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https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#1
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810019/alveolar-recruitment-strategies-after-cardiac-surgery-reply
#2
Marcelo B P Amato, Marcia S Volpe, Ludhmila A Hajjar
No abstract text is available yet for this article.
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28810016/alveolar-recruitment-strategies-after-cardiac-surgery
#3
Jayshil J Patel, Kurt Pfeifer
No abstract text is available yet for this article.
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28810015/alveolar-recruitment-strategies-after-cardiac-surgery
#4
Guohui Li, Xueyin Shi
No abstract text is available yet for this article.
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28808078/relationship-of-kidney-injury-biomarkers-with-long-term-cardiovascular-outcomes-after-cardiac-surgery
#5
Chirag R Parikh, Jeremy Puthumana, Michael G Shlipak, Jay L Koyner, Heather Thiessen-Philbrook, Eric McArthur, Kathleen Kerr, Peter Kavsak, Richard P Whitlock, Amit X Garg, Steven G Coca
Clinical AKI, measured by serum creatinine elevation, is associated with long-term risks of adverse cardiovascular (CV) events and mortality in patients after cardiac surgery. To evaluate the relative contributions of urine kidney injury biomarkers and plasma cardiac injury biomarkers in adverse events, we conducted a multicenter prospective cohort study of 968 adults undergoing cardiac surgery. On postoperative days 1-3, we measured five urine biomarkers of kidney injury (IL-18, NGAL, KIM-1, L-FABP, and albumin) and five plasma biomarkers of cardiac injury (NT-proBNP, H-FABP, hs-cTnT, cTnI, and CK-MB)...
August 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28807801/impact-of-diabetes-mellitus-on-clinical-outcomes-and-quality-of-life-after-transcatheter-aortic-valve-implantation-for-severe-aortic-valve-stenosis
#6
Tomasz Tokarek, Artur Dziewierz, Agata Wiktorowicz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Pawel Kleczynski, Dariusz Dudek
BACKGROUND: Diabetes mellitus (DM) has been considered as a marker of poor prognosis after cardiac surgery. We sought to investigate the impact of DM on clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). METHODS: A total of 148 consecutive patients with symptomatic, severe aortic stenosis who underwent TAVI were included. Baseline characteristics, procedural and long-term clinical outcomes as well as the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM...
August 11, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28807663/incidence-and-predictors-of-late-atrioventricular-conduction-recovery-among-patients-requiring-permanent-pacemaker-for-complete-heart-block-after-cardiac-surgery
#7
Erich L Kiehl, Tarek Makki, Ralph M Matar, Douglas R Johnston, John W Rickard, Khaldoun G Tarakji, Mohamed Kanj, Oussama M Wazni, Walid I Saliba, Niraj Varma, Bruce L Wilkoff, Daniel J Cantillon
BACKGROUND: New-onset complete heart block (CHB) commonly complicates cardiac surgery, for which some patients require a permanent pacemaker (PPM). Little is known regarding late atrioventricular (AV) conduction recovery. OBJECTIVE: To characterize the incidence and predictors of late AV conduction recovery among patients requiring PPM after cardiac surgery. METHODS: Consecutive patients receiving PPM for CHB following cardiac surgery at a high-volume US center from 2000-2014 were evaluated...
August 11, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28807550/decreased-gene-expression-of-fatty-acid-binding-protein-3-in-the-atrium-of-patients-with-new-onset-of-atrial-fibrillation-in-cardiac-perioperative-phase
#8
Yasushige Shingu, Takashi Yokota, Shingo Takada, Haruki Niwano, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
BACKGROUND: Post-operative atrial fibrillation (POAF) frequently occurs after cardiac surgery. However, the mechanisms of POAF have not been fully elucidated. We aimed to examine whether pre-operative atrial gene expression related to cardiac metabolism is changed in patients with POAF. METHODS: Right atrial tissue was obtained during surgery from 38 patients who underwent cardiac surgery from 2013 to 2015. Atrial expression levels were determined by reverse transcription polymerase chain reaction for the following genes: glucose transporter type 4, peroxisome proliferator-activated receptor-α, fatty acid translocase, carnitine palmitoyltransferase 1B, and fatty acid binding protein 3 (FABP3)...
August 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#9
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
July 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28806174/left-ventricular-apex-venting-in-high-risk-redo-sternotomy-with-severe-aortic-insufficiency-a-case-report
#10
Brett J Wakefield, Alexander J Leone, Shiva Sale
Redo cardiac surgery in patients with severe aortic insufficiency can present unique challenges to the anesthesiologist. We report a case highlighting the challenge and importance of interdisciplinary planning between cardiothoracic surgeons and anesthesiologists prior to high-risk surgery. Failure to place an endoaortic balloon and percutaneous coronary sinus catheter due to anatomical abnormalities prompted the adoption of an alternate technique involving apical ventricular venting to assist sternal reentry...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28805027/acute-and-midterm-results-following-perventricular-device-closure-of-muscular-ventricular-septal-defects-a-multicenter-pices-investigation
#11
Robert G Gray, Shaji C Menon, Joyce T Johnson, Aimee K Armstrong, Michael A Bingler, John P Breinholt, Damien Kenny, John Lozier, Joshua J Murphy, Shyam K Sathanandam, Nathaniel W Taggart, Sara M Trucco, Bryan H Goldstein, Brent M Gordon
OBJECTIVES: To describe acute and mid-term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). BACKGROUND: Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. METHODS: This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014...
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28804896/load-dependence-of-myocardial-deformation-variables-a-clinical-strain-echocardiographic-study
#12
M Fredholm, K Jörgensen, E Houltz, S-E Ricksten
BACKGROUND: The effects of left ventricular (LV) loading on myocardial deformation variables are not well-studied in the clinical setting. In the present study, we evaluated the effects of isolated changes in preload, afterload and heart rate on LV longitudinal strain, systolic (SR-S) and early diastolic strain rate (SR-E) in post-cardiac surgery patients. METHODS: Twenty-one patients were studied early after cardiac surgery. Longitudinal myocardial strain and SR were analysed off-line using 2-D speckle echocardiography...
August 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28804230/the-effect-of-blood-transfusion-on-outcomes-in-aortic-surgery
#13
REVIEW
Camilo A Velasquez, Mrinal Singh, Syed Usman Bin Mahmood, Adam J Brownstein, Mohammad A Zafar, Ayman Saeyeldin, Bulat A Ziganshin, John A Elefteriades
The use of blood transfusion in cardiac surgery varies widely. The beneficial effects of blood products are offset by an increase in morbidity and mortality. Despite multiple studies showing an association between blood product exposure and adverse short- and long-term events, it is difficult to determine causality. Nevertheless, the implication is sufficient to warrant the search for alternative strategies to reduce the use of blood products while providing a standard of care that optimizes postoperative outcomes...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28803773/low-dose-versus-high-dose-tranexamic-acid-reduces-the-risk-of-nonischemic-seizures-after-cardiac-surgery-with-cardiopulmonary-bypass
#14
Pierre Couture, Jean-Sébastien Lebon, Éric Laliberté, Georges Desjardins, Marie-Ève Chamberland, Christian Ayoub, Antoine Rochon, Jennifer Cogan, André Denault, Alain Deschamps
OBJECTIVE: The incidence of postoperative nonischemic seizures associated with the use of tranexamic acid (TXA) and the possibility of prevention with a low-dose regimen of TXA were evaluated. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: A total of 12,195 patients who underwent cardiac surgical procedures under cardiopulmonary bypass (CPB) were evaluated. INTERVENTIONS: The files of every clinical seizure case diagnosed in the surgical intensive care unit between April 2006 and April 2014 were reviewed...
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#15
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803769/urine-biomarkers-of-tubular-renal-cell-damage-for-the-prediction-of-acute-kidney-injury-after-cardiac-surgery-a-pilot-study
#16
Tanja Mayer, Daniel Bolliger, Markus Scholz, Oliver Reuthebuch, Michael Gregor, Patrick Meier, Martin Grapow, Manfred D Seeberger, Jens Fassl
OBJECTIVE: To evaluate the perioperative course of urine levels of the renal damage biomarkers tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) and to evaluate the predictive value of elevated TIMP-2 × IGFBP7 concentrations to predict acute kidney injury (AKI) early after cardiac on-pump surgery. DESIGN: Prospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: The study comprised 110 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) between January and March 2014...
April 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803768/assessment-of-preoperative-anxiety-in-cardiac-surgery-patients-lacking-a-history-of-anxiety-contributing-factors-and-postoperative-morbidity
#17
Joaquín Hernández-Palazón, Diego Fuentes-García, Luis Falcón-Araña, María José Roca-Calvo, Sebastián Burguillos-López, Paloma Doménech-Asensi, Rubén Jara-Rubio
OBJECTIVES: The aim of this study was to measure the level of preoperative anxiety in patients scheduled for cardiac surgery, identify any influencing clinical factors, and assess the relationship between anxiety and postoperative morbidity. DESIGN: A prospective and consecutive study. SETTING: A single university hospital. PARTICIPANTS: The study comprised 200 patients scheduled for cardiac surgery. INTERVENTIONS: Each patient was asked to grade his or her preoperative anxiety level using the Visual Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale, and set of specific anxiety-related questions...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803717/noninvasive-stroke-volume-variation-using-electrical-velocimetry-for-predicting-fluid-responsiveness-in-dogs-undergoing-cardiac-surgery
#18
Kazumasu Sasaki, Tatsushi Mutoh, Tomoko Mutoh, Yasuyuki Taki, Ryuta Kawashima
OBJECTIVE: To evaluate the ability of a noninvasive cardiac output monitoring system with electrical velocimetry (EV) for predicting fluid responsiveness in dogs undergoing cardiac surgery. STUDY DESIGN: Prospective experimental trial. ANIMALS: A total of 30 adult Beagle dogs. METHODS: Stroke volume (SV), stroke volume variation (SVV) and cardiac index were measured using the EV device in sevoflurane-anaesthetized, mechanically ventilated dogs undergoing thoracotomies for experimental creation of right ventricular failure...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28803657/early-extubation-after-cardiac-surgery-the-evolution-continues
#19
EDITORIAL
Hilary P Grocott
No abstract text is available yet for this article.
July 25, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28803639/atrial-fibrillation-and-stroke-as-initial-manifestations-of-painless-type-a-aortic-dissection
#20
Claudia Stöllberger, Lilian Schäffl-Doweik, Maria Korn, Josef Finsterer
Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection...
July 21, 2017: Neurologia i Neurochirurgia Polska
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