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Thoracic surgery, anticoagulant

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https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#1
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-amongst-thoracic-surgeons
#2
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 amongst 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...
May 4, 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
#3
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
#4
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
#5
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...
April 4, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28054894/a-rare-case-of-a-pedicled-mobile-thrombus-in-right-atrium
#6
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
#7
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
#8
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
#9
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
#10
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...
November 1, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27797404/pentasaccharides-for-the-prevention-of-venous-thromboembolism
#11
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
#12
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...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27645969/perceval-sutureless-valve-dysfunction-caused-by-valvular-thrombosis
#13
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
https://www.readbyqxmd.com/read/27576217/risk-of-hematoma-in-patients-with-a-bleeding-risk-undergoing-cardiovascular-surgery-with-a-paravertebral-catheter
#14
Kenta Okitsu, Takeshi Iritakenishi, Mitsuo Iwasaki, Tatsuyuki Imada, Yuji Fujino
OBJECTIVE: This study aimed to determine the risk of hematoma associated with thoracic paravertebral block (TPVB) in patients undergoing cardiovascular surgery. DESIGN: Retrospective analysis. SETTING: Single university hospital. PARTICIPANTS: The study comprised 141 patients who underwent cardiovascular surgery with TPVB to relieve postoperative pain. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three patients were excluded and of the remaining 138, TPVB was performed in 135, ages 11 to 96 years, who either had a clotting abnormality or were on anticoagulant or antiplatelet therapy...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27554701/endovascular-management-of-concomitant-thoracic-and-abdominal-aortic-ruptures-resulting-from-brucellosis-aortitis
#15
Samuel L Chen, Isabella J Kuo, Roy M Fujitani, Nii-Kabu Kabutey
BACKGROUND: Acute aortic symptomatology is an unusual manifestation of Brucella melitensis infection. We present a rare case of acute multifocal thoracic and abdominal aortic ruptures arising from Brucellosis aortitis managed exclusively with endovascular surgery. METHODS: A 71-year-old Hispanic male with a history of atrial fibrillation and prior stroke on chronic anticoagulation presented with shortness of breath and malaise. In addition, he had been treated approximately 1 year previously in Mexico for B...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27400312/case-load-and-valve-surgery-outcome-in-australia
#16
E Anne Russell, Robert A Baker, Jayme S Bennetts, Alex Brown, Christopher M Reid, Robert Tam, Lavinia Tran, Warren F Walsh, Graeme P Maguire
BACKGROUND: In Australia it has been suggested that heart valve surgery, particularly for rheumatic heart disease (RHD), should be consolidated in higher volume centres. International studies of cardiac surgery suggest large volume centres have superior outcomes. However the effect of site and surgeon case load on longer term outcomes for valve surgery has not been investigated. METHODS: The Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed...
October 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27161707/po-20-crosstalk-between-the-lectin-pathway-and-haemostasis-in-patients-with-pulmonary-cancer
#17
J B Larsen, T D Christensen, C L Hvas, A M Hvas
INTRODUCTION: Recent research has focused on the complement system in cancer, including the lectin pathway of complement activation. Mannose-binding lectin (MBL), a key activator of the lectin pathway, can bind to tumor cell surfaces in vitro, and lectin pathway activation is increased in several types of cancer. The exact role of the complement system in cancer is currently discussed. However, one possible consequence of the increased complement activation could be contribution to the increased thrombosis risk which cancer patients experience...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27132702/variation-in-warfarin-use-at-hospital-discharge-after-isolated-bioprosthetic-mitral-valve-replacement-an-analysis-of-the-society-of-thoracic-surgeons-adult-cardiac-surgery-database
#18
Thomas A Schwann, Robert H Habib, Rakesh M Suri, J Matthew Brennan, Xia He, Vinod H Thourani, Milo Engoren, Gorav Ailawadi, Brian R Englum, Mark R Bonnell, James S Gammie
BACKGROUND: Anticoagulation with warfarin following bioprosthetic mitral valve replacement (BMVR) is recommended by multiple practice guidelines. We assessed practice variability and patient characteristics associated with warfarin prescription following BMVR. METHODS: We analyzed 7,637 patients in the Society of Thoracic Surgeons Database (January 1, 2008 to June 30, 2011) who were discharged following isolated primary nonemergent BMVR. Patients requiring preoperative warfarin, those with preoperative atrial fibrillation, or those with a contraindication to warfarin were excluded...
September 2016: Chest
https://www.readbyqxmd.com/read/26947541/systematic-review-of-the-growth-rates-and-influencing-factors-in-thoracic-aortic-aneurysms
#19
REVIEW
D Oladokun, B O Patterson, J Sobocinski, A Karthikesalingam, I Loftus, M M Thompson, P J Holt
OBJECTIVE/BACKGROUND: The growth rates of thoracic aortic aneurysms (TAAs) and factors influencing their expansion are poorly understood. This study aimed to review systematically published literature describing TAA expansion and examine factors that may be associated with this. METHODS: A comprehensive search of MEDLINE and Embase databases was performed until 30 April 2015. Studies describing rates of TAA growth were identified and systematically reviewed. Outcomes of interest were TAA growth rates and associated factors...
May 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26780738/guidance-for-the-treatment-of-deep-vein-thrombosis-and-pulmonary-embolism
#20
REVIEW
Michael B Streiff, Giancarlo Agnelli, Jean M Connors, Mark Crowther, Sabine Eichinger, Renato Lopes, Robert D McBane, Stephan Moll, Jack Ansell
This guidance document focuses on the diagnosis and treatment of venous thromboembolism (VTE). Efficient, cost effective diagnosis of VTE is facilitated by combining medical history and physical examination with pre-test probability models, D dimer testing and selective use of confirmatory imaging. Clinical prediction rules, biomarkers and imaging can be used to tailor therapy to disease severity. Anticoagulation options for acute VTE include unfractionated heparin, low molecular weight heparin, fondaparinux and the direct oral anticoagulants (DOACs)...
January 2016: Journal of Thrombosis and Thrombolysis
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