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Cardiothoracic surgery

Romain Capoulade, Xin Zeng, Jessica R Overbey, Gorav Ailawadi, John H Alexander, Deborah Ascheim, Michael Bowdish, Annetine C Gelijns, Paul Grayburn, Irving L Kron, Robert A Levine, Michael J Mack, Serguei Melnitchouk, Robert E Michler, John C Mullen, Patrick O'Gara, Michael K Parides, Peter Smith, Pierre Voisine, Judy Hung
BACKGROUND: In ischemic mitral regurgitation (IMR), ring annuloplasty is associated with a significant rate of recurrent MR. Ring size is based on intertrigonal distance without consideration of left ventricular (LV) size. However, LV size is an important determinant of mitral valve (MV) leaflet tethering before and after repair. We aimed to determine whether LV-MV ring mismatch (mismatch of LV size relative to ring size) is associated with recurrent MR in patients with IMR after restrictive ring annuloplasty...
October 25, 2016: Circulation
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
Lorriana Elizabeth Leard
No abstract text is available yet for this article.
August 20, 2016: Journal of Heart and Lung Transplantation
Balaji K Tamarappoo, Allan L Klein
Post-pericardiotomy syndrome (PPS) occurs in a subgroup of patients who have undergone cardiothoracic surgery and is characterized by fever, pleuritic pain, pleural effusion, and pericardial effusion. It is associated with significant morbidity, and the leading complications include tamponade and constrictive pericarditis. Epidemiologic studies have found that PPS often occurs among younger patients; however, there is a lack of comprehensive risk stratification. It is therefore important to be able to identify patients who are at high risk for developing this disease...
November 2016: Current Cardiology Reports
Wei Yu, Bo Ye, Liyun Xu, Zhaoyu Wang, Hanbo Le, Shanjun Wang, Hanbo Cao, Zhenda Chai, Zhijun Chen, Qingquan Luo, Yongkui Zhang
BACKGROUND: The solitary pulmonary nodule (SPN) is a common and challenging clinical problem, especially solid SPN. The object of this study was to explore the predictive factors of SPN appearing as pure solid with malignance and to establish a clinical prediction model of solid SPNs. METHODS: We had a retrospective review of 317 solid SPNs (group A) having a final diagnosis in the department of thoracic surgery, Shanghai Chest Hospital from January 2015 to December 2015, and analyzed their clinical data and computed tomography (CT) images, including age, gender, smoking history, family history of cancer, previous cancer history, diameter of nodule, nodule location (upper lobe or non-upper lobe, left or right), clear border, smooth margin, lobulation, spiculation, vascular convergence, pleural retraction sign, air bronchogram sign, vocule sign, cavity and calcification...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
C Michael White, Elaine Nguyen
OBJECTIVE: To review the limitations of current antiarrhythmic drugs in atrial fibrillation (AF) and discuss the rationale and clinical trials supporting the use of ranolazine in AF. DATA SOURCES: MEDLINE was searched from 1980 to September 2016 using the terms ranolazine, atrial fibrillation, coronary artery bypass grafting, and valve surgery STUDY SELECTION AND DATA EXTRACTION: English-language studies and reviews assessing antiarrhythmic drugs, including ranolazine, were incorporated...
October 6, 2016: Annals of Pharmacotherapy
Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
Balraj Singh, Jennifer M Treece, Ghulam Murtaza, Samit Bhatheja, Steven J Lavine, Timir K Paul
A young otherwise healthy 27-year-old male who has been using anabolic steroids for a long time developed Type I aortic dissection associated with heavy weightlifting. The patient did not have a recent history of trauma to the chest, no history of hypertension, and no illicit drug use. He presented with severe chest pain radiating to back and syncopal event with exertion. Initial vitals were significant for blood pressure of 80/50 mmHg, pulse of 80 beats per minute, respirations of 24 per minute, and oxygen saturation of 92% on room air...
2016: Case Reports in Cardiology
Ngai-Yin Chan, Chi-Chung Choy
OBJECTIVE: The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. METHODS: In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. RESULTS: 56 (0...
October 12, 2016: Heart: Official Journal of the British Cardiac Society
Marije Smit, Maureen J M Werner, Annemieke Oude Lansink-Hartgring, Willem Dieperink, Jan G Zijlstra, Matijs van Meurs
BACKGROUND: Intra-abdominal hypertension (IAH) is frequently present in critically ill patients and is an independent predictor for mortality. Better recognition of clinically important thresholds is necessary. Increased intra-abdominal pressure (IAP) is associated with renal dysfunction, and renal failure is one of the most consistently described organ dysfunctions associated with IAH. Obesity is also associated with kidney injury. The underlying mechanisms are not yet fully understood...
December 2016: Annals of Intensive Care
Anthony T Gerlach, Danielle M Blais, G Morgan Jones, Pamela K Burcham, Stanislaw P Stawicki, Charles H Cook, Claire V Murphy
BACKGROUND: Dexmedetomidine is commonly used for sedation in the Intensive Care Unit (ICU), and its use may be associated with hypotension. We sought to determine predictors of dexmedetomidine-associated hypotension. METHODS: Retrospective, single-center study of 283 ICU patients in four adults ICUs over a 12 month period. Univariate analyses were performed to determine factors associated with dexmedetomidine-related hypotension. Risk factors significant at the 0...
July 2016: International Journal of Critical Illness and Injury Science
Prakashchandra Shetty, Satheesha B Nayak, Rajesh Thangarajan, Melanie Rose D'Souza
Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. The right cephalic vein ascended upwards, superficial to the lateral part of the clavicle and terminated into the external jugular vein...
September 2016: Anatomy & Cell Biology
Nicholas Tan, Rahul Sampath, Omar M Abu Saleh, Marysia S Tweet, Dragan Jevremovic, Saba Alniemi, Nancy L Wengenack, Priya Sampathkumar, Andrew D Badley
Ten case reports of disseminated Mycobacterium chimaera infections associated with cardiovascular surgery were published from Europe. We report 3 cases of disseminated M chimaera infections with histories of aortic graft and/or valvular surgery within the United States. Two of 3 patients demonstrated ocular involvement, a potentially important clinical finding.
September 2016: Open Forum Infectious Diseases
Maja S Sommer, Karen Trier, Jette Vibe-Petersen, Karl B Christensen, Malene Missel, Merete Christensen, Klaus R Larsen, Seppo W Langer, Carsten Hendriksen, Paul F Clementsen, Jesper H Pedersen, Henning Langberg
INTRODUCTION: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. OBJECTIVES: The objective is to present health-related quality of life (HRQoL) changes over time before and 1 year after surgery in patients with NSCLC participating in a rehabilitation program. METHODS: Forty patients with NSCLC in disease stage I to IIIa, referred for surgical resection at the Department of Cardiothoracic Surgery RT, Rigshospitalet, were included in the study...
October 3, 2016: Integrative Cancer Therapies
Sharon L Cheatham, Grace M Deyo
Hybrid stage I palliation combines cardiothoracic surgery and interventional transcatheter procedures for treatment of hypoplastic left heart syndrome. The approach is an alternative to the Norwood procedure, the traditional first stage of surgical palliation. Hybrid stage I palliation involves placing bilateral branch pulmonary artery bands and a patent ductus arteriosus stent through a median sternotomy, performed without cardiopulmonary bypass. The purpose of the bands is to control blood flow to the lungs and protect the pulmonary bed while the stent sustains systemic cardiac output...
October 2016: Critical Care Nurse
Joanne F Irons, Lachlan F Miles, Kaustuv R Joshi, Andrew A Klein, Marco Scarci, Piergiorgio Solli, Guillermo Martinez
OBJECTIVE: General anesthesia with endobronchial intubation and one-lung positive-pressure ventilation always has been considered mandatory for thoracic surgery. Recently, there has been interest in nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients. The authors' center developed a nonintubated technique with spontaneous ventilation with the patient under general anesthesia using a supraglottic airway device. The authors believe that this was the first study to compare a nonintubated general anesthetic technique with an intubated general anesthetic technique for VATS...
July 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
H W Wu, L Sun, D M Li, H Jing, B Xu, C T Wang, L Zhang
Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Hasanat Sharif, Hamza Zaheer Ansari, Awais Ashfaq, Wasiq Faraz Rawasia, Gulshan Bano, Shiraz Hashmi
OBJECTIVE: To build a clinical predictive model to determine the need for transfusing blood and its products in coronary artery bypass grafting (CABG) procedures in South East Asian population. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Section of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi, from January 2006 to October 2014. METHODOLOGY: Information on pre-, intra- and postoperative variables were collected for all adult patients who underwent on-pump CABG...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
J Shahin, P Ferrando-Vivas, G S Power, S Biswas, S T Webb, K M Rowan, D A Harrison
The models used to predict outcome after adult general critical care may not be applicable to cardiothoracic critical care. Therefore, we analysed data from the Case Mix Programme to identify variables associated with hospital mortality after admission to cardiothoracic critical care units and to develop a risk-prediction model. We derived predictive models for hospital mortality from variables measured in 17,002 patients within 24 h of admission to five cardiothoracic critical care units. The final model included 10 variables: creatinine; white blood count; mean arterial blood pressure; functional dependency; platelet count; arterial pH; age; Glasgow Coma Score; arterial lactate; and route of admission...
September 26, 2016: Anaesthesia
Han-Yu Deng, Wen-Ping Wang, Yi-Dan Lin, Long-Qi Chen
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Can mitomycin facilitate endoscopic dilatation treatment of benign esophageal stricture (mainly including caustic and anastomotic esophageal stricture)?' Altogether, 115 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question, which included 1 randomized controlled trial, 1 systematic review and 4 cohort studies. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
September 23, 2016: Interactive Cardiovascular and Thoracic Surgery
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