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https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#1
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29145107/postoperative-thoracic-hemorrhage-after-right-upper-lobectomy-with-thoracic-wall-resection-during-rivaroxaban-anticoagulant-therapy-for-deep-leg-vein-thrombosis-a-case-report
#2
Taiji Kuwata, Masatoshi Kanayama, Ayako Hirai, Shuichi Shinohara, Masaru Takenaka, Soichi Oka, Yasuhiro Chikaishi, Naoko Imanishi, Koji Kuroda, Fumihiro Tanaka
INTRODUCTION: Postoperative pulmonary embolism (PE) is the one of the most important complications after thoracic surgery. This complicatin after the surgery is often treated by new anticoaglant drug, such as rivaroxaban, which dose not need to the monitoring of blood coaglation system. We experienced postoperative bleeding case during anticoaglant therapy using rivaroxaban. PRESENTATION OF CASE: The patient underwent a right upper lobectomy with lung and chest wall resection for lung cancer...
November 11, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#3
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28856146/a-critical-reappraisal-of-the-treatment-modalities-of-normal-appearing-thoracic-aorta-mural-thrombi
#4
REVIEW
Georgios Karaolanis, Demetrios Moris, Chris Bakoyiannis, Diamantis I Tsilimigras, Viktoria-Varvara Palla, Eleftherios Spartalis, Dimitrios Schizas, Sotirios Georgopoulos
Mural thrombus in non-atherosclerotic or aneurysmatic thoracic aorta is a relatively uncommon entity. Currently there is no consensus on the appropriate therapeutic algorithm of its management. We aim to present the current knowledge on the treatment of thoracic aorta mural thrombi (TAMT) in minimally atherosclerotic vessels and we hope that the juxtaposed discussions will shed light on the uncharted waters regarding this rare syndrome. The MEDLINE/PubMed database was searched for publications with the medical subject "aortic mural thrombus" and keywords "thoracic", "embolism", "normal vessel", "minimally atherosclerotic vessel" or "treatment"...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28846822/extended-pharmacologic-thromboprophylaxis-in-oncologic-liver-surgery-is-safe-and-effective
#5
B J Kim, R W Day, C H Davis, N Narula, M H Kroll, C W D Tzeng, T A Aloia
Essentials The risk for venous thromboembolism after liver surgery remains high in the modern era. We evaluated the safety/efficacy of extended anticoagulation in liver surgery. This protocol reports zero venous thromboembolism events in 124 liver surgery patients. Extended anticoagulation after oncologic liver surgery is safe and effective. SUMMARY: Background The incidence of venous thromboembolism (VTE) after liver surgery remains high. Objective To evaluate the safety and efficacy of extended pharmacologic thromboprophylaxis after liver surgery for the prevention of VTE...
November 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#6
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/28790282/-arrhythmia-perioperative-management-and-the-prevention
#7
Masayoshi Inoue
Perioperative/postoperative atrial fibrillation and flutter( POAF) is one of the common complications after pulmonary resection and the frequency is reported as 12.6% according to Society of Thoracic Surgeons general thoracic surgery database. We usually observed POAF 2~3 day after operation. While the etiology remains uncertain, the left atrial overload by the refilling from the 3rd space or systemic inflammation after surgery could raise this complication in addition to the right atrial overload following pulmonary resection and postoperative hypoxia status...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790281/-perioperative-management-for-prevention-of-cardiac-complications-in-general-thoracic-surgery
#8
Terumoto Koike, Masanori Tsuchida
For general thoracic surgeons, perioperative management for prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac disease. Sever cardiac failure should be detected and treated prior to surgery, and coronary artery may be examined in patients with risk factors for ischemic heart disease. Pulmonary resection sometimes causes right-sided heart failure due to reducing pulmonary vascular bed. In high-risk patients for rightsided heart failure, pulmonary artery pressure monitoring by right heart catheterization should be considered in addition to blood pressure and central venous pressure monitoring, and precise fluid management is required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28749044/video-assisted-thoracoscopic-lobectomy-after-percutaneous-coronary-intervention-in-lung-cancer-patients-with-concomitant-coronary-heart-disease
#9
Xin Li, YiLi Fu, JinBai Miao, Hui Li, Bin Hu
BACKGROUND: In recent years, based on clinical observations, the number of lung cancer patients with concomitant coronary heart disease (CHD) has gradually increased. However, because of the requirement of long-term anticoagulant therapy after percutaneous coronary intervention (PCI), some of these patients lose the opportunity for surgical treatment, resulting in tumor progression. The objective of this study was to determine the appropriate timing of video-assisted thoracic surgery (VATS) lobectomy after PCI without increasing perioperative cardiovascular risk...
September 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28567220/should-we-check-the-routine-postoperative-mri-for-hematoma-in-spinal-decompression-surgery
#10
Hun-Kyu Shin, Hwa-Jae Jeong, Eugene Kim, Jai Hyung Park, Se-Jin Park, Yongun Cho
BACKGROUND: A postoperative magnetic resonance imaging (MRI) is performed as a routine to assess decompression of the spinal cord as well as to evaluate postoperative complications. The purpose of this study is to analyze the efficacy of postoperative MRI for hematoma in spinal decompression surgery. METHODS: Between January 1, 2008 and January 31, 2015, 185 patients who underwent postoperative MRI after spinal decompression surgery were included in this study. We checked the history of the use of an anticoagulant or antiplatelet agent, withdrawal period, blood platelet count, and prothrombin time (international normalized ratio [INR])...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#11
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28479450/perception-of-chemical-venous-thromboprophylaxis-for-oncologic-lung-resections-among-thoracic-surgeons
#12
Rafael D Malgor, Thomas V Bilfinger, John Blebea, Harry Ma, Shirliejean R Arnold
BACKGROUND: Controversies on chemical venous thromboembolic (VTE) prophylaxis in patients undergoing lung resection for malignancy exist. The available guidelines on VTE do not specifically address its prophylaxis in patients undergoing oncologic lung resections. The goal of this survey was to evaluate the perception of VTE prophylaxis among thoracic surgeons performing these operations. METHODS: A self-reported online survey was distributed to 267 active members of the General Thoracic Surgical Club between July and September 2015...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28454810/time-to-achieving-therapeutic-international-normalized-ratio-increases-hospital-length-of-stay-after-heart-valve-replacement-surgery
#13
Christopher J Arendt, Joon Hwa Hong, Richard C Daly, Christopher Scott, Ramila A Mehta, Kent Bailey, Jyotishman Pathak, Naveen L Pereira
BACKGROUND: Achieving a therapeutic international normalized ratio (INR) before hospital discharge is an important inpatient goal for patients undergoing mechanical cardiac valve replacement (MCVR). The use of clinical algorithms has reduced the time to achieve therapeutic INR (TTI) with warfarin therapy. Whether TTI prolongs length of stay (LOS) is unknown. METHODS: Patients who underwent MCVR over a consecutive 42-month period were included. Clinical data were obtained from the Society of Thoracic Surgeons Adult Cardiac Surgery database and electronic medical records...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28415059/-a-case-of-slowly-progressive-brain-metastasis-with-minor-bleeding-after-removal-of-and-chemotherapy-for-non-small-cell-lung-cancer
#14
Hiroshi Matsufuji, Eri Shiozaki, Yasutaka Nakatake, Koichi Yoshida, Kensaku Kamada, Takayuki Matsuo
Of all brain metastases, the most common primary lesion is derived from the lung. These types of metastases enlarge aggressively with unfavorable prognoses. We report the case of a 75-year-old male patient who had a history of pulmonary resection for Stage IA non-small cell lung cancer(NSCLC), and received chemotherapy. One year after NSCLC surgery, he experienced a cardiogenic cerebral infarction, and anticoagulant therapy was initiated. Mass lesions with hemorrhage were detected bilaterally in the frontal lobes through magnetic resonance imaging three years after the NSCLC surgery...
April 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28374810/risk-factors-in-iatrogenic-spinal-cord-injury
#15
A Montalva-Iborra, M Alcanyis-Alberola, C Grao-Castellote, F Torralba-Collados, M Giner-Pascual
STUDY DESIGN: In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. OBJECTIVE: The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. METHODS: A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted...
September 2017: Spinal Cord
https://www.readbyqxmd.com/read/28054894/a-rare-case-of-a-pedicled-mobile-thrombus-in-right-atrium
#16
Xiaodong Li, Liping Chen, Xiumei Duan, Xiaocong Wang
Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well...
December 2, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28040318/transcatheter-mitral-valve-replacement-for-patients-with-symptomatic%C3%A2-mitral%C3%A2-regurgitation-a-global-feasibility-trial
#17
David W M Muller, Robert Saeid Farivar, Paul Jansz, Richard Bae, Darren Walters, Andrew Clarke, Paul A Grayburn, Robert C Stoler, Gry Dahle, Kjell A Rein, Marty Shaw, Gregory M Scalia, Mayra Guerrero, Paul Pearson, Samir Kapadia, Marc Gillinov, Augusto Pichard, Paul Corso, Jeffrey Popma, Michael Chuang, Philipp Blanke, Jonathon Leipsic, Paul Sorajja
BACKGROUND: Symptomatic mitral regurgitation (MR) is associated with high morbidity and mortality that can be ameliorated by surgical valve repair or replacement. Despite this, many patients with MR do not undergo surgery. Transcatheter mitral valve replacement (TMVR) may be an option for selected patients with severe MR. OBJECTIVES: This study aimed to examine the effectiveness and safety of TMVR in a cohort of patients with native valve MR who were at high risk for cardiac surgery...
January 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27855287/the-burden-and-implications-of-preoperative-atrial-fibrillation-in-australian-heart-valve-surgery-patients
#18
E Anne Russell, Warren F Walsh, Lavinia Tran, Robert Tam, Christopher M Reid, Alex Brown, Jayme S Bennetts, Robert A Baker, Graeme P Maguire
BACKGROUND: Atrial fibrillation (AF) is the most common preoperative arrhythmia in heart valve surgery patients and its prevalence is rising. This study aims to investigate the impact of AF on valve surgery early complications and survival and on valve disease of different aetiologies and populations with particular reference to Indigenous Australians with rheumatic heart disease (RHD). METHODS: The Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed to determine the association between preoperative AF and valve surgery outcome...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27847992/-esc-guidelines-on-atrial-fibrillation-2016-summary-of-the-most-relevant-recommendations-and-modifications
#19
REVIEW
L Eckardt, K G Häusler, U Ravens, M Borggrefe, P Kirchhof
The first European Society of Cardiology (ESC) guidelines on atrial fibrillation (AF) developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) were published in August 2016. These guidelines replace the revised guidelines from 2012 and contain some interesting new aspects. The topics range from the pathophysiology through diagnostics, therapy and stroke prevention up to special clinical situations, such as atrial fibrillation in cardiopathy, sport and pregnancy. Early screening, patient informed consent, individualized therapy and the modification of factors promoting atrial fibrillation are of particular importance...
December 2016: Herz
https://www.readbyqxmd.com/read/27803121/new-onset-atrial-fibrillation-after-anatomic-lung-resection-predictive-factors-treatment-and-follow-up-in-a-uk-thoracic-centre
#20
Megan Garner, Tom Routledge, Juliet E King, John E Pilling, Lukacs Veres, Karen Harrison-Phipps, Andrea Bille, Leanne Harling
Objectives: Postoperative atrial fibrillation (POAF) increases morbidity, hospital stay and healthcare expenditure. This study aims to determine the perioperative factors correlating with POAF as well as to evaluate both treatment strategies and AF persistence beyond discharge. Methods: The records of all patients undergoing anatomical lung resection over a 1-year period were retrospectively reviewed. Patients with a history of arrhythmia were excluded. POAF was defined by clinical diagnosis and electrocardiography...
February 1, 2017: Interactive Cardiovascular and Thoracic Surgery
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