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Perioperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/29145278/safety-of-continuing-aspirin-therapy-during-spinal-surgery-a-systematic-review-and-meta-analysis
#1
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
BACKGROUND: Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. OBJECTIVE: The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. METHODS: Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145170/perioperative-thrombocytopenia-predicts-poor-outcome-in-patients-undergoing-transcatheter-aortic-valve-implantation
#2
Maciej Mitrosz, Remigiusz Kazimierczyk, Malgorzata Chlabicz, Bozena Sobkowicz, Ewa Waszkiewicz, Anna Lisowska, Slawomir Dobrzycki, Wlodzimierz J Musial, Tomasz Hirnle, Karol A Kaminski, Agnieszka M Tycinska
PURPOSE: To determine the time point at which thrombocytopenia after TAVI procedure is an indicator of the worst prognosis, with special consideration of perioperative platelet and coagulation activation as its potential causes. METHODS: Thirty two patients (mean age 78.5±7.9years, 62% females) qualified for TAVI procedure were prospectively evaluated. Platelet counts were assessed at baseline and for the next three postoperative (POD) days. Platelet activation was evaluated by P-selectin (PS, serum, ELISA) and platelet factor 4 (PF-4, CTAD plasma), and blood coagulation activation by prothrombin fragments 1+2 (F1+2, plasma, ELISA)...
November 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29131462/outcomes-of-liver-transplantation-in-pediatric-recipients-with-cardiovascular-disease
#3
Márcio Miranda Brito, Joao Seda Neto, Eduardo A Fonseca, Renata Pugliese, Vera B Danesi, Helry L Candido, Adriana Porta, Cristian V B Borges, Gilda Porta, Paulo Chapchap, Irene Kazue Miura
LT exerts considerable stress on the heart perioperatively. Limited data exist on impact of cardiovascular diseases on LT children. This study evaluated the outcomes of children with CVD who underwent LT and compared with pretransplant findings. From 518 LT recipients, 82 (15.8%) had CVD. Sixty patients were classified as low-risk adjustment for congenital heart surgery 1 (RACHS 1 and 2). Five patients were classified as RACHS ≥3. The most common echocardiographic finding in the CVD patients (25/82) was ASD...
November 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#4
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29121664/does-preoperative-mechanical-prophylaxis-have-additional-effectiveness-in-preventing-postoperative-venous-thromboembolism-in-elderly-patients-with-hip-fracture-retrospective-case-control-study
#5
Ji-Hoon Nam, Dae-Hwan Kim, Je-Hyun Yoo, Ji-Hyo Hwang, Jun-Dong Chang
BACKGROUND: Elderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients. METHODS: Of 539 consecutive patients aged 70 years or older undergoing HFS, 404 (control group) did not receive preoperative mechanical thromboprophylaxis, while 135 (study group) received mechanical thromboprophylaxis using an intermittent pneumatic compression device and graduated compression stockings from the time of admission until surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29121474/outcomes-following-video-assisted-thoracoscopic-lobectomy-versus-open-lobectomy-for-early-stage-lung-cancer-in-older-adults
#6
Nicole Ezer, Minal Kale, Keith Sigel, Sameer Lakha, Grace Mhango, Emily Goodman, Daniel Nicastri, Scott Swanson, Alfred Neugut, Juan P Wisnivesky
RATIONALE: Video-assisted thoracoscopic surgery and open lobectomy are both standard of care for treatment of early stage NSCLC because of equivalent long-term survival. OBJECTIVE: To evaluated whether the improved peri-operative outcomes associated with VATS are explained by differences in case volume and specialty training. METHODS: We analyzed the Surveillance, Epidemiology and End Results-Medicare linked registry to identify stage I-II NSCLC in patients above 65 years of age...
November 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29107488/perioperative-complications-of-total-knee-arthroplasty-in-dialysis-patients
#7
Shih-Hsiang Yen, Jen-Hung Chen, Yu-Der Lu, Jun-Wen Wang
BACKGROUND: Total hip arthroplasty in patients with end-stage renal disease (ESRD) may be associated with a high complication rate. However, the perioperative complication and mortality rates in these patients after total knee arthroplasty (TKA) have rarely been investigated. The purposes of this study were to measure the mortality and complication rates and to evaluate the 2- to 10-year clinical outcome of TKA in dialysis patients at our hospital during the past decade. METHODS: We retrospectively assessed 21 patients (26 knees) with ESRD who underwent primary TKA between 2007 and 2015...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107324/daytime-variation-of-perioperative-myocardial-injury-in-cardiac-surgery-and-its-prevention-by-rev-erb%C3%AE-antagonism-a-single-centre-propensity-matched-cohort-study-and-a-randomised-study
#8
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
https://www.readbyqxmd.com/read/29098342/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
#9
REVIEW
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 guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29077608/a-prospective-international-multicentre-cohort-study-of-intraoperative-heart-rate-and-systolic-blood-pressure-and-myocardial-injury-after-noncardiac-surgery-results-of-the-vision-study
#10
Tom E F Abbott, Rupert M Pearse, R Andrew Archbold, Tahania Ahmad, Edyta Niebrzegowska, Andrew Wragg, Reitze N Rodseth, Philip J Devereaux, Gareth L Ackland
BACKGROUND: The association between intraoperative cardiovascular changes and perioperative myocardial injury has chiefly focused on hypotension during noncardiac surgery. However, the relative influence of blood pressure and heart rate (HR) remains unclear. We investigated both individual and codependent relationships among intraoperative HR, systolic blood pressure (SBP), and myocardial injury after noncardiac surgery (MINS). METHODS: Secondary analysis of the Vascular Events in Noncardiac Surgery Cohort Evaluation (VISION) study, a prospective international cohort study of noncardiac surgical patients...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049799/neurological-outcome-and-efficacy-of-intensive-craniocervical-screening-for-elective-cardiac-surgery
#11
Ken-Ichi Imasaka, Eiki Tayama, Shigeki Morita, Yukihiro Tomita
OBJECTIVES: To evaluate the efficacy of intensive craniocervical screening before elective cardiovascular surgery. METHODS: A retrospective analysis of 1134 consecutive patients who underwent routine screening before cardiovascular surgery between November 2004 and December 2014 was conducted. The study was divided into 2 distinct cohorts of patients undergoing surgery: before (n = 500) and after (n = 634) the introduction of intensive screening in January 2009...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049563/red-cell-distribution-width-is-a-prognostic-marker-of-perioperative-stroke-in-patients-undergoing-cardiac-valve-surgery
#12
Piotr Duchnowski, Tomasz Hryniewiecki, Mariusz Kusmierczyk, Piotr Szymanski
OBJECTIVES: Numerous studies have shown that elevated red cell distribution width (RDW) is associated with poor outcomes in patients with cardiovascular diseases such as coronary artery disease, peripheral artery disease or stroke. The usefulness of the RDW as a predictor of perioperative stroke in patients with valve disease undergoing valve surgery is currently unknown. The aim of the study was to evaluate the prognostic value of RDW for stroke in the early postoperative period in patients undergoing valve replacement or repair surgery...
July 7, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29044300/3rd-guideline-for-perioperative-cardiovascular-evaluation-of-the-brazilian-society-of-cardiology
#13
Danielle Menosi Gualandro, Pai Ching Yu, Bruno Caramelli, André Coelho Marques, Daniela Calderaro, Luciana Savoy Fornari, Claudio Pinho, Alina Coutinho Rodrigues Feitosa, Carisi Anne Polanczyk, Carlos Eduardo Rochitte, Carlos Jardim, Carolina L Z Vieira, Debora Y M Nakamura, Denise Iezzi, Dirk Schreen, Eduardo Leal Adam, Elbio Antonio D'Amico, Emerson Q de Lima, Emmanuel de Almeida Burdmann, Enrique Indalecio Pachón Mateo, Fabiana Goulart Marcondes Braga, Fabio S Machado, Flavio J de Paula, Gabriel Assis Lopes do Carmo, Gilson Soares Feitosa-Filho, Gustavo Faibischew Prado, Heno Ferreira Lopes, João R C Fernandes, José J G de Lima, Luciana Sacilotto, Luciano Ferreira Drager, Luciano Janussi Vacanti, Luis Eduardo Paim Rohde, Luis F L Prada, Luis Henrique Wolff Gowdak, Marcelo Luiz Campos Vieira, Maristela Camargo Monachini, Milena Frota Macatrão-Costa, Milena Ribeiro Paixão, Mucio Tavares de Oliveira, Patricia Cury, Paula R Villaça, Pedro Silvio Farsky, Rinaldo F Siciliano, Roberto Henrique Heinisch, Rogerio Souza, Sandra F M Gualandro, Tarso Augusto Duenhas Accorsi, Wilson Mathias
No abstract text is available yet for this article.
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#14
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28985025/multidisciplinary-approach-to-cardiac-and-pulmonary-vascular-disease-risk-assessment-in-liver-transplantation-an-evaluation-of-the-evidence-and-consensus-recommendations
#15
Lisa B VanWagner, Matthew E Harinstein, James R Runo, Christopher Darling, Marina Serper, Shelley Hall, Jon A Kobashigawa, Laura L Hammel
Liver transplant (LT) candidates today are older, have greater medical severity of illness, and have more cardiovascular comorbidities than ever before. In addition, there are specific cardiovascular responses in cirrhosis that can be detrimental to the LT candidate. Cirrhotic cardiomyopathy, a condition characterized by increased cardiac output and a reduced ventricular response to stress, is present in up to 30% of patients with cirrhosis thus challenging perioperative management. Current noninvasive tests that assess for subclinical coronary and myocardial disease have low sensitivity, and altered hemodynamics during the LT surgery can unmask latent cardiovascular disease either intraoperatively or in the immediate postoperative period...
October 6, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28976400/-perioperative-assessment-of-elderly-patient-with-cardiovascular-disease
#16
Evrim Şimşek, Cahide Soydaş Çınar
Elderly people who require surgery is increasing as a resul of increased life expectancy. Surgery is a major stress factor for all patients however older patients have limited reserve to handle this stress. In this review preoperative assessment of cardiovascular reserve in elderly population and major subjects to take attention in perioperative period were evaluated according to recent guidelines and literatüre.
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28974076/association-between-preoperative-pulse-pressure-and-perioperative-myocardial-injury-an-international-observational-cohort-study-of-patients-undergoing-non-cardiac-surgery
#17
T E F Abbott, R M Pearse, R A Archbold, A Wragg, E Kam, T Ahmad, A W Khan, E Niebrzegowska, R N Rodseth, P J Devereaux, G L Ackland
Background: The management of elevated blood pressure before non-cardiac surgery remains controversial. Pulse pressure is a stronger predictor of cardiovascular morbidity in the general population than systolic blood pressure alone. We hypothesized that preoperative pulse pressure was associated with perioperative myocardial injury. Methods: This is a secondary analysis of the Vascular Events in Non-cardiac Surgery Patients Cohort Evaluation (VISION) international cohort study...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28973220/effect-of-individualized-vs-standard-blood-pressure-management-strategies-on-postoperative-organ-dysfunction-among-high-risk-patients-undergoing-major-surgery-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Emmanuel Futier, Jean-Yves Lefrant, Pierre-Gregoire Guinot, Thomas Godet, Emmanuel Lorne, Philippe Cuvillon, Sebastien Bertran, Marc Leone, Bruno Pastene, Vincent Piriou, Serge Molliex, Jacques Albanese, Jean-Michel Julia, Benoit Tavernier, Etienne Imhoff, Jean-Etienne Bazin, Jean-Michel Constantin, Bruno Pereira, Samir Jaber
Importance: Perioperative hypotension is associated with an increase in postoperative morbidity and mortality, but the appropriate management strategy remains uncertain. Objective: To evaluate whether an individualized blood pressure management strategy tailored to individual patient physiology could reduce postoperative organ dysfunction. Design, Setting, and Participants: The Intraoperative Norepinephrine to Control Arterial Pressure (INPRESS) study was a multicenter, randomized, parallel-group clinical trial conducted in 9 French university and nonuniversity hospitals...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28967731/new-assessment-for-advanced-age-italian-study-protocol-on-the-assessment-of-surgical-risk-in-the-over-75-year-age-group
#19
Annarita Pilleri, Giampaolo Scorcu
The role of age in the risk stratification of patients candidate for non-cardiac surgery is still today an unresolved issue. European guidelines, in contrast to American guidelines, do not attribute to age an independent role in increasing the risk, and the indices for assessment of perioperative cardiovascular risk are based on studies that were carried out on middle-aged subgroups of the population without specific attention to the elderly patient. While the indices of geriatric assessment have still not yet gained a standardized role in the risk stratification of patients candidate to non-cardiac surgery, their need is becoming increasingly urgent considering the epidemiological impact of elderly patients with multi-comorbidities who more and more in the future will undergo such interventions...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967723/preoperative-cardiac-risks-in-noncardiac-surgery-the-role-of-coronary-angiography
#20
Carlo Lombardi, Marco Sbolli, Dario Cani, Garbriele Masini, Marco Metra, Pompilio Faggiano
The preoperative  evaluation of  patients candidates  to noncardiac  surgery requires a knowledge  of  factors  related  both to  type of  surgery and  to  features of the  single patient, potentially  responsible  for  perioperative  cardiovascular  complications , fatal and nonfatal. The assessment of   symptoms  and/or noninvasive  testing indicating the  presence of  coronary  artery  disease may  suggest the  need  for  medical therapy  optimization and, eventually, coronary  arteriography  before  the  scheduled timing  of noncardiac  surgery...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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