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Arun Shivajirao Bade, Shakil Sattar Ahmed Shaikh, Hemant Khemani, Gurkirat Singh, Narender Omprakash Bansal
Background: Thrombosis is a complication of prosthetic valves on oral anticoagulants which is associated with significant morbidity and mortality. A re-operation carries a substantial risk, with mortality rate from 10% to 15% in selected series, which may be 2- or 3-folds higher in critically ill patients. This study conducted in a tertiary care cardiology unit aimed to evaluate the effectiveness and safety of thrombolytic therapy in stuck mitral bileaflet heart valves. Methods: As a prospective observational study, clinical symptoms and fluoroscopy were the mainstay in diagnosis of stuck mitral valve...
June 2018: Cardiology Research
Alistair Royse, Zulfayandi Pawanis, David Canty, Jared Ou-Young, David Eccleston, Andrew Ajani, Christopher M Reid, Rinaldo Bellomo, Colin Royse
OBJECTIVES: Saphenous vein graft (SVG) remains the predominant conduit used in coronary surgery. The internal mammary artery has higher later term patency and confers superior survival. Current debate focuses on the increased use of arterial conduits rather than eradication of venous conduits. METHODS: Patient data extracted from the Australian and New Zealand Society of Cardiothoracic Surgeons database from 2001-2013 were linked to the national death registry held by the Australian Institute of Health and Welfare for all-cause mortality with censor date 7 October 2014...
June 8, 2018: European Journal of Cardio-thoracic Surgery
Ahmed Fouad Ahmed, Mohammed Nabil Abd Al Jawad
BACKGROUND: Proper visualization has always been the cornerstone for conducting proper cardiac interventions. Although many incisions have been described for mitral valve exposure, the feasibility of some comes at the expense of proper exposure. When it comes to a small left atrium, larger incisions may venture into critically situated structures, creating a heavy toll of increased morbidity and mortality. We aim to evaluate the safety and efficacy of a superior left atrium approach for mitral valve interventions and left atrial mass resection, particularly in a small left atrium...
May 29, 2018: Heart Surgery Forum
Grant Paulsen, Samantha Blum, Lara Danziger-Isakov
MRSA infection following SOT is an important cause of morbidity and mortality, but epidemiology and risk factors for colonization prior to pediatric SOT remain unclear. A retrospective cohort of SOT patients ≤21 years of age from 2009 to 2014 was evaluated. Demographics, MRSA screens, timing of transplantation, and MRSA infection were abstracted. From 2013 to 2014, 130 SOT candidates were screened or had known prior MRSA infection. Seventeen patients (13%) were MRSA colonized. Liver transplant candidates were least likely to be colonized (OR 0...
June 11, 2018: Pediatric Transplantation
X F Yu, L S Qiu, J F Liu, X Liu, H F Hong
Objective: To explore the surgical strategy for Ebstein anomaly in children. Methods: From January 2003 to December 2015, a total of 141 cases of Ebstein anomaly were treated at Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University. There were 65 male and 76 female patients, with age of (6.9±1.6) years (ranging from 10 months to 15 years), weight of (19.6±4.7) kg (ranging from 6.5 to 59.0 kg). All patients were diagnosed by 2 dimensional Doppler echocardiography and the septal leaflet and posterior leaflet displaced downward from 1...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Chun Wu, Zhengxia Pan, Yuhao Wu, Quan Wang, Yonggang Li, Yong An, Hongbo Li, Gang Wang, Yi Wang, Jiangtao Dai
PURPOSE: To summarize the etiology and treatment of 119 patients with chylothorax in our hospital. METHODS: A total of 119 patients with chylothorax, divided into a neonate group, an infant group, and an older-than-1-year group, were included in our study and analyzed from January 2000 to July 2017 in the Children's Hospital of Chongqing Medical University. RESULTS: A total of 90 males and 29 females were included in our study. In the neonate group, 21 chylothorax cases were due to idiopathic factors, constituting 72...
May 18, 2018: Journal of Pediatric Surgery
Gerda A Zeilmaker-Roest, Annewil van Saet, Joost van Rosmalen, Soma Bahmany, Antony van Dijk, Enno D Wildschut, Dick Tibboel, Ad J J C Bogers
BACKGROUND: Use of donor blood in congenital cardiac surgery increases the risk for post-operative morbidity and mortality. To reduce the need for allogenic blood transfusion a technique for peri-operative mechanical red cell salvage is applied. Blood from the operation site is collected in a reservoir, processed, passed through a lipophilic filter and returned to the patient. Influence of this cellsaver system on coagulation, fibrinolysis and inflammatory markers is known. To our knowledge no studies have been performed on the effects of autotransfusion on drug concentrations...
June 8, 2018: Journal of Cardiothoracic Surgery
Jordi Broncano, Daniel Vargas, Sanjeev Bhalla, Kristopher W Cummings, Constantine A Raptis, Antonio Luna
The term vasculitis includes a variable group of entities in which the common characteristic is inflammation of the walls of blood vessels occurring at some time during the course of the disease. The vasculitides can be divided into primary and secondary vasculitides, depending on the etiology and according to the size of the vessel affected. Both primary vasculitis and secondary vasculitis are associated with cardiac morbidity that is often subclinical. Cardiac involvement is associated with prognostic implications and higher rates of related mortality...
June 8, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Trevor Birkey, Jennifer Dixon, Roni Jacobsen, Salil Ginde, Melodee Nugent, Ke Yan, Pippa Simpson, Joshua Kovach
Adult congenital heart disease (ACHD) patients often require repeat cardiothoracic surgery, which may result in significant morbidity and mortality. Currently, there are few pre-operative risk assessment tools available. In the general adult population, pre-operative cardiopulmonary exercise testing (CPET) has a predictive value for post-operative morbidity and mortality following major non-cardiac surgery. The utility of CPET for risk assessment in ACHD patients requiring cardiothoracic surgery has not been evaluated...
June 7, 2018: Pediatric Cardiology
Shaneel Bappayya, Fiona Chen, Megan Alderuccio, Heinrich Schwalb
BACKGROUND: Rural and regional Australia presents a unique challenge in the delivery of surgical services by virtue of its geographical vastness and low population density. While up to 33% of Australians live in rural or regional areas, only 14.8% of surgeons work in a rural or regional area. Data regarding the caseload distribution of general surgeons working in a regional setting in Australia remain scarce. In order to better examine the training needs of rural general surgeons, this study aims to examine the caseload distribution of general surgeons working in regional Australia...
June 5, 2018: ANZ Journal of Surgery
Marissa A Brunetti, J William Gaynor, Lauren B Retzloff, Jessica L Lehrich, Mousumi Banerjee, Venugopal Amula, David Bailly, Darren Klugman, Josh Koch, Javier Lasa, Sara K Pasquali, Michael Gaies
OBJECTIVES: Cardiopulmonary failure in children with cardiac disease differs from the general pediatric critical care population, yet the epidemiology of extracorporeal membrane oxygenation support in cardiac ICUs has not been described. We aimed to characterize extracorporeal membrane oxygenation utilization and outcomes across surgical and medical patients in pediatric cardiac ICUs. DESIGN: Retrospective analysis of the Pediatric Cardiac Critical Care Consortium registry to describe extracorporeal membrane oxygenation frequency and outcomes...
June 2018: Pediatric Critical Care Medicine
Robert S Butler, Douglas Johnston, Michael W Kattan
Background: Mandated assessment of medical personnel by comparing individual performance averages to external targets is standard practice in many health care systems. This method of assessment uses only raw or adjusted averages without considering the associated variation. Failure to correctly incorporate variation in the assessment of medical personnel results in evaluations which are neither accurate nor fair with respect to assessing personnel performance. Methods: Accepted statistical methods for process evaluation and quality control, including regression, control charts, and adjusted means comparisons will be used to analyze hospital length of stay (LOS) patient data for the period between January and October 2010 for 12 physicians in the Cardiothoracic Surgery service line at the Cleveland Clinic...
April 2018: Annals of Translational Medicine
Hamid Shokoohi, Ali Pourmand, Keith Boniface, Rebecca Allen, Bruno Petinaux, Babak Sarani, James P Phillips
As terrorist actors revise their tactics to outmaneuver increasing counter-terrorism security measures, a recent trend toward less-sophisticated attack methods has emerged. Most notable of these "low tech" trends are the Targeted Automobile Ramming MAss Casualty (TARMAC) attacks. Between 2014 and November 2017, 18 TARMAC attacks were reported worldwide, resulting in 181 deaths and 679 injuries. TARMAC attack-related injuries are unique compared to accidental pedestrian trauma and other causes of mass casualty incidents (MCI), and therefore they require special consideration...
May 29, 2018: American Journal of Emergency Medicine
Nupur Verma, Charles S White, Tan-Lucien Mohammed
No abstract text is available yet for this article.
April 2018: Seminars in Roentgenology
Rose Mark, Swithin Song, Peter Mark
Descending necrotising mediastinitis (DNM) is an uncommon clinical entity which may arise secondary to primary odontogenic or neck infection in susceptible patients. Infection may spread contiguously via the alar or 'danger' space, a potential anatomical space posterior to the true retropharyngeal space.1 Spread of infection to the mediastinum almost always necessitates urgent cardiothoracic surgical intervention.2-4 This case report describes a male patient whose clinical deterioration following the diagnosis of submandibular abscess was investigated with CT imaging of the chest, where a diagnosis of DNM was made...
May 30, 2018: BMJ Case Reports
J A McCaughan, R K Battle, S K S Singh, J M Tikkanen, Y Moayedi, H J Ross, L G Singer, S Keshavjee, K J Tinckam
The development of do novo donor specific HLA antibodies (dnDSA) after transplantation is associated with graft failure, mortality, and cost. There is no effective therapeutic intervention to prevent dnDSA or ameliorate associated injury. The aims of this study were to identify specific HLA factors associated with dnDSA development and to propose primary prevention strategies which could reduce the incidence of dnDSA without prohibitively limiting access to transplant. The investigation cohort included heart transplant recipients from 2008-2015 (n=265)...
May 30, 2018: American Journal of Transplantation
Nia A Luxton, Ross MacKenzie, Patti Shih
BACKGROUND: Smoking cessation (SC) care in the perioperative period of cardiothoracic surgery is important to reduce surgical risk and help achieve long-term smoking abstinence in patients who continue to smoke. The implementation of clinical guidelines for SC care in the perioperative period has proved challenging, yet little is known of what influences the inter-disciplinary team involved in the cardiothoracic area. This qualitative study explored the views of the clinicians involved in perioperative period of cardiothoracic surgery in Australia on their SC advice and support...
May 8, 2018: Heart, Lung & Circulation
Laurence Weinberg, Moon Hae Pyo, Manfred Spanger, Stephen Arthur Barnett
No abstract text is available yet for this article.
May 26, 2018: BMJ Case Reports
James E Scriven, Antonia Scobie, Neville Q Verlander, Angela Houston, Tim Collyns, Vjeran Cajic, Onn Min Kon, Tamara Mitchell, Omar Rahama, Amy Robinson, Shirmila Withama, Peter Wilson, David Maxwell, Daniel Agranoff, Eleri Davies, Meirion Llewelyn, Shiu-Shing Soo, Amandip Sahota, Mike Cooper, Michael Hunter, Jennifer Tomlins, Simon Tiberi, Simon Kendall, Martin Dedicoat, Eliza Alexander, Teresa Fenech, Maria Zambon, Theresa Lamagni, E Grace Smith, Meera Chand
OBJECTIVES: Mycobacterium chimaera infection following cardiac surgery, due to contaminated cardiopulmonary bypass heater-cooler units, has been reported worldwide. However, the spectrum of clinical disease remains poorly understood. To address this, we report the clinical and laboratory features, treatment and outcome of the first 30 UK cases. METHODS: Case note review was performed for cases identified retrospectively through outbreak investigations and prospectively through on-going surveillance...
May 24, 2018: Clinical Microbiology and Infection
Daniel M Blumenthal, Linda R Valsdottir, Yuansong Zhao, Changyu Shen, Ajay J Kirtane, Duane S Pinto, Fred S Resnic, Karen E Joynt Maddox, Jason H Wasfy, Roxana Mehran, Ken Rosenfield, Robert W Yeh
Importance: Public reporting of procedural outcomes has been associated with lower rates of percutaneous coronary intervention (PCI) and worse outcomes after myocardial infarction. Contemporary data are limited on the influence of public reporting on interventional cardiologists' clinical decision making. Objective: To survey a contemporary cohort of interventional cardiologists in Massachusetts and New York about how public reporting of PCI outcomes influences clinical decision making...
May 9, 2018: JAMA Cardiology
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