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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28228937/predictors-of-total-morbidity-burden-on-days-3-5-and-8-after-cardiac-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28197281/prediction-of-symptomatic-embolism-in-filipinos-with-infective-endocarditis-using-the-embolic-risk-french-calculator
#6
Jaime Alfonso M Aherrera, Maria Teresa B Abola, Maria Margarita O Balabagno, Lauro L Abrahan, Jose Donato A Magno, Paul Ferdinand M Reganit, Felix Eduardo R Punzalan
BACKGROUND: Cardioembolic events are life-threatening complications of infective endocarditis (IE). The embolic risk French calculator estimates the embolic risk in IE computed on admission. Variables in this tool include age, diabetes, atrial fibrillation, prior embolism, vegetation length, and Staphylococcus aureus on culture. A computed risk of > 7% was considered high in the development of this tool. Knowledge of this risk applied in our local setting is important to guide clinicians in preventing such catastrophic complications...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28197046/outcome-of-noncardiac-surgical-patients-admitted-to-a-multidisciplinary-intensive-care-unit
#7
Pradeep Kumar, M K Renuka, M S Kalaiselvan, A S Arunkumar
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#8
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28194489/the-effect-of-preoperative-anemia-on-the-outcome-after-coronary-surgery
#9
Tuomas Tauriainen, Joni Koski-Vähälä, Eeva-Maija Kinnunen, Fausto Biancari
BACKGROUND: Preoperative anemia is associated with increased morbidity and mortality after cardiac surgery. Since anemia is ultimately treated with red blood cell transfusions, we investigated the independent impact of anemia and transfusion on the outcome after coronary artery bypass grafting (CABG). METHODS: This study included 2761 consecutive patients who underwent isolated CABG. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men...
February 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#10
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28186624/adverse-events-associated-with-antipsychotic-use-in-hospitalized-older-adults-after-cardiac-surgery
#11
Dae H Kim, Krista F Huybrechts, Elisabetta Patorno, Edward R Marcantonio, Yoonyoung Park, Raisa Levin, Abdurrahman Abdurrob, Brian T Bateman
OBJECTIVES: To evaluate in-hospital adverse events associated with typical and atypical antipsychotic medications (APMs) after cardiac surgery. DESIGN: Retrospective cohort study. SETTING: Nationwide inpatient database, 2003 to 14. PARTICIPANTS: Individuals (mean age 70) newly treated with oral atypical (n = 2,580) or typical (n = 1,126 APMs) after coronary artery bypass grafting or valve surgery (N = 3,706). MEASUREMENTS: In-hospital mortality, arrhythmia, pneumonia, use of brain imaging (surrogate for oversedation and neurological events), and length of stay after drug initiation RESULTS: In the propensity score-matched cohort, median treatment duration was 3 days (interquartile range (IQR) 1-6 days) for atypical APMs and 2 days (IQR 1-3 days) for typical APMs...
February 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28183564/the-effect-of-tramadol-plus-paracetamol-on-consumption-of-morphine-after-coronary-artery-bypass-grafting
#12
Dilek Altun, Özlem Çınar, Emre Özker, Ayda Türköz
STUDY OF OBJECTIVE: To compare the effects of oral tramadol+paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol. DESIGN: A prospective, double-blind, randomized, clinical study. SETTING: Single-institution, tertiary hospital. PATIENTS: Fifty cardiac surgical patients undergoing primary CABG surgery. INTERVENTIONS: After surgery, the patients were allocated to 1 of 2 groups...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28171827/vascular-inflammation-and-media-calcification-are-already-present-in-early-stages-of-chronic-kidney-disease
#13
Kerstin Benz, Ildiko Varga, Daniel Neureiter, Valentina Campean, Christoph Daniel, Christian Heim, Albrecht Reimann, Michael Weyand, Karl F Hilgers, Kerstin Amann
BACKGROUND: While patients with chronic kidney disease (CKD) have a high prevalence of classical coronary risk factors, there is increasing evidence that atherosclerosis is different in renal compared to nonrenal patients. Therefore, the present study compares changes in different vessels obtained at cardiac surgery between patients with early and advanced CKD and nonrenal control patients. METHODS AND RESULTS: Fifty patients undergoing cardiac bypass surgery were divided into three groups: (i) 24 control patients with creatinine <1...
January 23, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28160375/heparin-versus-bivalirudin-for-non-primary-percutaneous-coronary-intervention-a-post-hoc-analysis-of-the-cport-e-trial
#14
Matthew J Czarny, Chao-Wei Hwang, Daniel Q Naiman, Cynthia C Lemmon, Rani K Hasan, Thomas Wang, Thomas Aversano
OBJECTIVES: To compare bivalirudin to heparin during non-primary percutaneous coronary intervention (PCI). BACKGROUND: The optimal anticoagulant to support PCI remains uncertain. METHODS: We performed a propensity score-based analysis comparing clinical outcomes of patients receiving heparin to those receiving bivalirudin during non-primary PCI. RESULTS: Of 18,867 patients in the Cardiovascular Patient Outcomes Research Team Non-Primary PCI (CPORT-E) trial, we selected 7,913 patients undergoing non-staged PCI of whom 57...
February 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28147253/minimally-invasive-vs-open-congenital-diaphragmatic-hernia-repair-is-there-a-superior-approach
#15
Luke R Putnam, Kuojen Tsao, Kevin P Lally, Martin L Blakely, Tim Jancelewicz, Pamela A Lally, Matthew T Harting
BACKGROUND: The minimally-invasive (MIS) approach for congenital diaphragmatic hernia (CDH) repair remains controversial. Our objective was to compare outcomes and complications of the MIS and open approaches, with risk-stratification of patients based on defect size and key patient characteristics. STUDY DESIGN: The multi-national CDH Study Group (CDHSG) registry was queried for the period from 2007-2015. Patient demographics and operative details including the CDHSG Staging System defect size (A-D) were reviewed...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28143401/acute-kidney-injury-induces-high-sensitivity-troponin-measurement-changes-after-cardiac-surgery
#16
Amr S Omar, Khaled Mahmoud, Samy Hanoura, Hany Osman, Praveen Sivadasan, Suraj Sudarsanan, Yasser Shouman, Rajvir Singh, Abdulaziz AlKhulaifi
BACKGROUND: The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS: Single center observational retrospective study...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28140303/-off-pump-coronary-revascularization-late-survival
#17
Juan Espinoza, Mariano Camporrontondo, Mariano Vrancic, Fernando Piccinini, Juan Camou, Daniel Navia
Although randomized clinical trials have compared the short-term results of coronary revascularization with on-pump vs. off-pump, the long-term survival effect of off-pump coronary surgery has not been analyzed. The aim of this study was to compare the long-term survival of patients with coronary surgery with off-pump technique. All patients that underwent coronary revascularization from November 1996 to March 2015 were included (n = 4687). We analyzed the long-term survival and the incidence of cardiac events between patients who received off-pump coronary revascularization (n = 3402) against those revascularized with on-pump technique (n = 1285)...
2017: Medicina
https://www.readbyqxmd.com/read/28133683/restrictive-and-liberal-fluid-administration-in-major-abdominal-surgery
#18
Qianyun Pang, Hongliang Liu, Bo Chen, Yan Jiang
To determine whether perioperative fluid restrictive administration can reduce specific postoperative complications in adults undergoing major abdominal surgery.  Methods: We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, Google scholar, and article reference lists (up to December 2015) for studies that assessed fluid therapy and morbidity or mortality in patients undergoing major abdominal surgeries. The quality of the trials was assessed using the Jadad scoring system, and a meta-analysis of the included randomized, controlled trials was conducted using Review Manager software, version 5...
February 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28131428/a-new-intraoperative-protocol-for-reducing%C3%A2-perioperative-transfusions-in%C3%A2-cardiac-surgery
#19
J Hunter Mehaffey, Sarah A Schubert, Michael G Gelvin, Eric J Charles, Robert B Hawkins, Lily E Johnston, Gorav Ailawadi, Irving L Kron, Leora T Yarboro
BACKGROUND: Perioperative anemia and blood product transfusion increases short-term and long-term morbidity and mortality during cardiac surgery. We hypothesized that streamlined cardiopulmonary bypass circuit and rotational thromboelastometry (ROTEM) would reduce blood product usage and improve outcomes. METHODS: All patients with Society of Thoracic Surgeons risk scores at our institution from January 2013 to June 2015 were included. Individuals were chronologically stratified into 2 groups according to institutional changes to a streamlined bypass circuit and ROTEM-guided transfusion...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28126156/syntax-score-and-long-term%C3%A2-outcomes-the-bari-2d-trial
#20
Fumiaki Ikeno, Maria Mori Brooks, Kaori Nakagawa, Min-Kyu Kim, Hideaki Kaneda, Yoshiaki Mitsutake, Helen A Vlachos, Leonard Schwartz, Robert L Frye, Sheryl F Kelsey, Katsuhisa Waseda, Mark A Hlatky
BACKGROUND: The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. OBJECTIVES: This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial...
January 31, 2017: Journal of the American College of Cardiology
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