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Perioperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#1
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
#2
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
#3
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 5,978 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
(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
#10
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
#11
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
#12
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
#13
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
#14
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...
May 2, 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
#15
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
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#16
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28464540/safety-and-feasibility-of-liver-resection-with-continued-antiplatelet-therapy-using-aspirin
#17
Kazuteru Monden, Hiroshi Sadamori, Masayoshi Hioki, Satoshi Ohno, Hiromi Saneto, Toru Ueki, Kazuhisa Yabushita, Kazumi Ono, Kousaku Sakaguchi, Norihisa Takakura
BACKGROUND: Aspirin is widely used for the secondary prevention of ischemic stroke and cardiovascular disease. Perioperative aspirin may decrease thrombotic morbidity, but may also increase hemorrhagic morbidity. In particular, liver resection carries risks of bleeding, leading to higher risks of hemorrhagic morbidity. Our institution has continued aspirin therapy perioperatively in patients undergoing liver resection. This study examined the safety and feasibility of liver resection while continuing aspirin...
July 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28450765/effect-of-body-mass-index-on-postoperative-complications-in-beating-coronary-artery-surgery
#18
Feridoun Sabzi, Reza Faraji
BACKGROUND: Body Mass Index (BMI) is considered as an important risk factor in cardiovascular surgery. We designed a historical cohort study for the evaluation of perioperative complications related to BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB). METHODS: We studied 1120 consecutive patients who underwent OPCAB between January 2008 and December 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groups according to BMI: underweight/low BMI (< 18...
November 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28438326/transapical-transcatheter-aortic-valve-implantation-using-the-j-valve-system-a-1-year-follow-up-study
#19
Xiang Luo, Xu Wang, Xuan Li, Xin Wang, Fei Xu, Mingzheng Liu, Bing Yu, Fei Li, Minghui Tong, Wei Wang
OBJECTIVE: Transcatheter aortic valve implantation has become a routine procedure to treat screened inoperable or high-risk patients. In this study, we present the first outcome of echocardiographic midterm using a new second-generation transcatheter aortic valve implantation system, the J-Valve system (Jie Cheng Medical Technologies, Suzhou, China), in patients with aortic stenosis or aortic regurgitation. METHODS: From July 2014 to June 2015, 21 patients with isolated aortic valve disease at high risk for open surgery received transapical transcatheter aortic valve implantation using the J-Valve system...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28431770/aortic-stenosis-and-non-cardiac-surgery-a-systematic-review-and-meta-analysis
#20
Chun Shing Kwok, Rodrigo Bagur, Muhammad Rashid, Ronit Lavi, Mario Cibelli, Mark A de Belder, Neil Moat, David Hildick-Smith, Peter Ludman, Mamas A Mamas
BACKGROUND: Aortic stenosis (AS) poses a perioperative management dilemma to physicians looking after patients who require non-cardiac surgery. The objective of this review is to investigate mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery. METHODS: We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery...
August 1, 2017: International Journal of Cardiology
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