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Cardiac surgery , coronary artery bypass grafting , valve repair

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https://www.readbyqxmd.com/read/29877976/triple-valve-surgery-results-from-a-multicenter-experience
#1
Alessandro Leone, Daniela Fortuna, Davide Gabbieri, Francesco Nicolini, Giovanni Andrea Contini, Florio Pigini, Claudio Zussa, Rossana De Palma, Roberto Di Bartolomeo, Davide Pacini
AIMS: Triple valve surgery (TVS) may still be considered a challenge in cardiac surgery, and is still associated with a not negligible mortality and morbidity. This study analyzed retrospectively patients' data from RERIC (Registro Regionale degli Interventi Cardiochirurgici) registry, to evaluate early and mid-term results of TVS. METHODS: From April 2002 to December 2013, data from n = 44 211 cardiac surgical procedures were collected from six Cardiac Surgery Departments (RERIC)...
July 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#2
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#3
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29559262/integration-of-simulation-components-enhances-team-training-in-cardiac-surgery
#4
David L Joyce, Brian D Lahr, Simon Maltais, Sameh M Said, John M Stulak, Gregory A Nuttall, Lyle D Joyce
OBJECTIVES: Simulation in resident medical education has traditionally focused on isolated components of a surgical procedure. We hypothesized that incorporating an interdisciplinary team into a high-fidelity simulation laboratory would enhance the modeling of real-world challenges during cardiac surgery. METHODS: Simulation exercises were performed with staffing by surgeons, anesthesiologists, perfusionists, surgical assistants, and operating room technicians. Twelve accredited cardiothoracic surgical residents were divided into 3 teams...
June 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29442340/aortic-valve-replacement-using-autologous-pericardium-single-centre-experience-with-the-ozaki-technique
#5
Oliver Reuthebuch, Luca Koechlin, Ulrich Schurr, Martin Grapow, Jens Fassl, Friedrich S Eckstein
OBJECTIVE: To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD: Between September 2015 and May 2017 30 patients (20 males, mean ± standard deviation age 66.83 ± 10.55 years) suffering from aortic stenosis (AS, n = 7), aortic regurgitation (AR, n = 12), or a combination of both (AS/AR, n = 11) were assigned for an Ozaki procedure...
February 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#6
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29240627/extracorporeal-membrane-oxygenation-bridges-inoperable-patients-to-definitive-cardiac-operation
#7
Nikola Dobrilovic, Omar Lateef, Lauren Michalak, Maja Delibasic, Jaishankar Raman
Extracorporeal membrane oxygenation (ECMO) offers an opportunity for patient recovery through complete cardiopulmonary support but is associated with complications that limit duration and overall utility. We examine the role of ECMO as a potential bridge to high-risk cardiac surgery in otherwise inoperable cases. This study reports a retrospective, multi-institution experience examining all patients for whom ECMO was used preoperatively as a bridge to definitive cardiac surgery without exception. A consecutive patient database (December 2011 through August 2017) was utilized...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28964415/aortic-valve-replacement-with-perceval-bioprosthesis-single-center-experience-with-617-implants
#8
Giovanni Concistrè, Francesca Chiaramonti, Giacomo Bianchi, Alfredo Cerillo, Michele Murzi, Rafik Margaryan, Pierandrea Farneti, Marco Solinas
BACKGROUND: This study describes the clinical and echocardiographic outcomes in a large single-center cohort of patients who underwent aortic valve replacement (AVR) with a sutureless Perceval (LivaNova, Milan, Italy) aortic bioprosthesis. METHODS: Between March 2011 and December 2015, 617 patients underwent AVR with a Perceval bioprosthesis. The mean age was 76 ± 7 years, 388 patients were female (63%), and the mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 6...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28826848/preoperative-aspirin-does-not-increase-transfusion-or-reoperation-in-isolated-valve-surgery
#9
Jordan E Goldhammer, Corey R Herman, Mark W Berguson, Marc C Torjman, Richard H Epstein, Jian-Zhong Sun
OBJECTIVE: Preoperative aspirin has been studied in patients undergoing isolated coronary artery bypass graft surgery. However, there is a paucity of clinical data available evaluating perioperative aspirin in other cardiac surgical procedures. This study was designed to investigate the effects of aspirin on bleeding and transfusion in patients undergoing non-emergent, isolated, heart valve repair or replacement. DESIGN: Retrospective, cohort study. SETTING: Academic medical center...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28673705/reoperative-aortic-root-replacement-outcome-in-a-contemporary-series
#10
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Vinod H Thourani, Edward P Chen
OBJECTIVES: Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. METHODS: From 2006 to 2015, 280 consecutive patients at an academic center underwent reoperative aortic root replacement after a variety of previous aortic or cardiac operations...
September 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669501/surgical-ablation-of-atrial-fibrillation-in-the-united-states-trends-and-propensity-matched-outcomes
#11
MULTICENTER STUDY
Vinay Badhwar, J Scott Rankin, Niv Ad, Maria Grau-Sepulveda, Ralph J Damiano, A Marc Gillinov, Patrick M McCarthy, Vinod H Thourani, Rakesh M Suri, Jeffrey P Jacobs, James L Cox
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) effectively restores sinus rhythm. Incompletely defined risk has previously limited concomitant performance of SA during cardiac operations. The study goals were to define performance trends and risk-adjusted outcomes for contemporary SA. METHODS: From July 2011 to June 2014, 86,941 patients with AF, but without endocarditis, underwent primary nonemergent cardiac operations in The Society of Thoracic Surgeons (STS) database...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28661969/structural-nursing-and-physician-characteristics-and-30-day-mortality-for-patients-undergoing-cardiac-surgery-in-pennsylvania
#12
MULTICENTER STUDY
Meghan B Lane-Fall, Tara S Ramaswamy, Sydney E S Brown, Xu He, Jacob T Gutsche, Lee A Fleisher, Mark D Neuman
OBJECTIVE: Cardiac surgery ICU characteristics and clinician staffing patterns have not been well characterized. We sought to describe Pennsylvania cardiac ICUs and to determine whether ICU characteristics are associated with mortality in the 30 days after cardiac surgery. DESIGN: From 2012 to 2013, we conducted a survey of cardiac surgery ICUs in Pennsylvania to assess ICU structure, care practices, and clinician staffing patterns. ICU data were linked to an administrative database of cardiac surgery patient discharges...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#13
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28606278/-efficacy-of-mitral-valve-repair-versus-replacement-in-severe-ischemic-mitral-regurgitation
#14
Z B Qiu, X Chen, M Xu, Y S Jiang, L M Wang, F H Huang, P S Liu, R Wang, F Xiang, J J Shao, W Qin
Objective: To compare the mortality, survival rate and the therapeutic efficacy between mitral valve repair and replacement as treatment for severe ischemic mitral regurgitation (IMR), and explore the middle- and long-term outcomes. Methods: Between January 2000 and January 2016, 378 patients with severe IMR underwent coronary artery bypass grafting (CABG) combined with mitral valve repair (n=162) or mitral valve replacement (n=216) in the Department of Cardiovascular Surgery of Nanjing First Hospital. Clinical data, in-hospital morbidity and mortality of patients were retrospectively reviewed...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28577850/chronic-myocardial-ischemia-leads-to-loss-of-maximal-oxygen-consumption-and-complex-i-dysfunction
#15
David A Schipper, Ryan Palsma, Katherine M Marsh, Connor O'Hare, Destiny S Dicken, Scott Lick, Toshinobu Kazui, Kitsie Johnson, Ryszard T Smolenski, Dirk J Duncker, Zain Khalpey
BACKGROUND: Cardiomyocytes rely heavily on mitochondrial energy production through oxidative phosphorylation. Chronic myocardial ischemia may cause mitochondrial dysfunction and affect ATP formation. Metabolic changes due to ischemia alters cardiac bioenergetics and hence myocardial function and overall bioenergetic state. Here, we evaluate differences in functional status of respiratory complexes in mitochondrial isolates extracted from left atrial appendage tissue (LAA) from patients undergoing cardiac surgery, with and without chronic ischemia...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#16
Christine H Attenhofer Jost, Heidi M Connolly, Christopher G Scott, Naser M Ammash, Juan M Bowen, Hartzell V Schaff
BACKGROUND: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). METHODS: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. RESULTS: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7)...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28503127/the-role-of-platelet-function-analyzer-testing-in-cardiac-surgery-transfusion-management
#17
Dejana Bogdanic, Nenad Karanovic, Jela Mratinovic-Mikulandra, Branka Paukovic-Sekulic, Dijana Brnic, Ivanka Marinovic, Diana Nonkovic, Nikolina Bogdanic
BACKGROUND: Identifying high-risk patients for transfusion after cardiac operations would alter postoperative management. The aim of this study was to investigate closure time (CT) measured by platelet function analyzer (PFA) for prediction of bleeding and transfusions. METHODS: 66 patients were scheduled for coronary artery bypass graft (CABG) surgery and 30 patients for valve repair and replacement (non-CABG). Measurements of PFA-100® CT for collagen and adenosine diphosphate (cADP) and collagen and epinephrine (cEPI) were performed 15 min after protamine administration...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28461805/repair-of-intrapericardial-diaphragmatic-hernia-during-aortic-surgery-in-a-78-year-old-woman
#18
Konstantinos Spiliotopoulos, Kim I de la Cruz, Georgios Gkotsis, Ourania Preventza, Joseph S Coselli
Intrapericardial diaphragmatic hernias are reported very rarely. Those of congenital origin are most often diagnosed in neonates, and those caused by indirect blunt trauma occur chiefly in adults. The latter type can be asymptomatic; however, the results of a computed tomographic scan can yield a definitive diagnosis. Once discovered, these hernias should be corrected to avoid severe sequelae such as bowel strangulation and necrosis, peritonitis, mediastinitis, and cardiac tamponade. We report the case of a 78-year-old woman who presented for elective ascending aortic aneurysm repair...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28393785/modifying-risks-to-improve-outcome-in-cardiac-surgery-an-anesthesiologist-s-perspective
#19
REVIEW
Murali Chakravarthy
Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#20
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
October 2017: Journal of Cardiovascular Surgery
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