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Preoperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#1
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29759739/aortic-valve-bypass-surgery-in-severe-aortic-valve-stenosis-insights-from-cardiac-and-brain-magnetic-resonance-imaging
#2
Cesare Mantini, Massimo Caulo, Daniele Marinelli, Piero Chiacchiaretta, Armando Tartaro, Antonio Raffaele Cotroneo, Gabriele Di Giammarco
OBJECTIVE: To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. METHODS: We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29756506/dislocation-rate-increases-with-bariatric-surgery-before-total-hip-arthroplasty
#3
Brian T Nickel, Mitchell R Klement, Colin Penrose, Cynthia L Green, Michael P Bolognesi, Thorsten M Seyler
INTRODUCTION: Annually in the USA, 113,000 patients with refractory obesity undergo bariatric surgery (BS), and a subset does so in order to lower body mass index to become a more desirable total hip arthroplasty (THA) candidate. This study aims to evaluate THA risk with and without bariatric surgery. METHODS: 12,160 patients were identified in a claim-based review of the entire Medicare database with ICD-9 codes to identify patients in three groups. Patients who underwent BS prior to THA (Group I: 1,545 experimental group) and two control groups that did not undergo BS but had either a body mass index >40 (Group II: 6,918 bariatric control) or <25 (Group III: 3,697 normal weight control)...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29753505/off-pump-technique-reduces-surgical-mortality-after-elective-coronary-artery-bypass-grafting-in-patients-with-preoperative-renal-failure
#4
Chikara Ueki, Hiroaki Miyata, Noboru Motomura, Ryuzo Sakata, Genichi Sakaguchi, Takehide Akimoto, Shinichi Takamoto
OBJECTIVES: Most randomized controlled trials of off-pump versus on-pump coronary artery bypass grafting (CABG) have included limited numbers of patients with preoperative renal failure. This study was performed to evaluate the association between the clinical benefit of the off-pump technique and chronic kidney disease stage. METHODS: We analyzed 38,051 patients with chronic kidney disease who underwent primary nonemergent isolated CABG from 2013 to 2015 as reported in the Japan Cardiovascular Surgery Database-Adult section...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29739455/longitudinal-recovery-patterns-of-penile-length-and-the-underexplored-benefit-of-long-term-phosphodiesterase-5-inhibitor-use-after-radical-prostatectomy
#5
Young Suk Kwon, Nicholas Farber, Ji Woong Yu, Kevin Rhee, Christopher Han, Patrick Ney, Jeong Hee Hong, Paul Lee, Nikhil Gupta, Wun-Jae Kim, Isaac Yi Kim
BACKGROUND: Penile length (PL) shortening is an underreported phenomenon following radical prostatectomy (RP) and risk factors are not fully explored. We aimed to describe longitudinal patterns of PL recovery and evaluate factors predicting complete return to baseline PL. METHODS: PL measurement was performed during a preoperative and postoperative follow-up visits at 7 days and 3, 6, 9, and 12 months. Patients who completely recovered (CR: N = 397) their preoperative stretched PL measured during at least one of their follow-up visits were compared to those with incomplete recovery (IR: N = 131)...
May 9, 2018: BMC Urology
https://www.readbyqxmd.com/read/29720187/simulation-as-a-preoperative-planning-approach-in-advanced-heart-failure-patients-a-retrospective-clinical-analysis
#6
Massimo Capoccia, Silvia Marconi, Sanjeet Avtaar Singh, Domenico M Pisanelli, Claudio De Lazzari
BACKGROUND: Modelling and simulation may become clinically applicable tools for detailed evaluation of the cardiovascular system and clinical decision-making to guide therapeutic intervention. Models based on pressure-volume relationship and zero-dimensional representation of the cardiovascular system may be a suitable choice given their simplicity and versatility. This approach has great potential for application in heart failure where the impact of left ventricular assist devices has played a significant role as a bridge to transplant and more recently as a long-term solution for non eligible candidates...
May 2, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29707335/impact-of-comorbidity-burden-on-morbidity-following-thoracoscopic-lobectomy-a-propensity-matched-analysis
#7
Ruoyu Zhang, Thomas Kyriss, Jürgen Dippon, Sebastian Ciupa, Enole Boedeker, Godehard Friedel
Background: Given the positive effect of a thoracoscopic approach on improving postoperative outcomes, it is reasonable to speculate whether an increased comorbidity burden is related to higher morbidity following thoracoscopic lobectomy. We sought to evaluate the impact of comorbidity burden on adverse postoperative outcomes in this patient population. Methods: A retrospective review of our institutional database included 512 patients undergoing thoracoscopic lobectomy for early-stage non-small cell lung cancer (NSCLC) from 2009 through 2016...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29705865/real-time-spectral-analysis-of-the-arterial-pressure-waveform-using-a-wirelessly-connected-tablet-computer-a-pilot-study
#8
David Andrew Pybus
Spectral analysis of the arterial pressure waveform, using specialized hardware, has been used for the retrospective calculation of the 'Spectral Peak Ratio' (SPeR) of the respiratory and cardiac arterial spectral peaks. The metric can quantify the cardiovascular response to volume loading by analysing the effect of changing tidal volume (indexed to body weight) (VTI ) on pulse pressure variability. In this pilot study, the feasibility of real-time SPeR calculation, using a mobile computer which was wirelessly connected to the patient monitor, was evaluated by examining the determinants of SPeR in 60 cardiac-surgical patients...
April 28, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29703571/-complications-after-bariatric-surgery
#9
Regis Souche, Audrey de Jong, Claire Nomine-Criqui, Marius Nedelcu, Laurent Brunaud, David Nocca
Bariatric surgery became consensual after the NIH consensus of 1991 and the appearance of laparoscopic approach. This type of operation has a functional role (improvement of quality of life, locomotion and digestive symptoms as gastro-esophageal reflux disease), a prevention role (increase in life expectancy, reduction of risk of cancer and cardiovascular disease) and a curative role (remission of diabetes mellitus, obstructive sleep apnea syndrome and arterial hypertension). The laparoscopic approach for bariatric surgery led to a major reduction of postoperative morbi-mortality...
April 24, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29701385/predictors-of-acute-kidney-injury-in-the-postoperative-period-of-cardiac-surgery-associated-with-cardiopulmonary-bypass
#10
Raquel Moreira, Tiago Jacinto, Paulo Neves, Luís Vouga, Cristina Baeta
INTRODUCTION: Acute kidney injury (AKI) in the postoperative period of cardiac surgery occurs in 1 to 30% of the patients, mainly caused by ischemia secondary to renal hypoperfusion. Cardiopulmonary bypass (CPB) has a deleterious effect on renal function, constituting an aggression to the patient's homeostasis. AIM: To evaluate the incidence of AKI in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with CPB, and explore the association between incidence of AKI and predictors related to CPB...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29617501/cabg-and-preoperative-use-of-beta-blockers-in-patients-with-stable-angina-are-associated-with-better-cardiovascular-survival
#11
Victor Dayan, Diego Perez, Eloisa Silva, Gerardo Soca, Jorge Estigarribia
OBJECTIVE: In contrast to unstable angina, optimal therapy in patients with stable angina is debated. Our aim was to evaluate the outcomes of patients with stable angina scheduled for isolated coronary artery bypass grafts and the effect of preoperative use of beta-blockers. Overall and cardiovascular survivals were our primary outcome. Operative mortality and postoperative complications along with subgroup analysis of diabetic patients were our secondary outcomes. METHODS: Retrospective evaluation of patients with stable angina scheduled for isolated coronary artery bypass grafts was included...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29616526/effects-of-chronic-statin-use-on-30-day-major-adverse-cardiac-and-cerebrovascular-events-after-thoracic-endovascular-aortic-repair
#12
Sung Y Ham, Suk W Song, Sang B Nam, Soo J Park, Sijin Kim, Young Song
BACKGROUND: Cardiac and cerebrovascular complications are major causes of adverse outcomes following thoracic endovascular aortic repair (TEVAR). The benefits of statins have been established, but little is known about their impact on patients undergoing TEVAR. We investigated whether chronic statin use protected against early postoperative major adverse cardiac and cerebrovascular events (MACCEs) after TEVAR. METHODS: We retrospectively reviewed 211 patients who underwent TEVAR between February 2013 and March 2017 classified into two groups, those with acute aortic syndrome (AAS, n=79) and those without (non-AAS, n=132)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29598850/evaluation-of-risk-factors-for-complications-after-bariatric-surgery
#13
D Quilliot, M-A Sirveaux, C Nomine-Criqui, T Fouquet, N Reibel, L Brunaud
The decision to perform a bariatric surgical procedure, the conclusion of a clinical pathway in which management is individually adapted to each patient, is taken after multidisciplinary consultation. Paradoxically, the patients who would most benefit from surgery are also those who have the highest operative risk. In practice, predictive factors of mortality and severe postoperative complications (Clavien-Dindo>III) must be used to evaluate the benefit/risk ratio most objectively. The main risk factors are age, male gender, body mass index, obstructive sleep apnea syndrome, insulin resistance and diabetes, tobacco abuse, cardiovascular disease, ability to lose weight before surgery, hypoalbuminemia and functional disability...
March 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29564751/complexity-of-preoperative-blood-pressure-dynamics-possible-utility-in-cardiac-surgical-risk-assessment
#14
Teresa S Henriques, Madalena D Costa, Pooja Mathur, Priyam Mathur, Roger B Davis, Murray A Mittleman, Kamal R Khabbaz, Ary L Goldberger, Balachundhar Subramaniam
Complexity measures are intended to assess the cardiovascular system's capacity to respond to stressors. We sought to determine if decreased BP complexity is associated with increased estimated risk as obtained from two standard instruments: the Society of Thoracic Surgeons' (STS) Risk of Mortality and Morbidity Index and the European System for Cardiac Operative Risk Evaluation Score (EuroSCORE II). In this observational cohort study, preoperative systolic, diastolic, mean (MAP) and pulse pressure (PP) time series were derived in 147 patients undergoing cardiac surgery...
March 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29562416/-myocardial-revascularization-among-patients-with-severe-left-ventricular-dysfunction-a-comparison-between-on-pump-beating-heart-and-off-pump-coronary-artery-bypass-grafting
#15
J Q Shen, Q Ji, W J Ding, L M Xia, K Song, L Wei, Y X Sun, C S Wang
Objective: To evaluate the impacts of an on-pump beating-heart versus an off-pump coronary artery bypass grafting (CABG) technique for surgical revascularization on the early clinical outcomes in patients with a left ventricular ejection fraction (EF) of 35% or less. Methods: A total of 216 consecutive patients with an echocardiographic estimated EF of 35% or less who underwent non-emergency, primary, isolated CABG from January 2010 to December 2014 at Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were included in this study and were divided into either an OBCAB group (patients who received on-pump beating-heart CABG surgery, n =88) or an OPCAB group (patients who received off-pump CABG surgery, n =128)...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29534177/predictors-of-ischaemic-mitral-regurgitation-recurrence-in-patients-undergoing-combined-surgery-additional-value-of-cardiovascular-magnetic-resonance-imaging
#16
Sigita Glaveckaite, Egle Uzdavinyte-Gateliene, Zaneta Petrulioniene, Darius Palionis, Nomeda Valeviciene, Gintaras Kalinauskas, Pranas Serpytis, Aleksandras Laucevicius
OBJECTIVES: We aimed to evaluate (i) the effectiveness of combined surgery (coronary artery bypass grafting with restrictive mitral valve annuloplasty) and (ii) the late gadolinium enhancement cardiovascular magnetic resonance-based predictors of ischaemic mitral regurgitation (IMR) recurrence. METHODS: The prospective analysis included 40 patients with multivessel coronary artery disease, IMR >II° and left ventricular (LV) dysfunction undergoing combined surgery...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29529205/carotid-stenosis-with-impaired-brain-flow-reserve-is-associated-with-an-increased-risk-of-stroke-in-on-pump-cardiovascular-surgery
#17
Kazumasa Tsuda, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita, Kazuhiro Ohkura, Daisuke Takahashi, Yumi Kando, Kayoko Natsume, Ken Yamanaka, Yuki Takeuchi
OBJECTIVES: To prevent haemodynamic stroke during cardiovascular surgery in patients with carotid stenosis, we routinely evaluated magnetic resonance angiography and selectively evaluated brain perfusion single-photon emission computed tomography with acetazolamide challenge. Off-pump surgery was preferred when cerebral blood flow reserve was impaired. This strategy's usefulness was investigated. METHODS: Among the 1059 consecutive patients who underwent preoperative carotid screening by magnetic resonance angiography, 84 (7...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29527983/preoperative-echocardiographic-differences-and-transplant-outcomes-among-patients-receiving-simultaneous-liver-kidney-versus-liver-transplant-alone
#18
Nik R Mazumder, Stuart D Russell, Aliaksei Pustavoitau, Matthews Chacko, Nicole Rizkalla, Behnam Saberi, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar, Fizza F Naqvi
OBJECTIVES: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. MATERIALS AND METHODS: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29514145/preoperative-midrregional-proadrenomedulin-and-high-sensitivity-troponin-t-predict-perioperative-cardiovascular-events-in-non-cardiac-surgery
#19
Mladjan Golubovic, Radmilo Jankovic, Dusan Sokolovic, Vladan Cosic, Vesna Maravic, Tomislav Kostic, Zoran Perisic, Nebojsa Ladjevic
OBJECTIVE: We evaluated the utility of preoperative mid-regional pro-adrenomedulin (MR-proADM) and cardiac troponin T (TnT) for improved detection of patients at high risk for perioperative cardiac events and mortality after major non-cardiac surgery. SUBJECTS AND METHODS: This prospective, single-center, observational study enrolled 79 patients undergoing major non-cardiac surgery. After initial clinical assessment (clinical history, physical examination, echocardiogram, blood tests, and chest X-ray), mid-regional pro-adrenomedulin and high sensitivity troponin T (hsTnT) were measured within 48 hours prior to surgery by immunoluminometric and electrochemiluminescence-immuno assay...
March 7, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29501637/predictors-of-heparin-resistance-before-cardiovascular-operations-in-adults
#20
Satoshi Kawatsu, Konosuke Sasaki, Ko Sakatsume, Shingo Takahara, Katsuhiro Hosoyama, Naoki Masaki, Yusuke Suzuki, Yukihiro Hayatsu, Ichiro Yoshioka, Kei Sakuma, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Naotaka Motoyoshi, Shunsuke Kawamoto, Yoshikatsu Saiki
BACKGROUND: Heparin resistance (HR) is often encountered during cardiovascular operations that require cardiopulmonary bypass. Clinical risk factors and the mechanism underlying heparin resistance are yet to be determined. The aim of this study was to elucidate the clinically valid preoperative predictors related to HR. METHODS: The study evaluated 489 patients undergoing cardiovascular operations. Of these, 25 patients presented with HR and received antithrombin III for the initiation of cardiopulmonary bypass with an effective activated coagulation time...
May 2018: Annals of Thoracic Surgery
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