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Perioperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/28870052/-clinical-efficacy-of-enhanced-recovery-after-surgery-in-atrial-caval-shunting-for-type-%C3%A2-budd-chiari-syndrome
#1
G J Tian, D Y Li, H B Yu, Y D Dong, Y N Peng, P Liu, Y K Wei, H Z Xue
Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28857800/outcomes-in-patients-undergoing-cardiac-surgery-who-decline-transfusion-and-received-erythropoietin-compared-to-patients-who-did-not-a-matched-cohort-study
#2
Lorent Duce, Mary L Cooter, Sharon L McCartney, Frederick W Lombard, Nicole R Guinn
BACKGROUND: Erythropoiesis-stimulating agents, such as erythropoietin (EPO), can be used to treat preoperative anemia. Some studies suggest an increased risk of mortality and thrombotic events, and use in cardiovascular surgery remains off-label. This study compares outcomes in cardiac surgery patients declining blood transfusion who received EPO with a matched cohort who did not. METHODS: After institutional review board approval, we conducted a retrospective review of all patients who decline blood transfusion who underwent cardiac surgery and received EPO between January 1, 2004, and June 15, 2015, at a single institution...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28844467/patient-selection-and-perioperative-outcomes-of-bypass-and-endovascular-intervention-as-first-revascularization-strategy-for-infrainguinal-arterial-disease
#3
Thomas C F Bodewes, Jeremy D Darling, Sarah E Deery, Thomas F X O'Donnell, Alexander B Pothof, Katie E Shean, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: The optimal initial revascularization strategy remains uncertain for patients with peripheral arterial disease. The purpose of this study was to evaluate current nationwide selection and perioperative outcomes of patients undergoing bypass or endovascular intervention for infrainguinal disease in those with no prior ipsilateral revascularization. METHODS: Patients undergoing nonemergent first-time infrainguinal revascularization were identified in the Targeted Vascular module of the National Surgical Quality Improvement Program (NSQIP) for 2011 to 2014 and stratified by symptom status (chronic limb-threatening ischemia [CLTI] or claudication)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28842832/perioperative-management-of-antithrombotic-therapy-in-patients-receiving-cardiovascular-implantable-electronic-devices-a-network-meta-analysis
#4
Hua He, Bing-Bing Ke, Yan Li, Fu-Sheng Han, Xiaodong Li, Yu-Jie Zeng
PURPOSE: Network meta-analysis (NMA) has advantages including being able to simultaneously compare and rank multiple treatments over traditional meta-analysis. We evaluated by a NMA the optimal antithrombotic strategy during the perioperative period of implantation of cardiovascular implantable electronic devices (CIEDs). METHODS: We performed a network meta-analysis of observational studies (cohort and case-control studies). The eligible studies tested the following antithrombotic therapy during the CIED placement: aspirin, clopidogrel, warfarin, novel oral anticoagulants (NOACs), and heparin bridging...
August 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28842773/reduction-of-framingham-bmi-score-after-rapid-weight-loss-in-severely-obese-subjects-undergoing-sleeve-gastrectomy-a-single-institution-experience
#5
David Gutierrez-Blanco, David Funes-Romero, SriGita Madiraju, Federico Perez-Quirante, Emanuele Lo Menzo, Samuel Szomstein, Raul J Rosenthal
BACKGROUND: There is vast evidence that supports the importance of obesity in the pathogenesis and progression of cardiovascular disease. Rapid weight loss induced by laparoscopic Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB) has proven beneficial. The aim of this study is to evaluate laparoscopic sleeve gastrectomy (LSG) as an alternative treatment modality and its impact on the Framingham-BMI 10-year risk score. METHODS: We retrospectively reviewed all patients that underwent bariatric surgery at our institution between 2010 and 2014...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28830227/day-case-holmium-laser-enucleation-of-the-prostate-holep-prospective-evaluation-of-90-consecutive-cases
#6
Vincent Comat, Thibault Marquette, Willy Sutter, Gilles Pasticier, Gregoire Capon, Jean-Christophe Bernhard, Henri Bensadoun, Jean-Marie Ferriere, Gregoire Robert
PURPOSE: To prospectively assess the feasibility and safety of Holmium Laser Enucleation of the Prostate (HoLEP) as day-case surgery for the treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: A prospective observational study was conducted by a single surgeon between June 2012 and October 2015. Except for patients ineligible for day-case surgery due to unstable cardiovascular disease, all patients with lower urinary tract symptoms presumably due to benign prostatic hyperplasia were consecutively included...
August 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28821166/perioperative-acute-myocardial-infarction-associated-with-non-cardiac-surgery
#7
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Jeffrey S Berger, Sripal Bangalore
Aims: Acute myocardial infarction (AMI) is a significant cardiovascular complication following non-cardiac surgery. We sought to evaluate national trends in perioperative AMI, its management, and outcomes. Methods and results: Patients who underwent non-cardiac surgery from 2005 to 2013 were identified using the United States National Inpatient Sample. Perioperative AMI was evaluated over time. Propensity score matching was used to compile a cohort of AMI patients managed invasively (defined as cardiac catheterization or coronary revascularization) vs...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28820484/platelet-aggregometry-testing-molecular-mechanisms-techniques-and-clinical-implications
#8
REVIEW
Katalin Koltai, Gabor Kesmarky, Gergely Feher, Antal Tibold, Kalman Toth
Platelets play a fundamental role in normal hemostasis, while their inherited or acquired dysfunctions are involved in a variety of bleeding disorders or thrombotic events. Several laboratory methodologies or point-of-care testing methods are currently available for clinical and experimental settings. These methods describe different aspects of platelet function based on platelet aggregation, platelet adhesion, the viscoelastic properties during clot formation, the evaluation of thromboxane metabolism or certain flow cytometry techniques...
August 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28794833/preoperative-cardiac-evaluation-with-transthoracic-echocardiography-before-non-cardiac-surgery
#9
REVIEW
Chi Young Shim
Transthoracic echocardiography has become increasingly popular in clinical practice. It is used for the functional evaluation of patients with various cardiovascular diseases. Its use has been extended further in routine screening for cardiovascular health and in preoperative risk assessment before non-cardiac surgery because it is non-invasive, easy to perform, reproducible, and cost-effective. When the results of preoperative echocardiography contain abnormalities, the findings must be interpreted to determine clinical relevance...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28783209/impact-of-pre-operative-cardiology-consultation-prior-to-intermediate-risk-surgical-procedures
#10
Volkan Dogan, Murat Biteker, Eda Özlek, Bülent Özlek, Özcan Başaran, Birdal Yıldırım, Kadir Kayataş, Oğuzhan Çelik, Marwa Mouline Doğan
BACKGROUND: Patients undergoing noncardiac, nonvascular surgery (NCNVS) are at risk of perioperative cardiovascular events. However, benefits of cardiology consultation (CC) in patients with known or suspected cardiac disease undergoing intermediate-risk NCNVS is unknown. METHODS: The study group included 700 consecutive patients referred for CC before intermediate-risk NCNVS in a tertiary-care teaching hospital. The control group included 1200 age-matched and sex-matched consecutive patients proceeded to the intermediate-risk surgery without preoperative CC during the same period...
August 7, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28782109/low-vs-high-haemoglobin-trigger-for-transfusion-in-vascular-surgery-protocol-for-a-randomised-trial
#11
A Møller, H B Nielsen, J Wetterslev, O B Pedersen, D Hellemann, S Shahidi
BACKGROUND: In patients with cardiovascular disease, guidelines for administration of red blood cells (RBC) are mainly based on studies outside the vascular surgical setting with the recommendation to use a haemoglobin (hb) trigger-level lower than by guidelines from The European Society for Vascular Surgery. Restricting RBC transfusion may affect blood O2 transport with a risk for development of tissue ischaemia and postoperative complications. METHODS: In a single-centre, open-label, assessor blinded trial, 58 vascular surgical patients (> 40 years of age) awaiting open surgery of the infrarenal aorta or infrainguinal arterial bypass surgery undergo a web-based randomisation to one of two groups: perioperative RBC transfusion triggered by hb < 8 g/dl or hb < 9...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#12
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28705404/midterm-results-of-internal-iliac-artery-aneurysm-embolization
#13
A Pirvu, N Gallet, S Perou, F Thony, J-L Magne
OBJECTIVE: We describe the immediate and midterm results of endovascular treatment of isolated internal iliac artery aneurysms (IIAA). METHODS: This was a retrospective single center study. From 2005 to 2014, data from 20 consecutive patients who had an embolisation for an isolated atherosclerotic internal iliac artery aneurysm underwent an endovascular treatment. We retrospectively evaluated the technical aspects and outcomes. RESULTS: The mean aneurysm diameter was 42mm (range 30-97mm)...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28691253/cardiovascular-disease-risk-in-patients-receiving-organ-transplantation-a-national-cohort-study
#14
Hsin-I Tsai, Fu-Chao Liu, Chao-Wei Lee, Chang-Fu Kuo, Lai-Chu See, Ting-Ting Chung, Huang-Ping Yu
Although organ transplantation is the definitive treatment for end-stage organ failure, the post-transplant outcomes can be substantially influenced by cardiovascular complications. A national cohort study was performed to estimate risks of cardiovascular diseases in those with heart, lung, kidney, and liver transplantation. This cohort study consisted of 5978 solid organ transplantations identified using the Taiwan National Health Insurance Database. Cardiovascular and mortality risks in transplant recipients were evaluated using standardized incidence ratios, excess absolute risks, and standardized mortality ratios as compared to those in the general population...
July 10, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28678119/risk-factors-for-and-clinical-outcomes-of-dysphagia-after-anterior-cervical-surgery-for-degenerative-cervical-myelopathy-results-from-the-aospine-international-and-north-america-studies
#15
MULTICENTER STUDY
Narihito Nagoshi, Lindsay Tetreault, Hiroaki Nakashima, Paul M Arnold, Giuseppe Barbagallo, Branko Kopjar, Michael G Fehlings
BACKGROUND: Although dysphagia is a common complication after anterior cervical decompression and fusion, important risk factors have not been rigorously evaluated. Furthermore, the impact of dysphagia on neurological and quality-of-life outcomes is not fully understood. The aim of this study was to determine the prevalence of and risk factors for dysphagia, and the impact of this complication on short and long-term clinical outcomes, in patients treated with anterior cervical decompression and fusion...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28668459/are-outcomes-of-thoracoabdominal-aortic-aneurysm-repair-different-in-men-versus-women-a-propensity-matched-comparison
#16
Konstantinos Spiliotopoulos, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Qianzi Zhang, Ourania Preventza, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Women fare worse than men after many cardiovascular operations, including coronary artery bypass grafting and valve surgery. We sought to determine whether sex affects outcomes after open thoracoabdominal aortic aneurysm repair. METHODS: We evaluated data on 3353 consecutive patients (1281 women, 38.2%) who underwent open thoracoabdominal aortic aneurysm repair between October 1986 and July 2015. We compared preoperative characteristics, surgical variables, and outcomes between men and women in the overall group...
June 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28655812/in-patient-code-stroke-a-quality-improvement-strategy-to-overcome-knowledge-to-action-gaps-in-response-time
#17
Charles D Kassardjian, Jacqueline D Willems, Krystyna Skrabka, Rosane Nisenbaum, Judith Barnaby, Pawel Kostyrko, Daniel Selchen, Gustavo Saposnik
BACKGROUND AND PURPOSE: Stroke is a relatively common and challenging condition in hospitalized patients. Previous studies have shown delays in recognition and assessment of inpatient strokes leading to poor outcomes. The goal of this quality improvement initiative was to evaluate an in-hospital code stroke algorithm and educational program aimed at reducing the response times for inpatient stroke. METHODS: An inpatient code stroke algorithm was developed, and an educational intervention was implemented over 5 months...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28593749/impact-of-atrial-fibrillation-on-long-term-survival-following-oesophagectomy-a-21-year-observational-study
#18
Cameron I Wells, Jason P Robertson, Sandra Campbell, Fadhel Al-Herz, Bruce Rhind, Mike Young
BACKGROUND: Post-operative atrial fibrillation (AF) is a common complication of oesophagectomy and thought to signal a complicated post-operative course. AF is associated with prolonged admissions, increased healthcare costs and inpatient mortality. However, the impact of post-operative AF on long-term outcomes remains uncertain. METHODS: Patients undergoing open Ivor-Lewis oesophagectomy from 1994 to 2014 at Palmerston North Hospital, New Zealand, were retrospectively evaluated...
June 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28590308/perioperative-factors-related-to-the-severity-of-vocal-cord-paralysis-after-thoracic-cardiovascular-surgery-a-retrospective-review
#19
Hiroki Taenaka, Sho Carl Shibata, Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Akinori Uchiyama, Yuji Fujino
BACKGROUND: Vocal cord paralysis (VCP) is a rare complication of thoracic cardiovascular surgery. In severe cases, life-threatening airway obstruction may occur. OBJECTIVE: To evaluate the incidence and severity of VCP among patients who underwent thoracic cardiovascular surgery and to identify possible risk factors. DESIGN: Single-centre retrospective review of adult patients. SETTING: Osaka University Hospital, Suita, Japan, from January 2013 to August 2015...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28575906/-preoperative-evaluation-of-adult-patients-before-elective-non-cardiothoracic-surgery
#20
(no author information available yet)
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anaesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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