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Morbidity in cardiac surgery

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https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#1
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28423125/coronary-arteriovenous-fistulas-in-adult-patients-surgical-management-and-outcomes
#2
Sebnem Albeyoglu, Mustafa Aldag, Ufuk Ciloglu, Murat Sargin, Tugba Kemaloglu Oz, Hakan Kutlu, Sabri Dagsali
Objective: The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes. Methods: Twenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#3
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28421779/oral-glutamine-reduces-myocardial-damage-after-coronary-revascularization-under-cardiopulmonary-bypass-a-randomized-clinical-trial
#4
Mariana Chávez-Tostado, Fernando Carrillo-Llamas, Porfirio Eduardo Martínez-Gutiérrez, Araceli Alvarado-Ramírez, Jaime Gilberto López-Taylor, José Clemente Vásquez-Jiménez, Clotilde Fuentes-Orozco, Jorge Rendón-Félix, Leire Irusteta-Jiménez, Vanessa Carolina Calil-Romero, José Antonio Ramírez-Jiménez, Luis Rodrigo Michel-Espinoza, Carmen Karina Contreras-López, Lizbeth Araceli Cuesta-Maquez, Alejandro González-Ojeda
BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28408715/postoperative-infection-in-developing-world-congenital-heart-surgery-programs-data-from-the-international-quality-improvement-collaborative
#5
Amitabh Chanchal Sen, Debra Forbes Morrow, Rakhi Balachandran, Xinwei Du, Kimberlee Gauvreau, Byalal R Jagannath, Raman Krishna Kumar, Jennifer Koch Kupiec, Monica L Melgar, Nguyen Tran Chau, Gail Potter-Bynoe, Orlando Tamariz-Cruz, Kathy J Jenkins
BACKGROUND: Postoperative infections contribute substantially to morbidity and mortality after congenital heart disease surgery and are often preventable. We sought to identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery, using data from the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries. METHODS AND RESULTS: Pediatric cardiac surgical cases performed between 2010 and 2012 at 27 participating sites in 16 developing countries were included...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28408455/cell-therapy-trials-in-congenital-heart-disease
#6
REVIEW
Hidemasa Oh
Dramatic evolution in medical and catheter interventions and complex surgeries to treat children with congenital heart disease (CHD) has led to a growing number of patients with a multitude of long-term complications associated with morbidity and mortality. Heart failure in patients with hypoplastic left heart syndrome predicated by functional single ventricle lesions is associated with an increase in CHD prevalence and remains a significant challenge. Pathophysiological mechanisms contributing to the progression of CHD, including single ventricle lesions and dilated cardiomyopathy, and adult heart disease may inevitably differ...
April 14, 2017: Circulation Research
https://www.readbyqxmd.com/read/28407126/mitral-valve-replacement-in-severely-calcified-mitral-valve-annulus-a-10-year-experience
#7
Kareem Salhiyyah, Hassan Kattach, Ahmed Ashoub, Diana Patrick, Szabolcs Miskolczi, Geoffrey Tsang, Sunil K Ohri, Clifford W Barlow, Theodore Velissaris, Steve Livesey
OBJECTIVES: Severe calcification in the mitral valve annulus is a challenging problem during mitral valve surgery. We describe our experience with mitral valve replacement in severely calcified mitral valve without decalcification of the annulus. METHODS: Between April 2001 and July 2011, 61 patients underwent mitral valve replacement with severe mitral annulus calcification without decalcification of the annulus. This retrospective study was performed to assess the surgical and the long-term postoperative outcomes in this group...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28399114/lung-hypoplasia-in-newborn-rabbits-with-a-diaphragmatic-hernia-affects-pulmonary-ventilation-but-not-perfusion
#8
Andreas W Flemmer, Marta Thio, Megan J Wallace, Katie Lee, K Marcus J Kitchen, Lauren Kerr, Charles C Roehr, Andreas Fouras, Richard Carnibella, Jaccques J Jani, Philip DeKoninck, Arjan B tePas, James T Pearson, Stuart B Hooper
BACKGROUND: A congenital diaphragmatic hernia can result in severe lung hypoplasia that increases the risk of morbidity and mortality after birth, but little is known about the cardiorespiratory transition at birth. METHODS: Using phase contrast X-ray imaging and angiography, we examined the cardiorespiratory transition at birth in rabbit kittens with diaphragmatic hernias (DH). Surgery was performed on pregnant New Zealand white rabbits (n=18) at 25 days gestation to induce a left-sided DH...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28396082/pregnancy-related-spontaneous-coronary-artery-dissection-a%C3%A2-case-series-and-literature-review
#9
Emily Rose, Maheedhar Gedela, Nathan Miller, Paul L Carpenter
BACKGROUND: Cardiac emergencies during pregnancy are rare but have significant associated morbidity and mortality when they do occur. The emergency physician must not only be aware of potentially life-threatening conditions in the pregnant woman, but also know the emergent management and treatment of these conditions to avoid worsening of the underlying condition. Pregnancy-related spontaneous coronary artery dissection has been described in the cardiology literature, but is not well-known in emergency medicine literature...
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28393778/safety-and-efficacy-of-ketamine-dexmedetomidine-versus-ketamine-propofol-combinations-for-sedation-in-patients-after-coronary-artery-bypass-graft-surgery
#10
Mona Mohamed Mogahd, Mohammed Shafik Mahran, Ghada Foad Elbaradi
BACKGROUND AND AIMS: Prolonged mechanical ventilation after cardiac surgery is associated with serious complications that increase morbidity and mortality. The present study was designed to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for sedation and analgesia in patients after coronary artery bypass graft (CABG) surgery as regards hemodynamics, total fentanyl dose, time of weaning from mechanical ventilation, time of extubation, and any adverse outcome...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#11
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28386925/vagus-nerve-stimulation-surgical-technique-of-implantation-and-revision-and-related-morbidity
#12
Flavio Giordano, Anna Zicca, Carmen Barba, Renzo Guerrini, Lorenzo Genitori
Indications for vagus nerve stimulation (VNS) therapy include focal, multifocal epilepsy, drop attacks (tonic/atonic seizures), Lennox-Gastaut syndrome, tuberous sclerosis complex (TSC)-related multifocal epilepsy, and unsuccessful resective surgery. Surgical outcome is about 50-60% for seizures control, and may also improve mood, cognition, and memory. On this basis, VNS has also been proposed for the treatment of major depression and Alzheimer's' disease. The vagus nerve stimulator must be implanted with blunt technique on the left side to avoid cardiac side effects through the classic approach for anterior cervical discectomy...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28384188/baroreflex-sensitivity-and-outcomes-following-coronary-surgery
#13
Marco Ranucci, Alberto Porta, Vlasta Bari, Valeria Pistuddi, Maria Teresa La Rovere
Postoperative atrial fibrillation, acute kidney dysfunction and low cardiac output following coronary surgery are associated with morbidity and mortality. The purpose of this study is to determine if the preoperative autonomic control is a determinant of these postoperative complications. This is a prospective cohort study on 150 adult patients undergoing surgical coronary revascularization with cardiopulmonary bypass. The patients received an autonomic control assessment after the induction of anesthesia. Baroreflex sensitivity was computed by spectral analysis and expressed as BRSαHF and BRSαLF for measure respectively in the high and low frequency domains...
2017: PloS One
https://www.readbyqxmd.com/read/28382803/impact-of-previous-cardiac-surgery-in-patients-undergoing-transcatheter-aortic-valve-implantation-a-systematic-review
#14
Sharaf-Eldin Shehada, Yacine Elhmidi, Nazan Puluca, Öznur Öztürk, Ender Demircioglu, Daniel Wendt, Heinz Jakob, Matthias Thielmann
INTRODUCTION: Redo surgical aortic valve replacement after prior cardiac surgery is usually related to a higher risk of mortality and morbidity. Transcatheter aortic valve implantation (TAVI) became an alternative therapy for those patients in the past couple of years. EVIDENCE ACQUISITION: We aimed in this study to analyze the outcomes of patients undergoing TAVI after a prior cardiac surgery especially those who underwent coronary artery bypass grafting (CABG) and to see if TAVI offers any advantages for those patients than conventional surgical aortic valve replacement...
April 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28381430/impact-of-sleep-disordered-breathing-on-short-term-post-operative-outcome-after-elective-coronary-artery-bypass-graft-surgery-a-prospective-observational-study
#15
Sven Rupprecht, Torsten Schultze, Andreas Nachtmann, Ardawan Julian Rastan, Torsten Doenst, Matthias Schwab, Otto W Witte, Sebastian Rohe, Isabelle Zwacka, Heike Hoyer
Sleep disordered breathing (SDB) is common in patients with coronary disease, but its impact on post-operative recovery after coronary artery bypass graft surgery (CABG) is unclear. We therefore determined the effects of SDB on post-operative outcome after elective CABG.In this prospective two-centre study, 219 patients due to receive elective CABG underwent cardiorespiratory polygraphy for SDB prior to surgery and were monitored for post-operative complications. The primary end-point was a composite of 30-day mortality or major post-operative complications (cardiac, respiratory, surgical, infectious, acute renal failure or stroke)...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28373479/eligibility-criteria-specific-to-pancreaticoduodenectomy-for-octogenarians-single-center-opinion
#16
Shunichi Shiozawa, Takebumi Usui, Kotaro Kuhara, Akira Tsuchiya, Tatsuomi Miyauchi, Teppei Kono, Yukio Shimojima, Shinichi Asaka, Kentaro Yamaguchi, Hajime Yokomizo, Takeshi Shimakawa, Kazuhiko Yoshimatsu, Takao Katsube, Yoshihiko Naritaka
BACKGROUND/AIM: Pancreaticoduodenectomy (PD) treatment outcomes in elderly patients have been reported to be acceptable, but the eligibility criteria are not clear. To elucidate the importance of PD in octogenarians in particular, we set five eligibility criteria for elderly patients based on preoperative cardiac and pulmonary function, nutritional status, daily activity status, and psychological independence status for the first time and evaluated prospectively whether the validity of patient selection was adaptable...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28372451/effectiveness-of-arterial-embolization-in-recurrent-bleeding-due-to-duodenal-ulcer-during-postoperative-cardiac-surgery
#17
Caridad Marín Hernández, Pablo Ramírez Romero, Rubén Jara, Daniel Carbonell, Pascual Parrilla
Upper gastrointestinal bleeding is one of the most frequent complications after cardiac surgery and endoscopic treatment (ET) is often the first-choice procedure. When it fails, surgery can be an option but has significant mortality and morbidity. We propose arterial embolization (TAE: transcatheter arterial embolization) as an alternative treatment in selected cases.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28369475/national-trends-and-variability-in-blood-utilization-in-paediatric-cardiac-surgery
#18
Mohsen Karimi, Jill M Sullivan, Trudy Lerer, Carla Hronek
OBJECTIVES: Red blood cell transfusion is a common practice in paediatric cardiac surgery. Transfusion of red blood cells has been shown to be associated with an increase in morbidity in paediatric patients undergoing cardiac surgery. There is a huge variability in the practice of blood utilization within and across different practices. The aim of this study was to demonstrate the current variability and the trends over the past decade in blood usage among children's hospitals performing paediatric cardiac surgery...
March 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28369234/postoperative-atrial-fibrillation-following-cardiac-surgery-a-persistent-complication
#19
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28366715/twenty-years-of-anesthetic-and-perioperative-management-of-patients-with-tetralogy-of-fallot-with-absent-pulmonary-valve
#20
John D Jochman, Douglas B Atkinson, Luis G Quinonez, Morgan L Brown
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. DESIGN: Retrospective chart review. SETTING: Large academic children's hospital. PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. INTERVENTIONS: None...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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