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Perioperative arrhythmia

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https://www.readbyqxmd.com/read/28217063/ultrasound-guided-probe-generated-artifacts-stimulating-ventricular-tachycardia-a-rare-phenomenon
#1
Rafat Shamim, Rudrashish Haldar, Ashutosh Kaushal
Electrocardiographic (ECG) artifacts may arise due to interference, faulty earthing, and current leakages in biomedical equipment which might create clinical dilemmas in the perioperative settings. Piezoelectric signals generated by ultrasonography probe are another uncommon source which might be sensed by the ECG electrodes and produce tracings similar to pathological arrhythmias triggering false alarms and avoidable therapies. Anesthesiologists should be familiar with these uncommon sources which might produce these artifacts and they should be identified swiftly...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28194733/surgical-management-for-achalasia-after-coronary-artery-bypass-graft-using-the-right-gastroepiploic-artery-a-case-report
#2
Ryo Muranushi, Tatsuya Miyazaki, Hideyuki Saito, Kengo Kuriyama, Tomonori Yoshida, Yuji Kumakura, Hiroaki Honjyo, Takehiko Yokobori, Makoto Sakai, Makoto Sohda, Hiroyuki Kuwano
BACKGROUND: The right gastroepiploic artery is commonly used in coronary artery bypass grafting. Appropriate strategies are required when performing upper abdominal surgeries after the right gastroepiploic artery has been used in coronary artery bypass grafting because compressing or injuring the graft may cause myocardial ischemia and fatal arrhythmias. To our knowledge, this is the first reported case of surgery for achalasia performed after coronary artery bypass grafting using the right gastroepiploic artery...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#3
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181294/adverse-outcomes-associated-with-postoperative-atrial-arrhythmias-after-lung-transplantation-a-meta-analysis-and-systematic-review-of-the-literature
#4
REVIEW
Nathan H Waldron, Rebecca Y Klinger, Matthew G Hartwig, Laurie D Snyder, James P Daubert, Joseph P Mathew
BACKGROUND: Postoperative atrial arrhythmias (AAs) are common after lung transplantation but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta-analysis to determine whether AAs after lung transplantation impede postoperative recovery. METHODS: MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched to identify studies comparing outcomes in adult patients undergoing lung transplantation who experienced postoperative AAs in the immediate postoperative period versus those without postoperative AAs...
February 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#5
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28100967/anesthetic-management-in-radiofrequency-catheter-ablation-of-ventricular-tachycardia
#6
REVIEW
Yi Deng, Payam S Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Radiofrequency catheter ablation is increasingly being used to treat patients who have ventricular tachycardia, and anesthesiologists frequently manage their perioperative care. This narrative review is intended to familiarize anesthesiologists with preprocedural, intraprocedural, and postprocedural implications of this ablation. Ventricular tachycardia typically arises from structural heart disease, most often from scar tissue after myocardial infarction. Many patients thus affected will benefit from radiofrequency catheter ablation in the electrophysiology laboratory to ablate the foci of arrhythmogenesis...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#7
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28088937/traumatic-cardiac-injury-experience-from-a-level-1-trauma-centre
#8
Biplab Mishra, Amit Gupta, Sushma Sagar, Maneesh Singhal, Subodh Kumar
PURPOSE: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. METHODS: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28076594/predictive-factors-of-atrial-fibrillation-after-coronary-artery-bypass-grafting
#9
Cynthia de Oliveira Folla, Cinthia Cristina de Santana Melo, Rita de Cassia Gengo E Silva
Objective: To analyze predictive demographic and perioperative variables of postoperative atrial fibrillation in patients who underwent exclusively coronary artery bypass grafting. Methods: This was a retrospective cohort. We randomly selected 105 medical records of patients who underwent exclusively coronary artery bypass grafting in 2014. Demographic, clinical (preoperative and immediate postoperative) data and related with surgical procedure were collected from medical records...
October 2016: Einstein
https://www.readbyqxmd.com/read/28072699/prevention-preferable-to-treatment-3-case-reports-of-patients-experiencing-right-sided-heart-failure-after-ebstein-anomaly-correction
#10
Ming Luo, Jing Lin, Zhen Qin, Lei Du
RATIONALE: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. PATIENT CONCERNS: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#11
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28039238/effect-of-beta-blockers-on-perioperative-outcomes-in-vascular-and-endovascular-surgery-a-systematic-review-and-meta-analysis
#12
S Hajibandeh, S Hajibandeh, S A Antoniou, F Torella, G A Antoniou
BACKGROUND: To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery. METHODS: We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27984052/beta-adrenergic-receptor-blockers-in-hypertension-alive-and-well
#13
William H Frishman
βeta-Adrenergic receptor blockers (β-blockers) are an appropriate treatment for patients having systemic hypertension (HTN) who have concomitant ischemic heart disease (IHD), heart failure, obstructive cardiomyopathy, aortic dissection or certain cardiac arrhythmias. β-blockers can be used in combination with other antiHTN drugs to achieve maximal blood pressure control. Labetalol can be used in HTN emergencies and urgencies. β-blockers may be useful in HTN patients having a hyperkinetic circulation (palpitations, tachycardia, HTN, and anxiety), migraine headache, and essential tremor...
October 27, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#14
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27884409/percutaneous-perventricular-device-closure-of-ventricular-septal-defect-from-incision-to-pinhole
#15
Changping Gan, Ling Peng, Zhonglei Liang, Haibo Song, Jiahuang Yang, Weiqiang Ruan, Shuhua Luo, Ke Lin
BACKGROUND: As an alternative to open surgical repair, perventricular device closure provides minimally invasive treatment for doubly committed subarterial ventricular septal defects. However, unlike percutaneous transcatheter access, mini-thoracotomy is still needed. This report describes the percutaneous perventricular device closure technique and its short-term results for this type of heart defect. METHODS: Sixteen patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous perventricular device closure...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27869053/incidence-risk-factors-and-outcomes-of-acute-kidney-injury-in-adults-undergoing-surgery-for-congenital-heart-disease
#16
David M Kwiatkowski, Elizabeth Price, David M Axelrod, Anitra W Romfh, Brian S Han, Scott M Sutherland, Catherine D Krawczeski
BACKGROUND: Acute kidney injury after cardiac surgery is a frequent and serious complication among children with congenital heart disease (CHD) and adults with acquired heart disease; however, the significance of kidney injury in adults after congenital heart surgery is unknown. The primary objective of this study was to determine the incidence of acute kidney injury after surgery for adult CHD. Secondary objectives included determination of risk factors and associations with clinical outcomes...
November 21, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#17
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27858888/percutaneous-device-closure-of-atrial-septal-defect-with-totally-transthoracic-echocardiography-guide-without-x-ray-machine
#18
Hua Cao, Qiang Chen, Gui-Can Zhang, Liang-Wan Chen, Zhi-Huang Qiu, Heng Lu
The present study investigated the feasibility of totally transthoracic echocardiography-guided percutaneous device occlusion of atrial septal defects (ASDs) without using x-ray equipment.Between September and December 2014, we performed totally transthoracic echocardiography-guided percutaneous device occlusion for 20 patients with secundum ASD without using x-ray equipment. We carried out percutaneous femoral vein puncture, used a specialized delivery sheath during operation, and closed the ASD by releasing an occluder...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27803121/new-onset-atrial-fibrillation-after-anatomic-lung-resection-predictive-factors-treatment-and-follow-up-in-a-uk-thoracic-centre
#19
Megan Garner, Tom Routledge, Juliet E King, John E Pilling, Lukacs Veres, Karen Harrison-Phipps, Andrea Bille, Leanne Harling
OBJECTIVES: Postoperative atrial fibrillation (POAF) increases morbidity, hospital stay and healthcare expenditure. This study aims to determine the perioperative factors correlating with POAF as well as to evaluate both treatment strategies and AF persistence beyond discharge. METHODS: The records of all patients undergoing anatomical lung resection over a 1-year period were retrospectively reviewed. Patients with a history of arrhythmia were excluded. POAF was defined by clinical diagnosis and electrocardiography...
November 1, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27769228/quantifying-the-effect-of-complications-on-patient-flow-costs-and-surgical-throughputs
#20
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
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