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Safety in cardiac surgery

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https://www.readbyqxmd.com/read/27901332/safety-and-efficacy-of-non-continuous-echocardiographic-guided-pericardiocentesis-a-single-center-study-of-478-patients
#1
Ilaria Battistoni, Marco Marini, Luca Angelini, Matteo Francioni, Alberto Gili, Stefano Moretti, Carlo Costantini, Christian Corinaldesi, Marica Bordicchia, Gian P Perna
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis in Italy. The aim of the study was to evaluate safety and efficacy of pericardiocentesis, performed with non-continuous echocardiography monitoring. All the procedures performed at Department of Cardiovascular Disease, Ospedali Riuniti Ancona, from January 2001 to June 2013, were retrospectively analyzed to determine risks connected to the procedure and its success rate. Epidemiological data, procedure indications and etiology of the effusions were also recorded...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#2
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27875729/-seesaw-balloon-wire-cutting-technique-is-superior-to-tornus-catheter-in-balloon-uncrossable-chronic-total-occlusions
#3
Jingyi Xue, Jianqiang Li, Hongjun Wang, Li Sheng, Yongtai Gong, Danghui Sun, Shuang Li, Weimin Li, Dingyu Wang, Yue Li
BACKGROUND: Inability to advance a balloon is a well-recognized cause leading to a failure in recanalization of chronic total occlusions (CTOs) despite successfully passing a guidewire. A few techniques and devices have been introduced to facilitate balloon passage, especially the use of Tornus catheter. However, complex manipulation, expensive cost, and availability limit the application of these methods. This study was to evaluate the efficiency and safety of "seesaw balloon-wire cutting" technique in comparison with Tornus catheter for balloon uncrossable CTOs...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27871596/confirmation-of-optimal-guidewire-length-for-central-venous-catheter-placement-using-transesophageal-echocardiography
#4
Manabu Yoshimura, Toshiyuki Nakanishi, Seishi Sakamoto, Takashi Toriumi
STUDY OBJECTIVE: Several authors have reported rare, but severe, complications associated with the length of the intravascular guidewire during central venous catheter placement, as the wire tip can cause cardiac arrhythmia or perforation or become trapped within the vessel. Although one report investigated the optimal guidewire length using fluoroscopy, few reports have precisely measured guidewire position using transesophageal echocardiography (TEE). Here, we investigated the appropriate intravascular length of a guidewire for right internal jugular vein approach using TEE during cardiac surgery...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27831826/hospitalist-vascular-surgery-comanagement-effects-on-complications-and-mortality
#5
Colin T Iberti, Alan Briones, Erin Gabriel, Andrew S Dunn
OBJECTIVES: Hospitalized vascular surgery patients have multiple severe comorbidities, poor functional status, and high perioperative cardiac risk. Thus they may be ideal patients for a collaborative care model. However, there is little evidence for a comanagement model on clinical outcomes. METHODS: The two-year pre-post study consisted of a comanagement model where a hospitalist actively participated in the medical care of American Society of Anesthesiologist Physical Status Classification scale 3 or 4 vascular surgery patients...
November 24, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27830337/the-impact-of-surgical-left-atrial-appendage-amputation-ligation-on-stroke-prevention-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#6
Daisuke Endo, Tomoko S Kato, Tai Iwamura, Atsumi Oishi, Yasutaka Yokoyama, Kenji Kuwaki, Hirotaka Inaba, Atsushi Amano
Stroke is a major adverse event in patients developing atrial fibrillation (AF) after cardiac surgery. Surgical left atrial appendage amputation/ligation (LAA-A/L) during off-pump coronary artery bypass grafting (OPCAB) is routinely performed in our institution. We analyzed 578 consecutive patients (mean age 69 years, male 82%) undergoing OPCAB with or without concomitant LAA-A/L from 2011 to 2014 at our institution in a prospective observational manner. The safety and efficacy of the concomitant LAA-A/L on preventing early (<30 days) and overall postoperative stroke were examined...
November 9, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27807090/surgical-ablation-of-atrial-fibrillation-a-protocol-for-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#7
Graham R McClure, Emilie P Belley-Cote, Rohit K Singal, Iqbal H Jaffer, Nazari Dvirnik, Kevin R An, Gabriel Fortin, Jessica Spence, Richard P Whitlock
INTRODUCTION: Atrial fibrillation (AF) affects 10% of patients undergoing cardiac surgery and is an independent risk factor for all-cause mortality, ischaemic stroke and heart failure. Surgical AF ablation has been shown to significantly improve maintenance of sinus rhythm, however, small to medium size trials conducted to date lack the power required to assess patient-important outcomes such as mortality, stroke, heart failure and health-related quality of life. Moreover, a recent randomised trial (RCT) suggested harm by surgical AF ablation with an almost threefold increase in the requirement for permanent pacemaker postablation...
November 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27806902/very-thin-strut-biodegradable-polymer-everolimus-eluting-and-sirolimus-eluting-stents-versus-durable-polymer-zotarolimus-eluting-stents-in-allcomers-with-coronary-artery-disease-bio-resort-a-three-arm-randomised-non-inferiority-trial
#8
Clemens von Birgelen, Marlies M Kok, Liefke C van der Heijden, Peter W Danse, Carl E Schotborgh, Martijn Scholte, R Melvyn Tjon Joe Gin, Samer Somi, K G van Houwelingen, M G Stoel, Frits H A F de Man, J Hans W Louwerenburg, Marc Hartmann, Paolo Zocca, Gerard C M Linssen, Job van der Palen, Carine J M Doggen, Marije M Löwik
BACKGROUND: In patients with coronary artery disease, treated with durable polymer-coated drug-eluting stents, the life-long presence of the polymer might delay arterial healing. Novel very thin strut biodegradable polymer stents, which leave only a bare metal stent after polymer resorption, might improve long-term outcome. We investigated in allcomers the safety and efficacy of three stents eluting either everolimus, sirolimus, or zotarolimus, often clinically used but never compared, of which the biodegradable polymer everolimus-eluting stent was never before assessed in allcomers...
November 26, 2016: Lancet
https://www.readbyqxmd.com/read/27796512/gene-therapy-in-heart-failure
#9
Anthony S Fargnoli, Michael G Katz, Charles R Bridges, Roger J Hajjar
Heart failure is a significant burden to the global healthcare system and represents an underserved market for new pharmacologic strategies, especially therapies which can address root cause myocyte dysfunction. Modern drugs, surgeries, and state-of-the-art interventions are costly and do not improve survival outcome measures. Gene therapy is an attractive strategy, whereby selected gene targets and their associated regulatory mechanisms can be permanently managed therapeutically in a single treatment. This in theory could be sustainable for the patient's life...
October 28, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27792703/-percutaneous-intervention-in-the-correction-of-congenital-heart-deffects-dcc-experience-in-as-umae
#10
Vicente Campos-García, Guillermo Ordóñez-Toquero, Sarain Monjaraz-Rodríguez, Eduardo Gómez-Conde
INTRODUCTION: Congenital heart defects are common in infants and adults, affecting quality of life if not corrected. Unlike open surgery, percutaneous intervention allows correction with a high success rate and speedy recovery. In Mexico, there are not enough studies to describe their efficacy and safety. METHODS: A cohort study was conducted in the Hospital "Manuel Avila Camacho", in Puebla, Mexico, including 149 patients with congenital heart defects repaired by percutaneous intervention, recording data from clinical records...
September 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27786420/outcomes-of-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation-in-small-children-after-cardiac-surgery-experience-and-protocol-from-a-single-center
#11
Anna Musielak, Alfred Warzywoda, Michał Wojtalik, Bartłomiej Kociński, Paweł Kroll, Danuta Ostalska-Nowicka, Jacek Zachwieja
Patients after a cardiac surgery in cardiopulmonary bypass often present an acute kidney failure. Continuous renal replacement therapy (CRRT) is often required. The aim of this study was to present effectiveness and safety of CRRT with regional citrate anticoagulation (RCA-CRRT) in small children after cardiac surgery. A retrospective analysis was conducted on 15 patients after cardiac surgery and who had RCA-CRRT performed in 2014. The established protocol was followed. Mean time on the RCA-CRRT was 192 h 40 min with the circuit mean lifetime of 43 h 33 min...
October 27, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27779776/a-phase-i-study-to-determine-the-pharmacokinetic-profile-safety-and-tolerability-of-sildenafil-revatio-%C3%A2-in-cardiac-surgery-the-revaki-1-study
#12
Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
AIMS: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio(®) , Pfizer Inc.), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. The aim of this study is to assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients...
October 25, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27748695/efficacy-of-%C3%AE-blocker-therapy-for-secondary-prevention-for-patients-undergoing-coronary-artery-bypass-grafting-surgery
#13
Cheng Sun, Heng Zhang, Zhe Zheng
PURPOSE OF REVIEW: The efficacy and safety of β-blockers in the treatment of cardiovascular diseases, such as ischemic heart disease, cardiac arrhythmias, and heart failure, have been well established for decades. In this article, we review the current opinions on the application of β-blockers for secondary prevention in patients undergoing coronary artery bypass grafting (CABG) surgery. RECENT FINDINGS: As the average age of patients treated surgically for coronary artery disease (CAD) is increasing, it is not uncommon to have candidates for CABG presenting with concomitant atrial fibrillation, heart failure or hypertension, most of which were caused by excessive activation of the adrenergic nervous system...
November 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27742998/neutralization-of-ep217609-a-new-dual-action-fiia-fxa-anticoagulant-by-its-specific-antidote-avidin-a-phase-i-study
#14
P Gueret, S Combe, C Krezel, E Fuseau, P L M van Giersbergen, M Petitou, E Neuhart
INTRODUCTION: EP217609 is a representative of a new class of synthetic parenteral anticoagulants with a dual mechanism of action. It combines in a single molecule a direct thrombin inhibitor and an indirect factor Xa inhibitor. EP217609 can be neutralized by a specific antidote avidin, which binds to the biotin moiety of EP217609. PURPOSE: The primary objective was to assess the neutralization of EP217609 by avidin in healthy subjects. Secondary objectives were to define the optimal avidin monomer/EP217609 molar ratio to achieve an adequate neutralization of EP217609 and to assess the safety and tolerability of EP217609 and avidin...
October 15, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27738059/lead-extraction-outcomes-in-patients-with-congenital-heart-disease
#15
Erin A Fender, Ammar M Killu, Bryan C Cannon, Paul A Friedman, Christopher J Mcleod, David O Hodge, Craig S Broberg, Charles A Henrikson, Yong-Mei Cha
AIMS: Patients with congenital heart disease (CHD) are at increased risk for intracardiac device malfunction and infection that may necessitate extraction; however, the risk of extraction is poorly understood. This study addresses the safety of extraction in patients with structural heart disease and previous cardiac surgery. METHODS: This retrospective study included 40 CHD and 80 matched control patients, who underwent transvenous lead extractions between 2001 and 2014...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27736197/spinal-cord-infarction-post-cardiac-arrest-in-stemi-a-potential-complication-of-intra-aortic-balloon-pump-use
#16
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27733069/current-status-of-transcatheter-mitral-valve-repair-therapies-from-surgical-concepts-towards-future-directions
#17
Sten Lyager Nielsen
Transcatheter mitral valve (MV) intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation (MR) in patients considered to be inoperable or at high operative risk for surgical MV surgery. In primary mitral regurgitation, surgical repair is the standard of care. Transcatheter edge-to-edge MV repair with the MitraClip system has the largest clinical experience to date and offers a sustained clinical benefit in selected surgical high-risk patients. Surgery for secondary MR remains a challenge...
November 6, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27731885/transfusion-thresholds-and-other-strategies-for-guiding-allogeneic-red-blood-cell-transfusion
#18
REVIEW
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27730796/acenocoumarol-a-review-of-anticoagulant-efficacy-and-safety
#19
Abhijit Trailokya, J S Hiremath, Jps Sawhney, Y K Mishra, Vivek Kanhere, R Srinivasa, Mangesh Tiwaskar
Anticoagulant treatment is required for the treatment and prevention of thromboembolic disorders. Vitamin K antagonists are commonly used oral anticoagulants worldwide. Acenocoumarol is mono-coumarin derivative with racemic mixture of R (+) and S (-) enantiomers. Efficacy and safety of acenocoumarol has been evaluated in atrial fibrillation, cardiac valve replacement, after myocardial infarction, treatment of deep vein thrombosis, after major surgeries and after critical illness requiring prolonged hospitalization...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27709094/goal-directed-perfusion-in-neonatal-aortic-arch-surgery
#20
Robert Anton Cesnjevar, Ariawan Purbojo, Frank Muench, Joerg Juengert, André Rueffer
Reduction of mortality and morbidity in congenital cardiac surgery has always been and remains a major target for the complete team involved. As operative techniques are more and more standardized and refined, surgical risk and associated complication rates have constantly been reduced to an acceptable level but are both still present. Aortic arch surgery in neonates seems to be of particular interest, because perfusion techniques differ widely among institutions and an ideal form of a so called "total body perfusion (TBP)" is somewhat difficult to achieve...
July 2016: Translational pediatrics
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