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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28329291/coronary-artery-bypass-graft-surgery-versus-drug-eluting-stent-implantation-for-high-surgical-risk-patients-with-left-main-or-multivessel-coronary-artery-disease
#1
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: There are limited data comparing long-term outcomes of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with high surgical risk. We evaluated 5-year outcomes following CABG versus PCI with DES in 598 patients with left main or multivessel coronary artery disease (CAD) and a high surgical risk [EuroSCORE (European system for cardiac operative risk evaluation) ≥ 6]. METHODS: Databases were merged from the BEST, PRECOMBAT and SYNTAX trials...
December 20, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28321002/five-year-outcomes-of-the-first-pivotal-clinical-trial-of-balloon-expandable-transcatheter-aortic-valve-replacement-in-japan-prevail-japan
#2
Yoshiki Sawa, Morimasa Takayama, Tsuyoshi Goto, Shuichiro Takanashi, Tatsuhiko Komiya, Tetsuya Tobaru, Koichi Maeda, Toru Kuratani, Yasushi Sakata
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320316/clinical-outcomes-of-conventional-surgery-versus-mitraclip%C3%A2-therapy-for-moderate-to-severe-symptomatic-mitral-valve-regurgitation-in-the-elderly-population-an-institutional-experience
#3
Anthony Alozie, Liliya Paranskaya, Bernd Westphal, Alexander Kaminski, Mohammad Sherif, Magnus Sindt, Stephan Kische, Jochen Schubert, Doreen Diedrich, Hüseyin Ince, Gustav Steinhoff, Alper Öner
BACKGROUND: The aim of this study was to compare treatment of moderate to severe symptomatic mitral regurgitation (MR) with either conventional surgery or the mitral valve edge-to-edge device (MitraClip®) in very elderly patients. The newly introduced MitraClip device has demonstrated promising acute results in treating this patient cohort. Also noteworthy is the fact that patients who otherwise would have been denied surgery are increasingly referred for treatment with the MitraClip device...
March 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28303630/comparison-of-5-year-outcomes-of-paclitaxel-eluting-and-endeavor-zotarolimus-eluting-stents-in-new-york
#4
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVES: To evaluate long-term outcomes in patients undergoing either paclitaxel-eluting stents (PES) or endeavor zotarolimus-eluting stents (E-ZES) placement and to assess comparative effectiveness of PES vs. E-ZES in different "off-label" and "high-risk" patient subgroups. BACKGROUND: PES and E-ZES are frequently used in percutaneous coronary interventions (PCIs). However, the long-term comparative effectiveness of PES vs. E-ZES in real practice is unknown...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28299450/the-prevalence-of-post-thyroidectomy-chronic-asthenia-a-prospective-cohort-study
#5
Gregorio Scerrino, Giuseppina Melfa, Cristina Raspanti, Andrea Attard, Sergio Mazzola, Roberto Gullo, Sebastiano Bonventre, Marco Attard, Gianfranco Cocorullo, Gaspare Gulotta
PURPOSE: Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. METHODS: A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre- and post-operative thyroid hormone levels, and BMI outside the normal range...
March 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28291723/cardiac-surgery-in-systemic-lupus-erythematosus-patients-clinical-characteristics-and-outcomes
#6
Javier Tejeda-Maldonado, Lauro Quintanilla-González, Jaime Galindo-Uribe, Andrea Hinojosa-Azaola
OBJECTIVES: To study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery. METHODS: Retrospective analysis of 30 SLE patients who underwent cardiac surgery at a single center. Demographics, comorbidities, clinical and serologic characteristics, cardiovascular risk scores and treatment were recorded. Type of surgery, postoperative complications, mortality and histology were analyzed. RESULTS: Disease duration at surgery was 2 years...
March 11, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28288051/long-term-effects-of-remote-ischemic-preconditioning-on-kidney-function-in-high-risk-cardiac-surgery-patients-follow-up-results-from-the-renalrip-trial
#7
Alexander Zarbock, John A Kellum, Hugo Van Aken, Christoph Schmidt, Mira Küllmar, Peter Rosenberger, Sven Martens, Dennis Görlich, Melanie Meersch
BACKGROUND: In a multicenter, randomized trial, the authors enrolled patients at high-risk for acute kidney injury as identified by a Cleveland Clinic Foundation score of 6 or more. The authors enrolled 240 patients at four hospitals and randomized them to remote ischemic preconditioning or control. The authors found that remote ischemic preconditioning reduced acute kidney injury in high-risk patients undergoing cardiac surgery. The authors now report on the effects of remote ischemic preconditioning on 90-day outcomes...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28267981/healthcare-associated-infections-in-cardiac-surgery-patients-with-prolonged-intensive-care-unit-stay
#8
Michael Mazzeffi, James Gammie, Bradley Taylor, Sarah Cardillo, Nicholina Haldane-Lutterodt, Anthony Amoroso, Anthony Harris, Kerri Thom
BACKGROUND: Healthcare-associated infections (HAIs) are responsible for many deaths of hospitalized patients each year. Patients with prolonged hospitalization are at high risk for HAIs. Increased efforts have been made to decrease these infections, but a recent report from the Centers for Disease Control suggests that some HAIs may be increasing. We hypothesized that HAIs would remain frequent among cardiac surgery patients with prolonged intensive care unit stay and would be associated with increased mortality...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267752/serum-glycated-hemoglobin-level-as-a-predictor-of-atrial-fibrillation-a-systematic-review-with-meta-analysis-and-meta-regression
#9
Wenwei Qi, Nixiao Zhang, Panagiotis Korantzopoulos, Konstantinos P Letsas, Min Cheng, Fusheng Di, Gary Tse, Tong Liu, Guangping Li
BACKGROUND AND AIM: Glycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the utility of HbA1c level in predicting AF. METHODS: PubMed and the Cochrane Library databases were searched for relevant studies up to March 2016. Prospective cohort studies and retrospective case-control studies were included...
2017: PloS One
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#10
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28262296/duration-of-mechanical-ventilation-and-perioperative-care-quality-after-neonatal-cardiac-operations
#11
Joshua J Blinder, Ravi Thiagarajan, Kathryn Williams, Meena Nathan, John Mayer, Thomas J Kulik
BACKGROUND: This study was conducted to determine whether the duration of mechanical ventilation (DOMV) could be used to benchmark the overall quality of care after neonatal congenital heart operations. METHODS: Children aged younger than 30 days undergoing cardiac operations were reviewed. Technical adequacy was assessed using the Technical Performance Score (TPS), a previously validated tool for determining the adequacy of a palliative or corrective surgical procedure that uses echocardiography criteria and need for unplanned reintervention to determine technical adequacy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28250485/mortality-prediction-in-indian-cardiac-surgery-patients-validation-of-european-system-for-cardiac-operative-risk-evaluation-ii
#12
Prachi Kar, Kanithi Geeta, Ramachandran Gopinath, Padmaja Durga
BACKGROUND AND AIMS: Risk Stratification has an important place in cardiac surgery to identify high-risk cases and optimally allocate resources. Hence various risk scoring systems have been tried to predict mortality. The aim of the present study was to validate the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) in Indian cardiac surgical patients. METHODS: After obtaining ethics committee clearance, data on EuroSCORE II variables were collected for all patients >18 years undergoing on-pump coronary artery bypass graft (CABG), valve surgery and mixed (CABG + valve) procedures between January 2011 and December 2012...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28248604/middle-ear-obliteration-with-blind-sac-closure-of-the-external-auditory-canal-for-spontaneous-csf-otorrhea
#13
Shawn M Stevens, Ryan Crane, Myles L Pensak, Ravi N Samy
Outcome Objectives To (1) identify unique features of patients who underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal for spontaneous cerebrospinal fluid (CSF) otorrhea and (2) explore outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults treated for spontaneous cerebrospinal fluid otorrhea from 2007 through 2015 were reviewed and stratified into 2 groups based on the surgery performed: (1) 11 patients underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal and (2) 26 patients underwent other procedures...
March 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#14
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
February 20, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28237986/relationship-among-mortality-of-patients-with-acute-kidney-injury-after-cardiac-surgery-fluid-balance-and-ultrafiltration-of-renal-replacement-therapy-an-observational-study
#15
Buyun Wu, Jian Sun, Si Liu, Xiangbao Yu, Yamei Zhu, Huijuan Mao, Changying Xing
BACKGROUND/AIMS: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT). METHODS: From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed. RESULTS: The 30-day mortality of all the 63 patients in the study was 58...
February 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/28228937/predictors-of-total-morbidity-burden-on-days-3-5-and-8-after-cardiac-surgery
#16
Julie Sanders, Jackie Cooper, Michael G Mythen, Hugh E Montgomery
BACKGROUND: Post-operative morbidity affects up to 36% of cardiac surgical patients. However, few countries reliably record morbidity outcome data, despite patients wanting to be informed of all the risks associated with surgery. The Cardiac Post-Operative Morbidity Score (C-POMS) is a new tool for describing and scoring (0-13) total morbidity burden after cardiac surgery, derived by noting the presence/absence of 13 morbidity domains on days 3, 5, 8 and 15. Identifying modifiable C-POMS risk factors may suggest targets for intervention to reduce morbidity and healthcare costs...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28223056/transcatheter-aortic-valve-in-valve-implantation-using-lotus-valve-for-failed%C3%A2-surgical-bioprostheses
#17
Fausto Castriota, Roberto Nerla, Antonio Micari, Caterina Cavazza, Francesco Bedogni, Luca Testa, Matteo Montorfano, Mauro Del Giglio, Alberto Cremonesi
BACKGROUND: Patients with failed bioprostheses are an increasing population at high risk for redo surgery. Valve-in-valve transcatheter aortic valve implantation is a promising alternative but a limited number of first-generation devices have proven efficacy in all cases. METHODS: Patients with degenerated bioprostheses at high risk for redo surgery were included in the registry after being assigned to valve-in-valve intervention by a local heart team. Main basal and follow-up data (at 1 month and 6 months) of patients undergoing valve-in-valve transcatheter aortic valve implantation with the Lotus valve system (Boston Scientific, Natick, MA) in three high-volume Italian centers were entered in the registry...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#18
REVIEW
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Javier Mendoza, Florencia Sartori
PURPOSE OF REVIEW: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings. RECENT FINDINGS: Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28205344/utility-of-a-standardized-postcardiopulmonary-bypass-epicardial-echocardiography-protocol-for-stage-i-norwood-palliation
#19
Kenan W D Stern, Kimberlee Gauvreau, Sitaram Emani, Tal Geva
OBJECTIVE: Stage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known...
February 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28202201/acute-kidney-injury-is-an-independent-risk-factor-for-myocardial-injury-after-noncardiac-surgery-in-critical-patients
#20
Xiu-Juan Zhao, Feng-Xue Zhu, Shu Li, Hong-Bin Zhang, You-Zhong An
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) contributes to mortality and morbidity. However, risk factors accelerating its development remain unclear. The aim of this study was to identify the incidence and risk factors of MINS. METHODS: A retrospective and observational cohort study of critical patients (n=1087) after noncardiac surgery was carried out at a large and tertiary university hospital from January 2012 to January 2013. The clinical data including medical history as well as intraoperative and postoperative variables were recorded...
January 26, 2017: Journal of Critical Care
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