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Cardiothoracic surgery

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https://www.readbyqxmd.com/read/29454226/dysphagia-and-laryngeal-pathology-in-post-surgical-cardiothoracic-patients
#1
Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, Kelly Lynn
PURPOSE: Cardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment. METHODS: Clinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist...
February 9, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29453324/incidence-and-predictors-of-perioperative-complications-with-transvenous-lead-extractions-real-world-experience-with-national-cardiovascular-data-registry
#2
Nitesh Sood, David T Martin, Rachel Lampert, Jeptha P Curtis, Craig Parzynski, Jude Clancy
BACKGROUND: Transvenous lead extraction is an integral part of management of patients with cardiovascular implantable electronic devices. Real-world incidence and predictors of perioperative complications in extractions involving implantable cardioverter-defibrillator leads have not been described in detail. METHODS AND RESULTS: Data from the National Cardiovascular Data Registry Implantable Cardioverter-Defibrillator Registry were analyzed. Lead extraction was defined as removal of leads implanted for >1 year...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29437722/transudative-chylothorax-an-uncommon-illness-due-to-a-common-cause
#3
Arindam Mukherjee, Inderpaul Singh Sehgal, Bhagwant Rai Mittal, Sahajal Dhooria
Chylothorax is defined as presence of chyle in the pleural space. It is commonly associated with cardiothoracic surgery, trauma, malignancy or some benign disorders. Transudative chylothorax is uncommon. A 52-year-old man presented with bilateral chylothorax with preceding history of blunt trauma to the chest. On further evaluation, he was diagnosed to have a transudative chylothorax due to cirrhosis of liver with coexisting chylous ascites and evidence of peritoneopleural communication. The patient was managed with diuretics followed by chemical pleurodesis with iodopovidone...
February 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29428358/central-veno-arterial-extracorporeal-membrane-oxygenation-c-va-ecmo-after-cardiothoracic-surgery-a-single-center-experience
#4
Antonio Rubino, Diego Costanzo, Daniel Stanszus, Kamen Valchanov, David Jenkins, Federico Sertic, Jo-Anne Fowles, Alain Vuylsteke
OBJECTIVES: Central veno-arterial extracorporeal membrane oxygenation (C-VA-ECMO) provides temporary cardiorespiratory support for patients in heart failure who cannot be weaned from cardiopulmonary bypass successfully. Outcomes are influenced by the reversibility of the initial insult and complications of the technique. METHODS: The authors reviewed their single-center experience over the last 8 years to inform future practice. The study included all patients supported with C-VA-ECMO after cardiothoracic surgery between January 2008 and July 2016...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29410135/risk-factors-of-recurrence-of-atrial-fibrillation-after-af-surgery-in-patients-with-af-and-mitral-valve-disease
#5
Yosuke Ishii, Shun-Ichiro Sakamoto, Yasuo Miyagi, Yasuhiro Kawase, Toshiaki Otsuka, Takashi Nitta
OBJECTIVE: The purpose of this study was to determine the 22-year experience of the relationship between the pre-operative left atrial diameter (LAD) and atrial fibrillation (AF) recurrence after AF surgery. METHODS: Between November 1993 and April 2015, 244 patients underwent AF surgery concomitant with mitral valve surgery, and were completely followed in our institute. The full-maze procedure was performed in 231 patients and pulmonary vein isolation (PVI) in 13...
February 1, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29408244/risk-factors-for-development-and-progression-of-scoliosis-after-pediatric-cardiothoracic-surgery
#6
Carlos M Mery, Francisco A Guzmán-Pruneda, Luis E De León, Wei Zhang, Frederick H Kuo, Kyle L Carpenter, Lisa D Stringer, Iki Adachi, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser, Darrell S Hanson
BACKGROUND: The purpose of this study was to determine the incidence and risk factors for development and rate of progression of scoliosis and moderate/severe scoliosis in patients undergoing cardiothoracic surgery (CTS). METHODS: Patients <12 years old that underwent CTS in 1995-2006, with a preoperative chest X-ray (CXR) and a CXR at least 8 years after CTS were included. Scoliosis and moderate/severe scoliosis were defined as a Cobb angle ≥10° and an angle ≥25° or need for surgical intervention, respectively...
February 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29402665/malpractice-litigation-in-the-endovascular-era
#7
Kenny Oh, Goda Savulionyte, Satish Muluk
OBJECTIVE: The standard of care in the treatment of vascular disease continues to evolve as endovascular therapies develop. Currently, it is unclear how medical malpractice litigation has adapted to the "endovascular era." This retrospective case review is the most comprehensive analysis to date of malpractice actions involving endovascular procedures performed by vascular surgeons (VSs), interventional radiologists (IRs), interventional cardiologists (ICs), and cardiothoracic surgeons (CTSs)...
February 3, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29402623/association-of-red-blood-cell-transfusion-and-short-and-longer-term-mortality-after-coronary-artery-bypass-graft-surgery
#8
Hossam Tantawy, Alice Li, Feng Dai, Mohamed Elgammal, Nitin Sukumar, John Elefteriades, Shamsuddin Akhtar
OBJECTIVE: Red blood cell (RBC) transfusion has been linked to increased morbidity and mortality. However, strict RBC transfusion recommendations recently have been questioned. The aim of this study was to investigate the short- and long-term mortality outcomes after RBC transfusion in patients undergoing coronary artery bypass graft surgery (CABG). DESIGN: This was a retrospective medical record review. SETTING: Tertiary care academic medical center...
December 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#9
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#10
John M Costello, Michael C Mongé, Kevin D Hill, Sunghee Kim, Sara K Pasquali, Babatunde A Yerokun, Jeffrey P Jacobs, Carl L Backer, Mjaye L Mazwi, Marshall L Jacobs
BACKGROUND: After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29397100/advancing-the-legislative-priorities-of-cardiothoracic-surgeons-the-society-of-thoracic-surgeons-political-action-committee
#11
Jess L Thompson, Alan M Speir, Douglas J Mathisen, Keith S Naunheim, Richard L Prager, Stephen J Lahey
In the late 1990s, several federal government health policy decisions threatened the viability of thoracic surgery as a specialty. To respond to such decisions, active participation in political processes was given extremely high priority by the Executive Committee of The Society of Thoracic Surgeons (STS). Creation of the STS Political Action Committee (STS-PAC) in 1997 was a part of the platform of participation. The purpose of the STS-PAC is to enhance the Society's voice and stature in health care policymaking...
January 31, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29390580/successful-management-of-a-complicated-clinical-crisis-a-patient-with-left-sided-endocarditis-and-secondary-hemophagocytic-lymphohistiocytosis-a-rare-case-report-and-literature-review
#12
Peipei Xu, Hui Zeng, Min Zhou, Jian Ouyang, Bing Chen, Qiguo Zhang
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) secondary to methicillin-resistant Staphylococcus epidermidis (MRSE)-related left-sided infectious endocarditis had never been reported before. In the last decade, daptomycin, a novel lipopeptide antibiotic, showed its excellent role in anti-Gram-positive bacteria, including soft tissue infection, bloodstream and deep tissueinfection. PATIENT CONCERNS: An Asian women under sever condition due to the cooccurrence of HLH and MRSE-related endocarditis while also be allergic to vancomycin...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384705/a-self-efficacy-enhancing-intervention-for-pulmonary-rehabilitation-based-on-motivational-interviewing-for-postoperative-lung-cancers-patients-modeling-and-randomized-exploratory-trial
#13
Fei-Fei Huang, Qing Yang, Juan Zhang, Xuan Ye Han, Jing-Ping Zhang, Man Ye
The objective of this study was to evaluate the feasibility and preliminary efficacy of a self-efficacy enhancing intervention designed for pulmonary rehabilitation based on motivational interviewing (MI) for postsurgical non-small cell lung cancer (NSCLC) patients. This study was a 2-arm pilot randomized controlled trial and was conducted in two cardiothoracic surgery departments, a tertiary hospital in Fuzhou, China. 28 postsurgical NSCLC patients were randomized to a 3 month (6 session) self-efficacy enhancing intervention based on MI or usual care (UC)...
January 31, 2018: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/29369877/a-multidisciplinary-qi-initiative-to-improve-or-icu-handovers
#14
Dawn Krimminger, Carrie Sona, Elaine Thomas-Horton, Marilyn Schallom
: Background: Handover from the operating room (OR) staff to the ICU staff is a critical transition time for patients, in which the potential for error and miscommunication is high. Therefore, minimization of extraneous interruptions during the exchange of crucial information between the anesthesia and surgical teams and the nursing, respiratory therapy, and medical teams is imperative. OBJECTIVES: The aim of this quality improvement (QI) initiative was, first, to examine the impact of a standardized handover process between the OR and the ICU on process and information-sharing errors, and second, to examine provider satisfaction with the handover process...
February 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29366583/transcatheter-aortic-valve-replacement-the-journal-of-thoracic-and-cardiovascular-surgery-and-the-evolution-of-clinical-research-in-cardiothoracic-surgery
#15
EDITORIAL
Mario Gaudino
No abstract text is available yet for this article.
December 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29365109/surgicel%C3%A2-packing-remnants-mimicking-mediastinitis-after-adult-cardiac-surgery
#16
Daisuke Kaneyuki, Kenji Mogi, Tomoki Sakata, Yoshiharu Takahara
Surgicel® is one of the most commonly used bioabsorbable topical haemostatic agents. Some articles have reported that Surgicel® remnants might be misdiagnosed as an abscess. However, the number of reports in the cardiothoracic surgical field is limited. Herein, we report a 65-year-old woman who was suspected of having mediastinitis on computed tomography after redo-Bentall operation. Reoperation revealed that internal accumulation of Surgicel® remnants mimicked mediastinitis. It is important to share the use and location of Surgicel® with radiologists...
January 19, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29361300/cardiothoracic-surgery-training-grants-provide-protected-research-time-vital-to-the-development-of-academic-surgeons
#17
Adishesh K Narahari, Eric J Charles, J Hunter Mehaffey, Robert B Hawkins, Sarah A Schubert, Curtis G Tribble, Richard B Schuessler, Ralph J Damiano, Irving L Kron
BACKGROUND: The Ruth L. Kirschstein Institutional National Research Service Award (T32) provides institutions with financial support to prepare trainees for careers in academic medicine. In 1990, the Cardiac Surgery Branch of the National Heart, Lung and Blood Institute (NHLBI) was replaced by T32 training grants, which became crucial sources of funding for cardiothoracic (CT) surgical research. We hypothesized that T32 grants would be valuable for CT surgery training and yield significant publications and subsequent funding...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29357785/safety-efficacy-and-timeliness-of-intravenous-potassium-chloride-replacement-protocols-in-a-pediatric-cardiothoracic-intensive-care-unit
#18
Rambod Amirnovin, Phuong Lieu, Flerida Imperial-Perez, Carol Taketomo, Barry P Markovitz, David Y Moromisato
OBJECTIVE: Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K+). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal K+ replacement regimen, compared to an historical low-dose protocol. Our objective was to evaluate the safety, efficacy, and timeliness of these protocols...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29353118/magnesium-supplementation-pharmacokinetics-in-cardiac-surgery-patients-with-normal-renal-function
#19
Peter Biesenbach, Johan Mårtensson, Eduardo Osawa, Glenn Eastwood, Salvatore Cutuli, Jessica Fairley, George Matalanis, Rinaldo Bellomo
BACKGROUND: Intravenous magnesium is routinely administered in intensive care units (ICU) to treat arrhythmias after cardiothoracic surgery. There are no data on the pharmacokinetics of continuous magnesium infusion therapy. OBJECTIVE: To investigate the pharmacokinetics of continuous magnesium infusion, focusing on serum and urinary magnesium concentration, volume of distribution and half-life. METHODS: We administered a 10 mmol bolus of magnesium-sulfate followed by a continuous infusion of 3 mmol/h for 12 h in twenty cardiac surgery patients...
January 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29350834/proton-pump-inhibitors-elevate-infection-rate-in-cardiothoracic-surgery-patients-by-influencing-pmn-function-in-vitro-and-in-vivo
#20
Carolin Maria Haas, Martina Maywald, Andreas Goetzenich, Christian Stoppe, Lothar Rink
Proton-pump inhibitors (PPI) as pantoprazole are highly effective acid suppressive agents that belong to the world's most sold medication. However, they are pronounced to have immunosuppressive aspects. In our study, a negative influence of PPI on functions of polymorphonuclear cells in vitro like phagocytosis, oxidative burst, chemotaxis, and killing activity was shown, whereas formation of neutrophil extracellular traps (NET)osis remained unaffected. Pantoprazole stimulation additionally reduced the production of the proinflammatory cytokine IL-1β in whole blood assay as well as the production of IL-2 and IFN-γ after whole blood stimulation with phytohaemagglutinin...
January 19, 2018: Journal of Leukocyte Biology
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