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https://www.readbyqxmd.com/read/28315287/elective-primary-or-secondary-delayed-sternal-closure-improves-outcome-in-severely-compromised-patients
#1
Antonio M Calafiore, Azmat A Sheikh, Juan J Alfonso, Tarek Tantawi, Belgeit Maklouf, Ahmed Shawki, Ahmed Allam, Mohammed O Awadi, Ahmed A Osman, Aly M Habib, Michele Di Mauro
Background Delayed sternal closure (DSC) in patients with severely compromised preoperative hemodynamics can be helpful as the chest sometimes cannot be able to contain both lungs and heart. We report our experience to evaluate the midterm results of this strategy in an adult population. Materials and Methods From May 2009 till July 2015, 33 patients had DSC as first treatment of severe hemodynamic deterioration after cardiac surgery. Surgical procedures were valvular (9.27%) or coronary artery bypass grafting + others (24...
March 17, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28302746/current-interventional-and-surgical-management-of-congenital-heart-disease-specific-focus-on-valvular-disease-and-cardiac-arrhythmias
#2
Kimberly A Holst, Sameh M Said, Timothy J Nelson, Bryan C Cannon, Joseph A Dearani
Successful outcome in the care of patients with congenital heart disease depends on a comprehensive multidisciplinary team. Surgery is offered for almost every heart defect, despite complexity. Early mortality for cardiac surgery in the neonatal period is ≈10% and beyond infancy is <5%, with 90% to 95% of patients surviving with a good quality of life into the adult years. Advances in imaging have facilitated accurate diagnosis and planning of interventions and surgical procedures. Similarly, advances in the perioperative medical management of patients, particularly with intensive care, has also contributed to improving outcomes...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28302288/valvular-heart-disease-patients-on-edoxaban-or-warfarin-in-the-engage%C3%A2-af-timi-48-trial
#3
Raffaele De Caterina, Giulia Renda, Anthony P Carnicelli, Francesco Nordio, Marco Trevisan, Michele F Mercuri, Christian T Ruff, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) instead of vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and coexisting valvular heart disease (VHD) is of substantial interest. OBJECTIVES: This study explored outcomes in patients with AF with and without VHD in the ENGAGE AF-TIMI 48 (Effective Anticoagulation with factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial, comparing edoxaban with warfarin...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28302287/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-valvular-heart-disease
#4
Giulia Renda, Fabrizio Ricci, Robert P Giugliano, Raffaele De Caterina
BACKGROUND: Valvular heart disease (VHD) and atrial fibrillation (AF) often coexist. Phase III trials comparing non-vitamin K antagonist oral anticoagulants (NOACs) with warfarin excluded patients with moderate/severe mitral stenosis or mechanical heart valves, but variably included patients with other VHD and valve surgeries. OBJECTIVES: This study aimed to determine relative safety and efficacy of NOACs in patients with VHD. METHODS: We performed a meta-analysis of the 4 phase III AF trials of the currently available NOACs versus warfarin in patients with coexisting VHD to assess pooled estimates of relative risk (RR) and 95% confidence intervals (CIs) for stroke/systemic embolic events (SSEE), major bleeding, intracranial hemorrhage (ICH), and all-cause death...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28300569/obesity-as-an-effect-modifier-in-sleep-disordered-breathing-and-post-cardiac-surgery-atrial-fibrillation
#5
Roop Kaw, Samer El Zarif, Lu Wang, James Bena, Eugene Blackstone, Reena Mehra
INTRODUCTION: As the inter-relationships of objectively-ascertained sleep disordered breathing (SDB), post-cardiac surgery atrial fibrillation (PCSAF) and obesity remain unclear; we aimed to further investigate in a clinic-based cohort. METHODS: Patients with polysomnography (PSG) and cardiac surgery (coronary artery bypass surgery and/or valvular surgery) within 3 years, from January 2009 to January 2014 were identified excluding those with pre-existing AF. Logistic models were used to determine the association of SDB (apnea hypopnea index (AHI) per 5 unit increase) and secondary predictors [central sleep apnea (CSA) (central apnea index>5) and oxygen desaturation index (ODI)] with PCSAF...
March 11, 2017: Chest
https://www.readbyqxmd.com/read/28296135/assessment-of-trans-aortic-pressure-gradient-using-a-coronary-pressure-wire-in-patients-with-mechanical-aortic-and-mitral-valve-prostheses
#6
Nisharahmed Kherada, Juan Carlos Brenes, Annapoorna S Kini, George D Dangas
Accurate evaluation of trans-aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non-invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans-valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295517/a-giant-aneurysm-of-noncoronary-sinus-of-valsalva-concomitant-with-aortic-regurgitation-and-mitral-regurgitation
#7
Yi Luo, Zhi Fang, Wei Meng
Aneurysms of the sinus of Valsalva (ASV) are rare, with an incidence ranging from 0.1% to 3.5% of all congenital cardiac defects and a prevalence of 0.009% in an autopsy series.ASVs occur much more frequently in the right coronary sinus of Valsalva. Previous reports, based on necropsy and cardiac surgery findings, estimated that 20% of ASVs are unruptured. Patients with an unruptured ASV may remain asymptomatic for a long period of time until rupture. They may also presented with dyspnea, palpitation, and angina-like chest pain...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28283362/syntax-score-ii-in-patients-with-coronary-artery-disease-undergoing-percutaneous-mitral-repair-with-the-mitraclip
#8
Slayman Obeid, Adrian Attinger-Toller, Maurizio Taramasso, Giovanni Pedrazzini, Gabor Suetsch, Fabienne Landolt, Fatih Karbeyaz, Hector Rodriguez, Daniel Sürder, Tiziano Moccetti, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Percutaneous mitral valve repair (PMVR) using the MitraClip™ system has become a valuable alternative in patients with severe mitral regurgitation (MR) and high surgical risk. We sought to evaluate the prognostic value of the SYNTAX II score (SSII) in patients with concomitant coronary artery disease (CAD) undergoing a Mitraclip procedure. METHODS: In seventy-five consecutive patients who underwent PMVR at the University Heart Center Zürich and the Cardiocentro Ticino, the SSSII was calculated at baseline...
February 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28274519/regional-heterogeneity-in-the-mitral-valve%C3%A2-apparatus-in-patients-with-ischemic%C3%A2-mitral-regurgitation
#9
Feroze Mahmood, Ziyad O Knio, Lu Yeh, Rabia Amir, Robina Matyal, Azad Mashari, Robert C Gorman, Joseph H Gorman, Kamal R Khabbaz
BACKGROUND: Apical displacement of the coaptation point of the mitral valve (MV) in response to ischemic mitral regurgitation (IMR) represents remodeling of the MV apparatus. Whereas it implies chronicity, it lacks specificity in discriminating normal from a significantly remodeled MV apparatus. Regional aspects of MV remodeling have shown superior value over global remodeling in predicting recurrence after MV repair for IMR. Quite possibly, presence of specific regional changes in MV geometry that are unique to chronic IMR patients could also be used to diagnose the presence and track progression of remodeling...
March 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28270004/-the-first-use-of-iv-idarucizumab-for-dabigatran-reversal-in-hungary
#10
Lajos Driesz, Éva Barabás, Ildikó Bodócs, Zoltán Szántó, György Herr, Gábor Bencsik, László Pál, József Borbola
At present, the direct thrombin inhibitor dabigatran is the only one amongst the new direct anticoagulants which has an effective, specific reversal agent. The novel agent idarucizumab is a humanized, monoclonal antibody fragment binds to dabigatran within minutes thereby offers an opportunity to induce a safe, long-lasting reverse of the anticoagulant effects of dabigatran. The authors describe the first use of idarucizumab in Hungary (23. 05. 2016) in an old female patient with non-valvular paroxysmal atrial fibrillation of high stroke risk-score and renal dysfunction who was taking dabigatran (2 x 110 mg/day) when an acute abdomen developed requiring emergency cholecystectomy...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28265210/transcatheter-aortic-valve-replacement-comprehensive-review-and-present-status
#11
REVIEW
Sameer Arora, Jacob A Misenheimer, Radhakrishnan Ramaraj
Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28251509/indications-of-surgery-in-infective-endocarditis
#12
REVIEW
Aref A Bin Abdulhak, Imad M Tleyjeh
PURPOSE OF THE REVIEW: Infective endocarditis (IE) is a serious disease with significant morbidity and mortality. Valve surgery is fundamental in the standard of care of selected IE patients. Indeed, valve surgery can be a lifesaving procedure in critically ill endocarditis patients. Our goal from this review is to discuss the indications of surgery in IE population and international cardiac societies' guideline recommendations. RECENT FINDINGS: Though IE is an uncommon disease, its incidence is noted to be on rise in some parts of the world, and the disease is expected to continue to be a major health problem...
March 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28250283/characteristics-and-prognosis-of-pacemaker-identified-new-onset-atrial-fibrillation-in-japanese-people
#13
Yutaka Ogino, Toshiyuki Ishikawa, Tomoaki Ishigami, Katsumi Matsumoto, Junya Hosoda, Kouhei Iguchi, Hirooki Matsushita, Yuka Taguchi, Yoriko Horiguchi, Kazuo Kimura
BACKGROUND: The characteristics and prognosis of implanted pacemaker-identified new-onset atrial fibrillation (AF) in Japanese people has not been well evaluated.Methods and Results:A total of 395 consecutive patients with newly implanted pacemakers were retrospectively analyzed between January 2010 and December 2015 at Yokohama City University Hospital. Patients with a prior history of AF, VVI mode pacemaker, congenital heart disease, severe valvular heart disease, and cardiovascular surgery before pacemaker implantation were excluded...
March 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28238246/clinical-presentation-and-value-of-echocardiography-in-the-diagnosis-of-freestyle-aortic-bioprosthesis-leaflet-tears-a-retrospective-study
#14
Philippe Rheault, Siamak Mohammadi, Kim O'Connor, François Dagenais, Pierre Voisine, Sébastien Bergeron, Mathieu Bernier, Christian Couture, Paul Poirier, Alexandre Cinq-Mars, Michelle Dubois, Mario Sénéchal
BACKGROUND: The unique design of the Freestyle stentless aortic bioprosthesis has led to different mechanisms of failure, particularly leaflet tearing. The aim of this retrospective study was to review the clinical presentation and echocardiographic data of symptomatic patients with leaflet tears and significant aortic regurgitation (AR) following implantation of the Freestyle bioprosthesis. METHODS: Between January 1993 and May 2011, a total of 430 consecutive patients was identified at the authors' institution who had undergone primary aortic valve replacement with a Freestyle stentless aortic bioprosthesis...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28228300/lutembacher-s-syndrome-is-the-mitral-pathology-always-rheumatic
#15
Pradeep Vaideeswar, Supreet Marathe
The mitral valve disease (MVD) in Lutembacher's syndrome has been infrequently analyzed from a pathological standpoint. In this study, we have attempted to elucidate the pathology of MVD in this interesting syndrome in 44 autopsied cases of combined non-primum atrial septal defect (ASD) and MVD collected over 16 years. The patients were divided into 3 groups: Group 1: non-primum ASD with clinically diagnosed mitral stenosis (MS)±regurgitation, Group 2: non-primum ASD with clinically diagnosed mitral regurgitation (MR) and, Group 3: non-primum ASD with no clinically evident MVD, but with mitral valve pathology diagnosed at autopsy...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28209037/-lung-function-influenced-the-prognosis-of-cardiac-surgery-in-patients-with-chronic-obstructive-pulmonary-disease
#16
C T Wu, J H Zhao, D Wei, Y X Shi, G F Zhu
Objective: To investigate the value of lung function for the prognosis of cardiac surgery in patients with chronic obstructive pulmonary disease(COPD). Methods: A retrospective analysis was conducted on the hospitalized patients with coronary heart disease or valvular heart disease in Beijing Anzhen hospital during Janury 2013 to December 2015. The relationship between lung function and extubation time, time of staying in ICU, second time tracheal incubation, tracheotomy and mortality rate were analyzed. Results: There were 355 patients without surgery in a total 1 729 of patients, of which 65 (18...
February 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28197281/prediction-of-symptomatic-embolism-in-filipinos-with-infective-endocarditis-using-the-embolic-risk-french-calculator
#17
Jaime Alfonso M Aherrera, Maria Teresa B Abola, Maria Margarita O Balabagno, Lauro L Abrahan, Jose Donato A Magno, Paul Ferdinand M Reganit, Felix Eduardo R Punzalan
BACKGROUND: Cardioembolic events are life-threatening complications of infective endocarditis (IE). The embolic risk French calculator estimates the embolic risk in IE computed on admission. Variables in this tool include age, diabetes, atrial fibrillation, prior embolism, vegetation length, and Staphylococcus aureus on culture. A computed risk of > 7% was considered high in the development of this tool. Knowledge of this risk applied in our local setting is important to guide clinicians in preventing such catastrophic complications...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194628/association-between-ck-mb-area-under-the-curve-and-tranexamic-acid-utilization-in-patients-undergoing-coronary-artery-bypass-surgery
#18
Sean van Diepen, Peter D Merrill, Michel Carrier, Jean-Claude Tardif, Mihai Podgoreanu, John H Alexander, Renato D Lopes
Myonecrosis after coronary artery bypass graft (CABG) surgery is associated with excess mortality. Tranexamic acid (TA), an anti-fibrinolytic agent, has been shown to reduce peri-operative blood loss without increasing the risk of myocardial infarction (MI); however, no large study has examined the association between TA treatment and post-CABG myonecrosis. In the MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery II trial, inverse probability weighting of the propensity to receive TA was used to test for differences among the 656 patients receiving and 770 patients not receiving TA...
February 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#19
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28183575/choreoathetotic-syndrome-following-cardiac-surgery
#20
Michela Bisciglia, Frédéric London, Jonathan Hulin, André Peeters, Adrian Ivanoiu, Anne Jeanjean
Movement disorders following heart surgery are very unusual. Post-pump chorea is mainly a pediatric complication of heart surgery, typically manifesting after a latent period of normality and is usually related with long extracorporeal circulation time and deep hypothermia. We report a 73-year-old woman, without risk factors predisposing to paroxysmal movement disorders, presenting acute choreoathetoid movements 5 days after aortic valvular replacement with normal extracorporeal circulation time and perioperative normothermia...
February 2017: Journal of Clinical Anesthesia
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