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Cardiovascular surgery

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https://www.readbyqxmd.com/read/28109574/revascularization-strategies-and-outcomes-in-elderly-patients-with-multivessel-coronary-disease
#1
J Trevor Posenau, Daniel M Wojdyla, Linda K Shaw, Karen P Alexander, E Magnus Ohman, Manesh R Patel, Peter K Smith, Sunil V Rao
BACKGROUND: Balancing risks and benefits of revascularization in elderly patients with multivessel coronary artery disease (CAD) is challenging. The appropriate revascularization strategy for elderly patients with multivessel CAD is unclear. METHODS: We used the Duke Databank for Cardiovascular Disease to identify patients aged 75 years or more who had multivessel disease and treatment with percutaneous coronary intervention or coronary artery bypass graft surgery (CABG) within 30 days of the index catheterization between October 1, 2003, and June 30, 2013...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28106023/robotic-surgery-for-atrial-septal-defect-closure-in-a-case-of-kabuki-syndrome
#2
Burak Onan, Ünal Aydın, Zeynep Kahraman, İhsan Bakır
Kabuki syndrome is a rare congenital malformation syndrome characterized by mental retardation, skeletal deformities, auditory dysfunction, cardiac defects, and distinctive facial appearance. Although complex cardiovascular malformations present in early childhood, rarely, atrioventricular septal defects may also present in young adults. Presently described is case of a 22-year-old female with KS who presented with ostium secundum atrial septal defect with deficient rim and idiopathic thrombocytopenic purpura...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#3
Avisa Tabib, Seyed Ehsan Abrishami, Mohammad Mahdavi, Hojjat Mortezaeian, Ziae Totonchi
BACKGROUND: The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. OBJECTIVES: The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28105299/geographic-variation-in-selected-hospital-procedures-and-services-in-the-israeli-health-care-system
#4
Joseph Mendlovic, Ethel-Sherry Gordon, Ziona Haklai, Jill Meron, Arnon Afek
BACKGROUND: Medical practice variation refers to differences in health service utilization among regions in the same country. It is used as a tool for studying health inequities. In 2011, the OECD launched a Medical Practice Variation Project which examines regional differences within countries and explores the sources of the inter-regional differences. The aim of this study is to examine the patterns and trends in geographic variation for selected health services in Israel. METHODS: The analysis is based on data from the National Hospital Discharges Database (NHDD) of the Israeli Ministry of Health...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28105141/conservative-pharmacotherapy-vs-staged-percutaneous-coronary-intervention-for-non-culprit-vessels-in-patients-with-st-segment-elevation-myocardial-infarction
#5
Bo Zhao, Jianjun Peng, Lihui Ren, Licheng Lei, Zuoyan Wang, Huiming Ye
The present study aimed to compare the effect of conservative pharmacotherapy (CP) and staged percutaneous coronary intervention (SPCI) on significant non-culprit vessels in patients with ST-segment elevation myocardial infarction (STEMI). A total of 266 male and 40 female patients were divided into two groups following their first successful PCI treatment: i) Patients in the complete revascularization (CR) group undergoing SPCI; and ii) patients in the CP group undergoing CP. Follow-up data were collected at 180 or 360 days after surgery to compare the rates of major adverse cardiovascular events (MACE), recurrent myocardial infarction, recurrent angina pectoris and MACE-free survival rates between the two groups...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#6
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#7
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28104097/5-nahco3-is-appropriate-for-skin-cleaning-with-central-venous-catheters
#8
Hong-Lei Wu, Yang-Hui Xu, Jia-Hai Shi
OBJECTIVES: The purpose of this study was to compare the effects of skin cleaning with 5% NaHCO3 to 75% alcohol on the removal of skin grease and pain of patients with central venous catheters (CVC). MATERIALS AND METHODS: This was a randomized, controlled, single-blinded and prospective study. From January-September 2015, 143 consecutive patients who met the inclusion and exclusion criteria and who underwent elective cardiovascular surgery with placement of a CVC were selected...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28103931/developing-a-framework-to-guide-the-de-adoption-of-low-value-clinical-practices-in-acute-care-medicine-a-study-protocol
#9
Jeanna Parsons Leigh, Daniel J Niven, Jamie M Boyd, Henry T Stelfox
BACKGROUND: Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28101839/surgical-treatment-of-ischemic-mitral-regurgitation-valve-repair-versus-replacement
#10
REVIEW
Abhishek Sharma, Sahil Agrawal, Sunny Goel, Jeffrey S Borer
PURPOSE OF REVIEW: Ischemic mitral regurgitation (MR), which occurs in about 20-30% patients with a prior myocardial infarction, is associated with worsening heart failure and an increase in cardiovascular mortality. It should be treated surgically if certain hemodynamic severity criteria are met and in patients who continue to experience symptoms of heart failure despite optimal medical therapy. However, current guidelines do not suggest which of the available approaches to mitral valve surgery-mitral valve (MV) repair or replacement (MVR) is superior for this indication...
January 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28100940/surgery-in-pancreatic-necrosis-challenges-and-outcomes-in-an-industrial-hospital
#11
Ashok Chattoraj, Sunil Kumar
Twenty-seven cases of pancreatic necrosis were admitted and treated at our hospital from Jan 2010 till Jan 2015. Eight of these patients (29 %) underwent pancreatic necrosectomy. Of a total number of 957 patients admitted for acute pancreatitis, 27 patients (3 %) were diagnosed to have necrotizing pancreatitis. Of the 8 patients operated on, 5 patients (62.5 %) were treated successfully. The 3 patients who died had 3 organ (renal, respiratory and cardiovascular) failures. Nineteen patients of pancreatic necrosis responded to medical management and were successfully treated...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100523/endothelial-dysfunction-in-the-early-postoperative-period-after-major-colon-cancer-surgery
#12
S Ekeloef, M H H Larsen, A M V Schou-Pedersen, J Lykkesfeldt, J Rosenberg, I Gögenür
BACKGROUND: Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide pathway postoperatively. METHODS: Patients undergoing elective colon cancer surgery (n = 31) were included in this prospective observational cohort study. Endothelial function, as measured using the reactive hyperaemia index (RHI), was assessed non-invasively using digital pulse tonometry...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099297/sedentary-behavior-cadence-and-physical-activity-outcomes-after-knee-arthroplasty
#13
Sandra C Webber, Shaelyn M Strachan, Navjot S Pachu
PURPOSE: This study comprehensively examined sedentary behaviour and physical activity patterns in people with severe knee osteoarthritis awaiting total knee arthroplasty (TKA) and in individuals after TKA. METHODS: Pre-operative (n=32, mean ± SD = 69.9 ± 5.3 yr) and one-year post-operative participants with TKA (n=38, 67.9 ± 7.3 yr) wore ActiGraph GT3X+ activity monitors for 6.8 ± 0.6 days. Total sedentary time, time in long sedentary bouts (≥ 30 min) and physical activity outcomes (steps, time in moderate-to-vigorous physical activity [MVPA], cadence) were examined...
January 17, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#14
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28096572/current-and-emerging-treatments-for-hypercholesterolemia-a-focus-on-statins-and-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-for-perioperative-clinicians
#15
REVIEW
Terrence L Trentman, Steven G Avey, Harish Ramakrishna
Statins are a mainstay of hyperlipidemia treatment. These drugs inhibit the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase and have beneficial effects on atherosclerosis including plaque stabilization, reduction of platelet activation, and reduction of plaque proliferation and inflammation. Statins also have a benefit beyond atherosclerotic plaque, including anticoagulation, vasodilatation, antioxidant effects, and reduction of mediators of inflammation. In the perioperative period, statins appear to contribute to improved outcomes via these mechanisms...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096044/use-of-transesophageal-echocardiography-and-contrast-echocardiography-in-the-evaluation-of-cardiac-masses
#16
Hongmei Xia, Ling Gan, Yan Jiang, Qi Tang, Ping Zhang, Xuefeng Tang, Li Wen, Zheng Liu, Yunhua Gao
OBJECTIVES: To determine whether the combination of transesophageal echocardiography (TEE) and contrast echocardiography (CE) accurately diagnose suspected cardiac masses using large sample data. METHODS: Patients with cardiac masses undergoing surgical treatment were enrolled in this study. Routine transthoracic echocardiography (TTE) and TEE examinations were carried out, and CE examinations were carried out when needed. All patients' clinical data and imaging features were retrospectively reviewed...
January 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28094561/the-perioperative-dental-screening-and-management-of-patients-undergoing-cardiothoracic-vascular-surgery-and-other-cardiovascular-invasive-procedures-a-systematic-review
#17
Elisabetta Cotti, Mariantonietta Arrica, Andrea Di Lenarda, Sara B Serri, Pierpaolo Bassareo, Luigi Padeletti, Giuseppe Mercuro
Background One controversial issue in the relationship between oral care and cardiovascular diseases is how and whether to manage oral infections prior to cardiovascular surgery or other cardiovascular invasive procedures. Design We designed a systematic review to assess the information available on three main questions. Is there an agreement on the need for dental evaluation and treatment before cardiovascular interventions? Are consistent clinical recommendations or protocols available? Is dental treatment prior to cardiovascular interventions effective? Methods A systematic electronic search of MEDLINE, Scopus and Web of Science was performed from the database inceptions up to 31 April 2016...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#18
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28090354/what-weight-loss-treatment-options-do-geriatric-patients-with-overweight-and-obesity-want-to-consider
#19
M MacMillan, K Cummins, K Fujioka
INTRODUCTION: Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. OBJECTIVE: This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity...
December 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/28089997/the-impact-of-age-and-sex-on-in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention
#20
Aris Karatasakis, Rahel Iwnetu, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul Patel, Ehtisham Mahmud, William L Lombardi, R Michael Wyman, J Aaron Grantham, Anthony H Doing, Catalin Toma, James W Choi, Barry F Uretsky, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively...
January 15, 2017: Journal of Invasive Cardiology
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