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Perioperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/28821166/perioperative-acute-myocardial-infarction-associated-with-non-cardiac-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
June 27, 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
#12
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
#13
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
#14
(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
https://www.readbyqxmd.com/read/28573343/-preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#15
B Zwissler
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 is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28558082/analysis-of-the-use-of-extracorporeal-circulation-on-the-in-hospital-outcomes-of-dialytic-patients-who-underwent-myocardial-revascularization-surgery
#16
Matheus Miranda, João Nelson Rodrigues Branco, Guilherme Flora Vargas, Nelson Americo Hossne, Michele Costa Yoshimoto, José Honorio de Almeida Palma da Fonseca, José Osmar Medina de Abreu Pestana, Enio Buffolo
BACKGROUND: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. OBJECTIVES: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28523165/plasma-levels-of-matrix-metalloproteinase-9-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#17
Haiqing Li, Zhize Yuan, Sen Li, Quan Qi, Jun Liu, Mi Zhou, Junfeng Cai, Anqing Chen, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Matrix metalloproteinase 9 (MMP9) has recently emerged as a risk predictor in patients with cardiovascular diseases. However, little is known about the significance of increased plasma MMP9 in patients with perioperative myocardial injury. We aimed to investigate the role of MMP9 in the occurrence of myocardial injury during off-pump coronary artery bypass grafting (OPCAB). METHODS: A total of 34 consecutive patients with coronary artery diseases (CAD) were recruited in this prospective, observational study...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28486646/altered-preoperative-coagulation-and-fibrinolysis-are-associated-with-myocardial-injury-after-non-cardiac-surgery
#18
J Górka, K Polok, T Iwaniec, K Górka, A Wludarczyk, J Fronczek, P J Devereaux, J W Eikelboom, J Musial, W Szczeklik
Background: Myocardial injury after non-cardiac surgery (MINS), a complication with unclear pathogenesis, occurs within the first 30 days after surgery and worsens prognosis. Hypercoagulability induced by surgery might contribute to plaque rupture, with subsequent thrombosis and myocardial injury. This study assessed haemostatic markers before surgery and evaluated their association with MINS. Methods: This is a substudy of VISION, a prospective cohort study of perioperative cardiovascular events...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28472245/beta-blocker-subtype-and-risks-of-perioperative-adverse-events-following-non-cardiac-surgery-a-nationwide-cohort-study
#19
Mads E Jørgensen, Robert D Sanders, Lars Køber, Kala Mehta, Christian Torp-Pedersen, Mark A Hlatky, Jannik L Pallisgaard, Richard E Shaw, Gunnar H Gislason, Per F Jensen, Charlotte Andersson
Aims: Beta-blockers vary in pharmacodynamics and pharmacokinetic properties. It is unknown whether specific types are associated with increased perioperative risks. We evaluated perioperative risks associated with beta-blocker subtypes, overall and in patient subgroups. Methods and results: We performed a Danish Nationwide cohort study, 2005-2011, of patients treated chronically with beta blocker (atenolol, bisoprolol, carvedilol, metoprolol, propranolol, or other) prior to non-cardiac surgery...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28472145/preoperative-aspirin-use-and-acute-kidney-injury-after-cardiac-surgery-a-propensity-score-matched-observational-study
#20
Min Hur, Chang-Hoon Koo, Hyung-Chul Lee, Sun-Kyung Park, Minkyung Kim, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: The association between preoperative aspirin use and postoperative acute kidney injury (AKI) in cardiovascular surgery is unclear. We sought to evaluate the effect of preoperative aspirin use on postoperative AKI in cardiac surgery. METHODS: A total of 770 patients who underwent cardiovascular surgery under cardiopulmonary bypass were reviewed. Perioperative clinical parameters including preoperative aspirin administration were retrieved. We matched 108 patients who took preoperative aspirin continuously with patients who stopped aspirin more than 7 days or did not take aspirin for the month before surgery...
2017: PloS One
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