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Preoperative cardiovascular evaluation

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https://www.readbyqxmd.com/read/28164120/coronary-computed-tomography-angiography-in-combination-with-coronary-artery-calcium-scoring-for-the-preoperative-cardiac-evaluation-of-liver-transplant-recipients
#1
REVIEW
Jae Moon Choi, Yu-Gyeong Kong, Joon-Won Kang, Young-Kug Kim
Liver transplantation is the best treatment option for early-stage hepatocellular carcinoma, liver cirrhosis, fulminant liver failure, and end-stage liver diseases. Even though advances in surgical techniques and perioperative care have improved postoperative outcomes, perioperative cardiovascular complications are a leading cause of postoperative morbidity and mortality following liver transplantation. Ischemic coronary artery disease (CAD) and cardiomyopathy are the most common cardiovascular diseases and could be negative predictors of postoperative outcomes in liver transplant recipients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28138898/short-term-changes-in-cardiovascular-hemodynamics-in-response-to-bariatric-surgery-and-weight-loss-using-the-nexfin%C3%A2-non-invasive-continuous-monitoring-device-a-pilot-study
#2
Sjaak Pouwels, Bianca Lascaris, Simon W Nienhuijs, Arthur R Bouwman, Marc P Buise
BACKGROUND: Compared to healthy individuals, obese have significantly higher systolic and diastolic blood pressure, mean arterial pressure, heart rate, and cardiac output. The aim of this study was to evaluate cardiovascular hemodynamic changes before and 3 months after bariatric surgery. METHODS: Patients scheduled for bariatric surgery between the 29th of September 2016 and 24th of March 2016 were included and compared with 24 healthy individuals. Hemodynamic measurements were performed preoperatively and 3 months after surgery, using the Nexfin® non-invasive continuous hemodynamic monitoring device (Edwards Lifesciences/BMEYE B...
January 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#3
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28123475/clinical-effect-of-preoperative-high-dose-atorvastatin-against-no-reflow-after-pci
#4
Wenbo Liu, Zhipeng Zou, Haipeng Jiang, Qiang Li, Fangming Guo, Zhen Wang, Hongguang Zhu
The aim of the present study was to evaluate the use of preoperative high-dose atorvastatin to prevent the no-reflow phenomenon after percutaneous coronary intervention (PCI). A total of 138 patients with ST-segment elevation myocardial infarction, admitted from March 2014 to January 2015, were enrolled and randomly divided into 3 groups of 46 individuals each. The groups included a control group in which patients were not treated with atorvastatin before PCI; a conventional-dose atorvastatin treatment group in which patients received a single dose of 20 mg at bedtime one day prior to PCI; and a high-dose atorvastatin treatment group in which patients were treated with 40 mg divided in two doses the day before PCI...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28075435/cardiac-biomarkers-predict-1-year-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#5
Spyridon Katsanos, Andreas F Mavrogenis, Nikolaos Kafkas, Celestino Sardu, Vasileios Kamperidis, Panagiota Katsanou, Dimitrios Farmakis, John Parissis
This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28060192/imaging-of-the-lungs-in-organ-donors-and-its-clinical-relevance-a-retrospective-analysis
#6
Gracijela Bozovic, Catharina Adlercreutz, Peter Höglund, Isabella Björkman-Burtscher, Peter Reinstrup, Richard Ingemansson, Cornelia Schaefer-Prokop, Roger Siemund, Mats Geijer
PURPOSE: The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them. MATERIALS AND METHODS: Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective...
January 2, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28045816/risk-factors-predicting-nasoseptal-flap-failure-in-the-endoscopic-endonasal-transsphenoidal-approach
#7
Boo-Young Kim, Ji Hyeon Shin, Sung Won Kim, Yong Kil Hong, Sin-Soo Jeun, Soo Whan Kim, Jin Hee Cho, Yong Jin Park
OBJECTIVE: Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure. STUDY DESIGN: Patient series. SETTING: Retrospective review of medical records at a tertiary referral center...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28038718/preoperative-values-of-inflammatory-markers-predict-clinical-outcomes-in-patients-after-cabg-regardless-of-the-use-of-cardiopulmonary-bypass
#8
Dariusz Plicner, Jarosław Stoliński, Marcin Wąsowicz, Bugusław Gawęda, Hubert Hymczak, Bogusław Kapelak, Rafał Drwiła, Anetta Undas
OBJECTIVE: The impact of systemic inflammation on clinical outcomes after CABG surgery is still controversial. In this study, we evaluated the impact of the markers of inflammation, endothelial damage and platelet activation on clinical outcomes after on- and off-pump CABG. METHODS: A group of 191 consecutive on- and off-pump CABG patients were prospectively studied. Blood samples were drawn before surgery, 18-36h after the procedure and 5-7 days postoperatively and analyzed for 8-iso-prostaglandin F2α (8-iso-PGF2α), asymmetric dimethylarginine (ADMA) and β-thromboglobulin (β-TG)...
December 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27999506/preoperative-acute-inflammatory-markers-as-predictors-for-postoperative-complications-in-primary-total-knee-arthroplasty
#9
Gustavo Godoy, Gonzalo Sumarriva, J Lockwood Ochsner, George Chimento, Dana Schmucker, Vinod Dasa, Mark Meyer
BACKGROUND: C-reactive protein (CRP) has been suggested as an independent risk factor for cardiovascular pathology in the nonsurgical setting. While postoperative CRP and erythrocyte sedimentation rate (ESR) have an established role in aiding the diagnosis of periprosthetic joint infections, some authors suggest a link between preoperative CRP and postoperative complications in patients undergoing total joint arthroplasty. METHODS: We conducted a retrospective cohort study of 351 patients who underwent unilateral primary total knee arthroplasty by a single surgeon during a 28-month period (January 2013 through April 2015)...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27989068/underlying-rheumatic-disease-an-important-determinant-of-outcome-in-tricuspid-valve-repair
#10
Mandhir Munasur, Datshana Naidoo
BACKGROUND: Tricuspid regurgitation (TR) accompanying severe left-sided valve disease occurs on a functional basis, secondary to pulmonary hypertension and tricuspid annular dilatation. In the context of endemic left-sided rheumatic heart disease, non-recognition of organic disease of the tricuspid valve may adversely influence surgical decision-making, resulting in suboptimal outcomes. METHODS: A retrospective analysis of the perioperative and follow up data of 30 patients who underwent tricuspid valve surgery with concomitant left-sided valve replacement was undertaken...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27973966/a-computer-assisted-robotic-platform-for-vascular-procedures-exploiting-3d-us-based-tracking
#11
Marco Mura, Simone Parrini, Gastone Ciuti, Vincenzo Ferrari, Cinzia Freschi, Mauro Ferrari, Paolo Dario, Arianna Menciassi
BACKGROUND: Cardiovascular diseases are the first cause of death globally: an estimated 17.5 million people died in 2012. By combining the benefits of magnetic navigation and ultrasound (US) imaging, the authors proposed a robotic platform (i.e. the MicroVAST platform) for intravascular medical procedures. METHODS: A 3D imaging US-based tracking algorithm is implemented for the navigation of a magnetic-dragged soft-tethered device. Tests were performed to evaluate the algorithm in terms of tracking error and precision of locomotion...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27914496/computed-tomography-derived-skeletal-muscle-index-a-novel-predictor-of-frailty-and-hospital-length-of-stay-after-transcatheter-aortic-valve-replacement
#12
Vishal Dahya, Jingjie Xiao, Carla M Prado, Penny Burroughs, Dan McGee, Aline C Silva, Julian E Hurt, Shafi G Mohamed, Thomas Noel, Wayne Batchelor
: To determine the prevalence of low skeletal muscle mass in patients undergoing transcatheter aortic valve replacement (TAVR) and whether skeletal muscle mass measured from preoperative computed tomography (CT) images provides value in predicting postoperative length of stay (LOS). BACKGROUND: There are limited data on the use of body composition as a frailty measure in TAVR patients and no studies have determined if this measure predicts LOS. METHODS: We studied 104 consecutive patients who underwent TAVR at Tallahassee Memorial Hospital from 2012 to 2016...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#13
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27902607/perioperative-complications-following-preoperative-cessation-of-antithrombotic-agents-for-total-knee-arthroplasty-a-retrospective-study
#14
Jin-Young Hwang, Sohee Oh, Chong-Soo Kim, Jee-Eun Chang, Seong-Won Min
The number of elderly patients undergoing total knee arthroplasty (TKA) has steadily increased. Elderly patients undergoing TKA usually have underlying diseases, and some of them take antithrombotic agents for the prevention or treatment of these co-morbidities, including cardiovascular, cerebrovascular, or thromboembolic diseases. When these patients are scheduled to undergo TKA, preoperative cessation of antithrombotic agents is considered on the basis of its risks and benefits. This study was aimed to evaluate the impact of discontinuing antithrombotic agents for primary total knee arthroplasty (TKA) on perioperative complications...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#15
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#16
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27856106/surgical-management-of-colorectal-cancer-for-the-aging-population-a-survey-by-the-japanese-society-for-cancer-of-colon-and-rectum
#17
Hiroshi Matsuoka, Kotaro Maeda, Tsunekazu Hanai, Harunobu Sato, Koji Masumori, Yosikazu Koide, Hidetoshi Katsuno, Tomoyoshi Endo, Miho Shiota, Kenichi Sugihara
OBJECTIVE: The treatment policy of colorectal cancer in elderly patients is controversial due to a lack of specific guidelines. To clarify the present management of colorectal cancer for aged patients, a questionnaire survey was conducted by the Japanese Society for Cancer of the Colon and Rectum. METHODS: Questionnaire forms were sent to the 430 member institutions of the Japanese Society for Cancer of the Colon and Rectum. RESULTS: The response rate of the surgical department to the questionnaire was 39%...
November 14, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27844209/the-impact-of-parathyroidectomy-on-serum-adamts1-adamts4-levels-insulin-resistance-and-subclinical-cardiovascular-disease-in-primary-hyperparathyroidism
#18
Melia Karakose, Mustafa Caliskan, Muyesser Sayki Arslan, Taner Demirci, Suleyman Karakose, Erman Cakal
PURPOSE: Primary hyperparathyroidism has been associated with increased incidence of morbidity and mortality of the cardiovascular system. The etiopathogenetic mechanisms underlying this association are still not completely clear. Accumulating evidence suggested that a disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) has a role in the development of inflammation and atherosclerosis. In this study, we aimed to determine whether there is a change in serum levels of ADAMTS1, ADAMTS4, carotid intima-media thickness, and cardiovascular risk score after the surgery and also whether there is a relationship between ADAMTS levels and cardiovascular risk score in hypercalcemic primary hyperparathyroidism patients...
January 2017: Endocrine
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#19
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27775997/withholding-versus-continuing-angiotensin-converting-enzyme-inhibitors-or-angiotensin-ii-receptor-blockers-before-noncardiac-surgery-an-analysis-of-the-vascular-events-in-noncardiac-surgery-patients-cohort-evaluation-prospective-cohort
#20
Pavel S Roshanov, Bram Rochwerg, Ameen Patel, Omid Salehian, Emmanuelle Duceppe, Emilie P Belley-Côté, Gordon H Guyatt, Daniel I Sessler, Yannick Le Manach, Flavia K Borges, Vikas Tandon, Andrew Worster, Alexandra Thompson, Mithin Koshy, Breagh Devereaux, Frederick A Spencer, Robert D Sanders, Erin N Sloan, Erin E Morley, James Paul, Karen E Raymer, Zubin Punthakee, P J Devereaux
BACKGROUND: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. METHODS: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker users) at least 45 yr old who had in-patient noncardiac surgery from 2007 to 2011...
January 2017: Anesthesiology
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