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Diabetes and cardiac surgery

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https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#1
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#2
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/29108893/bariatric-surgery-as-a-treatment-for-heart-failure-review-of-the-literature-and-potential-mechanisms
#3
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/29104016/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#4
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
OBJECTIVE: Del Nido cardioplegia (DC) offers prolonged cardiac protection with single dose administration and has been shown to be safe in adult CABG surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of del Nido cardioplegia versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: From 8/2011 to 5/2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n=101) or DC (n= 77)...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29103604/incidence-predictors-and-mortality-of-infective-endocarditis-in-adults-with-congenital-heart-disease-without-prosthetic-valves
#5
Darren Mylotte, Dinela Rushani, Judith Therrien, Liming Guo, Aihua Liu, Kenneth Guo, Giuseppe Martucci, Andrew S Mackie, Jay S Kaufman, Ariane Marelli
Congenital heart disease (CHD) increases the risk of infective endocarditis (IE), though the lesion-specific risk and mortality are poorly defined. Using the population-based Quebec CHD database, we sought to describe the predictors of IE and to evaluate if IE was associated with mortality among adult CHD (ACHD) patients without prior valve replacement surgery. We extracted data on ACHD patients with IE and assessed the lesion-specific incidence of IE, risk factors for IE acquisition, and all-cause 1-year mortality...
October 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29092871/heart-transplant-outcomes-in-patients-with-pretransplant-diabetes-mellitus
#6
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Findings on outcomes of heart transplant patients who had diabetes mellitus before transplant are conflicting. OBJECTIVE: To compare survival, hospitalization, and complications in heart transplant recipients during the first 3 years after surgery in recipients with or without diabetes mellitus before transplant. METHODS: Of 347 recipients, 64 were diabetic (35.9% taking insulin; mean age 56 years; 17.2% females; 12.5% minorities) and 283 were not (mean age 51 years; 20...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29075499/metformin-therapy-and-postoperative-atrial-fibrillation-in-diabetic-patients-after-cardiac-surgery
#7
Suresh Basnet, Andrzej Kozikowski, Haiyan Sun, Melissa Troup, Luis E Urrutia, Renee Pekmezaris
BACKGROUND: Postoperative atrial fibrillation (AF) commonly occurs in cardiac surgery patients. Studies suggest inflammation and oxidative stress contribute to postoperative AF development in this patient population. Metformin exerts an anti-inflammatory effect that reduces oxidative stress and thus may play a role in preventing postoperative AF. METHODS: We conducted a matched, retrospective cohort study of diabetic patients' age ≥18 undergoing a coronary artery bypass graft (CABG) and/or cardiac valve surgery from January 1, 2009, to November 30, 2014...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29062740/outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-in-the-octogenarians-surgery-still-the-gold-standard
#8
Sameer A Hirji, Fernando Ramirez-Del Val, Ahmed A Kolkailah, Julius I Ejiofor, Siobhan McGurk, Ritam Chowdhury, Jiyae Lee, Pinak B Shah, Piotr S Sobieszczyk, Sary F Aranki, Marc P Pelletier, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR. METHODS: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062616/association-of-internal-mammary-artery-flow-with-different-comorbidities-and-post-coronary-artery-bypass-graft-complications
#9
Mudassir Iqbal Dar, Asim Hassan Dar, Muhammad Bilal, Mansoor Ahmad, Abdul Haseeb
Objective The internal mammary artery (IMA) is commonly used arterial graft for coronary artery bypass surgery (CABG). The IMA has a better patency and survival. This study considers different comorbidities and conditions where IMA flow may be low. Therefore, the main objective is to determine the flow of IMA in different diseases, its relation to gender, age, and in different blood groups in order to prevent possible complications. Methods A prospective study was conducted at the Cardiac Surgery Unit, Civil Hospital Karachi from January 2013 to December 2015...
August 20, 2017: Curēus
https://www.readbyqxmd.com/read/29049838/predicting-long-term-survival-after-coronary-artery-bypass-graft-surgery
#10
Md N Karim, Christopher M Reid, Mollah Huq, Samuel L Brilleman, Andrew Cochrane, Lavinia Tran, Baki Billah
OBJECTIVES: To develop a model for predicting long-term survival following coronary artery bypass graft surgery. METHODS: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Cox regression models were fitted separately, using the important preoperative variables, for 4 'time intervals' (31-90 days, 91-365 days, 1-3 years and >3 years), with optimal predictors selected using the bootstrap bagging technique...
October 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049633/cardiopulmonary-bypass-does-not-induce-lung-dysfunction-after-pulmonary-thrombarterectomy-role-of-pulmonary-compliance
#11
Thierry Sacuto, Yann Sacuto
OBJECTIVES: Pulmonary endarterectomy is a heavy surgical procedure that is performed under cardiopulmonary bypass (CPB) and aimed to cure postembolic pulmonary hypertension. Reperfusion oedema is both the hallmark of successful surgical procedure and the most frequent postoperative complication. Post-CPB lung dysfunction was not mentioned in any report. We undertook a study to determine whether post-CPB lung dysfunction was present in these patients. METHODS: In a retrospective cohort study with matching on some baseline covariates, we selected 41 patients who had undergone pulmonary endarterectomy and in whom pre-, intra- and postoperative records were complete...
July 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049508/outcomes-in-women-and-minorities-compared-with-white-men-1-year-after-everolimus-eluting-stent-implantation-insights-and-results-from-the-platinum-diversity-and-promus-element-plus-post-approval-study-pooled-analysis
#12
Wayne Batchelor, David E Kandzari, Scott Davis, Luis Tami, John C Wang, Islam Othman, Osvaldo S Gigliotti, Amir Haghighat, Sarabjeet Singh, Mario Lopez, Gregory Giugliano, Phillip A Horwitz, Jaya Chandrasekhar, Paul Underwood, Craig A Thompson, Roxana Mehran
Importance: There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI). Objective: To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents. Design, Settings, and Participants: The PLATINUM Diversity study was a single-arm study enrolling women and minorities. Patient-level pooling with the PROMUS Element Plus Post-Approval Study was prespecified...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#13
Dermot J Kelly, Sinéad M Farrell
More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe-akin to a Starling resistor-and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29047318/spontaneous-spinal-epidural-hemorrhage-following-disseminated-intravascular-coagulation-resulting-in-paraplegia-a-case-report
#14
Nazia Dildar, Saeed Bin Ayaz, Muhammad Omer Aamir, Nadeem Ahmad
CONTEXT: Spontaneous spinal epidural hemorrhage (SSEH) mostly presents as low back pain with or without a radiculopathy, and rarely with paraplegia or tetraplegia depending on the site and severity of spinal cord compression. We present here a case who had anemia and developed paraplegia following disseminated intravascular coagulation (DIC) due to a transfusion reaction. FINDINGS: A 65-year-old lady presented with sudden onset chest pain radiating to nape of the neck followed by loss of sensations and power in legs few hours after a blood transfusion...
October 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29045740/adding-vancomycin-to-perioperative-prophylaxis-decreases-deep-sternal-wound-infections-in-high-risk-cardiac-surgery-patients
#15
Sylvia Reineke, Thierry P Carrel, Verena Eigenmann, Brigitta Gahl, Urs Fuehrer, Christian Seidl, David Reineke, Eva Roost, Magi Bächli, Jonas Marschall, Lars Englberger
OBJECTIVES: Perioperative prophylaxis with cephalosporins reduces sternal wound infections (SWIs) after cardiac surgery. However, more than 50% of coagulase-negative staphylococci, an important pathogen, are cephalosporin resistant. The aim of this study was to determine the impact of adjunctive vancomycin on SWIs in high-risk patients. METHODS: We conducted a pre- and postintervention study in an academic hospital. Preintervention (2010-2011), all patients received prophylaxis with 1...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29036976/-comparison-of-perioperative-serum-thrombomodulin-levels-in-patients-underwent-off-pump-coronary-artery-bypass-grafting-with-and-without-cardiogenic-shock
#16
L Zhang, C Wang, T X Gu, C M Lu, Z W Wang
Objective: To observe the perioperative changes of serum thrombomodulin in patients with and without cardiogenic shock undergoing off-pump coronary artery bypass grafting surgery. Methods: A total of 66 patients with coronary artery disease who underwent off-pump coronary artery bypass grafting surgery between June and December 2015 in our hospital were included in this study.The patients were divided into non-cardiogenic shock group (n=51) and shock group (n=15) according to the absence or presence of cardiogenic shock...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29034031/coronary-artery-bypass-surgery-in-end-stage-renal-disease-patients
#17
REVIEW
Daijiro Hori, Atsushi Yamaguchi, Hideo Adachi
The number of patients requiring hemodialysis is continuously increasing around the world. Hemodialysis affects patient quality of life and it is also associated with a higher risk for cardiovascular events. In addition to traditional risk factors for cardiovascular events such as hypertension, hyperlipidemia, and diabetes, hemodialysis is associated with hyperphosphatemia, chronic inflammation, vascular calcification, and anemia which accelerate atherosclerosis, vascular stiffness, and cardiac ischemia. Treatment strategy for coronary revascularization in this progressive disease remains controversial...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29017807/unplanned-30-day-readmission-in-patients-with-diabetic-foot-wounds-treated-in-a-multidisciplinary-setting
#18
Courtenay M Holscher, Caitlin W Hicks, Joseph K Canner, Ronald L Sherman, Mahmoud B Malas, James H Black, Nestoras Mathioudakis, Christopher J Abularrage
OBJECTIVE: Readmission rates are known to be high for vascular surgery patients in general, but there are limited data describing the risk of surgical and nonsurgical readmission among patients with diabetic foot ulcers (DFUs). Our aim was to identify factors associated with unplanned readmission in DFU patients treated in a multidisciplinary setting. METHODS: We studied a single-center cohort of patients enrolled in a multidisciplinary diabetic foot service (July 2012-June 2017)...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29016439/examining-the-ability-of-artificial-neural-networks-machine-learning-models-to-accurately-predict-complications-following-posterior-lumbar-spine-fusion
#19
Jun S Kim, Robert K Merrill, Varun Arvind, Deepak Kaji, Sara D Pasik, Chuma C Nwachukwu, Luilly Vargas, Nebiyu S Osman, Eric K Oermann, John M Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following posterior lumbar spine fusion. SUMMARY OF BACKGROUND DATA: Machine learning models such as artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex datasets. ANNs have yet to be used for risk factor analysis in orthopedic surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent posterior lumbar spine fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28985857/cyclooxygenase-2-contributes-to-bradykinin-induced-microvascular-responses-in%C3%A2-peripheral-arterioles-after-cardiopulmonary-bypass
#20
Jun Feng, Kelsey Anderson, Yuhong Liu, Arun K Singh, Afshin Ehsan, Frank W Sellke
BACKGROUND: Diabetic patients are associated with impaired peripheral microvascular function after cardiopulmonary bypass (CPB) and cardiac surgery. We hypothesized that upregulation of the inducible cyclooxygenase 2 (COX-2) contributes to altered microvascular reactivity of peripheral arterioles in diabetic patients undergoing CPB and cardiac surgery. METHODS: Skeletal muscle samples of nondiabetic (ND) patients and patients with diabetes mellitus (DM; n = 8 per group) undergoing cardiac surgery were harvested before and after CPB...
October 2017: Journal of Surgical Research
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