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https://www.readbyqxmd.com/read/29723895/anticancer-drug-related-nonvalvular-atrial-fibrillation-challenges-in-management-and-antithrombotic-strategies
#1
Antonella Tufano, Maurizio Galderisi, Luca Esposito, Valentina Trimarco, Daniela Sorriento, Guy Gerusalem, Marco Picardi, Patrizio Lancellotti, Fabrizio Pane
Cancer patients may experience nonvalvular atrial fibrillation (AF) as a manifestation of cardiotoxicity. AF may be a direct effect of a neoplasm or, more often, appear as a postsurgical complication, especially after thoracic surgery. AF may also develop as a consequence of anticancer therapy (chemotherapy or radiotherapy), a condition probably underestimated. Cancer patients with AF require a multidisciplinary approach involving oncologists/hematologists, cardiologists, and coagulation experts. An echocardiogram should be performed to detect possible abnormalities of left ventricular systolic and diastolic function, as well as left atrial dilation and the existence of valvular heart disease, to determine pretest probability of sinus rhythm restoration, and identify the best treatment...
May 3, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29658209/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#2
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29626461/enoxaparin-40mg-per-day-is-inadequate-for-venous-thromboembolism-prophylaxis-after-thoracic-surgery
#3
Christopher J Pannucci, Kory I Fleming, Kathleen Holoyda, Lauren Moulton, Ann Marie Prazak, Thomas K Varghese
BACKGROUND: Many thoracic surgery patients have venous thromboembolism (VTE) events despite the receipt of chemical prophylaxis. Enoxaparin's pharmacologic impact can be quantified using anti-Factor Xa (aFXa) levels. We hypothesized that enoxaparin 40mg once daily would be inadequate for most thoracic surgery inpatients and that a real time dose adjustment algorithm would be impactful. METHODS: This prospective clinical trial enrolled thoracic surgery inpatients who were placed on enoxaparin 40mg once daily for VTE prophylaxis after surgical procedures...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29590385/the-new-2016-european-society-of-cardiology-european-association-for-cardio-thoracic-surgery-guidelines-enough-guidance-enough-evidence
#4
Manuel Castell√°
For the first time, the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have joined forces to develop consensus guidelines for the management of atrial fibrillation (AF). One of the main issues is the integrated care of patients with AF, with emphasis on multidisciplinary teams of general physicians, cardiologists, stroke specialists and surgeons, together with the patient's involvement for better management of AF. These guidelines also help in the detection of risk factors and concomitant cardiovascular diseases, stroke prevention therapies, including anticoagulation and antiplatelet therapies after acute coronary episodes, major haemorrhages or strokes...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29532185/polypoid-pulmonary-arteriovenous-malformation-causing-hemothorax-treated-with-thoracoscopic-wedge-resection
#5
Haruhiko Shiiya, Yasuhiro Suzuki, Shigeo Yamazaki, Kichizo Kaga
BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) can be associated with life-threatening complications such as paradoxical embolization, cerebral abscess, and hemothorax. Therefore, all adults with PAVMs should be offered treatment. Percutaneous transcatheter embolization is the first-line treatment, but 5-25% of cases require further treatment due to persistence after embolization. Recently, the role of minimally invasive thoracic surgery as a definitive treatment has been evaluated...
March 12, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29477681/surgical-missteps-in-the-management-of-venous-thoracic-outlet-syndrome-which-lead-to-reoperation
#6
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
BACKGROUND: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to reoperate is rare. We report our experience with reoperation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, reoperation, and final outcomes...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29397103/caprini-risk-model-decreases-venous-thromboembolism-rates-in-thoracic-surgery-cancer-patients
#7
Helene M Sterbling, Amy K Rosen, Krista J Hachey, Niru S Vellanki, Philip D Hewes, Sowmya R Rao, Emma Pinjic, Hiran C Fernando, Virginia R Litle
BACKGROUND: Extended postoperative chemoprophylaxis is effective in reducing venous thromboembolism (VTE) among general surgical patients. We hypothesized that implementation of the Caprini risk assessment model (RAM) would reduce VTE rates among patients undergoing lung and esophageal cancer surgery. METHODS: The Caprini RAM, consisting of patient risk stratification and extended postoperative chemoprophylaxis with low molecular weight heparin, was implemented on the thoracic surgery service at Boston Medical Center in July 2014...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29369958/epidural-hematoma-following-cessation-of-a-direct-oral-anticoagulant-a-case-report
#8
Jessica E Burjorjee, Rachel Rooney, Melanie Jaeger
OBJECTIVE: In this case report, we describe a case of epidural hematoma following epidural analgesia in a patient with recent cessation of a direct oral anticoagulant (DOAC). CASE REPORT: An 89-year-old woman requiring upper abdominal surgery presented with multiple comorbidities, including a prior cerebrovascular accident resulting in a left-sided hemiparesis and atrial fibrillation requiring anticoagulation with rivaroxaban. In accordance with our departmental guidelines at the time of procedure, rivaroxaban was discontinued 4 days preoperatively...
April 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29362794/association-between-left-atrial-appendage-occlusion-and-readmission-for-thromboembolism-among-patients-with-atrial-fibrillation-undergoing-concomitant-cardiac-surgery
#9
COMPARATIVE STUDY
Daniel J Friedman, Jonathan P Piccini, Tongrong Wang, Jiayin Zheng, S Chris Malaisrie, David R Holmes, Rakesh M Suri, Michael J Mack, Vinay Badhwar, Jeffrey P Jacobs, Jeffrey G Gaca, Shein-Chung Chow, Eric D Peterson, J Matthew Brennan
Importance: The left atrial appendage is a key site of thrombus formation in atrial fibrillation (AF) and can be occluded or removed at the time of cardiac surgery. There is limited evidence regarding the effectiveness of surgical left atrial appendage occlusion (S-LAAO) for reducing the risk of thromboembolism. Objective: To evaluate the association of S-LAAO vs no receipt of S-LAAO with the risk of thromboembolism among older patients undergoing cardiac surgery...
January 23, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29360741/a-patient-centered-approach-to-guide-follow-up-and-adjunctive-testing-and-treatment-after-first-rib-resection-for-venous-thoracic-outlet-syndrome-is-safe-and-effective
#10
Colin P Ryan, Nicolas J Mouawad, Patrick S Vaccaro, Michael R Go
Controversies in the treatment of venous thoracic outlet syndrome (VTOS) have been discussed for decades, but still persist. Calls for more objective reporting standards have pushed practice towards comprehensive venous evaluations and interventions after first rib resection (FRR) for all patients. In our practice, we have relied on patient-centered, patient-reported outcomes to guide adjunctive treatment and measure success. Thus, we sought to investigate the use of thrombolysis versus anticoagulation alone, timing of FRR following thrombolysis, post-FRR venous intervention, and FRR for McCleery syndrome (MCS) and their impact on patient symptoms and return to function...
January 23, 2018: Diagnostics
https://www.readbyqxmd.com/read/29333796/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#11
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29259148/successful-recovery-from-spontaneous-spinal-epidural-hematoma-in-a-patient-undergoing-hemodialysis
#12
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
BACKGROUND Spontaneous spinal epidural hematoma (SSEH) occurs in the spinal epidural space in the absence of traumatic or iatrogenic causes, and is considered to be a neurological emergency, as spinal cord compression may lead to neurological deficit. Prompt diagnosis of SSEH can be difficult due to the variety of presenting symptoms, which may resemble those of stroke. Patients who undergo hemodialysis (HD) are at risk of bleeding due to anticoagulation during dialysis and uremia. However, SSEH in HD patients undergoing HD has rarely been reported...
December 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29169795/paravertebral-block-for-thoracic-surgery
#13
REVIEW
Francine D'Ercole, Harendra Arora, Priya A Kumar
Local anesthetic injected into a wedge-shaped space lateral to the spinal nerves as they emerge from the intervertebral foramina produces somatosensory and sympathetic nerve blockade effective for anesthesia and for managing pain of unilateral origin from the chest and abdomen. Paravertebral blockade (PVB) is versatile and may be applied unilaterally or bilaterally. Unlike thoracic epidural, the PVB technique may be used to avoid contralateral sympathectomy, thereby minimizing hypotension and leading to better preservation of blood pressure...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#14
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...
February 2018: 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
#15
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...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#16
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
#17
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
#18
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
#19
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
#20
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
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