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Morbidity in cardiac surgery

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https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#1
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29149143/efficacy-of-magnesium-sulfate-added-to-local-anesthetic-in-a-transversus-abdominis-plane-block-for-analgesia-following-total-abdominal-hysterectomy-a-randomized-trial
#2
Kelany A Abd-Elsalam, Khaled M Fares, Montaser A Mohamed, Mohamed F Mohamed, Ahmad M Abd El-Rahman, Moaaz M Tohamy
BACKGROUND: Major abdominal surgeries are associated with severe pain, which can affect respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity. OBJECTIVE: We aim at evaluating the efficacy of magnesium sulfate as an adjuvant to local anesthetic in an ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in total abdominal hysterectomy. STUDY DESIGN: A prospective, randomized, double-blinded clinical trial...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29145887/postpartum-infective-endocarditis-with-enterococcus-faecalis-in-japan-a-case-report
#3
Miku Tamura, Mitsutaka Shoji, Ken Fujita, Shohei Nakamura, Yurika Takahashi, Yurika Suzuki, Mika Asakura, Shun Kimizuka, Makiko Sasaki, Katsuya Sugawara
BACKGROUND: The clinical characteristics of infective endocarditis include the presence of predisposing cardiac disease, a history of illegal drug use, and high morbidity in the elderly. Only a few cases of the disease after delivery have been reported in the literature. We describe here a first case of enterococcal postpartum infective endocarditis without underlying disease in Japan. CASE PRESENTATION: We report the case of a 31-year-old Japanese woman with postpartum infective endocarditis by Enterococcus faecalis...
November 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29138974/medical-complications-and-mortality-in-octogenarians-undergoing-elective-spinal-fusion-surgeries
#4
Sharad Rajpal, E Lee Nelson, Alan T Villavicencio, Jayratna Telang, Roshan Kantha, Kara Beasley, Sigita Burneikiene
BACKGROUND: The consequences of suffering postoperative complications in elderly undergoing spinal surgeries may be different compared to younger patients. The primary objective of this study was to identify the types and frequency of medical complications and mortality rates in patients 80 years of age or older undergoing elective spinal fusion surgeries for degenerative spinal disease. METHODS: A prospective observational study with a retrospective chart review was performed, which included all consecutive patients ≥80 years old undergoing elective spinal fusion surgeries from May 2012 to August 2015...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29132699/is-endocan-a-diagnostic-marker-for-pneumonia-after-cardiac-surgery-the-endolung-study
#5
Andréa Perrotti, Camille Chenevier-Gobeaux, Fiona Ecarnot, Karine Bardonnet, Benoit Barrucand, Guillaume Flicoteaux, Philippe Lassalle, Sidney Chocron
BACKGROUND: Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. METHODS: Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery)...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#6
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29129562/preoperative-use-of-oral-beta-adrenergic-blocking-agents-and-the-incidence-of-new-onset-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#7
REVIEW
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29128923/fluid-overload-independent-of-acute-kidney-injury-predicts-poor-outcomes-in-neonates-following-congenital-heart-surgery
#8
Kenneth E Mah, Shiying Hao, Scott M Sutherland, David M Kwiatkowski, David M Axelrod, Christopher S Almond, Catherine D Krawczeski, Andrew Y Shin
BACKGROUND: Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). METHODS: This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded...
November 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29126686/transfusion-threshold-of-hemoglobin-80-g-l-is-comparable-to-100-g-l-in-terms-of-bleeding-in-cardiac-surgery-a-prospective-randomized-study
#9
Antti Laine, Tomi Niemi, Alexey Schramko
OBJECTIVE: Anemia is common after cardiac surgery and, according to some suggestive evidence, may be associated with increased bleeding, other morbidity, and mortality. However, transfusion of red blood cells (RBC) may cause adverse effects and increase cost. The authors hypothesized that the restrictive hemoglobin threshold (Hb of 80 g/L) may aggravate bleeding more than the higher Hb threshold (Hb 100 g/L). DESIGN: Prospective randomized trial. TYPE OF HOSPITAL: University Hospital of Helsinki, Finland...
August 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29125824/intraluminal-valves-development-function-and-disease
#10
REVIEW
Xin Geng, Boksik Cha, Md Riaj Mahamud, R Sathish Srinivasan
The circulatory system consists of the heart, blood vessels and lymphatic vessels, which function in parallel to provide nutrients and remove waste from the body. Vascular function depends on valves, which regulate unidirectional fluid flow against gravitational and pressure gradients. Severe valve disorders can cause mortality and some are associated with severe morbidity. Although cardiac valve defects can be treated by valve replacement surgery, no treatment is currently available for valve disorders of the veins and lymphatics...
November 1, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29124558/development-of-a-simple-device-enabling-percutaneous-flow-regulation-for-a-small-vascular-graft-for-a-blalock-taussig-shunt-capable-of-flow-regulation-complete-translation-of-a-review-article-originally-published-in-pediatric-cardiology-and-cardiac-surgery
#11
Yoshikazu Motohashi, Ryo Shimada, Tomoyasu Sasaki, Takahiro Katsumata, Kazunori Dan, Yasuhiro Tsutsui, Shintaro Nemoto
OBJECTIVES: The Blalock-Taussig shunt (BTS) operation is a cornerstone as initial palliative surgery for congenital heart disease with severely reduced pulmonary blood flow (PBF). The ideal PBF provided by BTS is crucial for an uneventful postoperative course, since excess PBF results in acute distress of the systemic circulation and insufficient PBF requires another BTS surgery. Therefore, the goal of this study was to develop a simple device to control the shunt graft flow percutaneously using a constrictor balloon connected to a subcutaneous port...
November 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123584/analysis-of-postoperative-morbidity-and-mortality-following-surgery-for-gastric-cancer-surgeon-volume-as-the-most-significant-prognostic-factor
#12
Maciej Ciesielski, Wiesław J Kruszewski, Jakub Walczak, Mariusz Szajewski, Jarosław Szefel, Jacek Wydra, Tomasz Buczek, Maksymilian Czerepko
Introduction: Surgical resection is the only potentially curative modality for gastric cancer and it is associated with substantial morbidity and mortality. Aim: To determine risk factors for postoperative morbidity and mortality following major surgery for gastric cancer. Material and methods: Between 1.08.2006 and 30.11.2014 in the Department of Oncological Surgery of Gdynia Oncology Centre 162 patients underwent gastric resection for adenocarcinoma...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#13
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29120136/postoperative-atrial-fibrillation-prophylaxis-and-lung-resection-%C3%A2-our-experience-with-608-consecutive-patients
#14
Vjekoslav Karadža, Dinko Stančić-Rokotov, Jasna Špiček Macan, Nevenka Hodoba, Nevenka Kolarić, Sanja Sakan
Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. This period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29108893/bariatric-surgery-as-a-treatment-for-heart-failure-review-of-the-literature-and-potential-mechanisms
#15
Tammy L Kindel, Jennifer L Strande
Heart failure due to severe obesity is a complex disease due to multiple mechanisms, including increased body mass, inflammation, and impaired cardiac metabolism that is complicated by obesity-associated co-morbidities, such as type 2 diabetes and obstructive sleep apnea. Bariatric surgery significantly improves cardiac geometry, function, and symptoms related to obesity cardiomyopathy. There is a consistently positive impact of bariatric surgery on diastolic function with the potential to significantly improve systolic function as measured by ejection fraction in patients with advanced heart failure...
October 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29104127/incidence-risk-factors-and-prognostic-impact-of-re-exploration-for-bleeding-after-cardiac-surgery-a-retrospective-cohort-study
#16
Lucas B Ohmes, Antonino Di Franco, T Sloane Guy, Christopher Lau, Monica Munjal, William Debois, Zhongyi Li, Karl H Krieger, Alexandra N Schwann, Jeremy R Leonard, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative re-exploration for bleeding (RB) is a frequent complication following cardiac surgery. We aim to assess incidence, risk factors, and prognostic significance of RB in a large cohort of cardiac patients. MATERIALS AND METHODS: We reviewed prospectively collected data for all patients who underwent cardiac surgery at our institution from 2007 to 2015. Logistic regression analysis was used to identify independent predictors of RB and specific outcomes...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29102688/beating-heart-mitral-valve-repair-using-a-novel-eptfe-cordal-implantation-device-prospective-trial
#17
James S Gammie, Krzysztof Bartus, Andrzej Gackowski, Michael N D'Ambra, Piotr Szymanski, Agata Bilewska, Mariusz Kusmierczyk, Boguslaw Kapelak, Jolanta Rzucidlo-Resil, Neil Moat, Alison Duncan, Rashmi Yadev, Steve Livesey, Paul Diprose, Gino Gerosa, Augusto D'Onofrio, Demetrio Pitterello, Paolo Denti, Giovanni La Canna, Michele De Bonis, Ottavio Alfieri, Judy Hung, Piotr Kolsut
BACKGROUND: We evaluated safety and performance of the Harpoon Mitral Valve Repair System (H-MVRS), a transesophageal echocardiographic-guided device designed to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on mitral leaflets in the beating heart. METHODS: In a prospective multicenter study, 30 consecutive patients with severe degenerative mitral regurgitation (MR) were treated with H-MVRS via small left thoracotomy. The primary (30 day) endpoint was successful implantation of cords with MR reduction to moderate or less...
October 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29101934/effect-of-cardiac-rehabilitation-dose-on-mortality-and-morbidity-a-systematic-review-and-meta-regression-analysis
#18
Carolina Santiago de Araújo Pio, Susan Marzolini, Maureen Pakosh, Sherry L Grace
OBJECTIVE: To ascertain the effect of cardiac rehabilitation (CR) dose (ie, duration × frequency/wk; categorized as low [<12 sessions], medium [12-35 sessions], or high [≥36 sessions]) on mortality and morbidity. METHODS: The Cochrane, CINAHL, EMBASE, PsycINFO, and MEDLINE databases were systematically searched from inception through November 30, 2015. Inclusion criteria included randomized or nonrandomized studies with a minimum CR dose of 4 or higher and presence of a control/comparison group...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29096877/-comparison-of-postoperative-analgesia-with-methadone-versus-morphine-in-cardiac-surgery
#19
Ana Carolina Carvalho, Fábio Jean Goulart Sebold, Patrícia Mello Garcia Calegari, Benhur Heleno de Oliveira, Fabiana Schuelter-Trevisol
BACKGROUND AND OBJECTIVES: Pain is an aggravating factor of postoperative morbidity and mortality. The aim of this study was to compare the effects of methadone versus morphine using the numerical rating scale of pain and postoperative on-demand analgesia in patients undergoing myocardial revascularization. METHOD: A randomized, double-blind, parallel clinical trial was performed with patients undergoing coronary artery bypass grafting. The subjects were randomly divided into two groups: Morphine Group (MoG) and Methadone Group (MeG)...
October 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29096673/sternal-reconstruction-after-post-sternotomy-mediastinitis
#20
REVIEW
Pankaj Kaul
BACKGROUND: Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. METHODOLOGY AND REVIEW: This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery...
November 2, 2017: Journal of Cardiothoracic Surgery
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