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Complications in cardiac surgery

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https://www.readbyqxmd.com/read/28636506/incidence-and-predictors-of-atrial-fibrillation-after-coronary-artery-bypass-surgery-detection-by-event-loop-recorder-monitoring-from-a-contemporary-multicentre-cohort
#1
Zainab Abdel-Salam, Wail Nammas
Background Atrial fibrillation (AF) is a frequent complication after cardiac surgery. We explored the incidence and predictors of post-operative AF at 30-day follow-up in an unselected multi-centre cohort of patients undergoing elective coronary artery bypass grafting (CABG) in contemporary practice. Methods and results We enrolled 740 consecutive patients scheduled for elective CABG with or without valve surgery. Cardiac rhythm was continuously monitored for 15 days after surgery by an ambulatory event loop recorder...
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28636504/prognostic-value-of-the-new-high-sensitive-cardiac-troponin-t-assay-hs-ctnt-after-coronary-artery-bypass-grafting
#2
Arash Mehdiani, Payam Akhyari, Hiroyuki Kamiya, Joachim Ahlers, Erhard Godehardt, Alexander Albert, Udo Boeken, Artur Lichtenberg
Background The aim of the study was to assess the value of post-operative cardiac troponin T-levels, measured with a new highly sensitive assay (hs-cTnT), as a suitable parameter to predict patients' outcome after cardiac surgery. With the introduction of the new hs-cTnT assay the correlation between measured levels and the post-operative patient's outcome remains to be evaluated. Methods Patients undergoing coronary artery bypass grafting (n = 213) were included. Perioperative measurements of hs-cTnT and CK-MB were correlated to parameters of clinical outcome and further explored...
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28632652/utility-of-cardiac-magnetic-resonance-imaging-in-the-management-of-adult-congenital-heart-disease
#3
Giuseppe Muscogiuri, Aurelio Secinaro, Paolo Ciliberti, Megan Fuqua, Arni Nutting
The increasing number of patients with adult congenital heart disease (ACHD) calls for the development of noninvasive imaging techniques that allow a long-term evaluation of native and postsurgical anatomy and function. Echocardiography remains the imaging modality of choice for congenital heart disease, but it is affected by limited acoustic windows and poor tissue characterization. Cardiac computed tomography and cardiac catheter angiography are 2 valid alternatives for the anatomic and functional assessment of ACHD; however, both use ionizing radiation, and cardiac catheter angiography requires an invasive approach...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#4
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#5
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#6
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28628748/does-young-age-really-put-the-heart-at-risk
#7
Michael P Belanger, Luke Yang Tan, Carin Wittnich
Despite significant advances in the management and treatment of heart disease in children, there continue to be patients who have worse outcomes than might be expected. A number of risk factors that could be responsible have been identified. Evidence based findings will be reviewed including whether young age and/or reduced body weight exacerbate these responses. For example, newborn children undergoing congenital cardiac surgery are known to have worse outcomes than older children. Evidence exists that newborn hearts do not tolerate ischemia as well as adults; developing irreversible injury sooner and exhibiting at risk metabolic profiles...
June 19, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28625607/postoperative-myocardial-infarction-in-an-orthognatic-jaw-surgery
#8
F Vieira Marques, F Montenegro Sá, T Lapa, I Simões
Cardiovascular complications, in particular perioperative myocardial infarctions, are central contributors to morbidity and mortality after non-cardiac surgery. We present a case of a 41-year-old male, smoker and dyslipidemic, who underwent bimaxillary orthognathic jaw surgery with the development of an acute coronary syndrome in the immediate postoperative period. We managed to early diagnose the myocardial infarction and promptly performed a percutaneous transluminal coronary angioplasty, resulting in a positive outcome...
June 15, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28625356/prognostic-markers-of-outcome-in-patients-undergoing-infra-inguinal-revascularisation-a-prospective-observational-pilot-study
#9
M Kanakaraj, D R Yates, R J T Wilson, M L Baroni, S J Davies
OBJECTIVES: The aim was to investigate whether cardiopulmonary exercise testing (CPET) variables derived from cycle and arm ergonometry correlate, and whether CPET variables and pre-operative N-terminal pro-brain natriuretic peptide (NT-proBNP) have prognostic significance and if the combination of the two has incremental value. METHODS: A prospective observational pilot study was conducted; 70 patients who underwent infra-inguinal bypass surgery were recruited...
June 15, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28625238/-risk-factors-of-perioperative-intra-aortic-balloon-pump-complications-in-cardiac-surgery-a-12-year-single-institution-analysis
#10
Hongyan Zhou, Yonghui Zhang, Yu Du, Fangfang Cao, Ji Wang, Li Zhao, Yu Nie, Haitao Zhang
OBJECTIVE: To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. METHODS: The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623953/early-versus-late-initiation-of-renal-replacement-therapy-impacts-mortality-in-patients-with-acute-kidney-injury-post-cardiac-surgery-a-meta-analysis
#11
Honghong Zou, Qianwen Hong, Gaosi Xu
BACKGROUND: Acute kidney injury (AKI) is a common clinical complication of cardiac surgery and increases mortality and hospitalization. We aimed to explore and perform an updated meta-analysis of qualitative and quantitative evaluations of the relationship between early renal replacement therapy (RRT) and mortality. METHODS: We searched the Chinese Biomedical Database, the Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed. RESULTS: Fifteen studies (five randomized controlled trials (RCTs), one prospective cohort and nine retrospective cohorts) including 1479 patients were identified for detailed evaluation...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623015/inadvertent-left-ventricular-pacing-and-perforation-by-a-temporary-pacemaker
#12
Jingyang Lin, Lihong Wang, Yan Zhao
Myocardial perforation by pacemaker electrode is a very serious complication. Usually, the pacemaker electrode perforates the right ventricle, but rarely the left ventricular myocardium. We describe an 82-year-old female patient who presented with left ventricular pacing after temporary pacemaker implantation and was diagnosed with myocardial perforation. Emergency thoracotomy showed that the exact position of the cardiac perforation was close to the left ventricular apex. Perforation of the left ventricular free wall by an electrode sometimes progresses slowly...
June 3, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28617685/adult-congenital-heart-disease-magnitude-of-the-problem
#13
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. RECENT FINDINGS: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28616836/outpatient-versus-observation-inpatient-parotidectomy-patient-factors-and-perioperative-complications
#14
Adam J Van Horn, Richard A Goldman, Richard J Charnigo, Kai C Johnson, Joseph Valentino, Rony K Aouad
The objective of this manuscript is to review a single institution's experience with superficial or total parotidectomy in outpatient and observation/inpatient groups. All patients who underwent superficial or total parotidectomy between 2009 and 2015 were identified. Patients were excluded if they had undergone concurrent surgery such as neck dissection, had prior radiation treatment or surgery at the operative site. Main outcomes were perioperative complications in both groups. 215 consecutive patients were included in the study, 116 (54%) patients in the inpatient group and 99 (46%) in the outpatient group...
June 14, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28616346/emergent-aortic-surgery-in-octogenarians-is-the-advanced-age-a-contraindication
#15
REVIEW
Mario Castaño, Javier Gualis, Jose M Martínez-Comendador, Elio Martín, Pasquale Maiorano, Laura Castillo
Surgery of both the ascending and descending aortic segments in the context of an acute aortic syndrome is one of the greatest challenges for the cardiac surgeon. In the case of surgery of the descending aorta, surgical risk increases due to the technical complexity, the required aggressive approach and because surgical indication is usually established as a result of complications and therefore involves, almost always, critically ill patients. The aging of the population is causing such surgery to be considered in an increasing number of octogenarians...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616343/debranching-aortic-surgery
#16
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616279/benefits-of-a-right-anterolateral-minithoracotomy-rather-than-a-median-sternotomy-in-isolated-tricuspid-redo-procedures
#17
Aikebaier Maimaiti, Lai Wei, Ye Yang, Huan Liu, Chunsheng Wang
BACKGROUND: To compare results of tricuspid valve (TV) reoperation between incision via a right anterolateral minithoracotomy (RAMT) and median sternotomy (MS). METHODS: We performed a retrospective analysis of 49 patients who underwent isolated TV surgery as a reoperation at our institution between 2006 and 2015. Previous cardiac operations included mitral, aortic, and TV surgeries, atrial septal defect repair, and pericardiectomy. The mean age of the patients was 51...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614020/cardiovascular-assessment-for-non-cardiac-surgery-european-guidelines
#18
Edward Gilbert-Kawai, Hugh Montgomery
In 2014, a joint task force involving the European Society of Cardiology and European Society of Anaesthesiology assembled 'Guidelines on non-cardiac surgery: cardiovascular assessment and management'. The guidelines, subsequently published in the European Heart Journal, are intended for physicians and collaborators involved in the perioperative care of patients undergoing non-cardiac surgery, in whom heart disease is a potential source of complications. While the guidelines are an extremely relevant and useful aid for most, if not all, medics within the hospital environment, the sheer size of the document (49 pages) renders it a feat to read and digest...
June 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28612915/how-to-predict-the-risk-of-postoperative-complications-after-coronary-artery-bypass-grafting-in-patients-under-50-and-over-80-years-old-a-retrospective-cross-sectional-study
#19
Jacek Piątek, Anna Kędziora, Grzegorz Kiełbasa, Marta Olszewska, Dorota Sobczyk, Bryan HyoChan Song, Janusz Konstanty-Kalandyk, Tomasz Darocha, Karol Wierzbicki, Irena Milaniak, Krzysztof Wróbel, Bogusław Kapelak
BACKGROUND: Coronary artery disease (CAD) remains the leading cause of death in developed countries and there is an increasing number of both young and elderly patients requiring surgical treatment. Despite improvement of conventional risk stratification scores (EuroSCORE II, STS risk score), all of the calculations are estimated based on the typical population and the studies emphasize that the scales may need further investigation and modernization, as demographic changes of the population suffering from CAD are unavoidable...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28607609/efficacy-of-ranolazine-in-preventing-atrial-fibrillation-following-cardiac-surgery-results-from-a-meta-analysis
#20
REVIEW
Chintan Trivedi, Ankit Upadhyay, Kinjal Solanki
BACKGROUND: Atrial fibrillation (AF) is a common complication after cardiac surgery. Ranolazine is a Food and Drug Administration approved anti-ischemic drug, which also has anti-arrhythmic properties. Recent studies have demonstrated the benefit of ranolazine in preventing post-operative AF (POAF) in patients undergoing cardiac surgery. Hence, we performed a meta-analysis of published studies comparing ranolazine plus standard therapy versus standard therapy for POAF prevention in patients undergoing cardiac surgery...
June 2017: Journal of Arrhythmia
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