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https://www.readbyqxmd.com/read/27920021/venous-and-arterial-air-embolism-a-rare-phenomenon-with-fatal-consequences
#1
Jatan Shah, Nasheena Jiwa, Natasha Mamdani, David Hill
Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27916322/the-routine-use-of-the-pulmonary-artery-catheter-should-be-abandoned
#2
Nayer Youssef, Richard P Whitlock
The pulmonary artery catheter (PAC) is the most common method of measuring cardiac output in cardiac surgery. However, its use has always been questioned in terms of survival benefit, specifically with regard to the accuracy of its measurements and its invasive nature, with the potential for serious complications. In this review we aimed to develop a clear understanding of the pitfalls of the use of PAC, and discuss its risks and available alternatives. We conclude that there is no indication for the routine use of PAC such that clinicians should carefully consider the clinical risks and benefits on a patient by patient basis...
October 17, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#3
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27887902/pro-pulmonary-artery-catheter-placement-after-anesthetic-induction-in-patients-undergoing-pulmonary-thromboendarterectomy
#4
Stephen Au, Liem Nguyen, Dalia Banks
No abstract text is available yet for this article.
September 14, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#5
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27875074/right-ventricular-dysfunction-after-cardiac-surgery-diagnostic-options
#6
Lars Grønlykke, Hanne Berg Ravn, Finn Gustafsson, Christian Hassager, Jesper Kjaergaard, Jens C Nilsson
Right ventricular (RV) failure after cardiac surgery is associated with an ominous prognosis. The aetiology of RV failure is multifaceted and the ability to recognize RV failure early is paramount in order to initiate timely treatment. The present review focuses on different diagnostic modalities for RV function and discusses the normal versus abnormal findings in RV monitoring after cardiac surgery and the limitations of the applicable diagnostic modalities. There are specific challenges in RV assessment after cardiac surgery due to a loss of longitudinal contraction and a concomitant gain of transverse contraction...
November 22, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27872993/cardiac-catheterization-in-pediatric-patients-supported-by-extracorporeal-membrane-oxygenation-a-15-year-experience
#7
Nicholas S Boscamp, Mariel E Turner, Matthew Crystal, Brett Anderson, Julie A Vincent, Alejandro J Torres
Cardiac catheterization is commonly performed in patients being supported by extracorporeal membrane oxygenation (ECMO). We aimed to evaluate the safety, benefit, and outcomes of catheterization in pediatric patients supported by ECMO. Retrospective review of cardiac catheterizations performed in patients ≤18 years of age while on ECMO at a large tertiary care center between January 2000 and May 2015. A total of 55 catheterizations were performed on 51 patients during 53 unique ECMO courses. Indications for ECMO include ventricular dysfunction (22), cardiac arrest (20), inability to wean from cardiopulmonary bypass (7), and persistent cyanosis (4)...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27866021/early-pulmonary-arterial-hypertension-immediately-after-closure-of-a-ventricular-or-complete-atrioventricular-septal-defect-beyond-6months-of-age
#8
P Bambul Heck, A Eicken, J Kasnar-Samprec, P Ewert, A Hager
BACKGROUND: Pulmonary arterial hypertension (PAH) is virtually absent after closure of ventricular septal defect (VSD) in the first six months of life. However the prevalence of PAH in patients, who underwent VSD closure later, is not clear. The aim of this study was to analyse the prevalence of PAH after a successful VSD closure after the age of 6months and whether there are risk factors for developing PAH. METHODS: Echocardiographic and right heart catheter data of patients with VSD or complete atrioventricular septal defect, who underwent VSD closure after the age of 6months in our institution between 01/2005 and 06/2014, were retrospectively analyzed...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27862909/single-center-experience-in-percutaneous-closure-of-arterial-duct-with-amplatzer-duct-occluder-ii-additional-sizes
#9
Heba Talat Mahmoud, Giuseppe Santoro, Gianpiero Gaio, Fabio Angelo D'Aiello, Cristina Capogrosso, Maria Teresa Palladino, Maria Giovanna Russo
OBJECTIVES: This study aimed to report a large, single-center experience of percutaneous arterial duct (AD) closure using Amplatzer Duct Occluder II Additional Sizes device (ADO II-AS)(St. Jude Medical Corp, St. Paul, MN, USA). BACKGROUND: Transcatheter closure of AD remains challenging in low body weight patients and those who have a persisting shunt following a previous attempt at interventional closure. Recent technical advances in device design may address these issues...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27861600/heart-rate-dependence-of-the-pulmonary-resistance-x-compliance-rc-time-and-impact-on-right-ventricular-load
#10
Thomas S Metkus, Christopher J Mullin, E Wilson Grandin, J Eduardo Rame, Emmanouil Tampakakis, Steven Hsu, Todd M Kolb, Rachel Damico, Paul M Hassoun, David A Kass, Stephen C Mathai, Ryan J Tedford
BACKGROUND: The effect of heart rate (HR) and body surface area (BSA) on pulmonary RC time and right ventricular (RV) load is unknown. METHODS: To determine the association of HR and BSA with the pulmonary RC time and measures of RV load, we studied three large patient cohorts including subjects with 1) known or suspected pulmonary arterial hypertension (PAH) (n = 1008), 2) pulmonary hypertension due to left heart disease (n = 468), and 3) end-stage heart failure with reduced ejection fraction (n = 150)...
2016: PloS One
https://www.readbyqxmd.com/read/27860173/novel-use-of-the-medtronic-micro-vascular-plug-for-pda-closure-in-preterm-infants
#11
Elizabeth W Wang-Giuffre, John P Breinholt
OBJECTIVES: To describe a single institution experience with a new endovascular occlusion device used for transcatheter patent ductus arteriosus (PDA) closure in preterm infants. BACKGROUND: The PDA is a defect largely treated via cardiac catheterization except for the smallest patients. METHODS: Medical records and catheterization reports of all premature neonates who underwent PDA device closure with the Medtronic Micro Vascular Plug (MVP) (Medtronic, Minneapolis, MN) between September 2015 and June 2016 were reviewed...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27858952/subintimal-angioplasty-for-lower-limb-arterial-chronic-total-occlusions
#12
REVIEW
ZhiHui Chang, JiaHe Zheng, ZhaoYu Liu
BACKGROUND: In recent years subintimal angioplasty (SIA) has become an established percutaneous procedure for the treatment of symptomatic lower limb arterial chronic total occlusions. However, the clinical benefits of this practice remain unclear. The aim of the review was to determine the effectiveness of SIA on clinical outcomes. This is an update of a review first published in 2013. OBJECTIVES: To assess the effectiveness of SIA versus other treatment for people with lower limb arterial chronic total occlusions, determined by the effects on clinical improvement, technical success rate, patency rate, limb salvage rate, and morbidity rates...
November 18, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27851569/1935-massive-hemoptysis-in-the-catheter-lab-a-ruptured-iatrogenic-pulmonary-artery-pseudoaneurysm
#13
Prashant Patel, Matthew Siuba, Guramrinder Thind, Sean Pippen, Jeffrey Wilt
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836647/corrective-effect-of-diaphragm-pacing-on-the-decrease-in-cardiac-output-induced-by-positive-pressure-mechanical-ventilation-in-anesthetized-sheep
#14
Hicham Masmoudi, Romain Persichini, Jérôme Cecchini, Julie Delemazure, Martin Dres, Julien Mayaux, Alexandre Demoule, Jalal Assouad, Thomas Similowski
Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis...
November 9, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27827796/effect-of-body-position-and-ventilation-on-umbilical-artery-and-venous-blood-flows-during-delayed-umbilical-cord-clamping-in-preterm-lambs
#15
Stuart B Hooper, Kelly J Crossley, Valerie A Zahra, Jeroen van Vonderen, Alison Moxham, Andrew W Gill, Martin Kluckow, Arjan B Te Pas, Euan M Wallace, Graeme R Polglase
OBJECTIVE: While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. METHODS: Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows...
November 8, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27824609/prospective-validation-of-right-ventricular-role-in-primary-graft-dysfunction-after-lung-transplantation
#16
Purificación Pérez-Terán, Oriol Roca, José Rodríguez-Palomares, Juan C Ruiz-Rodríguez, Ana Zapatero, Joaquim Gea, Joaquim Serra, Arturo Evangelista, Joan R Masclans
Primary graft dysfunction is a significant cause of lung transplant morbidity and mortality, but its underlying mechanisms are not completely understood. The aims of the present study were: 1) to confirm that right ventricular function is a risk factor for severe primary graft dysfunction; and 2) to propose a clinical model for predicting the development of severe primary graft dysfunction.A prospective cohort study was performed over 14 months. The primary outcome was development of primary graft dysfunction grade 3...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27813342/effect-of-solute-temperature-in-the-measurement-of-cardiac-output-in-children-using-the-thermodilution-technique
#17
Shyam Sathanandam, Pooja Kashyap, David Zurakowski, Lindsey Bird, Vera McGhee, Jeffrey Towbin, Benjamin Rush Waller
OBJECTIVES: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children. DESIGN: This is a prospective, case control study. SETTING: Cardiac catheterization lab at Le Bonheur Children's Hospital, Memphis, Tennessee. PATIENTS: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30%...
November 4, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27812780/pulmonary-arteriovenous-malformations-embolized-using-a-micro-vascular-plug-system-technical-note-on-a-preliminary-experience
#18
Eanuele Boatta, Christine Jahn, Matthieu Canuet, Julien Garnon, Nitin Ramamurthy, Roberto Luigi Cazzato, Afshin Gangi
AIM: To report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT). MATERIALS AND METHODS: Four consecutive female patients (mean age 38.0 years; range 25-55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization...
November 3, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27800456/successful-lung-transplant-after-prolonged-extracorporeal-membrane-oxygenation-ecmo-in-a-child-with-pulmonary-hypertension-a-case-report
#19
Cecile Tissot, Walid Habre, Paola Soccal, Maja Isabel Hug, Dominique Bettex, Michel Pellegrini, Yacine Aggoun, Anne Mornand, Afksendyios Kalangos, Peter Rimensberger, Maurice Beghetti
INTRODUCTION: The use of extracorporeal membrane oxygenation (ECMO) is considered a risk factor for, or even a potential contraindication to, lung transplantation. However, only a few pediatric cases have been described thus far. CASE PRESENTATION: A 9-year-old boy with idiopathic pulmonary arterial hypertension developed cardiac arrest after the insertion of a central catheter. ECMO was used as a bridge to lung transplantation. However, after prolonged resuscitation, he developed medullary ischemia and medullary syndrome...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27780836/variation-in-hospital-use-and-outcomes-associated-with-pulmonary-artery-catheterization-in-heart-failure-in-the-united-states
#20
Rohan Khera, Ambarish Pandey, Nilay Kumar, Rajeev Singh, Shah Bano, Harsh Golwala, Dharam J Kumbhani, Saket Girotra, Gregg C Fonarow
BACKGROUND: There has been an increase in the use of pulmonary artery (PA) catheters in heart failure (HF) in the United States in recent years. However, patterns of hospital use and trends in patient outcomes are not known. METHODS AND RESULTS: In the National Inpatient Sample 2001 to 2012, using International Classification of Diseases-Ninth Revision codes, we identified 11 888 525 adult (≥18 years) HF hospitalizations nationally, of which an estimated 75 209 (SE 0...
November 2016: Circulation. Heart Failure
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