani, Erica D Wittwer, Robert C Albright, John J Dillon
Blood leak alarms are important safety features in a hemodialysis machine to protect patients from loss of blood through a rupture in the dialyzer membrane (true alarms). A false blood leak alarm can be triggered by air bubbles or detector malfunction (such as deposits of grease or scale). Hydroxocobalamin is an injectable form of vitamin B12 approved by the US Food and Drug Administration for the treatment of confirmed or suspected cyanide toxicity. Due to observations of an increase in arterial pressure after high-dose hydroxocobalamin infusion for the treatment of acute cyanide poisoning, it has recently been reported as an off-label rescue treatment for post-cardiopulmonary bypass vasoplegic syndrome...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28593177/in-hospital-outcomes-and-long-term-follow-up-after-percutaneous-transcatheter-closure-of-postinfarction-ventricular-septal-defects
#13
Ruoxi Zhang, Yong Sun, Meng Sun, Hui Zhang, Jingbo Hou, Bo Yu
Postinfarction ventricular septal defects (VSD) represent a devastating complication of acute myocardial infarction and are associated with high mortality. Percutaneous interventional closure of postinfarction VSD has been proposed as a potential alternative to surgery. The study aimed to evaluate the therapeutic safety and efficacy of percutaneous interventional closure of postinfarction ventricular septal defects (VSD). Each patient was assigned to one of two groups, based on whether they died during hospitalization (death group) or survived (survival group) in this retrospective study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28580776/do-we-have-enough-evidence-for-minimally-invasive-cardiac-surgery-a-critical-review-of-scientific-and-non-scientific-information
#14
REVIEW
Torsten Doenst, Joseph Lamelas
Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits could not be demonstrated. In addition, any potential benefit comes at the cost of increased cardiopulmonary bypass and clamp times, leading to questions regarding the safety of minimally invasive cardiac surgery (MICS). Nevertheless, outcomes have been equivalent to matched sternotomy cases and there is no doubt that the number of patients undergoing minimally-invasive mitral or aortic procedures is slowly increasing...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28580663/autologous-blood-salvage-in-the-era-of-patient-blood-management
#15
REVIEW
R A Sikorski, N A Rizkalla, W W Yang, S M Frank
Almost 150 years after the first autologous blood transfusion was reported, intraoperative blood salvage has become an important method of blood conservation. The primary goal of autologous transfusion is to reduce or avoid allogeneic red blood cell transfusion and the associated risks and costs. Autologous salvaged blood does not result in immunological challenge and its consequences, provides a higher quality red blood cell that has not been subjected to the adverse effects of blood storage, and can be more cost-effective than allogeneic blood when used for carefully selected surgical patients...
June 5, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28578622/modular-minimal-invasive-extracorporeal-circuits-another-step-toward-universal-applicability
#16
Aschraf El-Essawi, Mohammed Morjan, Ingo Breitenbach, Ahmed Bechri, Rene Brouwer, Wolfgang Harringer
INTRODUCTION: Safety concerns have been one of the main reasons opposing a wider acceptance of minimal invasive extracorporeal circuits (MiECC). Following an extensive experience and a multitude of modifications, we have set out to employ a modular MiECC as a universal extracorporeal circuit. METHODS: A total of 129 cardiac surgical procedures were performed by a single surgeon in 2013. Excluding procedures done under circulatory arrest or with the potential need of such, the MiECC was utilized in almost 90% of surgeries...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28567359/non-surgical-extraction-of-right-atrial-mass-by-angiovac-aspiration-device-under-fluoroscopic-and-transesophageal-echocardiographic-guidance
#17
Tariq H Enezate, Arun Kumar, Kul Aggarwal, Sudarshan Balla, Jad Omran
Right-sided cardiac masses are commonly encountered. We present a challenging case of a right atrial thrombus in a patient who had a high surgical risk for open removal. AngioVac aspiration device, under transesophageal echocardiography (TEE) and fluoroscopy guidance, was successfully used to remove the thrombus. The patient tolerated the procedure well and was discharged home. Our case confirms the safety and efficacy of this procedure for treatment of unwanted intracardiac and intravascular masses in patients who are not candidates for conventional therapies of surgery or thrombolytics...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28557569/the-global-end-diastolic-volume-gedv-could-be-more-appropiate-to-fluid-management-than-central-venous-pressure-cvp-during-closed-hyperthermic-intrabdominal-chemotherapy-with-co2-circulation
#18
Francisco Javier Redondo, David Padilla, Pedro Villarejo, Victor Baladron, Patricia Faba, Sergio Sánchez, José Ramón Muñoz-Rodríguez, Natalia Bejarano
BACKGROUND: Closed hyperthermic intraperitoneal chemotherapy (HIPEC) may increase abdominal pressure and effects of hemodynamic changes due to maintenance hyperthermia. Our aim was to analyze the safety and effectiveness of our closed technique with CO2 circulation in management fluid status and hemodynamic parameters by means of cardiac preload control measured by Global End Diastolic Values (GEDV) and a gas exchanger. MATERIAL AND METHODS: A Pilot Clinical Study that included 18 advanced ovarian cancer patients undergoing citoreductive surgery and HIPEC...
May 30, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28552078/comparison-of-the-therapeutic-effects-and-side-effects-of-tadalafil-and-sildenafil-after-surgery-in-young-infants-with-pulmonary-arterial-hypertension-due-to-systemic-to-pulmonary-shunts
#19
Mohammad Reza Sabri, Hamid Bigdelian, Mohsen Hosseinzadeh, Alireza Ahmadi, Mehdi Ghaderian, Mohammad Shoja
Young children with CHD and large systemic-to-pulmonary shunts eventually develop pulmonary hypertension. At present, phosphodiesterase type-5 inhibitors such as sildenafil have been used to control pulmonary pressure before and after cardiac surgery. Recently, tadalafil has been utilised in older children with similar efficacy, but it has been used to a lesser extent in young infants. From April, 2015 to June, 2016, 42 patients aged 3-24 months with a large septal defect and pulmonary arterial hypertension were randomly divided into two equal groups: one group received oral sildenafil (1-3 mg/kg/day every 8 hours), whereas the other group received oral tadalafil (1 mg/kg once a day) from 7-10 days before surgery to 3-4 weeks after surgery...
May 29, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28545585/a-systematic-review-of-left-ventricular-cardio-endoscopic-surgery
#20
REVIEW
Erdinc Soylu, Emaddin Kidher, Hutan Ashrafian, George Stavridis, Leanne Harling, Thanos Athanasiou
Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique...
May 25, 2017: Journal of Cardiothoracic Surgery
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