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Morbidity in cardiac surgery

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https://www.readbyqxmd.com/read/28528049/an-old-solution-for-a-new-problem-eloesser-flap-management-of-infected-defibrillator-patches
#1
Heidi B Schubmehl, Huan Huan Sun, Jessica S Donington, Deane E Smith, Eugene A Grossi
Cardiac surgery patients with infected implantable cardioverter defibrillator hardware face high morbidity with both surgical and nonoperative management options. We present a case of infected epicardial patch defibrillator leads in a patient with prohibitively high risk of death with open surgical removal. As a less morbid alternative, an Eloesser flap was used to convert his presenting mediastinal empyema necessitans into a chronic, manageable wound.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28523023/surgical-repair-of-partial-atrioventricular-septal-defect
#2
Tariq Waqar, Muhammad Usman Riaz, Muhammad Shuaib
OBJECTIVE: To review the results of surgical correction of partial atrioventricular septal defect and associated cardiac comorbidities. METHODS: Retrospective case analysis of electronic database of department of paediatrics cardiac surgery, CPEIC, Multan was done. Forty consecutive patients operated for partial atrioventricular septal defect repair from September 2011 to October 2016 were included. Mean age was 14.67±7.96 years. 60% (24) patients were male. Regarding echocardiographic findings, pre-operatively 40% (n=16) had mild, 47...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28514319/prospective-external-validation-of-three-preoperative-risk-scores-for-prediction-of-new-onset-atrial-fibrillation-after-cardiac-surgery
#3
Matthew J Cameron, Diem T T Tran, Jean Abboud, Ethan K Newton, Houman Rashidian, Jean-Yves Dupuis
BACKGROUND: Postoperative atrial fibrillation (POAF) is associated with early and late morbidity and mortality of cardiac surgical patients. Prophylactic treatment of atrial fibrillation (AF) has been recommended to improve outcome in cardiac surgical patients at high risk of developing POAF. Reliable models for prediction of POAF are needed to achieve that goal. This study attempted to externally validate 3 risk models proposed for preoperative prediction of POAF in cardiac surgical patients: the POAF score, the CHA2DS2-VASc score, and the Atrial Fibrillation Risk Index...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28511922/simultaneous-transseptal-para-ring-leak-closure-and-transcatheter-mitral-valve-implantation-for-the-treatment-of-surgical-mitral-repair-failure
#4
James Roy, Mehdi Eskandari, Mark Monaghan, Olaf Wendler, Jonathan Byrne, Philip MacCarthy
Repeat cardiac surgery in patients with a previous sternotomy is associated with significant morbidity and mortality. While transcatheter aortic valve implantation in high risk surgical patients is now well established, experience with transcatheter mitral valve replacement is still at an early stage. Although many successful reports of transcatheter mitral valve replacements now exist, the predominant approach has been via a transapical approach. It is likely that, as with the evolution of favoured access routes for transcatheter aortic therapies, future directions for transcatheter mitral valves will focus on smaller delivery systems favouring the transvenous transseptal approach where possible...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506458/impact-of-postoperative-hypothermia-on-outcomes-in-coronary-artery-bypass-surgery-patients
#5
Pey-Jen Yu, Hugh A Cassiere, Nina Kohn, Allan Mattia, Alan R Hartman
OBJECTIVES: To determine the impact of postoperative hypothermia on outcomes in coronary artery bypass graft surgery (CABG) patients. DESIGN: A retrospective study was performed on patients who underwent isolated CABG between 2011 and 2014. SETTING: Single-center study at a university hospital. PARTICIPANTS: All patients who underwent isolated CABG with cardiopulmonary bypass between 2011 and 2014. INTERVENTIONS: Patients underwent isolated CABG on cardiopulmonary bypass...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#6
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28499868/exposure-to-particulate-matter-induces-cardiomyocytes-apoptosis-after-myocardial-infarction-through-nf%C3%AE%C2%BAb-activation
#7
Xueling Li, Jin Geng, Yuhan Chen, Fu Chen, Chen Liu, Qiwen Xu, Jinxuan Zhao, Jiaxin Hu, Jun Xie, Biao Xu
Clinical evidence has indicated an increased myocardial infarction (MI) morbidity and mortality after exposure to air pollution (particulate matter<2.5 μm, PM2.5). However, the mechanisms by which PM2.5 aggravates MI remain unknown. Present study was to explore the adverse effect of PM2.5 on myocardium after MI and the potential mechanisms. Male mice with MI surgery were treated with PM2.5 by intranasal instillation. Neonatal mice ventricular myocytes (NMVMs) subjected to hypoxia were also incubated with PM2...
June 17, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#8
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28496093/prediction-of-new-onset-and-recurrent-atrial-fibrillation-by-complete-blood-count-tests-a-comprehensive-systematic-review-with-meta-analysis
#9
Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Anton Sabashnikov, Aron-Frederik Popov, Seyed Jalil Mirhosseini, Tong Liu, Mohammadreza Lotfaliani, Michel Pompeu Barros de Oliveira Sá, William L L Baker, Senol Yavuz, Mohamed Zeriouh, Jae-Sik Jang, Hamidreza Dehghan, Lei Meng, Luca Testa, Fabrizio D'Ascenzo, Umberto Benedetto, Gary Tse, Luis Nombela-Franco, Pascal M Dohmen, Abhishek J Deshmukh, Cecilia Linde, Giuseppe Biondi-Zoccai, Gregg W Stone, Hugh Calkins, Integrated Meta-Analysis Of Cardiac Surgery And Cardiology-Group Imcsc-Group
BACKGROUND Atrial fibrillation (AF) is one of the most critical and frequent arrhythmias precipitating morbidities and mortalities. The complete blood count (CBC) test is an important blood test in clinical practice and is routinely used in the workup of cardiovascular diseases. This systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of hematological parameters in the CBC test with new-onset and recurrent AF. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating hematologic parameters in patients with new-onset AF and recurrent AF...
May 12, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28494978/post-operative-chylothorax-in-patients-with-congenital-heart-disease
#10
Jill J Savla, Maxim Itkin, Joseph W Rossano, Yoav Dori
BACKGROUND: Post-operative chylothorax in patients with congenital heart disease is a challenging problem with substantial morbidity and mortality. Currently, the etiology of chylothorax is poorly understood and treatment options are limited. OBJECTIVES: This study aimed to report lymphatic imaging findings, determine the mechanism of chylothorax after cardiac surgery, and analyze the outcomes of lymphatic embolization. METHODS: We conducted a retrospective review of 25 patients with congenital heart disease and post-operative chylothorax who presented for lymphatic imaging and intervention between July 2012 and August 2016...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#11
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28488956/introduction-of-thromboelastometry-guided-administration-of-fresh-frozen-plasma-is-associated-with-decreased-allogeneic-blood-transfusions-and-post-operative-blood-loss-in-cardiopulmonary-bypass-surgery
#12
Junko Ichikawa, Takahito Marubuchi, Keiko Nishiyama, Mitsuharu Kodaka, Klaus Görlinger, Makoto Ozaki, Makiko Komori
BACKGROUND: Cardiac surgery is frequently associated with excessive blood loss requiring multiple blood transfusions which are, in turn, associated with increased morbidity and mortality. We evaluated the effectiveness of rotational thromboelastometry (ROTEM(®))-guided administration of fresh-frozen plasma (FFP) with regards to blood loss, transfusion requirements, and major post-operative complications. MATERIALS AND METHODS: Coagulation management in 68 prospective patients undergoing cardiac surgery with cardiopulmonary bypass was based on a treatment algorithm guided by ROTEM(®) measurements...
March 23, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28486646/altered-preoperative-coagulation-and-fibrinolysis-are-associated-with-myocardial-injury-after-non-cardiac-surgery
#13
J Górka, K Polok, T Iwaniec, K Górka, A Wludarczyk, J Fronczek, P J Devereaux, J W Eikelboom, J Musial, W Szczeklik
Background: Myocardial injury after non-cardiac surgery (MINS), a complication with unclear pathogenesis, occurs within the first 30 days after surgery and worsens prognosis. Hypercoagulability induced by surgery might contribute to plaque rupture, with subsequent thrombosis and myocardial injury. This study assessed haemostatic markers before surgery and evaluated their association with MINS. Methods: This is a substudy of VISION, a prospective cohort study of perioperative cardiovascular events...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28483663/e-r-a-s-pathway-in-colorectal-surgery-in-elderly-our-experience
#14
Basilio Pirrera, Andrea Lucchi, Carlo Gabbianelli, Vincenzo Alagna, Giacomo Martorelli, Pierluigi Berti, Ilaria Panzini, Elisabetta Fabbri, Gianluca Garulli
AIM: Numerous geriatric patients develop colorectal disease. Elderly patients are often considered high-risk surgical candidates. Enhanced recovery after surgery (E.R.A.S.) has been proven to be beneficial for patients. The aim of the study was to evaluate the results of an ERAS protocol in older patients that underwent colorectal surgery compared to younger patients. METHOD: In the period between January 2010 to December 2015 a total of 589 patients underwent elective colorectal surgical interventions treated within the E...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28476513/animal-models-of-cachexia-and-sarcopenia-in-chronic-illness-cardiac-function-body-composition-changes-and-therapeutic-results
#15
REVIEW
Junichi Ishida, Masakazu Saitoh, Wolfram Doehner, Stephan von Haehling, Markus Anker, Stefan D Anker, Jochen Springer
Cachexia is defined as a complex metabolic syndrome associated with underlying illness that is characterized by the loss of body weight consisting of muscle and fat mass wasting. Sarcopenia is defined as the ageing related loss of muscle mass in health and disease that may not have an effect on body weight. As millions of patients are in cachectic or sarcopenic states, both conditions contribute to high numbers to death worldwide. A number of treatments have been proposed for cachexia and sarcopenia, but these are either in the preclinical stage or in clinical trials and hence not available to the general population...
April 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28475684/the-use-of-extracorporeal-membrane-oxygenation-in-neonates-with-severe-congenital-diaphragmatic-hernia-a-26-year-experience-from-a-tertiary-centre%C3%A2
#16
Ricky Vaja, Ahmed Bakr, Annabel Sharkey, Vijay Joshi, Gail Faulkner, Claire Westrope, Chris Harvey
OBJECTIVES: Neonates with severe congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation (ECMO) have a high rate of mortality. There is controversy regarding optimal time of surgical intervention. We present our data over a 26-year period. METHODS: We analysed data from our Extracorporeal Life Support Organization registry forms between 1989 and 2015, in order to determine the factors affecting survival outcome for repair of congenital diaphragmatic hernia with ECMO as a bridge to surgery and/or recovery...
May 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28475665/routine-use-of-viscoelastic-blood-tests-for-diagnosis-and-treatment-of-coagulopathic-bleeding-in-cardiac-surgery-updated-systematic-review-and-meta-analysis
#17
G F Serraino, G J Murphy
Viscoelastic point-of-care tests are commonly used to provide prompt diagnosis of coagulopathy and allow targeted treatments in bleeding patients. We updated existing meta-analyses that have evaluated the clinical effectiveness of viscoelastic point-of-care tests vs the current standard of care for the management of cardiac surgery patients at risk of coagulopathic bleeding. Randomized controlled trials comparing viscoelastic point-of-care diagnostic testing with standard care in cardiac surgery patients were sought...
May 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#18
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28466755/perioperative-management-of-cardiac-transplant-recipients-undergoing-noncardiac-surgery-unique-challenges-created-by-advancements-in-care
#19
Paul T Jurgens, Christina L Aquilante, Robert L Page, Amrut V Ambardekar
Advancements in postcardiac transplant care have resulted in significant reductions in morbidity and increased life expectancy for cardiac transplant recipients. Consequently, many cardiac transplant recipients are living long enough to require subsequent noncardiac surgery. The perioperative care of heart transplant recipients presents a unique challenge as many of the common preoperative risk assessments do not apply to a transplanted heart, immunosuppressive medications have side effects and potential for drug-drug interactions, and the denervated heart results in an altered autonomic physiology and response to medications...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28462447/predictive-power-of-the-nsqip-risk-calculator-for-early-post-operative-outcomes-after-whipple-experience-from-a-regional-center-in-northern-ontario
#20
Henry Y Jiang, Erica L Kohtakangas, Kengo Asai, Jeffrey B Shum
BACKGROUND: NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population...
May 2, 2017: Journal of Gastrointestinal Cancer
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