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https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#1
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#2
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29150087/dexmedetomidine-methadone-ketamine-versus-dexmedetomidine-methadone-alfaxalone-for-cats-undergoing-ovariectomy
#3
Rocio Fernandez-Parra, Chiara Adami, Thomas Dresco, Thomas M Donnelly, Luca Zilberstein
OBJECTIVE: To compare the duration, quality of anaesthesia and analgesia, and quality of recovery of dexmedetomidine and methadone combined with either ketamine or alfaxalone. STUDY DESIGN: Randomized, prospective clinical trial. ANIMALS: A group of 44 healthy client-owned cats presenting for ovariectomy. METHODS: Cats were randomly assigned to one of the two treatment groups: DAM (n=22), which was administered intramuscularly (IM) dexmedetomidine (15 μg kg(-1)), methadone (0...
May 27, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29150036/thoracic-surgery-considerations-in-the-child-and-young-adult
#4
REVIEW
Marvin D Atkins, Stephanie Fuller
Vascular rings and slings may represent life-threatening compression of the esophagus and trachea. Such anatomic variants, although rare, are encountered by all thoracic surgeons in the scope of their practice at some time. The thoracic surgeon, whether treating such patients in the practice of congenital heart surgery, or in the practice of adult cardiac or thoracic surgery must have a requisite understanding of such anatomic variants, their diagnostic workup and radiologic interpretation, as well as their surgical management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29149268/mitral-valve-replacement-with-the-novel-tribio-and-an-established-stented-bioprosthesis-in-a-sheep-model
#5
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: Heart valve replacement with a bioprosthesis is one of the most frequently performed procedures in cardiac surgery and represents a highly effective therapy to relieve diseased heart valves. Nevertheless, as postoperatively elevated transvalvular gradients and prosthesis-patient mismatch are reported as shortcomings of the procedure or of the currently used devices, there is a need for novel bioprostheses with improved haemodynamics. This study presents preclinical haemodynamic results after mitral valve replacement with the novel TRIBIO bioprosthesis (TRIBIO) compared with an established bioprosthesis in a sheep model...
November 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#6
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29148290/single-centre-experience-with-the-impella-cp-5-0-and-rp-in-109-consecutive-patients-with-profound-cardiogenic-shock
#7
Peter Blom Jensen, Sigrun Høegholm Kann, Karsten Tange Veien, Ole Kristian Møller-Helgestad, Jordi Sanchez Dahl, Charlotte Svejstrup Rud, Marianne Kjær Jensen, Lisette Okkels Jensen, Henrik Schmidt, Jacob Eifer Møller
RATIONALE: Short-term mechanical circulatory support is increasingly used in the management of cardiogenic shock, but data from controlled studies are sparse. Thus, real-life data on complication rates and predictors of adverse outcome are important. OBJECTIVE: The objective of this study was to analyse the experience with Impella devices in the management of profound cardiogenic shock. METHODS AND RESULTS: A retrospective study of 109 consecutive patients with severe shock after myocardial infarction, acute heart failure, or cardiac surgery...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29148256/toward-standardization-of-care-the-feeding-readiness-assessment-after-congenital-cardiac-surgery
#8
Daniel E Ehrmann, Matthew Mulvahill, Shaunda Harendt, Jessica Church, Amy Stimmler, Piyagarnt Vichayavilas, Sanja Batz, Jennifer Rodgers, Michael DiMaria, James Jaggers, Cindy Barrett, Jon Kaufman
BACKGROUND: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care. METHODS: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center...
November 17, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#9
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29147786/risk-factors-for-development-of-ectopic-atrial-tachycardia-in-post-operative-congenital-heart-disease
#10
Bradley C Clark, John T Berger, Charles I Berul, Richard A Jonas, Jonathan R Kaltman, Julianne Lapsa, Dilip S Nath, Elizabeth D Sherwin, Pranava Sinha, David Zurakowski, Jeffrey P Moak
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#11
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29144053/the-impact-of-flow-pra-on-outcome-in-pediatric-heart-recipients-in-modern-era-an-analysis-of-the-pediatric-heart-transplant-study-database
#12
B B Das, E Pruitt, K Molina, W Ravekes, S Auerbach, A Savage, L Knox, J K Kirklin, D C Naftel, D Hsu
Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by SPA using Luminex or flow cytometry with a positive retrospective cross-match and the post-transplant outcomes of acute rejection and graft survival. A total of 1459 of 1596 (91%) recipients had a PRA reported pretransplant; 26% had a PRA > 20%. Patients with a PRA > 20% were more likely to have CHD, prior cardiac surgery, ECMO support at listing, and waited longer for transplantation than patients with a PRA <20%...
November 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29142633/risk-factors-of-delayed-surgical-intervention-after-conservatively-treated-acute-traumatic-subdural-hematoma
#13
Hyungjoo Kwon, Kyu-Sun Choi, Hyeong-Joong Yi, Hyoung-Joon Chun, Young-Jun Lee, Dong-Won Kim
Objective: Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods: From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#14
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#15
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138760/cardiac-surgery-after-heart-transplantation-elective-operation-or-last-exit-strategy
#16
Johannes Goekler, Andreas Zuckermann, Emilio Osorio, Faris F Brkic, Keziban Uyanik-Uenal, Guenther Laufer, Arezu Aliabadi-Zuckermann
Background: Because of improved long-term survival after heart transplantation (HTx), late graft pathologies such as valvular disease or cardiac allograft vasculopathy (CAV) might need surgical intervention to enhance longer survival and ensure quality of life. To this date, there exist no guidelines for indication of cardiac surgery other than retransplantation after HTx. Methods: In this retrospective, single-center study, we evaluated patients who underwent cardiac surgery after HTx at our institution...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29138366/lower-repeat-revascularization-rates-among-patients-with-prior-coronary-artery-bypass-graft-surgery-are-due-to-lack-of-adequate-target-vessels
#17
Anirudh Kumar, John F Wagener, Daniel Wojdyla, W Schuyler Jones, Manesh R Patel, Sunil V Rao
BACKGROUND: Studies comparing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in patients with multivessel coronary artery disease (CAD) have shown lower repeat revascularization rates in patients who undergo CABG. The reason remains unclear. METHODS: We identified patients with multivessel CAD who received CABG or PCI enrolled in the Duke Databank for Cardiovascular Disease (2003 to 2012). We compared the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) between the two groups...
November 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#18
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29137584/dexmedetomidine-associated-hyperthermia-a-retrospective-cohort-study-of-intensive-care-unit-admissions-between-2009-and-2016
#19
Ked Grayson, A E Tobin, T K Lim, D E Reid, M Ghani
Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#20
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
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