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T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Madhu Bhamidipaty, Barend Mees, Timothy Wagner
While the intra-aortic balloon pump (IABP) itself has many useful and life-saving indications, it has a high complication rate, up to 30% in some studies. This report discusses the surgical removal and subsequent vascular repair in a patient with a ruptured and subsequently entrapped IABP and reviews the literature on the presentation and management of this rare but major complication.
April 2016: Aorta (Stamford, Conn.)
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
R Q Zhu, C Z Liu, J H Lu, Y P Su, S C Wen, G J Nie, Y Z Hu, L E Zuo
Objective: To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients. Methods: Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed. The clinical status before ECMO support, ECMO timing, complications and outcome were observed and analyzed.The hemodynamic data and the amount of vasoactive drugs at 2 hours before ECMO support and at 2, 6, 24 and 48 hours after ECMO support were collected and compared...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Łukasz Lewicki, Janusz Siebert, Jan Rogowski
BACKGROUND: Postoperative atrial fibrillation (AF) is a common arrhythmia that occurs after coronary artery bypass grafting (CABG). New surgical techniques, particularly off-pump coronary artery bypass (OPCAB), are thought to be less invasive and results in fewer complications, i.e. AF, but available data are inconsistent. The aim of this study is to present the incidence and risk factors of AF in patients operated on with or without cardiopulmonary bypass. METHODS: We studied 1836 consecutive patients with stable coronary artery disease who were operated on with (CABG) or without (OPCAB) cardiopulmonary bypass...
September 26, 2016: Cardiology Journal
Kevin Ergle, Parham Parto, Selim R Krim
BACKGROUND: Despite recent advances in the management of heart failure, cardiogenic shock remains a challenging and devastating condition with significant morbidity and mortality. METHODS: We review currently available percutaneous mechanical circulatory support (MCS) devices and address each device's characteristics, mechanism of action, specific clinical indications, and contraindications. RESULTS: Four types of percutaneous MCS devices are currently available: the intraaortic balloon pump (IABP), Impella devices, the TandemHeart, and extracorporal membrane oxygenation (ECMO)...
2016: Ochsner Journal
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
R de la Espriella-Juan, A Valls-Serral, B Trejo-Velasco, A Berenguer-Jofresa, Ó Fabregat-Andrés, D Perdomo-Londoño, C Albiach-Montañana, J V Vilar-Herrero, D Sanmiguel-Cervera, E Rumiz-Gonzalez, S Morell-Cabedo
OBJECTIVE: To analyze the use and impact of the intra-aortic balloon pump (IABP) upon the 30-day mortality rate and short-term clinical outcome of non-selected patients with ST-elevation acute myocardial infarction (acute STEMI) complicated by cardiogenic shock (CS). DESIGN: A single-center retrospective case-control study was carried out. SETTING: Coronary Care Unit. PATIENTS: Data were collected from 825 consecutive patients with acute STEMI admitted to a Coronary Care Unit from January 2009 to August 2015...
September 17, 2016: Medicina Intensiva
Dagmar M Ouweneel, Jasper V Schotborgh, Jacqueline Limpens, Krischan D Sjauw, A E Engström, Wim K Lagrand, Thomas G V Cherpanath, Antoine H G Driessen, Bas A J M de Mol, José P S Henriques
PURPOSE: Veno-arterial extracorporeal life support (ECLS) is increasingly used in patients during cardiac arrest and cardiogenic shock, to support both cardiac and pulmonary function. We performed a systematic review and meta-analysis of cohort studies comparing mortality in patients treated with and without ECLS support in the setting of refractory cardiac arrest and cardiogenic shock complicating acute myocardial infarction. METHODS: We systematically searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the publisher subset of PubMed updated to December 2015...
September 19, 2016: Intensive Care Medicine
Zeki Temizturk, Davut Azboy, Atakan Atalay, Hakan Atalay, Omer Faruk Dogan
OBJECTIVE: The aim of our study was to research the effects of levosimendan (LS) and sodium nitroprusside (SNP) combination on systolic and diastolic ventricular function after coronary artery bypass grafting (CABG) who required endoventricular patch repair (EVPR). PATIENTS AND METHODS: We studied 70 patients with ischemic dilated cardiomyopathy. LS and SNP combination was administered in 35 patients (study group, SG). In the remaining patients, normal saline solution was given (placebo group, PG)...
2016: Open Cardiovascular Medicine Journal
Vikas Singh, Abdulla A Damluji, Rodrigo Mendirichaga, Carlos E Alfonso, Claudia A Martinez, Donald Williams, Alan W Heldman, Eduardo J de Marchena, William W O'Neill, Mauricio G Cohen
OBJECTIVE: Evaluate the use of mechanical circulatory support (MCS) devices in high-risk patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: The use of MCS devices in elderly patients with multiple comorbidities undergoing TAVR is underexplored. METHODS: All patients undergoing TAVR at a single tertiary academic center who required MCS during index procedure between 2008 and 2015 were included in a prospective database...
October 2016: Journal of Interventional Cardiology
Z W Gao, Y Z Huang, H M Zhao, H Sun
OBJECTIVE: To evaluate the effects of intra-aortic balloon counterpulsation (IABP) on mortality in patients with acute myocardial infarction according to the type of revascularization. METHODS: Recruited randomized controlled trials of IABP compared with no-IABP controls in acute myocardial infarction patients from January 1970 to May 2015 were searched from Medline, Embase and Cochrane Library, according to inclusion criteria and exclusion criteria. These data were analyzed using the methods recommended by the Cochrane Collaboration's software RevMan 5...
July 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
H Sun, Y J Yang, H Y Xu, J G Yang, X J Gao, Y Wu, W Li, Y Wang, J Liu, C Jin, L Song
OBJECTIVE: To investigate the medical care resources of acute myocardial infarction (AMI) in Chinese hospitals of different regions and levels. METHODS: We selected 115 hospitals in China, including 61 northern hospitals, 54 southern hospitals, 52 eastern hospitals, 26 central hospitals, 37 western hospitals, 79 tertiary hospitals, 36 secondary hospitals, 34 pro vincial-level hospitals, 46 prefectural-level hospitals and 35 county hospitals. From November 2012 to August 2013, we sent questionnaire to the cardiologists in each hospital, to collect related information...
July 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Christina Kolyva, John R Pepper, Ashraf W Khir
The major hemodynamic benefits of intra-aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (Paug ) during inflation, and decrease in end-diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB...
August 2016: Artificial Organs
Antonio Loforte, Giacomo Murana, Mariano Cefarelli, Giuliano Jafrancesco, Mario Sabatino, Sofia Martin Suarez, Emanuele Pilato, Davide Pacini, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
Early graft failure (EGF) is a major risk factor for death after heart transplantation (Htx). We investigated the predictive risk factors for moderate-to-severe EGF requiring an intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) circulatory support as treatment after Htx. Between January 2000 and December 2014, 412 consecutive adult patients underwent isolated Htx at our institution. Moderate and severe EGF were defined as the need for IABP and ECMO support, respectively, within 24 h after Htx...
August 2016: Artificial Organs
Marco Robin Schroeter, Herdis Köhler, Astrid Wachter, Annalen Bleckmann, Gerd Hasenfuß, Wolfgang Schillinger
AIMS: Impella is a microaxial rotary pump that is placed across the aortic valve to expel aspirated blood from the left ventricle into the ascending aorta; it can be used in cardiogenic shock. While previous studies have evaluated the efficacy and safety of the Impella device, more clinically relevant data are necessary, especially with regard to outcomes. METHODS AND RESULTS: We screened our database of Impella patients in our heart center and found 68 consecutive patients who underwent Impella implantation due to acute coronary syndrome (ACS) complicated by cardiogenic shock...
August 15, 2016: Journal of Invasive Cardiology
Mohammed Saad, Georg Fuernau, Steffen Desch, Ingo Eitel, Christian Jung, Janine Pöss, Steffen Schneider, Gerhard Schuler, Karl Werdan, Uwe Zeymer, Holger Thiele
BACKGROUND: Several studies in patients with acute myocardial infarction (AMI) without cardiogenic shock (CS) indicate a better survival in smokers, the so called "smoker's paradox". For CS, this relationship has not been investigated so far in the primary percutaneous coronary intervention (PCI) era. METHODS: In a predefined substudy of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial and its accompanying registry including patients with CS complicating AMI we investigated differences in outcome of smokers compared to non-smokers...
November 1, 2016: International Journal of Cardiology
Ali Abbas, Ahmed Mahmoud, Mustafa Ahmed, Juan Aranda, Charles T Klodell, Peter V Draganov
BACKGROUND: Gastrointestinal bleeding (GIB) is a common adverse event after mechanical circulatory support device implantation. However, the majority of the reported data were obtained from small single-center studies. Our aim was to study the prevalence and predictors of GIB during the index hospitalization of mechanical circulatory support devices implantation using a nationwide database. METHODS: Nationwide inpatient sample (2009-2011) was used to perform a retrospective cross-sectional study...
August 10, 2016: Digestive Diseases and Sciences
K C Hiew, A Sachithanandan, M Arif, B Badmanaban, A Muiz, I Faisal, L Hamdan, O Evi Diana
BACKGROUND: Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia. OBJECTIVES: To determine the incidence of AKI, the associated risk factors, and its impact on early mortality and intensive care unit/hospital stay. METHOD: This is a single centre retrospective observational study to evaluate outcomes on 1260 consecutive patients from a multi-ethnic Southeast Asian population who underwent a primary isolated coronary artery bypass graft (CABG) operation...
June 2016: Medical Journal of Malaysia
H Parissis, V Graham, S Lampridis, M Lau, G Hooks, P C Mhandu
Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon inflation contributes to the coronary circulation and the presystolic deflation of the balloon reduces the resistance to systolic output. Consequently, the myocardial work is reduced. The overall effect of the IABP therapy is an increase in the myocardial oxygen supply/demand ratio and thus in endocardial viability.This is an overall synopsis of what we need to know regarding IABP...
August 4, 2016: Journal of Cardiothoracic Surgery
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