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Echocardiography in hip surgery

Marko Boban, Mijana Barisic, Viktor Persic, Drazen Zekanovic, Igor Medved, Marinko Zulj, Aleskandar Vcev
BACKGROUND: The aim of our study was to analyze muscle strength in patients with recent surgical treatment for ischemic and combined ischemic-valvular heart disease, based on existence of diabetes mellitus. Connections existing between muscle strength and patient characteristics or conventional diagnostic tests were analyzed as well. METHODS: Study prospectively included consecutive patients scheduled for cardiovascular rehabilitation 0-3months after heart surgery...
September 2016: Journal of Diabetes and its Complications
Marko Boban, Alessandro Laviano, Viktor Persic, Bojan Biocina, Mate Petricevic, Drazen Zekanovic, Cecilija Rotim, Ivan Aleric, Aleksandar Vcev
BACKGROUND/AIM: Metabolic derangements due to increased nutritional risk lead to catabolism and loss of proteins, muscle tissue and eventually mass of parenchymatous organs. The aim of our study was to assess whether transitory nutritional risk after heart surgery influences on the left ventricle myocardial mass (LVMM), assessed by echocardiography. METHODS: Consecutive sample of patients scheduled for cardiovascular rehabilitation, in period 0-3 months after surgery...
2016: Annals of Nutrition & Metabolism
Andrew Marcantonio, Brandon Steen, Michael Kain, Kasey-Jean Bramlett, John F Tilzey, Richard Iorio
PURPOSE: The purpose of this study was to evaluate preoperative transthoracic echocardiography (TTE) on cardiac intervention, length of stay (LOS), inpatient mortality, and costs. METHODS: A retrospective series of 43 preoperative TTE and 161 non-TTE (control) hip fracture patients (> 65 years) was reviewed. The data collected included ASA score, comorbidities, indication for TTE, perioperative cardiac intervention, LOS, inpatient mortality, and cost. RESULTS: One of 43 (2...
December 2015: Bulletin of the Hospital for Joint Diseases
Sérgio Madeira, Luís Raposo, Raquel David, Alexandre Marques, José Andrade Gomes, Nuno Cardim, Rui Anjos
Platypnea-orthodeoxia syndrome (POS) is an uncommon syndrome characterized by dyspnea and hypoxemia triggered by orthostatism and relieved by recumbency. It is often associated with an interatrial shunt through a patent foramen ovale (PFO). We report the case of a 92-year-old woman initially admitted in the setting of a traumatic femoral neck fracture (successfully treated with hip replacement surgery) in whom a reversible decline in transcutaneous oxygen saturation from 98% (in the supine position) to 84% (in the upright position) was noted early post-operatively...
September 2015: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Harun Mutlu, Fuat Bilgili, Serhat Mutlu, Ozgur Karaman, Beytullah Cakal, Ufuk Ozkaya
OBJECTIVE: To investigate the effects of preoperative cardiac tests on the surgical treatment plan and subsequent effects on mortality in elderly patients with hip fracture. METHODS: In this retrospective study, 116 patients aged 60 years or above who underwent hip fracture surgery between 2010-2013 were evaluated. Of the patients with similar preoperative clinical risk factors, 20 patients with additional preoperative cardiac tests such as echocardiography or thalium scintigraphy constituted Group 1, whereas 28 patients without additional cardiac tests constituted Group 2...
2016: Journal of Back and Musculoskeletal Rehabilitation
J Dixon, E Ahn, L Zhou, R Lim, D Simpson, E G Merriman
BACKGROUND/AIM: Symptomatic venous thromboembolism (VTE) complicates approximately 4% of major orthopaedic surgical procedures performed without thromboprophylaxis. Randomised clinical trials demonstrate primary thromboprophylaxis reduces VTE rates to <1%, with low rates of clinically important bleeding, using low molecular weight heparin (LMWH), oral FXa inhibitors or thrombin inhibitors. We reviewed the rates of VTE in patients undergoing major hip/knee joint surgery at Waitemata District Health Board (WDHB)...
April 2015: Internal Medicine Journal
Marko Boban, Viktor Peršić, Marinko Zulj, Mate Petricević, Ruzica Palić Kramarić, Aleksandar Vcev
Our aim was to evaluate the adipose tissue percentage content appraised with BIA in patients recently treated for cardiovascular disorders by means of surgery or percutaneous coronary interventions. Study included 208 consecutive patients, in age range 25-84 years, 176 male and 32 female. There were 108 (51.9%) percutaneous coronary interventions and 100 (48.1%) operations. Adipose tissue share appraised by BIA in our settings was 28.6-6.7% with significant differences in relation with gender (p<0.001) and no relations with the age of patients...
September 2014: Collegium Antropologicum
Rong Bing, John Yiannikas
INTRODUCTION: We present the case of a patient with exertional fat embolism on isolated exercise of his right leg two and four months after right total hip joint replacement. His immediate post-operative period had also been complicated by an acute episode of chest pain and hypotension, treated as acute coronary syndrome. To the best of our knowledge, this is the first reported case of exertional fat embolism following orthopedic surgery. CASE PRESENTATION: A 71-year-old Caucasian man underwent elective cementless total right hip joint replacement...
2014: Journal of Medical Case Reports
Marko Boban, Viktor Peršić, Marinko Zulj, Mate Petricević, Ruzica Palić Kramarić, Aleksandar Vcev
Our aim was to evaluate the adipose tissue percentage content appraised with BIA in patients recently treated for cardiovascular disorders by means of surgery or percutaneous coronary interventions. Study included 208 consecutive patients, in age range 25-84 years, 176 male and 32 female. There were 108 (51.9%) percutaneous coronary interventions and 100 (48.1%) operations. Adipose tissue share appraised by BIA in our settings was 28.6-6.7% with significant differences in relation with gender (p<0.001) and no relations with the age of patients...
September 2014: Collegium Antropologicum
D J Canty, C F Royse, D Kilpatrick, A Bowyer, A G Royse
Hip fracture surgery is associated with a high rate of mortality and morbidity; heart disease is the leading cause and is often unrecognised and inadequately treated. Pre-operative focused transthoracic echocardiography by anaesthetists frequently influences management, but mortality outcome studies have not been performed to date. Mortality over the 12 months after hip fracture surgery, in 64 patients at risk of cardiac disease who received pre-operative echocardiography, was compared with 66 randomised historical controls who did not receive echocardiography...
November 2012: Anaesthesia
Jong-Yeon Lee, Su-Yeon Lee, Inho Shin, Chunghyun Park, Byung-Sang Lee, Min Sung Kim
A pulmonary embolism and cerebral infarction are the second and third most common acute cardiovascular diseases after a myocardial infarction. Early diagnosis and appropriate management are important clinical challenges. In this case, a fatal pulmonary embolism and extensive cerebral infarction caused cardiac arrest during spinal anesthesia for total hip replacement surgery. Transesophageal echocardiography indicated a pulmonary embolism and brain CT showed large area of acute infarction at right middle cerebral artery territory...
December 2011: Korean Journal of Anesthesiology
Prithee Jettoo, Rajesh Kakwani, Shahid Junejo, Imtiyaz Talkhani, Paul Dixon
BACKGROUND: All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients. METHODS: All hip fracture patients (N = 349) between 01/06/08 and 01/06/09 were included in the study. 29 patients had pre-operative echocardiogram (echo group). A computer generated randomised sample of 40 patients was generated from N, 'non-echo' group...
September 23, 2011: Journal of Orthopaedic Surgery and Research
Sven O'hEireamhoin, Thomas Beyer, Motaz Ahmed, Kevin J Mulhall
BACKGROUND: Given the well recognized imperative to treat hip fractures as expeditiously as possible there can arise uncertainty regarding the balance between pre-operative medical optimization and delay of surgery. Echocardiography is often felt to considerably delay surgery with limited change to patient management. METHODS: We retrospectively reviewed forty-nine consecutive patients who had echocardiography prior to surgery for hip fracture and compared them to fifty-eight patients who did not have echocardiography...
November 2011: Journal of Trauma
Yun-jian Zhang, Ning Zhao, Guo-guang Xia, Tian-shui Li, Yan-xia Wang
OBJECTIVE: To investigate the changes of serum enzymes and their prognostic value in patients with pulmonary thromboembolism after orthopaedic surgery. METHODS: Clinical data of 134 cases of confirmed pulmonary thromboembolism after orthopaedic surgery from 1997 to 2010 were reviewed.The 134 cases were divided into dead group (n=28) and survival group (n=106). The clinical presentation, electrocardiogram, arterial oxygen pressure (PaO2), chest X-ray, echocardiography,and serum enzymes including alanine transaminase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (γ-GT), lactate dehydrogenase (LDH), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were analyzed...
December 18, 2010: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Timothy S J Shine, Neil G Feinglass, Bruce J Leone, Peter M Murray
Fat embolus has been known to occur during major orthopedic surgery. In many cases, fat embolus syndrome is a postoperative complication of long bone orthopedic surgery, particularly femoral fractures occurring after trauma. Changes in intraoperative cardiopulmonary function have been reported in a subset of these patients, and they are associated with the degree of embolization occurring with manipulation or cementing of prostheses in the fractured femur. Intraoperative cardiovascular collapse has been reported, and this cardiac event is temporally associated with intramedullary manipulations such as reaming or cementing...
2010: Iowa Orthopaedic Journal
Cabrera Schulmeyer, Jorge Farías, Eduardo Rajdl, Jaime de La Maza, Marcela Labbé
BACKGROUND AND OBJECTIVES: Severe and refractory hypotension is an infrequent perioperative situation during non-cardiac surgery, but determining its etiology is essential for successful management and therapy. METHODS: Adults undergoing non-cardiac surgery were prospectively enrolled in this study. Severe hypotension was defined as a drop from 30% of baseline systolic arterial pressure unresponsive to adequate fluids administration and to ephedrine, according to the anasthesiologist criteria...
September 2010: Revista Brasileira de Anestesiologia
Mohamed F Algahim, Thomas R Lux, Joshua G Leichman, Anthony F Boyer, Charles C Miller, Susan T Laing, Erik B Wilson, Terry Scarborough, Sherman Yu, Brad Snyder, Carol Wolin-Riklin, Ursula G Kyle, Heinrich Taegtmeyer
BACKGROUND: Obesity is a systemic disorder associated with an increase in left ventricular mass and premature death and disability from cardiovascular disease. Although bariatric surgery reverses many of the hormonal and hemodynamic derangements, the long-term collective effects on body composition and left ventricular mass have not been considered before. We hypothesized that the decrease in fat mass and lean mass after weight loss surgery is associated with a decrease in left ventricular mass...
June 2010: American Journal of Medicine
Vijay D Shetty, Santosh P Nazare, Bhushan R Shitole, Sanjeev K Jain, A V Ganesh Kumar
We studied 109 patients who were subjected to dobutamine stress echocardiography (DSE) for preoperative cardiac risk assessment before undergoing elective primary hip and knee arthroplasty. Patients were selected for DSE based on several criteria. There were 16 patients with history of ischemic heart disease and 93 patients without. Seven of the 93 patients showed a positive DSE test result, of which 5 developed postoperative cardiac events (P = .00). This study clearly shows that serious "silent" cardiac comorbidity can exist even in so-called healthier patients undergoing routine hip and knee arthroplasty...
April 2011: Journal of Arthroplasty
Krzysztof Laudanski, Samir P Patel, Yong G Peng
Pulmonary embolism (PE) by solid particles is an infrequent complication encountered during orthopedic procedures. A patent foramen ovale (PFO) allows embolic material into the left-sided circulation, potentially affecting several organs. A case of a 33-year-old woman undergoing total proximal femur resection with megaprosthesis reconstruction is presented. Towards the end of surgery, cement was injected to stabilize the prosthesis. Echodense particulate matter was first seen in the right atrium, subsequently in the right ventricle, and also in significant quantities in the left atrium and ventricle...
November 2009: Journal of Clinical Anesthesia
R Yoga, Jc Theis, M Walton, W Sutherland
BACKGROUND: Fat Embolism is a complication of long bone fractures, intramedullary fixation and joint arthroplasty. It may progress to fat embolism syndrome, which is rare but involves significant morbidity and can occasionally be fatal. Fat Embolism can be detected at the time of embolization by transoesophageal echocardiography or atrial blood sampling. Later, a combination of clinical signs and symptoms will point towards fat embolism but there is no specific test to confirm the diagnosis...
June 13, 2009: Journal of Orthopaedic Surgery and Research
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