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Echocardiography and hip surgery

Ely L Steinberg, Yaniv Warschawski, Jacob Elis, Dani Rotman, Gil Rachevsky, Shai Factor, Moshe Salai, Tomer Ben-Tov
AIM: Older patients with proximal femoral fractures often undergo preoperative tests due to coexisting morbidities. Our aim was to evaluate these tests and their impact on patient outcome and medical expenses. METHODS: This retrospective study includes data on head computed tomography, carotid ultrasound, echocardiography and pulmonary functional tests calculated according to the type of surgery (osteosynthesis or hip arthroplasty) carried out on 2798 patients. Time-to-surgery, test repeated postoperatively, American Society of Anesthesiology Physical Status score, additional procedures, hospitalization time, 30-day mortality and associated medical expenses were evaluated...
March 7, 2018: Geriatrics & Gerontology International
Nan Gai, Ronit Lavi, Philip M Jones, Hwa Lee, Douglas Naudie, Daniel Bainbridge
PURPOSE: Hip and knee arthroplasty surgeries are associated with embolism of materials such as air, cement, and fat. Patent foramen ovale (PFO) is a common congenital cardiac condition that has been reported to lead to paradoxical embolism. This observational study aimed to investigate if the presence of a PFO was associated with an increased risk of postoperative delirium in patients undergoing primary elective hip or knee arthroplasties. METHOD: This was a prospective cohort study at a tertiary teaching hospital...
January 24, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mahmut Kalem, Hakan Kocaoğlu, Ercan Şahin, Merve H Kocaoğlu, Kerem Başarır, Hakan Kınık
OBJECTIVE: The aim of this study was to analyze the effects of preoperative echocardiography on patient survival, timing of surgery in length of hospital stay in patients who will undergo hip nailing for an intertrochanteric fracture. METHODS: The clinical records of the patients who were admitted to a tertiary university hospital with an intertrochanteric femur fracture were retrospectively analyzed. The age, gender, American Society of Anesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription/modification, cardiac intervention and presence of an echocardiography assessment including detailed findings were reviewed...
January 2, 2018: Acta Orthopaedica et Traumatologica Turcica
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
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
Michel Francklyn Mitsomoy, Valerica Alexoiu, Matthias Kirsch
TWe present the case of a 64 years old male patient who had recently suffered an infective aortic valve endocarditis (Streptococcus agalactiae) complicated by embolic arthritis of the right hip. Initial echocardiography revealed moderate aortic insufficiency developed on a tricuspid aortic valve with a small vegetation (5 mm × 4 mm) on the left coronary cusp. Furthermore, an aneurysmal dilatation of the ascending aorta (maximal diameter, 54 mm) was noted. Other heart valves and left ventricular function were considered normal...
2015: Journal of Cardiovascular and Thoracic Research
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
Mariam A Alansari, Ahmed A Abdulmomen
A 70-year-old man underwent total hip replacement surgery under general anesthesia, endotracheal intubation, and controlled ventilation, with the patient in left lateral position. Intraoperatively, the patient was hemodynamically stable, with a normal range of pulse, ECG trace, oxygen saturation as measured by pulse oximetry (Spo2), and end-tidal CO2 (etco2). Five minutes after insertion of the hip prosthesis, his heart rate dropped to 30 beats/min, BP to 40/30 mm Hg, Spo2 to 70%, and etco2 to 10 mm Hg.
November 2014: Chest
Mohammad Bagher Sharifkazemi, Ali Reza Moarref, Shahed Rezaian, Gholam Reza Rezaian
The occurrence of Brucella endocarditis following Bentall operation is a rare and life threatening condition, particularly when it is complicated by development of a pseudoaneurysm. Here we present a 40-year-old veterinarian with bicuspid aortic valve, who developed type A aortic root dissection and required Bentall operation. His past medical history was positive for an episode of treated brucellosis. Four months after the operation, he developed signs, symptoms and serological findings of brucellosis for the second time and was treated with antibiotics...
December 2013: Journal of Cardiovascular Ultrasound
Byung-Hyun Joe, Hui-Jeong Hwang, Chang-Bum Park, Eun-Sun Jin, Il-Suk Sohn, Jin-Man Cho, Chong-Jin Kim
We report a case of Takotsubo cardiomyopathy, which involved the right ventricle at first presentation and demonstrated involvement of the left ventricle during recurrence. The patient was admitted to Kyung Hee University Hospital due to a left hip fracture, which was considered a result of physical stress. Complete recovery was confirmed by echocardiography prior to recurrence. The cause of the second event was surgery for the left hip fracture. Recurrence of Takotsubo cardiomyopathy at various cardiac locations provides evidence against the existing hypotheses that variants of Takotsubo cardiomyopathy are associated with anatomically different distributions of cardiac adrenergic receptors, the degree of stimulation by sympathetic activity and different susceptibilities to such sympathetic stimulation...
July 2013: Experimental and Therapeutic Medicine
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
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