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Complications in cardiac surgery

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https://www.readbyqxmd.com/read/29792393/outcomes-of-transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-geriatric-patients-with-chronic-kidney-disease
#1
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD...
May 24, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29792232/effect-of-postoperative-goal-directed-therapy-in-cancer-patients-undergoing-high-risk-surgery-a-randomized-clinical-trial-and-meta-analysis
#2
Aline Rejane Muller Gerent, Juliano Pinheiro Almeida, Evgeny Fominskiy, Giovanni Landoni, Gisele Queiroz de Oliveira, Stephanie Itala Rizk, Julia Tizue Fukushima, Claudia Marques Simoes, Ulysses Ribeiro, Clarice Lee Park, Rosana Ely Nakamura, Rafael Alves Franco, Patricia Inês Cândido, Cintia Rosa Tavares, Ligia Camara, Graziela Dos Santos Rocha Ferreira, Elisangela Pinto Marinho de Almeida, Roberto Kalil Filho, Filomena Regina Barbosa Gomes Galas, Ludhmila Abrahão Hajjar
BACKGROUND: Perioperative goal-directed hemodynamic therapy (GDHT) has been advocated in high-risk patients undergoing noncardiac surgery to reduce postoperative morbidity and mortality. We hypothesized that using cardiac index (CI)-guided GDHT in the postoperative period for patients undergoing high-risk surgery for cancer treatment would reduce 30-day mortality and postoperative complications. METHODS: A randomized, parallel-group, superiority trial was performed in a tertiary oncology hospital...
May 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#3
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29787349/head-and-neck-cancer-patients-rates-reasons-and-risk-factors-for-30-day-unplanned-readmission
#4
Michael K Ghiam, Alexander Langerman, Zoukaa Sargi, Sarah Rohde
Objective To analyze rates, risk factors, and complications for 30-day readmission among head and neck cancer (HNC) patients. Methods Retrospective review of administrative records from Vizient (Irving, Texas) Clinical Data Base/Resource Manager on HNC patients who underwent a head and neck surgical procedure from January 2013 through September 2015 at 176 academic and community medical centers. Results Of the 18,121 patients included in the study, 2502 patients were readmitted within 30 days (13.8%). Mean time to readmission was 11 ± 8...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29786408/impact-of-additional-tricuspid-valve-annuloplasty-in-tof-patients-undergoing-pulmonary-valve-replacement
#5
Sabrina Lueck, Eike Bormann, Kathrin Rellensmann, Sven Martens, Andreas Rukosujew
BACKGROUND: Many patients with tetralogy of Fallot (TOF) who underwent surgical correction of their congenital cardiac malformation during infancy develop right ventricular dysfunction and exercise intolerance in the long term. The right ventricle (RV) dilates due to the development of severe pulmonary regurgitation (and secondary tricuspid insufficiency). To reduce RV dilation and improve exercise tolerance pulmonary valve replacement (PVR) is the common therapeutic strategy. Whether concomitant tricuspid valve repair (TVR) is beneficial in these pure volume-overload conditions is still unknown...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#6
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#7
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29779802/feasibility-of-initiating-early-enteral-nutrition-after-congenital-heart-surgery-in-neonates-and-infants
#8
Rajat Kalra, Rohit Vohra, Malti Negi, Reena Joshi, Neeraj Aggarwal, Mridul Aggarwal, Raja Joshi
OBJECTIVE: To assess the feasibility of initiating enteral nutrition support with first 24 h of congenital heart repairs in neonates and Infants and its impact on outcomes following surgery. DESIGN: It is a prospective randomized control single blind study. SETTING: It is a single centre prospective study carried out in a tertiary care centre at Pediatric cardiac intensive care unit. PATIENTS: All patients with the cyanotic congenital heart disease with increase pulmonary blood flow, weighing less than 5 kg and undergoing congenital heart repair during the study period were included in the study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779449/continuous-cytokine-haemoadsorption-incorporated-into-a-venoarterial-ecmo-circuit-for-the-management-of-postcardiotomy-cardiogenic-and-septic-shock-a-case-report
#9
Endre Nemeth, Szabolcs Szigeti, Tamas Varga, Laszlo Daroczi, Zoltan Barati, Bela Merkely, Janos Gal
INTRODUCTION: The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. CASE REPORT: A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29777769/a-combined-approach-for-the-early-recognition-of-acute-kidney-injury-after-adult-cardiac-surgery
#10
Cédrick Zaouter, Julien Potvin, Marie-Lise Bats, Marie-Christine Beauvieux, Alain Remy, Alexandre Ouattara
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent complication. The current criteria to detect CSA-AKI rise only when organic dysfunction has occurred. The Doppler Renal Resistive Index (RRI) and the urinary G1 cell cycle arrest proteins (TIMP-2 and IGFBP7) have been advocated to predict CSA-AKI at an early stage after cardiac surgery. The primary objective was to determine the predictive value of these new markers to detect CSA-AKI after elective heart surgery in patients at risk to develop AKI...
May 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29777672/valvectomy-versus-replacement-for-the-surgical-treatment-of-tricuspid-endocarditis
#11
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#12
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29776423/minimally-invasive-mitral-valve-repair-via-right-mini-thoracotomy-in-patient-with-myelodysplastic-syndrome
#13
Takura Taguchi, Hiroyuki Nishi, Kimihiro Kurose, Kohei Horikawa, Go Kanazawa, Toshiki Takahashi
BACKGROUND: Cardiac surgery for myelodysplastic syndrome (MDS) patients is challenging because anemia and neutropenia develop as a result of the syndrome, leading to infection and bleeding tendency during surgery. We report the case of minimally invasive mitral valve repair via a right mini-thoracotomy and perioperative use of granulocyte colony-stimulating factor (G-CSF) in a patient with MDS. CASE PRESENTATION: A 77-year-old man with myelodysplastic syndrome (MDS) was referred for surgical treatment for mitral valve regurgitation and underwent a minimally invasive mitral valve repair via a right mini-thoracotomy (MICS mitral procedure)...
May 18, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#14
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#15
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770300/tissue-engineered-vascular-grafts-for-pediatric-cardiac-surgery
#16
REVIEW
Toshihiro Shoji, Toshiharu Shinoka
New technologies and science have contributed to improved surgical outcomes in patients with congenital cardiovascular diseases. However, current materials display shortcomings, such as risk of infection and lack of growth capacity when applied to the pediatric patient population. Tissue engineering has the potential to address these limitations as the ideal tissue engineered vascular graft (TEVG) would be durable, biocompatible, nonthrombogenic, and ultimately remodel into native tissue. The traditional TEVG paradigm consists of a scaffold, cell source, and the integration of the scaffold and cells via seeding...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29770295/recent-innovations-in-perfusion-and-cardiopulmonary-bypass-for-neonatal-and-infant-cardiac-surgery
#17
REVIEW
David Sturmer, Claude Beaty, Sean Clingan, Eric Jenkins, Whitney Peters, Ming-Sing Si
The development and refinement of cardiopulmonary bypass (CPB) has made the repair of complex congenital heart defects possible in neonates and infants. In the past, the primary goal for these procedures was patient survival. Now that substantial survival rates have been achieved for even the most complex of repairs in these patients, focus has been given to the reduction of morbidity. Although a necessity for these complex neonatal and infant heart defect repairs, CPB can also be an important source of perioperative complications...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769488/plasma-neutrophil-gelatinase-associated-lipocalin-pngal-level-to-identify-aki-early-in-patients-undergoing-cardiac-valve-surgery
#18
O F Miah, D K Roy, A A Chowdhury, K S Alam, M B Alam, M R Anwar, F A Dowel, A Latif, A N Hai, M A Mahmud, M A Razzak, T Ahammod, S U Ahammed, H Mahmud, R S Paul
Cardiac valve surgery is considered one of the most frequent surgical procedures in which AKI is a common & serious complication. Although serum creatinine is routinely used as a marker of renal function, it poorly reflects the immediate post operative period renal function. Within minutes to few hours after a renal insult, plasma neutrophil gelatinase associated lipocalin (pNGAL) is released. The aim of this study was to assess the superiority of pNGAL over serum creatinine in detecting AKI in early post operative period...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29769287/the-protective-role-of-macrophage-migration-inhibitory-factor-in-acute-kidney-injury-after-cardiac-surgery
#19
Christian Stoppe, Luisa Averdunk, Andreas Goetzenich, Josefin Soppert, Arnaud Marlier, Sandra Kraemer, Jil Vieten, Mark Coburn, Ana Kowark, Bong-Song Kim, Gernot Marx, Steffen Rex, Akinobu Ochi, Lin Leng, Gilbert Moeckel, Andreas Linkermann, Omar El Bounkari, Alexander Zarbock, Jürgen Bernhagen, Sonja Djudjaj, Richard Bucala, Peter Boor
Acute kidney injury (AKI) represents the most frequent complication after cardiac surgery. Macrophage migration inhibitory factor (MIF) is a stress-regulating cytokine that was shown to protect the heart from myocardial ischemia-reperfusion injury, but its role in the pathogenesis of AKI remains unknown. In an observational study, serum and urinary MIF was quantified in 60 patients scheduled for elective conventional cardiac surgery with the use of cardiopulmonary bypass. Cardiac surgery triggered an increase in MIF serum concentrations, and patients with high circulating MIF (>median) 12 hours after surgery had a significantly reduced risk of developing AKI (relative risk reduction, 72...
May 16, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#20
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
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