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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28625392/a-novel-risk-score-to-predict-the-need-for-nutrition-support-after-cardiac-surgery
#1
Rika E Ohkuma, Todd C Crawford, Patricia M Brown, Joshua C Grimm, J Trent Magruder, Arman Kilic, Alejandro Suarez-Pierre, Sukyee Snyder, Justin D Wood, Eric Schneider, Marc S Sussman, Glenn J R Whitman
BACKGROUND: In specific patients, early postoperative nutrition mitigates malnutrition-related morbidity and mortality. The goal of this study was to develop and validate a prediction score designed to stratify patients immediately after cardiac surgery according to risk for nutrition support (NS). METHODS: We identified adult cardiac surgery patients at our institution in 2012 requiring postoperative NS, enteral or parenteral. Using multivariable logistic regression modeling, we developed a Johns Hopkins Hospital Nutrition Support (JHH NS) score from relative odds ratios generated by variables that independently predicted the need for NS...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#2
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625194/preoperative-malnutrition-is-associated-with-increased-mortality-and-adverse-outcomes-after-paediatric-cardiac-surgery
#3
Faith Ross, Gregory Latham, Denise Joffe, Michael Richards, Jeremy Geiduschek, Michael Eisses, Douglas Thompson, Monique Radman
BACKGROUND: Malnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery. METHODS: We conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children's Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes...
June 19, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#4
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28616346/emergent-aortic-surgery-in-octogenarians-is-the-advanced-age-a-contraindication
#5
REVIEW
Mario Castaño, Javier Gualis, Jose M Martínez-Comendador, Elio Martín, Pasquale Maiorano, Laura Castillo
Surgery of both the ascending and descending aortic segments in the context of an acute aortic syndrome is one of the greatest challenges for the cardiac surgeon. In the case of surgery of the descending aorta, surgical risk increases due to the technical complexity, the required aggressive approach and because surgical indication is usually established as a result of complications and therefore involves, almost always, critically ill patients. The aging of the population is causing such surgery to be considered in an increasing number of octogenarians...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612915/how-to-predict-the-risk-of-postoperative-complications-after-coronary-artery-bypass-grafting-in-patients-under-50-and-over-80-years-old-a-retrospective-cross-sectional-study
#6
Jacek Piątek, Anna Kędziora, Grzegorz Kiełbasa, Marta Olszewska, Dorota Sobczyk, Bryan HyoChan Song, Janusz Konstanty-Kalandyk, Tomasz Darocha, Karol Wierzbicki, Irena Milaniak, Krzysztof Wróbel, Bogusław Kapelak
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in developed countries and there is an increasing number of both young and elderly patients requiring surgical treatment. Despite improvement of conventional risk stratification scores (EuroSCORE II, STS risk score), all of the calculations are estimated based on the typical population and the studies emphasize that the scales may need further investigation and modernization, as demographic changes of the population suffering from CAD are unavoidable...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28602412/definitive-chemoradiation-therapy-for-esophageal-cancer-in-the-elderly-clinical-outcomes-for-patients-exceeding-80%C3%A2-years-old
#7
Cai Xu, Mian Xi, Amy Moreno, Yutaka Shiraishi, Brian P Hobbs, Meilin Huang, Ritsuko Komaki, Steven H Lin
PURPOSE: The optimal treatment approach for patients ≥80 years ("elderly") with esophageal cancer is not well established. We assessed the clinical outcomes in elderly patients treated with definitive chemoradiation therapy (CCRT) at our institution. METHODS AND MATERIALS: 56 consecutive patients ≥80 years with esophageal cancer treated with conventional CCRT between 2001 and 2016 were propensity score matched 1:2 to generate 2 younger patient cohorts treated with CCRT without surgery: "intermediate" (65-79 years, n=112) and "younger" (<65 years, n=112)...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28598945/long-term-outcomes-of-pediatric-cardiac-patients-supported-by-extracorporeal-membrane-oxygenation
#8
Matthew D Elias, Barbara-Jo Achuff, Richard F Ittenbach, Chitra Ravishankar, Thomas L Spray, Stephanie Fuller, Lisa M Montenegro, J William Gaynor, Matthew J O'Connor
OBJECTIVE: Extracorporeal membrane oxygenation is an important form of short-term mechanical support in children with cardiac disease, but information on long-term outcomes and quality of life is limited. The primary objective of this study was to determine the long-term outcomes of children previously supported by extracorporeal membrane oxygenation for cardiac etiologies. DESIGN: A retrospective analysis was performed on patients with cardiac disease managed with extracorporeal membrane oxygenation between January 1, 1995, and December 31, 2012, at the Children's Hospital of Philadelphia...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28593152/treatment-of-atrial-fibrillation-in-elderly-patients-with-the-cox-maze-procedure-concurrently-with-other-cardiac-operations
#9
Ja Hong Kuh, Joon Young Song, Tae Youn Kim, Jong Hun Kim, Jong Bum Choi
BACKGROUND: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. METHODS: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28588090/associations-between-cardiac-troponin-mechanism-of-myocardial-injury-and-long-term-mortality-after-noncardiac-vascular-surgery
#10
Grant W Reed, Samuel Horr, Laura Young, Joshua Clevenger, Umair Malik, Stephen G Ellis, A Michael Lincoff, Steven E Nissen, Venu Menon
BACKGROUND: The time-sensitive hazard of perioperative cardiac troponin T (cTnT) elevation and whether long-term mortality differs by mechanism of myocardial injury are poorly understood. METHODS AND RESULTS: In this observational study of 12 882 patients who underwent noncardiac vascular surgery, patients were assessed for cTnT sampling within 96 hours postoperatively. Mortality out to 5-years was stratified by cTnT level and mechanism of myocardial injury. During a median follow-up of 26...
June 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28582328/euroscore-performance-in-minimally-invasive-cardiac-surgery-discrimination-ability-and-external-calibration
#11
Rafik Margaryan, Marco Moscarelli, Tommaso Gasbarri, Giacomo Bianchi, Enkel Kallushi, Alfredo Giuseppe Cerillo, Pierandrea Farneti, Marco Solinas
OBJECTIVE: Prediction of operative risk in adults undergoing cardiac surgery remains a challenge. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the most commonly used in clinical settings. Recently, the new EuroSCORE II was published attempting to improve the accuracy of risk prediction. We sought to assess the predictive value of EuroSCORE or EuroSCORE II in selected field of minimally invasive cardiac surgery. METHODS: Patients who underwent cardiac surgery operation with minimally invasive approach from 2007 to 2013 identified from prospective cardiac surgical database...
June 2, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28580658/improvement-in-perioperative-care-in-pediatric-cardiac-surgery-by-shifting-the-primary-focus-of-treatment-from-cardiac-output-to-perfusion-pressure-are-beta-stimulants-still-needed
#12
Amir-Reza Hosseinpour, Mathieu van Steenberghe, Marc-André Bernath, Stefano Di Bernardo, Marie-Hélène Pérez, David Longchamp, Mirko Dolci, Yann Boegli, Nicole Sekarski, Javier Orrit, Michel Hurni, René Prêtre, Jacques Cotting
OBJECTIVE: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach. DESIGN: A retrospective study...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28577472/general-movement-trajectories-and-neurodevelopment-at-3months-of-age-following-neonatal-surgery
#13
Cathryn Crowle, Karen Walker, Claire Galea, Iona Novak, Nadia Badawi
BACKGROUND: Neonates who undergo major surgery are at risk of neurodevelopmental disability. The General Movements Assessment (GMA) is a valid and reliable method to predict neurodevelopment, however, there are minimal data on the applicability among infants post-surgery. AIM: To describe GMs trajectories following neonatal surgery. STUDY DESIGN: Prospective cohort study. SUBJECTS: 217 infants following major cardiac and non-cardiac neonatal surgery...
May 31, 2017: Early Human Development
https://www.readbyqxmd.com/read/28571639/longitudinal-outcomes-of-patients%C3%A2-with%C3%A2-single-ventricle-after%C3%A2-the%C3%A2-fontan%C3%A2-procedure
#14
Andrew M Atz, Victor Zak, Lynn Mahony, Karen Uzark, Nicholas D'agincourt, David J Goldberg, Richard V Williams, Roger E Breitbart, Steven D Colan, Kristin M Burns, Renee Margossian, Heather T Henderson, Rosalind Korsin, Bradley S Marino, Kaitlyn Daniels, Brian W McCrindle
BACKGROUND: Multicenter longitudinal objective data for survival into adulthood of patients who have undergone Fontan procedures are lacking. OBJECTIVES: This study sought to describe transplant-free survival and explore relationships between laboratory measures of ventricular performance and functional status over time. METHODS: Exercise testing, echocardiography, B-type natriuretic peptide, functional health assessment, and medical history abstraction were repeated 9...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28570233/sex-related-differences-in-outcomes-after-percutaneous-balloon-aortic-valvuloplasty
#15
Marzena Daniec, Artur Dziewierz, Danuta Sorysz, Paweł Kleczyński, Tomasz Rakowski, Łukasz Rzeszutko, Jarosław Trębacz, Marek Tomala, Bartłomiej Nawrotek, Krzysztof Żmudka, Dariusz Dudek
OBJECTIVES: We aimed to evaluate sex-related differences in short-term and long-term outcomes of patients undergoing balloon aortic valvuloplasty (BAV) for severe aortic stenosis (AS). METHODS: A total of 112 patients with severe AS underwent 114 BAV procedures as palliative procedure, bridge to definitive treatment, or before urgent non-cardiac surgery. Patients were followed for 24 months. RESULTS: Of the 112 patients, 70 (62.5%) were women...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28566338/associations-between-adding-a-radial-artery-graft-to-single-and-bilateral-internal-thoracic-artery-grafts-and-outcomes-insights-from-the-arterial-revascularization-trial
#16
David P Taggart, Douglas G Altman, Marcus D Flather, Stephen Gerry, Alastair M Gray, Belinda Lees, Umberto Benedetto
Background -Whether the use of the radial artery (RA) can improve clinical outcomes in coronary artery bypass graft (CABG) surgery remains unclear. The Arterial Revascularization Trial (ART) was designed to compare survival after bilateral internal thoracic artery (BITA) over single left internal thoracic artery (SITA). In the ART, a large proportion of patients (~20%) also received a RA graft instead of a saphenous vein graft (SVG). We aimed to investigate the associations between using the RA instead of SVG to supplement SITA or BITA grafts and outcomes by performing a post-hoc analysis of the ART...
May 31, 2017: Circulation
https://www.readbyqxmd.com/read/28565761/clinical-application-of-intra-aortic-balloon-pump-in-patients-with-cardiogenic-shock-during-the-perioperative-period-of-cardiac-surgery
#17
Xuesong Jiang, Zhitao Zhu, Ming Ye, Yan Yan, Junbo Zheng, Qingqing Dai, Lianghe Wen, Huaiquan Wang, Shaofei Lou, Hongmei Ma, Pingwei Ma, Yunlong Li, Tuoyun Yang, Shu Zuo, Ye Tian
Intra-aortic balloon pumps (IABP) have saved many patients with cardiogenic shock during the perioperative period of cardiac surgery. However, the ideal insertion timing is controversial. In the present study, we aimed to optimize the insertion timing, in order to increase the survival rate of the patients. A total of 197 patients with cardiogenic shock during the perioperative period of cardiac surgery and implemented IABP from January 2011 to October 2015 were selected for the study. Patients were divided into five groups on the basis of application timing of IABP: 0-60, 61-120, 121-180, 181-240 and >240 min...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28557275/four-year-comparative-effectiveness-of-bare-metal-and-everolimus-eluting-stents-in-new-york
#18
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVES: To study four-year outcomes for patients receiving either bare-metal stents (BMS) or everolimus-eluting stents (EES) and to evaluate the comparative effectiveness of BMS versus EES in six "off-label" and two "high-risk" patient subgroups. BACKGROUND: BMS and EES (a second generation of drug-eluting stent) are used in contemporary practice to treat coronary artery disease. However, little is known about long-term comparative effectiveness between BMS and EES...
May 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28552392/diagnostic-accuracy-and-prognostic-valued-of-plasmatic-cystatin-c-in-children-undergoing-pediatric-cardiac-surgery
#19
Massimiliano Cantinotti, Raffaele Giordano, Marco Scalese, Sabrina Molinaro, Simona Storti, Bruno Murzi, Vitali Pak, Vincenzo Poli, Giorgio Iervasi, Aldo Clerico
BACKGROUND: Diagnosis and treatment of acute kidney injury (AKI) is often delayed in children after cardiac surgery due to the lack of an early biomarker of renal damage. Our aim was to evaluate the diagnostic accuracy of plasma cystatin-C as an early biomarker of AKI and its prognostic value in pediatric cardiac surgery. METHODS: Cystatin-C and creatinine were measured pre-operatively and at 2-6-12h post-surgery. The primary outcome was: AKI (defined as an increase of ≥1...
May 26, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28552372/impact-of-medicaid-expansion-on-cardiac-surgery-volume-and-outcomes
#20
Eric J Charles, Lily E Johnston, Morley A Herbert, J Hunter Mehaffey, Kenan W Yount, Donald S Likosky, Patricia F Theurer, Clifford E Fonner, Jeffrey B Rich, Alan M Speir, Gorav Ailawadi, Richard L Prager, Irving L Kron
BACKGROUND: Thirty-one states approved Medicaid expansion after implementation of the Affordable Care Act. The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. METHODS: Data from the Virginia (nonexpansion state) Cardiac Services Quality Initiative and the Michigan (expanded Medicaid, April 2014) Society of Thoracic and Cardiovascular Surgeons Quality Collaborative were analyzed to identify uninsured and Medicaid patients undergoing coronary bypass graft or valve operations, or both...
May 26, 2017: Annals of Thoracic Surgery
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