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Cardiac surgery , coronary artery bypass grafting , valve repair

Francesco Nappi, Cristiano Spadaccio, Antonio Nenna, Mario Lusini, Massimiliano Fraldi, Christophe Acar, Massimo Chello
OBJECTIVE: The symmetry of mitral valve tethering and regional left ventricle wall dysfunction are reported to play a fundamental role in the outcomes and long-term durability of surgical repair in ischemic mitral regurgitation (IMR). We recently demonstrated in a randomized clinical trial (the Papillary Muscle Approximation trial) the superiority of papillary muscle approximation (PMA) in combination with standard restrictive annuloplasty (RA) in severe IMR over annuloplasty alone in terms of adverse left ventricular remodeling and mitral regurgitation (MR) recurrence...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
Rachel L Bounds, Joseph Kuebler, Jill M Cholette, George M Alfieris, Sitaram M Emani, Carol A Wittlieb-Weber
A 2-month-old male with dysmorphic facies, neonatal thrombocytopenia, left congenital cataract, and long bone abnormalities became hypotensive with ST depression on induction of anesthesia for congenital cataract repair. Echocardiogram demonstrated decreased left ventricular function (ejection fraction 46%), mild mitral valve regurgitation (MR), and regional wall motion abnormalities. The left coronary artery could not be visualized. Subsequent cardiac catheterization confirmed atresia of the left main coronary artery...
September 12, 2016: World Journal for Pediatric & Congenital Heart Surgery
Yu Horiuchi, Mika Izumo, Takayoshi Kusuhara, Motoi Yokozuka, Takeshi Taketani, Kengo Tanabe
This report describes an elderly severe aortic stenosis (AS) patient, who had a history of coronary artery bypass grafting and endovascular repair for an abdominal aortic aneurysm (AAA). Type II endoleak with enlargement of AAA was diagnosed and ligation of inferior mesenteric artery (IMA) was recommended. Because aortic valve replacement (AVR) was high risk, we planned transcatheter aortic valve implantation (TAVI). Considering risks of IMA ligation under dual antiplatelet therapy, increased blood pressure after TAVI, and general anesthesia, we performed combined TAVI and IMA ligation...
September 7, 2016: Cardiovascular Intervention and Therapeutics
Samuele Baldasseroni, Alessandra Pratesi, Sara Francini, Rachele Pallante, Riccardo Barucci, Francesco Orso, Costanza Burgisser, Niccolò Marchionni, Francesco Fattirolli
OBJECTIVES: To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event. DESIGN: Observational. SETTING: In-hospital CR unit. PARTICIPANTS: Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4)...
August 2016: Journal of the American Geriatrics Society
Miriam Silaschi, Sanjay Chaubey, Omar Aldalati, Habib Khan, Mohammed Mohsin Uzzaman, Mrinal Singh, Max Baghai, Ranjit Deshpande, Olaf Wendler
BACKGROUND: Because of demographic changes, a growing number of elderly patients present with mitral valve (MV) disease. Although mitral valve repair (MV-repair) is the "gold standard" treatment for MV disease, in elderly patients, there is controversy about whether MV-repair is superior to mitral valve replacement. We reviewed results after MV surgery in elderly patients treated over the past 20 years. METHODS AND RESULTS: Our in-hospital database was explored for patients who underwent MV surgery between 1994 and 2015...
August 2016: Journal of the American Heart Association
Mostafa M Mokhles, Sabrina Siregar, Michel I M Versteegh, Luc Noyez, Bart van Putte, Alexander B A Vonk, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery. METHODS: All patients [N = 3411; 58% males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31%; reconstruction: N = 2364, 69%) in the Netherlands between January 2007 and December 2011 were included in this study...
September 2016: European Journal of Cardio-thoracic Surgery
Jaishankar Raman, Nancy Leveson, Aubrey Lynn Samost, Nikola Dobrilovic, Maggie Oldham, Sidney Dekker, Stan Finkelstein
OBJECTIVES: Checklists are being introduced to enhance patient safety, but the results have been mixed. The goal of this research is to understand why time-outs and checklists are sometimes not effective in preventing surgical adverse events and to identify additional measures needed to reduce these events. METHODS: A total of 380 consecutive patients underwent complex cardiac surgery over a 24-month period between November 2011 and November 2013 at an academic medical center, out of a total of 529 cardiac cases...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Sheena E Mathew, Craig J Beavers, Elizabeth McNeely
BACKGROUND: The rates of venous thromboembolism (VTE) post-cardiothoracic surgery are not well understood. The american college of chest physicians (CHEST) guidelines report weak recommendations for starting VTE prophylaxis post-cardiothoracic surgery. It is suspected that due to the increase in bleed risk, postsurgery initiation of pharmacologic VTE prophylaxis is limited. OBJECTIVE: The study sought to investigate the use of VTE prevention in US hospitals performing cardiac surgery and the use of mechanical/chemical prophylaxis postoperatively...
April 24, 2016: Journal of Pharmacy Practice
Christos G Mihos, Orlando Santana
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is an adjunctive subvalvular repair during mitral annuloplasty for secondary mitral regurgitation effective in preventing recurrent regurgitation? Altogether, 353 studies were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated...
February 2016: Interactive Cardiovascular and Thoracic Surgery
Tomoya Uchimuro, Toshihiro Fukui, Atsushi Shimizu, Shuichirou Takanashi
BACKGROUND: Mitral valve surgery in patients with severe mitral annular calcification can be challenging. We investigated surgical outcomes of mitral valve surgery with complete annular decalcification and reconstruction. METHODS: Between January 2004 and December 2013, 2,104 patients underwent mitral valve surgery at our institution. Of these, 61 patients (mean age 70 years) with severe mitral annular calcification were reviewed. Valve lesions were stenosis in 20 patients (32...
March 2016: Annals of Thoracic Surgery
Pranav Sharma, Chandrasekaran Ananthanarayanan, Nikunj Vaidhya, Amber Malhotra, Komal Shah, Ramanand Sharma
BACKGROUND: We aimed to assess the incidence and perioperative risk factors for hyperbilirubinemia after cardiac surgery, and determine its influence on early operative outcome. METHODS: This prospective observational study was conducted on 476 patients who underwent cardiac surgical procedures from January 2014 to March 2014. Postoperative hyperbilirubinemia was defined as serum total bilirubin >2.0 mg dL(-1). RESULTS: The overall incidence of postoperative hyperbilirubinemia was 25% (119 patients)...
November 2015: Asian Cardiovascular & Thoracic Annals
Bryan M Burt, Andrew W ElBardissi, Robert S Huckman, Lawrence H Cohn, Marisa W Cevasco, James D Rawn, Sary F Aranki, John G Byrne
OBJECTIVE: We hypothesized that increased postgraduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures. METHODS: Utilizing a prospectively collected retrospective database, we identified patients who underwent isolated coronary artery bypass grafting (CABG) (n = 3726), aortic valve replacement (AVR) (n = 1626), mitral valve repair (n = 731), mitral valve replacement (MVR) (n = 324), and MVR + AVR (n = 184) from January 2002 through June 2012...
November 2015: Journal of Thoracic and Cardiovascular Surgery
Zhongmin Li, Ezra A Amsterdam, J Nilas Young, Holly Hoegh, Ehrin J Armstrong
BACKGROUND: More than 40% of patients undergoing coronary artery bypass grafting (CABG) have diabetes. However, it is unknown how insulin treatment status influences cardiac surgical outcomes among patients with diabetes. METHODS: All isolated CABG, CABG plus aortic valve replacement or plus mitral valve repair/replacement procedures performed in 2012 were extracted from the California CABG Outcomes Reporting Program database. Patients were grouped into three categories: (1) no diabetes, (2) non-insulin-treated diabetes (NITDM), and (3) insulin-treated diabetes (ITDM)...
December 2015: Annals of Thoracic Surgery
Dong Liu, Wenzhang Wang, Aibing Cai, Zhiyi Han, Xiyuan Li, Jiagui Ma
OBJECTIVE: To analyze and summarize the clinical features and experience in surgical treatment of deep sternal infection (DSWI). METHODS: This was a retrospective study. From January 2008 to December 2013, 189 patients with secondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department. There were 116 male and 73 female patients. The mean age was (54 ± 21) years, the body mass index was (26. 1 ± 1. 3) kg/m2. The incidence of postoperation DSWI were after isolated coronary artery bypass grafting (CABG) in 93 patients, after other heart surgery plus CABG in 13 patients, after valve surgery in 47 patients, after thoracic aortic surgery in 16 patients, after congenital heart disease in 18 patients, and after cardiac injury in 2 patients...
March 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
T S Tischer, R Schneider, J Lauschke, C Nesselmann, G Steinhoff, Dietmar Bänsch
AIM: Several tools have been invented for surgical atrial fibrillation (AF) ablation. In this study, we investigated the real world efficacy of intraoperative AF ablation (AFA) with radiofrequency-energy or cryo-ablation and performed an electro-anatomical remap in some patients with recurrences. METHODS: Seventy-three consecutive patients (53 male, median age of 69 ± 7 years) with history of AF underwent cardiac surgery for valve repair (74 % mitral defects, 60 % aortic defects) and/or coronary artery bypass graft procedures (56 %)...
September 2015: Herzschrittmachertherapie & Elektrophysiologie
Raquel R Bartz, Renata G Ferreira, Jacob N Schroder, John Davies, Wen-Wei Liu, Andre Camara, Ian J Welsby
BACKGROUND: Post-cardiac surgery pulmonary dysfunction may be underreported. Therefore, we evaluated associated risk factors for prolonged pulmonary support after cardiac surgery. METHODS AND MATERIALS: We conducted a retrospective, observational study of consecutive patients undergoing coronary artery bypass grafting or coronary artery bypass grafting plus valve repair/replacement between Jan 1, 2005, and Dec 31, 2010, at an academic medical center. Using multivariate logistic regression and Cox proportional hazards modeling, we identified risk factors associated with prolonged mechanical ventilation and supplemental O2 support as well as in-hospital mortality...
October 2015: Journal of Critical Care
Jim K Wong, Bryan G Maxwell, Clete A Kushida, Kristin L Sainani, Robert L Lobato, Y Joseph Woo, Ronald G Pearl
OBJECTIVE: To test the hypothesis that obstructive sleep apnea (OSA) is a risk factor for development of postoperative atrial fibrillation (POAF) after cardiac surgery. DESIGN: Retrospective analysis. SETTING: Single-center university hospital. PARTICIPANTS: Five hundred forty-five patients in sinus rhythm preoperatively undergoing coronary artery bypass grafting (CABG), aortic valve replacement, mitral valve replacement/repair, or combined valve/CABG surgery from January 2008 to April 2011...
October 2015: Journal of Cardiothoracic and Vascular Anesthesia
Norihiko Ishikawa, Go Watanabe
Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery...
2015: Annals of Thoracic and Cardiovascular Surgery
Jada M Leahy, Benjamin Hoagland, Robert G Strange, Jared L Antevil
No modern studies have addressed the impact of cardiac surgery on military duty status, which is associated with constraints not applicable to the general population. A review of all active duty patients undergoing coronary artery bypass grafting (CABG), mitral valve repair (MVrep), bioprosthetic valve replacement (BIOVALVE), mechanical valve replacement (MECHVALVE), and septal defect closure (ASD/VSD) at Naval Medical Center Portsmouth between January 1, 2004 and December 31, 2011 was used to determine final duty status: Return to Full Duty (RTFD), Medical Board Separation or Planned Retirement/Separation...
July 2015: Military Medicine
Ahmed M Habib, Al-Rehan Dhanji, Sherif A Mansour, Alan Wood, Wael I Awad
OBJECTIVES: EuroSCORE is used to predict operative mortality following cardiac surgery. There are limited data to assess the ability of EuroSCORE to predict medium- to long-term survival. We aimed to test the ability of EuroSCORE to predict mid-term survival following cardiac surgery. METHODS: We analysed prospectively collected data from all patients undergoing cardiac surgery in an urban tertiary cardiac centre over a 6-year period. All-cause mortality following cardiac surgery was determined via Office of National Statistics data...
October 2015: Interactive Cardiovascular and Thoracic Surgery
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