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Perioperative arrhythmia

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https://www.readbyqxmd.com/read/29773835/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#1
Zhenhua Xing, Liang Tang, Pengfei Chen, Jiabing Huang, Xiaofan Peng, Xinqun Hu
Patients with left ventricular dysfunction (LVD) undergoing cardiac surgery have a high mortality rate. Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. It is not clear whether levosimendan can reduce mortality in cardiac surgery patients with LVD. The PubMed, Embase, and Cochrane Central databases were searched to identify randomized trials comparing levosimendan with conventional treatment in cardiac surgery patients with LVD. We derived pooled risk ratios (RRs) with random effects models...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29762917/association-of-change-in-patient-reported-health-status-after-transcatheter-aortic-valve-replacement-and-postoperative-outcomes
#2
Alexis Kofi Okoh, Nathan Kang, Dhaval Chauhan, Nicky Haik, Dustin Hanos, Marc Cohen, Chungeng Chen, Bruce Haik, Mark J Russo
BACKGROUND: The study aim was to investigate the relationship between postoperative morbidity after transcatheter aortic valve replacement (TAVR) and short-term patient-reported health status, using the Kansas City Cardiomyopathy Questionnaire (KCCQ). METHODS: The association between 30-day post-procedure changes in patient-reported heath status and post-TAVR outcomes was examined. Patients were stratified into three groups based on observed changes in KCCQ-Overall scores (OS): Group A, increase in KCCQ-OS ≥10 points; Group B, KCCQ-OS scores <10 points; and Group C, decline in KCCQ-OS ≥10 points...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29761338/-journey-of-the-s%C3%A2-icd-to-first-line-therapy
#3
REVIEW
Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29750691/propensity-score-methods-theory-and-practice-for-anesthesia-research
#4
Phillip J Schulte, Edward J Mascha
Observational data are often readily available or less costly to obtain than conducting a randomized controlled trial. With observational data, investigators may statistically evaluate the relationship between a treatment or therapy and outcomes. However, inherent in observational data is the potential for confounding arising from the nonrandom assignment of treatment. In this statistical grand rounds, we describe the use of propensity score methods (ie, using the probability of receiving treatment given covariates) to reduce bias due to measured confounders in anesthesia and perioperative medicine research...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29742783/-pro-epidural-analgesia-remains-the-gold-standard-for-abdominal-and-thoracic-surgery
#5
Hannah Listing, Daniel Pöpping
Pain relief with epidural analgesia is superior compared to systemic opioid analgesia after major abdominal and thoracic surgery. It remains a safe procedure, as long as it is embedded in a concept covering the whole perioperative period. This includes the knowledge of the anesthesiologist how to operate the process of catheter insertion as well as to treat complications like the hypotension, associated with the application of epidural local anesthetics. A close postoperative monitoring by an acute pain service team is a responsible task and should be available 24/7...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29733094/safety-profile-of-intraoperative-methadone-for-analgesia-after-major-spine-surgery-an-observational-study-of-1-478-patients
#6
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Salome B Alpert, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
OBJECTIVE: To investigate the incidence of perioperative adverse events in patients receiving intravenous methadone for major spine surgery. DESIGN: Retrospective review of perioperative records from March 2011 and February 2016. SETTING: University of Virginia Healthsystem. PATIENTS: Adult patients undergoing elective spinal fusion of two or more levels. MAIN OUTCOME MEASURES: Incidence of respiratory depression, time to extubation, hypotension, hypoxemia, reintubation, cardiac complications, and death...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29715708/the-feasibility-of-thoracoscopic-left-pneumonectomy
#7
Hao Xu, Linyou Zhang
OBJECTIVE:  In this study, we describe our experience with video-assisted thoracoscopic surgery (VATS) left pneumonectomy as a treatment for advanced malignant and benign diseases. METHODS:  Patients who underwent VATS left pneumonectomy in our clinic between October 2013 and August 2017 were retrospectively evaluated. VATS pneumonectomy was successfully completed in 46 patients. We reviewed and analyzed the characteristics of the patients in addition to intraoperative parameters, chest tube duration, length of hospital stay, morbidity, and mortality...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29707319/perioperative-management-and-outcomes-of-minimally-invasive-esophagectomy-case-study-of-a-high-volume-tertiary-center-in-taiwan
#8
Tzu Chang, Po-Ni Hsiao, Man-Yin Tsai, Pei-Ming Huang, Ya-Jung Cheng
Background: Mortality and complication rates for surgical esophagectomy remain high despite progress in surgical techniques and perioperative care. Minimally invasive surgery and intraoperative goal-directed fluid management are gaining popularity in Taiwan; however, perioperative complications and short-term outcomes have been rarely reported. In this retrospective study, we analyzed the surgical procedures performed as well as the perioperative outcomes and treatments after esophagectomy in a high-volume medical center in Taiwan...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29652270/pulmonary-hypertension-and-cardiac-anesthesia-anesthesiologist-s-perspective
#9
REVIEW
Manjula Sudeep Sarkar, Pushkar M Desai
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#10
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29628849/pectoralis-blocks-for-insertion-of-an-implantable-cardioverter-defibrillator-in-two-patients-with-duchenne-muscular-dystrophy
#11
Alexander B Froyshteter, Tarun Bhalla, Joseph D Tobias, Gregory S Cambier, Christopher T Mckee
Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopathy, depressed cardiac function, and arrhythmias. The latter may necessitate the placement of an automatic implantable cardioverter defibrillator (AICD) insertion. As a means of avoiding the need for general anesthesia and its inherent potential of morbidity, regional anesthesia may be used in specific cases...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29626346/propofol-for-implantable-cardioverter-defibrillator-implantation-in-patients-with-brugada-syndrome
#12
Hye-Mee Kwon, Sung-Hoon Kim, Se-Ung Park, Jin-Ho Rhim, Hee-Sun Park, Wook-Jong Kim, Gi-Byoung Nam
AIMS: Avoiding propofol in patients with Brugada syndrome has been suggested because of the theoretical risk of provoking ventricular arrhythmias, although propofol may be selected for conscious sedation during electrophysiological procedures in catheterization laboratories. This study aimed to document periprocedural electrocardiographic changes and adverse events in patients with Brugada syndrome undergoing implantable cardioverter defibrillator (ICD) implantation using propofol sedation...
April 6, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29625195/idiopathic-premature-ventricular-complexes-originating-from-the-distal-great-cardiac-vein-clinical-cardiac-and-electrophysiological-characteristics-and-catheter-ablation-outcome
#13
Wenkui Lv, Xianhui Zhou, Gulinuer Yiming, Ling Zhang, Qina Zhou, Yaodong Li, Qiang Xing, Jianghua Zhang, Yanmei Lu, Hongli Wang, Guiqiu Cao, Baopeng Tang
AIMS: Although catheter ablation for idiopathic ventricular arrhythmia (VA) has been generally well-established, VA originating from the great cardiac vein (GCV) may be clinically challenging due to its epicardial origin, proximity to coronary arteries and limited accessibility. The purpose of this study was to explore its electrophysiological characteristics and identify effective mapping/ablation strategies for idiopathic premature ventricular complexes (PVCs) originating from the GCV...
April 3, 2018: Life Sciences
https://www.readbyqxmd.com/read/29617497/opcabg-for-moderate-cimr-in-elderly-patients-a-superior-option
#14
Amber Malhotra, Chandrasekaran Ananthanarayanan, Vivek Wadhawa, Sumbul Siddiqui, Pranav Sharma, Kartik Patel, Komal Shah, Pratik Shah
OBJECTIVE: To compare the early and late outcomes of off-pump coronary artery bypass grafting and coronary artery bypass graft + mitral valve repair in elderly patients with moderate chronic ischemic mitral regurgitation. METHODS: One hundred and fifty elderly (age > 70 years) patients with moderate chronic ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting (n=95) or coronary artery bypass graft + mitral valve repair (n=55) between January 2007 and December 2014 were studied...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29608679/a-left-atrial-versus-a-biatrial-lesion-set-for-persistent-atrial-fibrillation-ablation-during-open-heart-surgery
#15
Alexander V Bogachev-Prokophiev, Alexander V Afanasyev, Alexei N Pivkin, Michail A Ovcharov, Sergei I Zheleznev, Ravil M Sharifulin, Alexander M Karaskov
OBJECTIVES: To compare the outcomes of left atrial ablation and biatrial (BA) ablation in patients with persistent and long-standing persistent atrial fibrillation undergoing open heart surgery. METHODS: Between January 2007 and December 2016, 588 consecutive patients with either persistent (20.9%) or long-standing persistent atrial fibrillation (79.1%) were enrolled in this study. To reduce between-group differences, propensity score-matched groups (156 patients/group) were obtained, with similar preoperative and perioperative characteristics...
March 28, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29602588/-transesophageal-echocardiography-in-perioperative-period-guiding-the-decision-making-during-hemodynamic-instability-due-to-atrial-fibrillation
#16
João Paulo Jordão Pontes, Aline Tonin Dos Santos, Marcello Fonseca Salgado Filho
BACKGROUND AND OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia, which may occur during the perioperative period and lead to hemodynamic instability due to loss of atrial systolic function. During atrial fibrillation management, electrical cardioversion is one of the therapeutic options in the presence of hemodynamic instability; however, it exposes the patient to thromboembolic event risks. Transesophageal echocardiography is a diagnostic tool for thrombi in the left atrium and left atrial appendage with high sensitivity and specificity, allowing early and safe cardioversion...
March 27, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29576105/perioperative-management-of-patients-with-congenital-or-acquired-disorders-of-the-qt-interval
#17
REVIEW
M O'Hare, Y Maldonado, J Munro, M J Ackerman, H Ramakrishna, D Sorajja
QT prolongation can be attributable to various causes that can be categorised as acquired or congenital. Arrhythmias related to QT prolongation can result in clinical presentations, such as syncope and sudden cardiac death. The perioperative period presents a number of issues that may affect a patient's risk of developing polymorphic ventricular tachycardia or torsades de pointes. Although most patients may have an unremarkable perioperative course, some may have complications; this review article aims to help clinicians avoid potential complications, and to help them address treatment for perioperative issues that may occur...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29575534/perioperative-management-of-children-with-glycogen-storage-disease-type-ii-pompe-disease
#18
Linelot Bosman, Sanne E Hoeks, Antonia González Candel, Hannerieke J M van den Hout, Ans T van der Ploeg, Lonneke M Staals
BACKGROUND: Pompe disease is a rare metabolic disorder caused by a deficiency of the lysosomal enzyme acid α-glucosidase. Glycogen accumulation damages skeletal, cardiac, and smooth muscles, causing a progressive and debilitating muscle weakness and cardiomyopathy. As life expectancy has much improved since the introduction of enzyme replacement therapy an increasing number of patients are referred for surgical procedures. Due to the potential cardiopulmonary complications, these patients form a high-risk group for the anesthesiologist...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29533470/perioperative-beta-blockers-for-preventing-surgery-related-mortality-and-morbidity
#19
REVIEW
Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29530770/enhanced-recovery-decreases-pulmonary-and-cardiac-complications-following-thoracotomy-for-lung-cancer
#20
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
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