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Morbidity in cardiac surgery

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https://www.readbyqxmd.com/read/28340319/apigenin-reduces-nf-%C3%AE%C2%BAb-and-subsequent-cytokine-production-as-protective-effect-in-a-rodent-animal-model-of-lung-ischemia-reperfusion-injury
#1
Ioannis Bougioukas, Vassilios Didilis, Alexander Emmert, Ahmad F Jebran, Regina Waldmann-Beushausen, Tomislav Stojanovic, Friedrich A Schoendube, Bernhard C Danner
PURPOSE: Lung ischemia-reperfusion injury (LIRI) can complicate lung transplantation or cardiac surgery with cardiopulmonary bypass, increasing morbidity and mortality. In LIRI, pro-inflammatory cytokines are activated, reactive oxygen species are generated and nuclear factor-κB (NF-κB) is up-regulated, altering lung mechanics. We tested the effect of the flavonoid apigenin on a rodent model of LIRI. METHODS: Thirty-seven Wistar rats were subjected to LIRI with or without a single or double dose of apigenin...
March 24, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#2
Elizabeth H Stephens, Jennifer Tingo, Marc Najjar, Betul Yilmaz, Stéphanie Levasseur, Jeffrey D Dayton, Ralph S Mosca, Paul Chai, Jan M Quaegebeur, Emile A Bacha
BACKGROUND: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention. METHODS: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329459/nineteen-years-of-adult-congenital-heart-surgery-in-a-single-center
#3
Madurra Perinpanayagam, Signe H Larsen, Kristian Emmertsen, Marianne B Møller, Vibeke E Hjortdal
BACKGROUND: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. METHODS: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#4
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Parth Solanki, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
BACKGROUND: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients. METHODS: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329292/surgical-septal-myectomy-or-alcohol-septal-ablation-which-approach-offers-better-outcomes-for-patients-with-hypertrophic-obstructive-cardiomyopathy
#5
Shi Sum Poon, Mark Field, Dhiraj Gupta, Duke Cameron
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether surgical septal myectomy (SM) is more beneficial than alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. Altogether 218 articles were found using the reported search, of which 15 studies represented the best evidence to answer the clinical question. There were 14 observational studies and 1 meta-analysis study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these articles are tabulated...
February 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28319545/systemic-lupus-erythematosus-is-associated-with-increased-adverse-postoperative-renal-outcomes-and-mortality-a-historical-cohort-study-using-administrative-health-data
#6
Rovnat Babazade, Huseyin Oguz Yilmaz, Steve M Leung, Nicole M Zimmerman, Alparslan Turan
BACKGROUND: Systemic lupus erythematosus (SLE) is a common autoimmune connective tissue disease that mainly harms kidneys, heart, lungs, and nervous system. Effects of surgical stimulus and anesthesia combined with SLE-related pathologies may increase morbidity and mortality. Therefore, we aimed to evaluate the association between SLE (versus none) and postoperative renal, cardiac, and in-hospital mortality complications among patients undergoing major surgeries. METHODS: We obtained censuses of 2009 to 2011 inpatient hospital discharges across 7 states and conducted a retrospective cohort study by using International Classification of Diseases and Injuries, Version 9, diagnosis codes, procedure codes, and present-on-admission indicators...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318659/cardiovascular-and-general-health-status-of-adults-with-trisomy-21
#7
Samuel A Hayes, Shelby Kutty, Joshua Thomas, Joyce T Johnson, Anji T Yetman
BACKGROUND: Patients with Trisomy 21 are now living well into adulthood. Little data exists to assist the cardiologist in the care of these patients. We sought to examine the cardiac and general health status of adults with Trisomy 21 undergoing cardiac evaluation. METHODS & RESULTS: A retrospective review of all affected adults >21years followed at 2 tertiary care institutions was performed. Of 193 patients identified, median age was 31 (range 21.1-60.5) years...
March 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#8
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28302739/changing-landscape-of-congenital-heart-disease
#9
Berto J Bouma, Barbara J M Mulder
Congenital heart disease is the most frequently occurring congenital disorder affecting ≈0.8% of live births. Thanks to great efforts and technical improvements, including the development of cardiopulmonary bypass in the 1950s, large-scale repair in these patients became possible, with subsequent dramatic reduction in morbidity and mortality. The ongoing search for progress and the growing understanding of the cardiovascular system and its pathophysiology refined all aspects of care for these patients. As a consequence, survival further increased over the past decades, and a new group of patients, those who survived congenital heart disease into adulthood, emerged...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28302078/early-serum-creatinine-accurately-predicts-acute-kidney-injury-post-cardiac-surgery
#10
Keren Grynberg, Kevan R Polkinghorne, Sharon Ford, Fiona Stenning, Thomas E Lew, Jonathan A Barrett, Shaun A Summers
BACKGROUND: Acute Kidney Injury (AKI) is a well recognized complication of cardiac surgery. It is associated with significant morbidity and mortality. The aims of our study are twofold; 1. To define the incidence of AKI post cardiac surgery. 2. To identify pre-morbid and operative risk factors for developing AKI and to determine if immediate post operative serum creatinine (IPOsCr) accurately predicts the development of AKI. METHODS: We prospectively studied 196 consecutive patients undergoing elective (on-pump) cardiac surgery...
March 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28300569/obesity-as-an-effect-modifier-in-sleep-disordered-breathing-and-post-cardiac-surgery-atrial-fibrillation
#11
Roop Kaw, Samer El Zarif, Lu Wang, James Bena, Eugene Blackstone, Reena Mehra
INTRODUCTION: As the inter-relationships of objectively-ascertained sleep disordered breathing (SDB), post-cardiac surgery atrial fibrillation (PCSAF) and obesity remain unclear; we aimed to further investigate in a clinic-based cohort. METHODS: Patients with polysomnography (PSG) and cardiac surgery (coronary artery bypass surgery and/or valvular surgery) within 3 years, from January 2009 to January 2014 were identified excluding those with pre-existing AF. Logistic models were used to determine the association of SDB (apnea hypopnea index (AHI) per 5 unit increase) and secondary predictors [central sleep apnea (CSA) (central apnea index>5) and oxygen desaturation index (ODI)] with PCSAF...
March 11, 2017: Chest
https://www.readbyqxmd.com/read/28299184/revisiting-blood-transfusion-and-predictors-of-outcome-in-cardiac-surgery-patients-a-concise-perspective
#12
REVIEW
Carlos E Arias-Morales, Nicoleta Stoicea, Alicia A Gonzalez-Zacarias, Diana Slawski, Sujatha P Bhandary, Theodosios Saranteas, Eva Kaminiotis, Thomas J Papadimos
In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement...
2017: F1000Research
https://www.readbyqxmd.com/read/28291723/cardiac-surgery-in-systemic-lupus-erythematosus-patients-clinical-characteristics-and-outcomes
#13
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/28285318/effects-on-qtc-interval-of-2-different-doses-of-spinal-anesthesia-in-inguinal-hernia-operations
#14
Onur Hanbeyoglu, Aykut Urfalioglu, Fatih Mehmet Yazar, Sibel Ozcan
BACKGROUND Cardiac arrhythmia is a significant cause of morbidity and mortality. In this study, through examination of the effects on the QTc interval of different doses of hyperbaric bupivacaine, we investigated the relationship with arrhythmia. MATERIAL AND METHODS A total of 60 patients were separated into 2 groups: spinal block was applied with 10 mg bupivacaine to Group S1 and with 15 mg to Group S2. The mean arterial pressure (MAP) and heart rate (HR) values were recorded before the spinal block and at 5 and 30 min after the block and at 60 min postoperatively...
March 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28282660/clinical-results-of-cardiac-surgery-in-patients-with-chronic-hepatitis-c-and-their-role-in-risk-models-a-case-control-study
#15
Cagdas Baran, Mehmet Cakici, Evren Ozcinar, Serkan Durdu, Bahadir Inan, Mustafa Sirlak, Ruchan Akar
Background To evaluate the results of patients with chronic hepatitis C virus (HCV) following cardiac surgery in the TurcoSCORE (TrS) database. Methods Sixty patients with HCV who underwent cardiac surgery between 2005 and 2016 in our clinic out of a total 8,018 patients from the TrS database were included in the study. The perioperative morbidity and mortality rates in these patients were compared with a matched cohort. Results The mean follow-up time was 96.6 ± 12.3 months. Hospital mortality rates (HCV group 5% vs...
March 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28281862/model-based-approach-for-quantitative-estimates-of-skin-heart-and-lung-toxicity-risk-for-left-side-photon-and-proton-irradiation-after-breast-conserving-surgery
#16
Francesco Tommasino, Marco Durante, Vittoria D'Avino, Raffaele Liuzzi, Manuel Conson, Paolo Farace, Giuseppe Palma, Marco Schwarz, Laura Cella, Roberto Pacelli
BACKGROUND: Proton beam therapy represents a promising modality for left-side breast cancer (BC) treatment, but concerns have been raised about skin toxicity and poor cosmesis. The aim of this study is to apply skin normal tissue complication probability (NTCP) model for intensity modulated proton therapy (IMPT) optimization in left-side BC. MATERIAL AND METHODS: Ten left-side BC patients undergoing photon irradiation after breast-conserving surgery were randomly selected from our clinical database...
March 10, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28278318/association-of-pseudoexfoliation-with-systemic-vascular-diseases-in-a-south-indian-population
#17
Ashok Vardhan S, Aravind Haripriya, Banushree Ratukondla, Pradeep Ramulu, Chandrasekaran Shivakumar, Manas Nath, Prabhu Vijayaraghavan, Alan L Robin
Importance: Ocular pseudoexfoliation (PEX) syndrome may be associated with systemic vascular diseases, which might suggest a broader health significance of PEX, although previous reports are conflicting. Objective: To determine whether prespecified vascular risk factors and cardiac abnormalities are more common among patients with PEX than among control individuals without PEX. Design, Setting, and Participants: This cross-sectional analysis of patients recruited into the Aravind Pseudoexfoliation study included South Indian patients older than 40 years with or without PEX who required cataract surgery...
March 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28277245/surgery-start-time-does-not-impact-outcome-in-elective-cardiac-surgery
#18
Joshua A Heller, Rishi Kothari, Hung-Mo Lin, Matthew A Levin, Menachem Weiner
OBJECTIVE: Determine if surgery start time impacts patient outcomes in elective cardiac surgery. DESIGN: This was a retrospective study. SETTING: This study was based at a single academic institution. PARTICIPANTS: Patients undergoing elective cardiac surgery over a 3-year period were included. INTERVENTIONS: There were no interventions. MEASUREMENTS AND MAIN RESULTS: The authors performed a retrospective study of patients undergoing elective cardiac surgery over a 3-year period...
August 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28275064/obesity-increases-risk-adjusted-morbidity-mortality-and-cost-following-cardiac-surgery
#19
Ravi K Ghanta, Damien J LaPar, Qianzi Zhang, Vishal Devarkonda, James M Isbell, Leora T Yarboro, John A Kern, Irving L Kron, Alan M Speir, Clifford E Fonner, Gorav Ailawadi
BACKGROUND: Despite the epidemic rise in obesity, few studies have evaluated the effect of obesity on cost following cardiac surgery. We hypothesized that increasing body mass index (BMI) is associated with worse risk-adjusted outcomes and higher cost. METHODS AND RESULTS: Medical records for 13 637 consecutive patients who underwent coronary artery bypass grafting (9702), aortic (1535) or mitral (837) valve surgery, and combined valve-coronary artery bypass grafting (1663) procedures were extracted from a regional Society of Thoracic Surgeons certified database...
March 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28267942/a-pilot-study-using-preoperative-cerebral-tissue-oxygen-saturation-to-stratify-cardiovascular-risk-in-major-non-cardiac-surgery
#20
Syb Wen, Azy Peng, S Boyle, S Cai, L Pope, M T Tran, T G Short, A Aneman, M Jaeger, A Chuan
This prospective pilot study evaluated whether low preoperative cerebral tissue oxygen saturation is associated with unfavourable outcomes after major elective non-cardiac surgery. Eighty-one patients over 60 years of age, American Society of Anesthesiologists physical status 3 or 4, were recruited. Resting cerebral tissue oxygen saturation was recorded on room air, and after oxygen supplementation, using cerebral oximetry. The primary outcome was 30-day major adverse event of combined mortality or severe morbidity, and the secondary outcome was 30-day new disability...
March 2017: Anaesthesia and Intensive Care
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