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Cardiothoracic surgery

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https://www.readbyqxmd.com/read/28515744/mycobacterium-chimaera-a-new-threat-for-cardiac-surgical-patients
#1
Radosław Jaworski, Łukasz Naumiuk, Konrad Paczkowski, Danuta Formella, Renata Pek, Jacek Zieliński, Ireneusz Haponiuk
An outbreak of invasive Mycobacterium chimaera infections associated with "heater-cooler" devices in patients treated with cardiac surgery has been described worldwide. The authors summarize the current state of knowledge regarding the epidemiology, diagnostics, treatment, and prevention of Mycobacterium chimaera infections in patients after cardiothoracic surgery.
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28511557/impact-of-a-perioperative-prophylaxis-guideline-on-post-cardiothoracic-surgery-atrial-fibrillation
#2
Rosanna Li, C Michael White, Jola Mehmeti, Spencer T Martin, Laura C Hobbs
BACKGROUND: National practice guidelines do not provide clear recommendations on combination pharmacological regimens to reduce cardiothoracic surgery (CTS) postoperative atrial fibrillation (POAF). OBJECTIVE: This study examines if there is a reduction in POAF rates after implementing a perioperative prophylaxis guideline that includes amiodarone, β-blockers, and high-intensity statins. METHODS: Data were retrospectively collected on 400 adults (200 patients pre-guideline implementation and 200 patients post-guideline implementation) with a CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age, Diabetes Mellitus, and Vascular Disease) score of at least 3 points after CTS...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28511438/assessing-the-safety-and-clinical-impact-of-thoracoscopic-lung-biopsy-in-patients-with-interstitial-lung-disease
#3
Scott Lieberman, James Benjamin Gleason, Mohamed Iyoob Mohamed Ilyas, Felipe Martinez, Jinesh P Mehta, Edward B Savage
INTRODUCTION: The clinical relevance of surgical lung biopsy in Interstitial Lung Disease (ILD) is supported in the literature. Yet most reports reflect institutional or personal bias. AIM: To evaluate the validity of radiologic diagnosis and clinical impact of lung biopsy to help clarify which patient benefit most from biopsy. MATERIALS AND METHODS: We performed a retrospective analysis of a prospectively managed database. All patients who had a surgical lung biopsy for ILD within a period of four year (2009 to 2013) were included...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508958/modeling-the-critical-care-pathway-for-cardiothoracic-surgery
#4
Nicolas Bahou, Claire Fenwick, Gillian Anderson, Robert van der Meer, Tony Vassalos
The west of Scotland heart and lung center based at the Golden Jubilee National Hospital houses all adult cardiothoracic surgery for the region. Increased demand for scheduled patients and fluctuations in emergency referrals resulted in increasing waiting times and patient cancellations. The main issue was limited resources, which was aggravated by the stochastic nature of the length of stay (LOS) and arrival of patients. Discrete event simulation (DES) was used to assess if an enhanced schedule was sufficient, or more radical changes, such as capacity or other resource reallocations should be considered in order to solve the problem...
May 16, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28503386/mechanical-thrombectomy-for-acute-ischemic-stroke-after-cardiac-surgery
#5
Ali S Haider, Prabhat Garg, Ian T Watson, Dean Leonard, Umair Khan, Ahmed Haque, Phu Nguyen, Kennith F Layton
Ischemic stroke is a rare yet devastating complication that may occur following cardiothoracic surgery. Fibrinolytic treatment is contraindicated due to elevated risk for hemorrhage. Mechanical thrombectomy entails a catheterized approach wherein the thrombus is physically removed from the vessel without the use of fibrinolytics, minimizing the possibility of intracranial hemorrhage. Here, we present two original cases of mechanical thrombectomy as treatment for patients experiencing emergent large vessel occlusion following cardiothoracic surgery...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28502622/how-andre-agassi-helped-me-during-my-cardiothoracic-surgery-training
#6
EDITORIAL
Ali N Ibrahimiye
No abstract text is available yet for this article.
April 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#7
Aadil Kakajiwala, Ji Young Kim, John Z Hughes, Andrew Costarino, John Ferguson, J William Gaynor, Susan L Furth, Joshua J Blinder
BACKGROUND: This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. METHODS: Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28496546/the-epidemiology-and-risk-factors-for-postoperative-pneumonia
#8
REVIEW
Morad Chughtai, Chukwuweike U Gwam, Nequesha Mohamed, Anton Khlopas, Jared M Newman, Rafay Khan, Ali Nadhim, Shervin Shaffiy, Michael A Mont
Postoperative pneumonia is a common complication of surgery, and is associated with marked morbidity and mortality. Despite advances in surgical and anesthetic technique, it persists as a frequent postoperative complication. Many studies have aimed to assess its burden, as well as associated risk factors. However, this complication varies among the different surgical specialties, and there is a paucity of reports that comprehensively evaluate this complication. Therefore, the purpose of this study was to review the epidemiology and risk factors of postoperative pneumonia in the setting of: 1) general surgery; 2) cardiothoracic surgery; 3) orthopedic and spine surgery; and 4) head and neck surgery...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28486386/fluid-overload-and-cumulative-thoracostomy-output-are-associated-with-surgical-site-infection-after-pediatric-cardiothoracic-surgery
#9
Anthony A Sochet, Aoibhinn Nyhan, Michael C Spaeder, Alexander M Cartron, Xiaoyan Song, Darren Klugman, Anna T Brown
OBJECTIVES: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. DESIGN: A single-center, nested, retrospective, matched case-control study. SETTING: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. PATIENTS: Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28481752/preoperative-cognitive-performance-and-postoperative-delirium-are-independently-associated-with-future-dementia-in-older-people-who-have-undergone-cardiac-surgery-a-longitudinal-cohort-study
#10
Helena Claesson Lingehall, Nina S Smulter, Elisabeth Lindahl, Marie Lindkvist, Karl Gunnar Engström, Yngve G Gustafson, Birgitta Olofsson
OBJECTIVE: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery. DESIGN: Longitudinal cohort study. SETTING: Cardiothoracic Division, Umeå University Hospital, Sweden. PATIENTS: Patients aged 70 years old or older (n = 114) scheduled for routine cardiac procedures with cardiopulmonary bypass without documented dementia were enrolled in 2009. INTERVENTION: Structured assessments were performed preoperatively, 1 and 4 days after extubation, and 1, 3, and 5 years postoperatively...
May 5, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28474581/presentations-and-management-of-different-causes-of-chylothorax-in-children-one-medical-center-s-experience
#11
Chien-Heng Lin, Wei-Ching Lin, Jeng-Sheng Chang
BACKGROUND: Chylothorax in children is a relatively rare cause of pleural effusion. However, it is usually a common complication of cardiothoracic operations like open-heart surgery. Other etiologies for chylothorax, such as trauma or malignancy, occur more common in adults and rare in children. To explore the etiologies of chylothorax in children, this study analyzed the pediatric patients that were admitted in to onea medical center. METHODS: We retrospectively reviewed the medical records of the pediatric patients that were admitted to this tertiary transfer center with a diagnosis of chylothorax during the period of 1995 to 2005...
March 2017: BioMedicine
https://www.readbyqxmd.com/read/28473362/helcococcus-kunzii-prosthetic-valve-endocarditis-secondary-to-lower-extremity-cellulitis
#12
Saira Farid, William Miranda, Joseph Maleszewski, Muhammad Rizwan Sohail
An 88-year-old man with history of bioprosthetic aortic valve replacement was hospitalised with fever, chills, malaise and right lower extremity cellulitis. Laboratory investigations revealed leucocytosis and blood cultures grew Helcococcus kunzii Although transoesophageal echocardiography was negative for endocarditis, the patient was treated with 4 week of intravenous ceftriaxone. However, he was readmitted 6 weeks later with symptoms of fever, chills and hypoxia in setting of recurrent H. kunzii bacteraemia...
May 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28468896/emergency-laparotomy-in-infants-born-at-26-weeks-gestation-a-neonatal-network-based-cohort-study-of-frequency-surgical-pathology-and-outcomes
#13
Jonathan Durell, Nigel J Hall, Melanie Drewett, Kujan Paramanantham, David Burge
OBJECTIVE: Identify the proportion of infants born at <26 completed weeks' gestation who require emergency laparotomy, and review the surgical pathology, incidence of subsequent surgical procedures and outcome. DESIGN: Retrospective cohort review. SETTING: Tertiary neonatal surgical unit. PATIENTS: All infants born at <26 weeks' gestation in a neonatal network over an 8-year period. RESULTS: Of 381 infants, laparotomy was indicated in 61 (16%) and performed in 57...
May 3, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28461793/nina-braunwald-a-female-pioneer-in-cardiac-surgery
#14
Nikhil Sabharwal, Harmanjit Dev, Hassiba Smail, David C McGiffin, Pankaj Saxena
Nina Starr Braunwald, the first female cardiac surgeon, made headlines during a time when almost all specialty surgeons were men. Women have typically been deterred from entering surgical specialties, in part because of their traditional dual burden of managing their households and careers. Instead, female medical students and junior doctors have tended to be more attracted to medical specialties. This was the reality during Dr. Braunwald's venture into medicine in 1949. However, she never allowed negative ideas to keep her from joining a surgical training program...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28458765/right-ventricular-perforation-from-a-floating-rib-following-deep-sternal-wound-infection-debridement-and-application-of-a-vacuum-assisted-closure-device-a-case-report-and-literature-review
#15
Amanda J Ross, Nada N Berry
Introduction: Deep sternal wound infection following major cardiac surgery is a deleterious complication with sequelae that can be life threatening. The use of vacuum-assisted closure therapy in management of sternal wounds with resultant right ventricular rupture has been documented in the cardiothoracic and to a lesser extent in the reconstructive literature. Methods/Case Report: We present a case of a 67-year-old male patient who suffered from right ventricular perforation from a floating rib following debridement of a deep sternal wound infection and placement of a vacuum-assisted closure device...
2017: Eplasty
https://www.readbyqxmd.com/read/28457372/lung-transplantation-from-donors-after-previous-cardiac-surgery-ideal-graft-in-marginal-donor
#16
A Palleschi, P Mendogni, D Tosi, M Montoli, R Carrinola, A V Mariolo, F Briganti, M Nosotti
Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457173/a-survey-on-pulmonary-thromboendarterectomy-in-the-asia-pacific-region
#17
Mohammad Bashar Izzat, Farouk Almohammad, Ahmad F Raslan
Background Surgical pulmonary thromboendarterectomy has been established as the treatment of choice for chronic thromboembolic pulmonary hypertension. We conducted a survey among Asia-Pacific cardiothoracic surgeons to examine their current practice demographics and reflect their views on the future prospects for pulmonary thromboendarterectomy surgery. Methods All cardiothoracic surgeons who were registered on the CTSNet.org website and based in the Asia-Pacific region were invited to participate in an online survey...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28451588/lead-extraction-of-cardiac-rhythm-devices-a-report-of-a-single-center-experience
#18
Ana Isabel Azevedo, João Primo, Helena Gonçalves, Marco Oliveira, Luís Adão, Elisabeth Santos, José Ribeiro, Marlene Fonseca, Adelaide V Dias, Luís Vouga, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: The rate of implanted cardiac electronic devices is increasing as is the need to manage long-term complications. Lead removal is becoming an effective approach to treat such complications. We present our experience in lead removal using different approaches, analyzing the predictors of the use of mechanical extractors/surgical removal. METHODS: Retrospective analysis of lead extractions in a series of 76 consecutive patients (mean age 70...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28450136/the-use-of-topical-hemostatic-agents-in-cardiothoracic-surgery
#19
REVIEW
Art Bracey, Aryeh Shander, Solomon Aronson, Bradley A Boucher, Domenico Calcaterra, Michael W A Chu, Richard Culbertson, Karim Jabr, Henrik Kehlet, Omar Lattouf, S Chris Malaisrie, C David Mazer, Martin M Oberhoffer, Sherri Ozawa, Theolyn Price, Todd Rosengart, Bruce D Spiess, Giuseppe Turchetti
Topical hemostatic agents are used in conjunction with conventional procedures to reduce blood loss. They are often used in cardiothoracic surgery, which is particularly prone to bleeding risks. Variation in their use exists because detailed policy and practice guidelines reflecting the current medical evidence have not been developed to promote best surgical practice in this setting. To address this need, the Society for the Advancement of Blood Management convened an International Hemostatic Expert Panel...
April 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28450134/variability-in-integrated-cardiothoracic-training-program-curriculum
#20
Elizabeth H Stephens, Dustin M Walters, Amanda L Eilers, Vakhtang Tchantchaleishvili, Andrew B Goldstone, Erin A Gillaspie, Amy Fiedler, Damien J LaPar
BACKGROUND: Development of curricula that appropriately progress a resident from medical school graduate to fully trained cardiothoracic surgeon is a key challenge for integrated cardiothoracic training programs. This study examined variability and perceived challenges in integrated curricula. METHODS: Responses to the 2016 TSDA/TSRA survey that accompanies the annual in-training exam taken by current cardiothoracic surgery residents were analyzed. Standard statistical methods were utilized to examine trends in participant responses...
June 2017: Annals of Thoracic Surgery
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