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Perioperative arrhythmia

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https://www.readbyqxmd.com/read/29147786/risk-factors-for-development-of-ectopic-atrial-tachycardia-in-post-operative-congenital-heart-disease
#1
Bradley C Clark, John T Berger, Charles I Berul, Richard A Jonas, Jonathan R Kaltman, Julianne Lapsa, Dilip S Nath, Elizabeth D Sherwin, Pranava Sinha, David Zurakowski, Jeffrey P Moak
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#2
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#3
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29126653/perioperative-levosimendan-in-cardiac-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#4
Alessandro Putzu, Sara Clivio, Alessandro Belletti, Tiziano Cassina
BACKGROUND: Several studies suggested beneficial effects of perioperative levosimendan on postoperative outcome after cardiac surgery. However, three large randomized controlled trials (RCTs) have been recently published and presented neutral results. We performed a systematic review with meta-analysis and trial sequential analysis (TSA) to assess benefits and harms of perioperative levosimendan therapy in cardiac surgery. METHODS: Electronic databases were searched up to September 2017 for RCTs on preoperative levosimendan versus any type of control...
October 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29103675/heart-valve-surgery-performed-by-trainee-surgeons-meta-analysis-of-clinical-outcomes
#5
REVIEW
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
October 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29049708/two-staged-hybrid-ablation-of-non-paroxysmal-atrial-fibrillation-clinical-outcomes-and-functional-improvements-after-1%C3%A2-year
#6
Petr Budera, Pavel Osmancik, David Talavera, Anna Kraupnerova, Richard Fojt, Jana Zdarska, Tomas Vanek, Zbynek Straka
OBJECTIVES: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy; however, data regarding its efficacy and safety are still limited. METHODS: Patients with non-paroxysmal AF were enrolled. First, a thoracoscopic, epicardial isolation of pulmonary veins and the left atrial posterior wall ('box lesion') was performed; a novel unipolar/bipolar radiofrequency device was used. Moreover, in 12 patients enrolled thereafter, the left atrial appendage was occluded...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#7
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29037481/surgical-outcomes-among-elderly-women-with-endometrial-cancer%C3%A2-treated-by-laparoscopic-hysterectomy-a-nrg-gynecologic-oncology-group-study
#8
Erin A Bishop, James J Java, Kathleen N Moore, Nick M Spirtos, Michael L Pearl, Oliver Zivanovic, David M Kushner, Floor Backes, Chad A Hamilton, Melissa A Geller, Jean Hurteau, Cara Mathews, Robert M Wenham, Pedro T Ramirez, Susan Zweizig, Joan L Walker
OBJECTIVE: Tolerance of and complications caused by minimally invasive hysterectomy and staging in the older endometrial cancer population is largely unknown despite the fact that this is the most rapidly growing age group in the United States. The objective of this retrospective review was to compare operative morbidity by age in patients on the Gynecologic Oncology Group Laparoscopic Surgery or Standard Surgery in Treating Patients With Endometrial Cancer or Cancer of the Uterus (LAP2) trial...
October 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29029356/total-hip-arthroplasty-dislocation-after-cardioversion-a-case-report
#9
Ahmed Siddiqi, Carl T Talmo, James V Bono
New onset postoperative atrial fibrillation (AF) is the most common perioperative arrhythmia in the elderly. The incidence after total joint arthroplasty is much lower than other non-cardiac surgeries. Since postoperative atrial fibrillation can cause increased length of hospital stay, mortality, and healthcare costs, it is critical to focus on prevention and prompt management. New onset atrial fibrillation is treated with rhythm control for patients who demonstrate hemodynamic instability or refractory to rate control measures...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29028637/hemorrhagic-shock-after-epicardial-pacing-wire-removal-a-case-report
#10
Paul A Warner, Lindsay L Warner, Alberto Pochettino, Tuhin K Roy
Epicardial pacing wires are routinely used to avoid hemodynamic instability due to perioperative arrhythmias after cardiac surgery. In rare cases, pacing wires themselves can be associated with potentially life-threatening complications. Herein, we present a novel case of hemorrhagic shock and hemoperitoneum after temporary epicardial pacing wire removal.
October 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28983217/the-incidence-of-perioperative-cardiac-events-after-orthopedic-surgery-a-single-institutional-experience-of-cases-performed-over-one-year
#11
Michael K Urban, Steffan W Wolfe, Neil M Sanghavi, Kara Fields, Steven K Magid
BACKGROUND: Orthopedic patients with ischemic heart disease are at risk for postoperative cardiac complications. QUESTIONS/PURPOSES: Using information from two medical information retrieval systems which insured the capture of all events for the period of study, our goals were to determine the incidence of myocardial injury in at-risk patients after orthopedic surgery and to delineate the type and incidence of cardiac complications in this population. METHODS: For one year, at an orthopedic hospital, we identified all postoperative patients with a measured cTnI level using an electronic ordering system...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28970629/cardiac-tachyarrhythmias-and-anaesthesia-general-principles-and-focus-on-atrial-fibrillation
#12
REVIEW
Satyen Parida, Chitra Rajeswari Thangaswamy
Cardiac tachyarrhythmias are encountered commonly during the perioperative period and need to be promptly identified and appropriately managed by the anaesthesiologist. This review intends to highlight important aspects of these tachyarrhythmias and explore a temporal relationship between common medications employed in the perioperative period and their causation. Mechanisms of initiation of tachyarrhythmias, drugs that can trigger those, as well as their diagnosis and management, are also parts of the current review...
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28807383/prediction-of-major-cardiac-events-after-vascular-surgery
#13
Danielle M Gualandro, Christian Puelacher, Giovanna LuratiBuse, Gisela B Llobet, Pai C Yu, Francisco A Cardozo, Noemi Glarner, Andres Zimmerli, Jaqueline Espinola, Sydney Corbière, Daniela Calderaro, Andre C Marques, Ivan B Casella, Nelson de Luccia, Mucio T Oliveira, Andreas Lampart, Daniel Bolliger, Luzius Steiner, Manfred Seeberger, Christoph Kindler, Stefan Osswald, Lorenz Gürke, Bruno Caramelli, Christian Mueller
OBJECTIVE: Predicting cardiac events is essential to provide patients with the best medical care and to assess the risk-benefit ratio of surgical procedures. The aim of our study was to evaluate the performance of the Revised Cardiac Risk Index (Lee) and the Vascular Study Group of New England Cardiac Risk Index (VSG) scores for the prediction of major cardiac events in unselected patients undergoing arterial surgery and to determine whether the inclusion of additional risk factors improved their accuracy...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28800884/ionic-mechanisms-of-the-action-of-anaesthetics-on-sinoatrial-node-automaticity
#14
REVIEW
Akiko Kojima, Hiroshi Matsuura
Although various general anaesthetics affect the heart rate in clinical settings, their precise mechanisms remain to be fully elucidated. Because the heart rate is determined by automaticity of the cardiac pacemaker sinoatrial node and its regulation by autonomic nervous system, it is important to clarify the effect of anaesthetics on sinoatrial node automaticity. The spontaneous electrical activity of sinoatrial node is generated by a complex but coordinated interaction of multiple ionic currents, such as the hyperpolarisation-activated cation current (If), T-type and L-type Ca(2+) currents (ICa,T and ICa,L), Na(+)/Ca(2+) exchange current (INCX), and rapidly and slowly activating delayed rectifier K(+) currents (IKr and IKs)...
November 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28790536/comparison-of-results-classical-and-eversion-carotid-endarterectomy
#15
Muhamed Djedovic, Emir Mujanovic, Amel Hadzimehmedagic, Dragan Totic, Haris Vukas, Haris Vranic
INTRODUCTION: Atherosclerosis blood vessels, be it on extra-cranial or intra-cranial circulation, the most common cause of incidents such as cerebro-vascular insult (ICV). Carotid endarterectomy (CEA) is a preventive operation to reduce the risk of stroke and it can be performed by eversion carotid endarterectomy (E-CEA) or a classical carotid endarterectomy (C-CEA). The aim of this study was to investigate the influence of the used techniques in basic perioperative results and the incidence of postoperative complications...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28790282/-arrhythmia-perioperative-management-and-the-prevention
#16
Masayoshi Inoue
Perioperative/postoperative atrial fibrillation and flutter( POAF) is one of the common complications after pulmonary resection and the frequency is reported as 12.6% according to Society of Thoracic Surgeons general thoracic surgery database. We usually observed POAF 2~3 day after operation. While the etiology remains uncertain, the left atrial overload by the refilling from the 3rd space or systemic inflammation after surgery could raise this complication in addition to the right atrial overload following pulmonary resection and postoperative hypoxia status...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790281/-perioperative-management-for-prevention-of-cardiac-complications-in-general-thoracic-surgery
#17
Terumoto Koike, Masanori Tsuchida
For general thoracic surgeons, perioperative management for prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac disease. Sever cardiac failure should be detected and treated prior to surgery, and coronary artery may be examined in patients with risk factors for ischemic heart disease. Pulmonary resection sometimes causes right-sided heart failure due to reducing pulmonary vascular bed. In high-risk patients for rightsided heart failure, pulmonary artery pressure monitoring by right heart catheterization should be considered in addition to blood pressure and central venous pressure monitoring, and precise fluid management is required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28754423/gender-differences-and-outcomes-in-left-ventricular-assist-device-support-the-european-registry-for-patients-with-mechanical-circulatory-support
#18
Christina Magnussen, Alexander M Bernhardt, Francisco M Ojeda, Florian M Wagner, Jan Gummert, Theo M M H de By, Thomas Krabatsch, Paul Mohacsi, Meike Rybczynski, Dorit Knappe, Bjoern Sill, Tobias Deuse, Stefan Blankenberg, Renate B Schnabel, Hermann Reichenspurner
BACKGROUND: Despite the increasing use of ventricular assist devices (VADs), gender differences in indications, hemodynamics, and outcome are not well understood. We examined gender differences and gender-specific predictors for perioperative outcome in patients on ventricular support. METHODS: Multicenter data of 966 patients (median age 55 years, 151 women) from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) were analyzed. Median follow-up was 1...
July 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28739038/anesthetic-and-perioperative-management-of-patients-with-brugada-syndrome
#19
REVIEW
Gregory Dendramis, Claudia Paleologo, Giuseppe Sgarito, Umberto Giordano, Roberto Verlato, Adrian Baranchuk, Pedro Brugada
Brugada syndrome (BrS) is an arrhythmogenic disease reported to be one among the leading causes of cardiac death in subjects under the age of 40 years. In these patients, episodes of lethal arrhythmias may be induced by several factors or situations, and for this reason, management during anesthesia and surgery must provide some precautions and drugs restrictions. To date, it is difficult to formulate guidelines for anesthetic management of patients with BrS because of the absence of prospective studies, and there is not a definite recommendation for neither general nor regional anesthesia, and there are no large studies in merit...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28728273/-a-retrospective-study-of-the-perioperative-complications-following-whole-lung-lavage-in-the-treatment-of-pulmonary-alveolar-proteinosis
#20
Z Q Zhou, W L Guo, Y Chen, C H Zhong, S Y Li
Objective: To evaluate the safety of the procedures of whole lung lavage(WLL) for pulmonary alveolar proteinosis(PAP) in perioperative period. Methods: In this retrospective study, we collected clinical data from 78 WLL procedures of PAP patients from January 2006 to June 2016 in Guangzhou Institute of Respiratory Disease. The causes of perioperative complications were analyzed. Results: Eighteen (23.07%) of the 78 procedures developed complications, including pleural effusion(n=4), pneumonia(n=4), cardiac failure(n=2), cardiac arrhythmia (n=2), pneumothorax(n=2), atelectasis(n=1), lung edema(n=1), laryngeal edema(n=1), pleural effusion and pneumonia(n=1)...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
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