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Thoracic surgery, anticoagulant

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https://www.readbyqxmd.com/read/28856146/a-critical-reappraisal-of-the-treatment-modalities-of-normal-appearing-thoracic-aorta-mural-thrombi
#1
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
#2
Bradford J Kim, Ryan W Day, Catherine H Davis, Nisha Narula, Michael H Kroll, Ching-Wei D Tzeng, Thomas A Aloia
BACKGROUND: The incidence of venous thromboembolism remains high after liver surgery. OBJECTIVE: To evaluate the safety and efficacy of extended pharmacologic thromboprophylaxis in liver surgery for the prevention of venous thromboembolism (VTE). PATIENT/METHODS: From August 2013 to April 2015, 124 patients who underwent liver resection for malignancy were placed on an extended pharmacologic thromboprophylaxis protocol. Intraoperative VTE prophylaxis included Thrombo-Embolic Deterrent hose and sequential compression devices...
August 28, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
https://www.readbyqxmd.com/read/27797404/pentasaccharides-for-the-prevention-of-venous-thromboembolism
#18
REVIEW
Kezhou Dong, Yanzhi Song, Xiaodong Li, Jie Ding, Zhiyong Gao, Daopei Lu, Yimin Zhu
BACKGROUND: Venous thromboembolism (VTE) is a common condition with potentially serious and life-threatening consequences. The standard method of thromboprophylaxis uses an anticoagulant such as low molecular weight heparin (LMWH) or warfarin. In recent years, another type of anticoagulant, pentasaccharide, an indirect factor Xa inhibitor, has shown good anticoagulative effect in clinical trials. Three types of pentasaccharides are available: short-acting fondaparinux, long-acting idraparinux and idrabiotaparinux...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#19
REVIEW
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
June 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27645969/perceval-sutureless-valve-dysfunction-caused-by-valvular-thrombosis
#20
Andreas Vötsch, Wolfgang Weihs, Martin Asslaber, Otto Dapunt
Until now, to our knowledge no case of bioprosthetic valvular thrombosis after implantation of the sutureless Sorin Perceval valve has been reported. Although sutureless aortic valve replacement has become a powerful tool in our daily practice, recent guidelines from the European Society of Cardiology, the European Association for Cardio-Thoracic Surgery, the American College of Cardiology, and the American Heart Association do not give specific recommendations on postoperative anticoagulation therapy. We report the first case of valve dysfunction resulting from thrombosis 12 months after implantation with a possible link to postoperative cortisole therapy...
October 2016: Annals of Thoracic Surgery
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