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Perioperative arrhythmia

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https://www.readbyqxmd.com/read/28100967/anesthetic-management-in-radiofrequency-catheter-ablation-of-ventricular-tachycardia
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27713852/delayed-cerebral-infarct-following-anterior-cervical-diskectomy-and-fusion
#16
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
https://www.readbyqxmd.com/read/27687339/acute-stroke-after-total-joint-arthroplasty-a-population-based-trend-analysis
#17
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
https://www.readbyqxmd.com/read/27680064/-study-on-the-association-of-gastric-conduit-width-and-postoperative-early-delayed-gastric-emptying-in-middle-lower-esophageal-cancer-patients-undergoing-ivor-lewis-procedure
#18
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
https://www.readbyqxmd.com/read/27665857/atrial-fibrillation-following-off-pump-versus-on-pump-coronary-artery-bypass-grafting-incidence-and-risk-factors
#19
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
https://www.readbyqxmd.com/read/27621857/lung-cancer-resection-with-concurrent-off-pump-coronary-artery-bypasses-safety-and-efficiency
#20
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
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