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Intra aortic balloon pump

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https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#1
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#2
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#3
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28065768/ventricular-septal-defect-complicating-st-elevation-myocardial-infarctions-a-call-for-action
#4
Vikas Singh, Alex P Rodriguez, Parth Bhatt, Carlos E Alfonso, Rahul Sakhuja, Igor F Palacios, Ignacio Inglessis-Azuaje, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
BACKGROUND: Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain a major contributor to mortality. METHODS: We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28057952/direct-thrombin-inhibitor-resistance-and-possible-mechanisms
#5
Maria Cardinale, Michael Ha, Michael H Liu, David P Reardon
Objective: To report 3 cases in which doses of bivalirudin higher than commonly used in clinical practice were required in order to achieve therapeutic anticoagulation as monitored by the activated partial thromboplastin time (aPTT). Case Summary: The medical records of 3 patients who required large doses of bivalirudin to remain therapeutic were thoroughly reviewed. In all 3 patients, bivalirudin was initiated at a rate appropriate for the patients' renal function and titrated using a nurse-driven protocol with recommended dose adjustments based on aPTT...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28044253/transvenous-inoue-balloon-aortic-valvuloplasty-with-intra-aortic-balloon-pump-in-treating-cardiogenic-shock-due-to-critical-calcific-aortic-stenosis
#6
Yoshihito Sakata
A 90-year-old female with severe peripheral vascular disease developed cardiogenic shock (CS) due to critical aortic stenosis (AS). The balloon aortic valvuloplasty was emergently performed via transvenous and transseptal antegrade approach (ante-BAV), which saved arterial accesses for intra-aortic balloon pump (IABP) and enabled us to use the Inoue balloon. The IABP augmented systemic perfusions and controlled left heart filling pressures. Multiple times of inflations with stepwisely increased balloon diameters were performed under IABP support (ante-Inoue-BAV + IABP), resulting in remarkable improvements both in clinical and hemodynamic conditions...
January 2, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28043662/a-novel-risk-score-model-for-prediction-of-contrast-induced-nephropathy-after-emergent-percutaneous-coronary-intervention
#7
Kai-Yang Lin, Wei-Ping Zheng, Wei-Jie Bei, Shi-Qun Chen, Sheikh Mohammed Shariful Islam, Yong Liu, Lin Xue, Ning Tan, Ji-Yan Chen
BACKGROUND: A few studies developed simple risk model for predicting CIN with poor prognosis after emergent PCI. The study aimed to develop and validate a novel tool for predicting the risk of contrast-induced nephropathy (CIN) in patients undergoing emergent percutaneous coronary intervention (PCI). METHODS: 692 consecutive patients undergoing emergent PCI between January 2010 and December 2013 were randomly (2:1) assigned to a development dataset (n=461) and a validation dataset (n=231)...
December 26, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040188/effect-of-early-initiation-of-mechanical-circulatory-support-on-survival-in-cardiogenic-shock
#8
Mir B Basir, Theodore L Schreiber, Cindy L Grines, Simon F Dixon, Jeffrey W Moses, Brijeshwar S Maini, Akshay K Khandelwal, E Magnus Ohman, William W O'Neill
The role and timing of percutaneous mechanical circulatory support (MCS) devices in the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) are not well understood. We sought to evaluate patient characteristics and predictors of outcomes in patients presenting with AMICS supported with an axial flow percutaneous MCS device; 287 consecutive unselected patients enrolled in the catheter-based ventricular assist device registry presenting with AMICS who underwent percutaneous coronary intervention (PCI) were included in this analysis...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28039285/patients-views-of-consent-in-clinical-trials-for-acute-myocardial-infarction-impact-of-trial-design
#9
Neal W Dickert, Kristopher A Hendershot, Candace D Speight, Alexandra E Fehr
OBJECTIVE: Seeking prospective informed consent is difficult in clinical trials for emergent conditions such as acute myocardial infarction (AMI). Prior data suggest that enrolment decisions of patients are often poorly informed in AMI trials but that patients prefer to be asked permission before enrolment. It is unknown whether this is true across trial designs or in comparative effectiveness research (CER) with approved treatments. METHODS: Structured interviews were conducted with 30 patients with AMI...
December 30, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28028723/shenfu-injection-inhibits-inflammation-in-patients-with-acute-myocardial-infarction-complicated-by-cardiac-shock
#10
Yan-Yan Jin, Hai Gao, Xin-Yong Zhang, Hui Ai, Xiao-Lin Zhu, Jing Wang
OBJECTIVES: To investigate the effect of Shenfu Injection (, SFI) on inflammatory factors in patients with acute myocardial infarction complicated by cardiogenic shock (CS) treated with and intra-aortic balloon pump (IABP). METHODS: This study enrolled 60 patients with ST-segment elevation myocardial infarction (STEMI) complicated by CS. Patients underwent IABP and emergency percutaneous coronary intervention (PCI) were randomly divided into two groups by random number table with 30 cases in each group, one given SFI treatment (100 mL/24 h), one not...
December 27, 2016: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28024549/temporary-mechanical-circulatory-support-in-cardiac-critical-care-a-state-of-the-art-review-and-algorithm-for-device-selection
#11
REVIEW
A Dave Nagpal, Rohit K Singal, Rakesh C Arora, Yoan Lamarche
With more than 60 years of continuous development and improvement, a variety of temporary mechanical circulatory support (MCS) devices and implantation strategies exist, each with unique advantages and disadvantages. A thorough understanding of each available device is essential for optimizing patient outcomes in a fiscally responsible manner. In this state of the art review we examine the entire range of commonly available peripheral and centrally cannulated temporary MCS devices, including intra-aortic balloon pumps, the Impella (Abiomed, Danvers, MA) family of microaxial pumps, the TandemHeart (CardiacAssist Inc, Pittsburg, PA) pump and percutaneous cannulas, centrally cannulated centrifugal pumps such as the CentriMag (Thoratec Corp, Pleasanton, CA/St Jude Medical, St Paul, MN/Abbott Laboratories, Abbott Park, IL) and Rotaflow (Maquet Holding BV & Co KG, Rastatt Germany), and extracorporeal membrane oxygenation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#12
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27994387/refractory-pediatric-cardiogenic-shock-a-case-for-mechanical-support
#13
Anil Sachdev, Bharat Mehra, Arun Mohanty, Dhiren Gupta, Neeraj Gupta
Acute left ventricular dysfunction in children justifies aggressive treatment because of the high potential for complete recovery. The options for providing mechanical support to the failing heart in a child include extracorporeal membrane oxygenation, left ventricular assist devices, and the use of the intra-aortic balloon pump (IABP). The IABP is a commonly used method of temporary circulatory support in adults. However, despite the availability of pediatric size balloons, the usage of IABP for temporary circulatory support in children has not been widespread...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27977615/total-revascularization-for-an-epsilon-right-coronary-artery-and-severe-left-main-disease-combined-with-profound-cardiogenic-shock-a-case-report
#14
Hsiu-Yu Fang, Wei-Chieh Lee, Chiung-Jen Wu
RATIONALE: Severe left main disease combined with right coronary artery occlusion was rarely encountered in our daily practice. Percutaneous coronary intervention in these patients was most challenging due to high probability of hemodynamic changes. PATIENT CONCERNS: Here, we report a 67-year-old man with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and profound cardiogenic shock and we attempted coronary intervention with total revisualization for severe left main (LM) disease and angulated epsilon right coronary artery total occlusion...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27970280/tct-117-impact-of-intra-aortic-balloon-pump-use-on-mortality-in-patients-with-cardiogenic-shock-treated-with-primary-percutaneous-coronary-intervention-an-observational-study-of-21-210-patients-with-st-elevation-myocardial-infarction-from-the-london-heart-attack
#15
Krishnaraj Rathod, Anthony Mathur, Andrew Wragg, Costas O'Mahony, Daniel Jones
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970279/tct-116-elective-use-of-intra-aortic-balloon-pump-for-high-risk-percutaneous-coronary-intervention-for-acs-meta-analysis-of-rct-s
#16
Mohammad Ansari, Daniel Garcia
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27959314/balloon-pumps-inserted-via-the-subclavian-artery-bridging-the-way-to-heart-transplant
#17
Catherine Murks, Colleen Juricek
Intra-aortic balloon pumps have traditionally been inserted via the femoral artery, limiting patients' activity and exposing patients to complications of immobility. For patients awaiting cardiac transplant, these complications may threaten a successful outcome, or at the least, complicate recuperation after transplant. A novel approach to insertion of balloon pumps via the subclavian artery is presented here, including routine nursing care, complications and related nursing actions, and experience with and advantages of this method...
July 2016: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#18
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931654/the-response-of-the-microcirculation-to-mechanical-support-of-the-heart-in-critical-illness
#19
REVIEW
Sakir Akin, Atila Kara, Corstiaan A den Uil, Can Ince
Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock, and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS does not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation (MC)...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27928583/incidence-laboratory-detection-and-prognostic-relevance-of-hypoxic-hepatitis-in-cardiogenic-shock
#20
Christian Jung, Georg Fuernau, Ingo Eitel, Steffen Desch, Gerhard Schuler, Malte Kelm, Volker Adams, Holger Thiele
BACKGROUND: Despite the improvement of therapeutic options for patients in acute myocardial infarction (AMI), cardiogenic shock (CS) remains a complication with high mortality rates. Organ failure centrally determines the prognosis of these high-risk patients. Aim of the current study was to assess the incidence of hypoxic hepatitis (HH) in CS, its laboratory detection evaluating novel and established biomarkers and to estimate the prognostic relevance of HH in current clinical practice...
December 8, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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