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surgery for heart failure

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https://www.readbyqxmd.com/read/29677037/small-left-ventricular-size-is-an-independent-risk-factor-for-ventricular-assist-device-thrombosis
#1
Venkat Keshav Chivukula, Jennifer A Beckman, Anthony R Prisco, Shin Lin, Todd F Dardas, Richard K Cheng, Stephen D Farris, Jason W Smith, Nahush A Mokadam, Claudius Mahr, Alberto Aliseda
The prevalence of ventricular assist device (VAD) therapy has continued to increase due to a stagnant donor supply and growing advanced heart failure (HF) population. We hypothesize that left ventricular (LV) size strongly influences biocompatibility and risk of thrombosis. Unsteady computational fluid dynamics (CFD) was used in conjunction with patient-derived computational modeling and virtual surgery with a standard, apically implanted inflow cannula. A dual-focus approach of evaluating thrombogenicity was employed: platelet-based metrics to characterize the platelet environment and flow-based metrics to investigate hemodynamics...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29673908/mechanism-underlying-the-contractile-activity-of-utp-in-the-mammalian-heart
#2
Ulrich Gergs, Daniel Rothkirch, Britt Hofmann, Hendrik Treede, Bernard Robaye, Andreas Simm, Christa E Müller, Joachim Neumann
We previously reported that uridine 5'-triphosphate (UTP), a pyrimidine nucleoside triphosphate produced a concentration- and time-dependent increase in the contraction force in isolated right atrial preparations from patients undergoing cardiac bypass surgery due to angina pectoris. The stimulation of the force of contraction was sustained rather than transient. In the present study, we tried to elucidate the underlying receptor and signal transduction for this effect of UTP. Therefore, we measured the effect of UTP on force of contraction, phosphorylation of p38 and ERK1/2, in human atrial preparations, atrial preparations from genetically modified mice, cardiomyocytes from adult mice and cardiomyocytes from neonatal rats...
April 16, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29673639/left-ventricular-diastolic-function-after-aortic-valve-replacement-for-chronic-aortic-regurgitation
#3
Wenrui Ma, Wei Zhang, Wei Shi, Ye Kong, Xinyu Ma
BACKGROUND: The aim of the present study was to investigate the evolution of left ventricular diastolic function after aortic valve replacement (AVR) for chronic severe aortic regurgitation. METHODS: Patients (n=183) who underwent isolated AVR for severe aortic regurgitation were included in this study. Degrees of left ventricular diastolic function were designated, according to the integration of two echocardiographic parameters: left atrial volume index and average E/e' ratio...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29668847/adiponectin-determines-farnesoid-x-receptor-agonism-mediated-cardioprotection-against-post-infarction-remodeling-and-dysfunction
#4
Yunlong Xia, Fuyang Zhang, Shihao Zhao, Yueyang Li, Xiyao Chen, Erhe Gao, Xinyue Xu, Zhenyu Xiong, Xiaomeng Zhang, Jinglong Zhang, Huishou Zhao, Wei Wang, Helin Wang, Yanjie Guo, Yi Liu, Congye Li, Shan Wang, Ling Zhang, Wenjun Yan, Ling Tao
Aims: The farnesoid X receptor (FXR) is a member of the metabolic nuclear receptor superfamily that plays a critical regulatory role in cardiovascular physiology/pathology. However, the role of systemic FXR activation in the chronic phase in myocardial infarction (MI)-induced cardiac remodeling and dysfunction remains unclear. In this study, we aimed to elucidate the role of long-term FXR activation on post-MI cardiac remodeling and dysfunction. Methods and Results: Mice underwent either MI surgery or sham operation...
April 14, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29666072/left-ventricular-assist-device-inflow-cannula-angle-and-thrombosis-risk
#5
Venkat Keshav Chivukula, Jennifer A Beckman, Anthony R Prisco, Todd Dardas, Shin Lin, Jason W Smith, Nahush A Mokadam, Alberto Aliseda, Claudius Mahr
BACKGROUND: As heart failure prevalence continues to increase in the setting of a static donor supply, left ventricular assist device (LVAD) therapy for end-stage heart failure continues to grow. Anecdotal evidence suggests that malalignment of the LVAD inflow cannula may increase thrombosis risk, but this effect has not been explored mechanistically or quantified statistically. Our objective is to elucidate the impact of surgical angulation of the inflow cannula on thrombogenicity. METHODS AND RESULTS: Unsteady computational fluid dynamics is used in conjunction with computational modeling and virtual surgery to model flow through the left ventricle for 5 different inflow cannula angulations...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29666009/in-vitro-validation-of-a-self-driving-aortic-turbine-venous-assist-device-for-fontan-patients
#6
Kerem Pekkan, Ibrahim Basar Aka, Ece Tutsak, Erhan Ermek, Haldun Balim, Ismail Lazoglu, Riza Turkoz
BACKGROUND: Palliative repair of single ventricle defects involve a series of open-heart surgeries where a single-ventricle (Fontan) circulation is established. As the patient ages, this paradoxical circulation gradually fails, because of its high venous pressure levels. Reversal of the Fontan paradox requires an extra subpulmonic energy that can be provided through mechanical assist devices. The objective of this study was to evaluate the hemodynamic performance of a totally implantable integrated aortic-turbine venous-assist (iATVA) system, which does not need an external drive power and maintains low venous pressure chronically, for the Fontan circulation...
March 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29665860/the-use-of-cangrelor-with-heparin-for-left-ventricular-assist-device-implantation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#7
Yan K Gernhofer, Michael Ross, Swapnil Khoche, Victor Pretorius
BACKGROUND: Optimal anticoagulation strategy for cardiopulmonary bypass (CPB) in end-stage heart failure patients with heparin-induced thrombocytopenia (HIT) requiring left ventricular assist device (LVAD) implantation remains uncertain. Presently, there are no large-scale randomized studies comparing outcomes of alternative anticoagulation strategies for CPB in this patient population. A novel antiplatelet agent - cangrelor, which is a potent P2Y12 inhibitor with robust antiplatelet efficacy, rapid reversibility, and measurable drug effect, has become available since 2015...
April 17, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29658862/progress-in-gene-therapy-for-chronic-heart-failure
#8
Zhi-Qiang Yin, Wan-Hong Xing
Chronic heart failure (CHF) is still the leading cause of morbidity and mortality worldwide, and carries with it large economic and social burdens. Although steady and substantial progress has been made in reducing mortality from heart failure using conventional treatments, novel pharmacologic and surgical interventions have not been effective in extending five year survival rates. Therefore, it is necessary to explore new therapies. Gene therapy was introduced in 1970s with the development of recombinant DNA technology...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29655951/acef-score-adapted-to-st-elevation-myocardial-infarction-patients-the-acef-stemi-score
#9
Martin Reindl, Sebastian Johannes Reinstadler, Christina Tiller, Markus Kofler, Markus Theurl, Nora Klier, Katherina Fleischmann, Agnes Mayr, Benjamin Henninger, Gert Klug, Bernhard Metzler
BACKGROUND: The age, creatinine and ejection fraction (ACEF) score has originally been developed for risk stratification of patients undergoing elective cardiac surgery. In patients with stable coronary artery disease treated by percutaneous coronary intervention (PCI), the prognostic accuracy of ACEF could be further improved by modifying the original scoring system (called "modified ACEF" or "ACEF-MDRD"). We aimed to specifically adapt the ACEF score for risk assessment of ST-elevation myocardial infarction (STEMI) patients...
April 6, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29652281/indications-and-perioperative-outcomes-of-extracorporeal-life-support-in-clermont-ferrand
#10
Abdel-Kémal Bori Bata, Adama Sawadogo, Nicolas D'ostrevy, Etienne Geoffroy, Nicolas Dauphin, Vedat Eljezi, Kasra Azarnoush, Lionel Camilleri
Objectives: To report the epidemiological profile of the patients who underwent extracorporeal life support (ECLS) and then analyze the indications and outcomes of this procedure. Methods: It consisted of a retrospective and descriptive study based on the database from the department of cardiovascular surgery. Setting: University hospital clinic. Patients: One hundred and sixty-one patients have participated in the study...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#11
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#12
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29648662/long-term-causes-of-death-in-patients-with-infective-endocarditis-who-undergo-medical-therapy-only-or-surgical-treatment-a-nationwide-population-based-study
#13
Lauge Østergaard, Louise Bruun Oestergaard, Trine Kiilerich Lauridsen, Anders Dahl, Mavish Chaudry, Gunnar Gislason, Christian Torp-Pedersen, Niels Eske Bruun, Nana Valeur, Lars Køber, Emil Loldrup Fosbøl
OBJECTIVES: It is known that patients surviving infective endocarditis have a poor long-term prognosis; however, few studies have addressed the long-term causes of death in patients surviving the initial hospitalization. METHODS: Using Danish administrative registries, we identified patients admitted to a hospital with 1st time infective endocarditis in the period from January 1996 to December 2014, who were alive at the time of discharge. The study population was categorized into (i) patients undergoing medical therapy only and (ii) patients undergoing surgical and medical treatment...
April 10, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29629485/has-the-time-come-to-be-more-aggressive-with-bariatric-surgery-in-obese-patients-with-chronic-systolic-heart-failure
#14
REVIEW
Amanda R Vest
PURPOSE OF REVIEW: Obesity is a strong risk factor for the development of heart failure (HF). Diet, exercise, and weight-loss pharmacotherapies have limited potential to achieve significant and sustainable weight loss, especially in patients with symptomatic systolic HF. This review seeks to determine the role of bariatric surgery for patients with systolic HF and obesity. RECENT FINDINGS: Bariatric surgeries such as the laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) represent the most successful long-term strategy for achieving weight loss and diabetes and hypertension remission in the general obese population...
April 8, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29629062/clinical-outcomes-of-the-simultaneous-bilateral-percutaneous-nephrolithotomy-pcnl-in-patients-with-kidney-stones-a-prospective-cohort-study
#15
Mohammad Reza Darabi, Salman Soltani, Alireza Akhavan Rezayat, Masoud Yousefi, Mehdi Kashefi, Mahmoud Tavakkoli, Shabnam Mohammadi
Background: Urinary tract stones is one of the most frequent medical emergencies which leads to life-threatening complications, namely obstructive uropathy as well as renal failure in some situations. Previously, bilateral stones were treated with either open surgery or percutaneous nephrolithotomy (PCNL). However, these treatment options were associated with lengthy operation time, need for more anesthesia, further bleeding, and long hospitalization. Therefore, much effort has been made to treat both sides simultaneously...
February 2018: Electronic Physician
https://www.readbyqxmd.com/read/29628154/-severity-of-disease-scoring-systems-and-mortality-after-non-cardiac-surgery
#16
Pedro Videira Reis, Gabriela Sousa, Ana Martins Lopes, Ana Vera Costa, Alice Santos, Fernando José Abelha
BACKGROUND: Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. METHODS: Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI)...
April 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#17
M U Ziegler, H Reinelt
BACKGROUND: Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI)...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29622911/submitral-left-ventricular-aneurysm-associated-with-thrombus
#18
Abdusamed Adem Abdusamed, Hailu Abera Mulatu, Reinaldo Nunez Martinez
Background: Submitral left ventricular aneurysm is a rarely reported cardiac abnormality that is encountered commonly among blacks. So far, only one case has been reported from Ethiopia and East Africa.Our aim is to report an interesting and rare case that we encountered at St. Paul's Hospital Millennium Medical College. Methods: In April 2017, a 25-year-old patient havingsubmitral left ventricular aneurysm with New York Heart Association (NYHA) class IV heart failure and mild left ventricular systolic dysfunctionreceived medical treatment at our institution...
January 2018: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29622424/two-dimensional-global-longitudinal-strain-is-superior-to-left-ventricular-ejection-fraction-in-prediction-of-outcome-in-patients-with-left-sided-infective-endocarditis
#19
Trine Kiilerich Lauridsen, Christina Alhede, Anna Lisa Crowley, Joseph Kisslo, Lars L Sørensen, Thomas Fritz Hansen, Niels Risum, Carsten Toftager Larsen, Christian Hassager, Peter Søgaard, Anders Dahl, Niels Eske Bruun
BACKGROUND: Impaired cardiac function is the main predictor of poor outcome in infective endocarditis (IE). Global longitudinal strain (GLS) derived from two-dimensional strain echocardiography has proven superior in prediction of long-term outcome as compared to left ventricular ejection fraction (LVEF) in valvular disease and heart failure in general. Whether measurements of cardiac deformation can predict survival in patients with IE has not previously been investigated. METHODS: The study included consecutive patients with Duke definite IE who underwent transthoracic and transesophageal echocardiography within 7 days...
June 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29622354/perioperative-risk-factors-for-hospital-readmission-after-elective-endovascular-aortic-aneurysm-repair
#20
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Fady Gabra, Roy M Fujitani
BACKGROUND: Elective endovascular aneurysm repair (EVAR) is generally well tolerated. However, the incidence of hospital readmission after EVAR and the risk factors and reasons for it are not well studied. This study sought to determine the incidence, to characterize the indications, and to identify perioperative patient-centered risk factors for hospital readmission within 30 days after elective EVAR. METHODS: All patients who underwent EVAR electively in 2012 to 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program Targeted Vascular database (n = 3886)...
April 2, 2018: Journal of Vascular Surgery
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