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Perioperative arrhythmia

Christopher S Graffeo, Ross C Puffer, Eelco F M Wijdicks, William E Krauss
BACKGROUND: Ischemic stroke following anterior cervical diskectomy and fusion (ACDF) is an exceedingly rare complication. There are only three previous cases focusing on this problem in the literature; here, we present the fourth case. CASE DESCRIPTION: A patient, cared for at an outside institution, developed a delayed ischemic stroke 3 days following an ACDF. This complication was attributed to carotid manipulation precipitating vascular injury in the setting of multiple comorbid vascular and coagulopathic risk factors, including previously undiagnosed carotid atherosclerosis, a prior history of pulmonary embolus requiring Warfarin anticoagulation (held perioperatively), acute dehydration, and atrial fibrillation...
2016: Surgical Neurology International
Mohammad R Rasouli, Reza Mostafavi Tabatabaee, Mitchell G Maltenfort, Antonia F Chen
STUDY OBJECTIVES: This study aims to determine trends and predictors of acute stroke among total joint arthroplasty (TJA) patients using nationally representative data. DESIGN: Retrospective database review. SETTING: Nationwide Inpatient Sample database. PATIENTS: A total of 1,762,496 TJAs from 2002 to 2011. INTERVENTIONS: Patients underwent primary or revision total hip or total knee arthroplasty...
November 2016: Journal of Clinical Anesthesia
Fuxi Zhen, Sailei Shi, Lei Xue, Jinyuan Liu, Jinhua Luo
OBJECTIVE: To examine the relationship between gastric conduit width and postoperative early delayed gastric emptying (DGE) in patients with middle-lower esophageal carcinoma who underwent Ivor-Lewis operation. METHODS: Clinical data of 282 consecutive patients with middle-lower esophageal cancer who underwent the Ivor-Lewis operation by same surgical team in our department from January 2013 to June 2015 were retrospectively analyzed. Patients were divided into three groups according to the width of gastric conduit: width > 5...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Łukasz Lewicki, Janusz Siebert, Jan Rogowski
BACKGROUND: Postoperative atrial fibrillation (AF) is a common arrhythmia that occurs after coronary artery bypass grafting (CABG). New surgical techniques, particularly off-pump coronary artery bypass (OPCAB), are thought to be less invasive and results in fewer complications, i.e. AF, but available data are inconsistent. The aim of this study is to present the incidence and risk factors of AF in patients operated on with or without cardiopulmonary bypass. METHODS: We studied 1836 consecutive patients with stable coronary artery disease who were operated on with (CABG) or without (OPCAB) cardiopulmonary bypass...
September 26, 2016: Cardiology Journal
Xuchen Ma, Fangjiong Huang, Zhitai Zhang, Feiqiang Song, Songlei Ou
BACKGROUND: To assess the safety and efficacy of combined surgery for patients with concurrent lung cancer and severe coronary heart disease (CHD). METHODS: Between 2003 and 2014, 34 patients with stage I or II lung cancer and simultaneous severe CHD underwent combined off-pump coronary artery bypass (OPCAB) grafting and lung resection. Surgically, myocardial revascularization was performed first and followed by lobectomies through the same or a second incision...
August 2016: Journal of Thoracic Disease
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
Andrew L Smith, William Y Shi, Alexander Rosalion, Michael Yii, Michael O'Keefe, Andrew E Newcomb, Philip Davis
BACKGROUND: The use of rapid-deployment aortic valve replacement (RD-AVR) has burgeoned in recent years. There are few studies comparing RD-AVR to conventional aortic valve replacement (cAVR) and no studies where both were inserted via full sternotomy. As such, we reviewed our experience and compared the two approaches. METHODS: From 2008 to 2015, 597 patients underwent isolated aortic valve replacement ± coronary artery bypass grafting (CABG) at a single centre...
July 16, 2016: Heart, Lung & Circulation
Judith A Ae Cuypers, Myrthe E Menting, Petra Opić, Elisabeth M Wj Utens, Willem A Helbing, Maarten Witsenburg, Annemien E van den Bosch, Ron T van Domburg, Sara J Baart, Eric Boersma, Folkert J Meijboom, Ad J Jc Bogers, Jolien W Roos-Hesselink
OBJECTIVE: To provide prospective information on long-term outcome after surgical correction of valvular pulmonary stenosis (PS). METHODS: Fifty-three consecutive patients operated for PS during childhood between 1968 and 1980 in one centre are followed longitudinally for 37±3.4 years, including extensive in-hospital examination every 10 years. RESULTS: Survival information was available in 100% of the original 53 patients. Cumulative survival was 94% at 20 years and 91% at 40 years...
August 11, 2016: Heart: Official Journal of the British Cardiac Society
J Biernawska, K Kotfis, M Kaczmarczyk, W Błaszczyk, E Barnik, M Żukowski
BACKGROUND: The autonomic nervous system plays an important role in heart function regulation. One of the most acknowledged methods for noninvasive measurement of autonomic system activity is to determine heart rate variability (HRV). Reduced HRV parameters-heart rate rigidity/stiffness-are an independent prognostic factor of sudden cardiac death risk because of arrhythmia. Renal transplantation is an important factor in HRV changes because of hemodynamic and ion disturbances. The main purpose of this study was to determine the influence of HRV disturbances during renal transplantation procedures on long-term mortality in patients with chronic kidney disease...
June 2016: Transplantation Proceedings
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
2016: Cochrane Database of Systematic Reviews
Anahi Perlas, Vincent W S Chan, Scott Beattie
BACKGROUND: This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. METHODS: All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time...
October 2016: Anesthesiology
Barry D Kussman, Christopher M Aasted, Meryem A Yücel, Sarah C Steele, Mark E Alexander, David A Boas, David Borsook, Lino Becerra
The predictability of pain makes surgery an ideal model for the study of pain and the development of strategies for analgesia and reduction of perioperative pain. As functional near-infrared spectroscopy reproduces the known functional magnetic resonance imaging activations in response to a painful stimulus, we evaluated the feasibility of functional near-infrared spectroscopy to measure cortical responses to noxious stimulation during general anesthesia. A multichannel continuous wave near-infrared imager was used to measure somatosensory and frontal cortical activation in patients undergoing catheter ablation of arrhythmias under general anesthesia...
2016: PloS One
Luis Angel Hernandez-Arenas, Lei Lin, Yang Yang, Ming Liu, William Guido, Diego Gonzalez-Rivas, Gening Jiang, Lei Jiang
OBJECTIVES: Uniportal subxiphoid video-assisted thoracoscopic (SVATS) surgery for major lung resections is a new approach, but clinical evidence is lacking. The aim of this study was to examine our experience with the use of the uniportal subxiphoid approach in video-assisted thoracoscopic (VATS) major lung resections and lymph node dissections. METHODS: From October 2014 to August 2015, 153 patients with early-stage non-small-cell lung carcinoma (NSCLC) and benign disease underwent uniportal subxiphoid VATS major lung resections...
July 11, 2016: European Journal of Cardio-thoracic Surgery
Deepanwita Das, Chaitali Sen, Anupam Goswami
INTRODUCTION: Etomidate is usually preferred in the induction of cardiac compromised patients due to its relative cardiovascular stability. However, the use of this drug has been limited as etomidate induces suppression of cortisol biosynthesis as a result of blockade of 11-beta-hydroxylation in the adrenal gland, mediated by the imidazole radical of etomidate. This study was carried out to observe the effect of Vitamin C on adrenal suppression after etomidate induction in patients undergoing cardiac surgery...
July 2016: Annals of Cardiac Anaesthesia
Hans-Joachim Priebe
The perioperative period is associated with alterations in the neuroendocrine, metabolic, and immune systems, referred to as "stress response." The resultant increased sympathetic activity and elevated serum concentrations of catecholamines may adversely affect the cardiovascular system, resulting in cardiovascular instability (hypertension, tachycardia, and arrhythmia), morbidity (myocardial ischemia, myocardial infarction, and stroke), and mortality (cardiac death and fatal stroke), particularly in patients at an elevated cardiovascular risk and with reduced cardiovascular reserve...
June 2016: Best Practice & Research. Clinical Anaesthesiology
Ebru Biricik, Zehra Hatipoğlu, Çağatay Küçükbingöz
Brugada Syndrome was first described in 1992 by Pedro Brugada as a genetic syndrome that is characterized by ventricular arrhythmias that may result in sudden cardiac arrest. In particular, a right bundle branch block and ST segment elevation in the right precordial leads are observed. Many perioperative pharmalogical and physiological factors can trigger malignant arrhythmias. Although it is a rare condition, the anaesthestic management of Brugada syndrome is important because of the potentially fatal complications...
April 2016: Turkish Journal of Anaesthesiology and Reanimation
Sadegh Ali-Hassan-Sayegh, Seyed Jalil Mirhosseini, Mahbube Tahernejad, Parisa Mahdavi, Azadeh Shahidzadeh, Ali Akbar Karimi-Bondarabadi, Ali-Mohammad Dehghan, Elham Rahimizadeh, Fatemeh Haddad, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Arezoo Shahidzadeh, Azam Ghanei, Mohammadreza Lotfaliani, Mohamed Zeriouh, Alexander Weymann, Aron-Frederik Popov, Anton Sabashnikov
This systematic review with meta-analysis sought to determine the strength of evidence in terms of the impact of common antioxidant supplementations, such as N-acetylcysteine (NAC), vitamin C, and polyunsaturated fatty acids (PUFA) on perioperative outcomes after cardiac surgery with particular focus on the incidence of atrial fibrillation (AF) and acute kidney injury (AKI) with associated mortality. A total of 29 trials were identified that reported incidence of AF and 17 trials that reported incidence of AKI...
October 2016: Cardiovascular Therapeutics
Eugene A Hessel
PURPOSE: Takotsubo cardiomyopathy (TTCM) is a form of stress cardiomyopathy that may occur in the perioperative period and among the critically ill. Therefore, anesthesiologists should be aware of its diagnosis and treatment. The aim of this narrative review is describe the features of TTCM and its relevance to the practice of anesthesiology. PRINCIPAL FINDINGS: Takotsubo cardiomyopathy occurs in about 2-9/100,000 persons in the general population annually and may occur in up to one in 6,700 cases in the perioperative period...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Nicolas Chudeau, Tommy Raveau, Laurence Carlier, Damien Leblanc, Guillaume Bouhours, Frédéric Gagnadoux, Emmanuel Rineau, Sigismond Lasocki
INTRODUCTION: The STOP BANG (SB) questionnaire, a tool originally proposed for identifying patients at risk of Obstructive Sleep Apnoea, may also identify patients at increased risk of perioperative complications (when > 3). Perioperative complications, including respiratory ones, are more frequent in emergency surgery. This study aimed at evaluating whether the SB is predictive of perioperative respiratory complications in urgent surgery. METHODS: Consecutive adult patients admitted for an urgent surgery under general anaesthesia were included...
June 16, 2016: Anaesthesia, Critical Care & Pain Medicine
Roland Tilz, Serge Boveda, Jean-Claude Deharo, Dan Dobreanu, Kristina H Haugaa, Nikolaos Dagres
The aim of this EP Wire was to assess the management, indications, and techniques for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) device replacement in Europe. A total of 24 centres in 14 European countries completed the questionnaire. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Replacement procedures were performed by electrophysiologists in 52% of the centres, by cardiologists in 33%, and both in the remaining centres...
June 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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