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Morbidity in cardiac surgery

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https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#1
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27910057/molecular-cardiac-surgery-with-recirculating-delivery-mcard-procedure-and-vector-transfer
#2
Michael G Katz, Anthony S Fargnoli, Andrew P Kendle, Charles R Bridges
Despite progress in clinical treatment, cardiovascular diseases are still the leading cause of morbidity and mortality worldwide. Therefore, novel therapeutic approaches are needed, targeting the underlying molecular mechanisms of disease with improved outcomes for patients. Gene therapy is one of the most promising fields for the development of new treatments for the advanced stages of cardiovascular diseases. The establishment of clinically relevant methods of gene transfer remains one of the principal limitations on the effectiveness of gene therapy...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27908284/obscured-hemorrhagic-pancreatitis-after-orthotopic-heart-transplantation-complicated-with-acute-right-heart-failure-and-hepatic-dysfunction-a-case-report
#3
Ting-Wei Lin, Meng-Ta Tsai, Jun-Neng Roan, Yi-Sheng Liu, Hong-Ming Tsai, Chwan-Yau Luo
BACKGROUND: Pancreatitis is a serious complication after cardiac surgery and can lead to significant morbidities and mortality. The incidence of pancreatitis is even higher in patients undergoing heart transplantation than in those undergoing other cardiac surgeries. Nevertheless, the clinical presentations of pancreatitis are frequently atypical in these patients. CASE PRESENTATION: We report a heart recipient who was complicated with acute right heart failure initially after orthotopic heart transplantation and developed devastating unanticipated hemorrhagic pancreatitis 1 month after the transplantation...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27907053/the-effect-of-diabetes-on-the-perioperative-outcomes-of-colorectal-cancer-surgery-patients
#4
Raymond Yap, Simon Wilkins, Margaret Staples, Karen Oliva, Paul J McMurrick
There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk...
2016: PloS One
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#5
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#6
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#7
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27900408/prevalence-and-risk-factors-for-pericardial-effusions-requiring-readmission-after-pediatric-cardiac-surgery
#8
Matthew D Elias, Andrew C Glatz, Matthew J O'Connor, Susan Schachtner, Chitra Ravishankar, Christoper E Mascio, Meryl S Cohen
Pericardial effusion (PE) may require readmission after cardiac surgery and has been associated with postoperative morbidity and mortality. We sought to identify the prevalence and risk factors for postoperative PE requiring readmission in children. A retrospective analysis of the Pediatric Health Information System database was performed between January 1, 2003, and September 30, 2014. All patients ≤18 years old who underwent cardiac surgery were identified by ICD-9 codes. Those readmitted within 1 year with an ICD-9 code for PE were identified...
November 30, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27899865/necrotizing-pneumonia-caused-by-h1n1-virus-in-a-child-with-total-anomalous-pulmonary-venous-connection-after-cardiac-surgery
#9
Mehmet G Ramoğlu, Tayfun Uçar, Tanıl Kendirli, Zeynep Eyileten, Semra Atalay
Total anomalous pulmonary venous connection is a rare form of congenital heart disease, occurring in only 1.5% of children with congenital heart disease. Although the mortality and morbidity of total anomalous pulmonary venous connection have decreased dramatically due to improvements in surgery, postoperative pulmonary venous obstruction is still a cause of late mortality in patients with corrected total anomalous pulmonary venous connection. Influenza A H1N1, the most common cause of human influenza in 2009, may cause pneumonia presenting with increased disease severity...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27895342/innovations-in-cardiovascular-care-historical-perspective-contemporary-practice-recent-trends-and-future-directions
#10
Hasanat Sharif, Mayera Tufail
Cardiovascular diseases continue to be a major cause of mortality and morbidity in the world population. First open heart procedure was performed by Gibbon in 1953, since then many advancements have been introduced to the field of cardiac surgery. Minimally invasive techniques were introduced, which include minimally invasive coronary artery bypass grafting (CABG), off-pump technique, minimally invasive valve surgery or transcatheter techniques to implant stentless or sutureless valves. The hybrid strategy to address coronary disease combines catheterisation procedures with standard surgical techniques...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27884743/mortality-and-morbidity-after-spinal-surgery-in-patients-with-parkinson-s-disease-a-retrospective-matched-pair-cohort-study
#11
Takeshi Oichi, Hirotaka Chikuda, Junichi Ohya, Ryo Ohtomo, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: There is a lack of information about postoperative outcomes and related risk factors associated with spinal surgery in patients with Parkinson's disease (PD). PURPOSE: To investigate the postoperative morbidity and mortality associated with spinal surgery for patients with PD, and the risk factors for poor outcomes. STUDY DESIGN: Retrospective matched-pair cohort study. PATIENT SAMPLE: Data of patients who underwent elective spinal surgery between July 2010 and March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27884410/complications-after-cardiac-operations-all-are-not-created-equal
#12
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Alejandro Suarez-Pierre, Christopher M Sciortino, Kaushik Mandal, Kenton J Zehr, John V Conte, Robert S Higgins, Duke E Cameron, Glenn J Whitman
BACKGROUND: Postoperative complications are associated with increased morbidity and mortality after cardiac operations. We sought to quantify the effect of multiple complications on noninstitutionalized recovery after cardiac operations. METHODS: We identified 2,477 adult patients from our institutional cardiac surgery database who underwent one of seven index cardiac surgical operations from 2011 to 2014. We calculated failure-to-rescue rates for all individual complications and combinations of complications...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27879531/b-type-natriuretic-peptide-predicts-morbidity-and-long-term-mortality-in-coronary-artery-bypass-grafting-and-valve-surgery
#13
Kendal M Endicott, Richard L Amdur, Michael D Greenberg, Gregory D Trachiotis
OBJECTIVE: To assess whether B-type natriuretic peptide (BNP) levels are a useful predictor of morbidity and mortality as well as long-term survival in patients after coronary artery bypass grafting (CABG) and valve surgery. METHODS: A retrospective review of CABG and/or valve surgery patients from 2012 to 2015 at a single center was conducted. A total of 432 patients were identified (CABG, 295 patients; valve, 82 patients; and CABG + valve, 55 patients). B-type natriuretic peptide levels were divided into quartiles (Q1-Q4)...
November 22, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#14
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27876519/the-effect-of-body-mass-index-on-major-outcomes-after-vascular-surgery
#15
REVIEW
George Galyfos, Georgios I Geropapas, Stavros Kerasidis, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Obesity has been associated with an increased risk for cardiovascular morbidity and mortality, although pooled evidence in patients undergoing vascular surgery are lacking. The aim of this systematic review was to evaluate the effect of body mass index (BMI) on major postoperative outcomes in patients undergoing vascular surgery. METHODS: A systematic literature review conforming to established criteria to identify eligible articles published before May 2016 was conducted...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27872996/surgical-repair-of-ventricular-septal-defect-contemporary-results-and-risk-factors-for-a-complicated-course
#16
Maartje Schipper, Martijn G Slieker, Paul H Schoof, Johannes M P J Breur
Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#17
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867583/acute-respiratory-distress-syndrome-after-cardiac-surgery
#18
REVIEW
Lisa Q Rong, Antonino Di Franco, Mario Gaudino
Acute respiratory distress syndrome (ARDS) is a leading cause of postoperative respiratory failure, with a mortality rate approaching 40% in the general population and 80% in the subset of patients undergoing cardiac surgery. The increased risk of ARDS in these patients has traditionally been associated with the use of cardiopulmonary bypass (CPB), the need for blood product transfusions, large volume shifts, mechanical ventilation and direct surgical insult. Indeed, the impact of ARDS in the cardiac population is substantial, affecting not only survival but also in-hospital length of stay and long-term physical and psychological morbidity...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867031/marine-n-3-fatty-acids-are-incorporated-into-atrial-tissue-but-do-not-correlate-with-postoperative-atrial-fibrillation-in-cardiac-surgery
#19
J Gu, Søren Lundbye-Christensen, Rikke B Eschen, Annette Andreasen, Jan J Andreasen
OBJECTIVES: Postoperative new-onset atrial fibrillation (POAF) in cardiac surgery is associated with increased morbidity and mortality. Because n-3 polyunsaturated fatty acids (n-3 PUFA) have an antiarrhythmic effect, we hypothesized that a high content of marine n-3 PUFA in the atrial wall was associated with a reduced risk of POAF. DESIGN: Venous blood and tissue from the right atrial appendage were obtained from 50 patients undergoing elective cardiac surgery...
November 17, 2016: Vascular Pharmacology
https://www.readbyqxmd.com/read/27866651/cardiac-surgery-in-patients-with-previous-hepatic-or-renal-transplantation-a%C3%A2-pair-matched-study
#20
Mina Farag, Marina Nikolic, Rawa Arif, Bastian Schmack, Anton Sabashnikov, Mohamed Zeriouh, Aron-Frederik Popov, Arjang Ruhparwar, Matthias Karck, Alexander Weymann
BACKGROUND: The objective of this study was to compare outcomes of patients with previous solid organ transplant with those of a pair-matched population. METHODS: Data from our prospectively maintained cardiac surgery registry were obtained and identified 70 transplant recipients (21 hepatic, 49 renal) who were operated on at our department of cardiac surgery between 2000 and 2013; they formed the transplant group. Those patients were pair-matched regarding age, sex, and cardinal cardiac risk factors to form the pair-matched group...
November 17, 2016: Annals of Thoracic Surgery
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