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surgery for heart failure

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https://www.readbyqxmd.com/read/28229912/mid-diastolic-left-ventricular-volume-and-mass-normal-values-for-coronary-computed-tomography-angiography
#1
Daniel Juneau, Fernanda Erthal, Owen Clarkin, Atif Alzahrani, Ali Alenazy, Alomgir Hossain, Joao R Inacio, Girish Dwivedi, Alexander J Dick, Frank J Rybicki, Benjamin J W Chow
BACKGROUND: The adoption of prospectively ECG-triggered acquisition coronary computed tomography angiography (CTA) has resulted in the inability to measure left ventricle (LV) end-diastolic volume and LV ejection fraction. However other prognostic measures such as LV mass and LV mid-diastolic volume (LVMDV) can still be assessed. The objective of this study is to establish normal reference values for LVMDV and LV mass. METHODS: Left ventricular mid-diastolic volumes and LV mass were prospectively measured in 2647 consecutive 'normal' patients undergoing prospectively ECG-triggered coronary CTA...
February 10, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28221206/significance-of-new-q-waves-and-their-location-in-postoperative-ecgs-after-elective-on-pump-cardiac-surgery-an-observational-cohort-study
#2
Eckhard Mauermann, Daniel Bolliger, Jens Fassl, Martin Grapow, Esther E Seeberger, Manfred D Seeberger, Miodrag Filipovic, Giovanna A L L Buse
BACKGROUND: The clinical significance of new pathological Q waves after on-pump cardiac surgery is uncertain. OBJECTIVES: To determine whether or not either the occurrence per se or the location of new pathological Q waves after on-pump cardiac surgery is associated with 12-month, all-cause mortality and/or major adverse cardiac events (MACEs). DESIGN: Observational cohort study. SETTING: Single university hospital from January 2007 to October 2010...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28218213/surgical-treatment-of-double-outlet-right-ventricle-complicated-by-pulmonary-hypertension
#3
Qing-Yu Wu, Dong-Hai Li, Hong-Yin Li, Ming-Kui Zhang, Zhong-Hua Xu, Hui Xue
BACKGROUND: Double outlet right ventricle (DORV) is a group of complex congenital heart abnormalities. Preoperative pulmonary hypertension (PH) is considered an important risk factor for early death during the surgical treatment of DORV. The aim of this study was to report our experience on surgical treatment of DORV complicated by PH. METHODS: From June 2004 to November 2016, 61 patients (36 males and 25 females) aged 2 weeks to 26 years (median: 0.67 years and interquartile range: 0...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28218210/optimal-timing-of-surgical-revascularization-for-myocardial-infarction-and-left-ventricular-dysfunction
#4
Rong Wang, Nan Cheng, Cang-Song Xiao, Yang Wu, Xiao-Yong Sai, Zhi-Yun Gong, Yao Wang, Chang-Qing Gao
BACKGROUND: The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results. METHODS: From January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#5
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#6
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28214967/increased-atrial-%C3%AE-adrenergic-receptors-and-grk-2-gene-expression-can-play-a-fundamental-role-in-heart-failure-after-repair-of-congenital-heart-disease-with-cardiopulmonary-bypass
#7
Marcela Silva Oliveira, Fabio Carmona, Walter V A Vicente, Paulo H Manso, Karina M Mata, Mara Rúbia Celes, Erica C Campos, Simone G Ramos
Surgeries to correct congenital heart diseases are increasing in Brazil and worldwide. However, even with the advances in surgical techniques and perfusion, some cases, especially the more complex ones, can develop heart failure and death. A retrospective study of patients who underwent surgery for correction of congenital heart diseases with cardiopulmonary bypass (CPB) in a university tertiary-care hospital that died, showed infarction in different stages of evolution and scattered microcalcifications in the myocardium, even without coronary obstruction...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214763/emergency-valve-surgery-for-infective-endocarditis-complicated-by-acute-intracranial-hemorrhage-a-case-report
#8
Takasumi Goto, Toshihiro Ohata, Takayuki Shijo, Daisuke Yoshioka, Mitsunori Kaneko
INTRODUCTION: Optimal timing of surgical treatment for infective endocarditis (IE) complicated by intracranial hemorrhage remains controversial. PRESENTATION OF CASE: A 43-year-old man with IE received appropriate antibiotic therapy but had recurrence of cerebral infarction and intracranial hemorrhage (ICH). Emergency valve surgery was performed 2days after ICH onset because of heart failure and recurrence of cerebral complications. Postoperatively, he showed no neurologic symptoms; neuroimaging showed no enlargement of ICH...
February 11, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28214000/comparison-of-results-of-tricuspid-valve-repair-versus-replacement-for-severe-functional-tricuspid-regurgitation
#9
Jeong Yoon Jang, Ran Heo, Sahmin Lee, Joon Bum Kim, Dae-Hee Kim, Sung-Cheol Yun, Jong-Min Song, Jae-Kwan Song, Jae-Won Lee, Duk-Hyun Kang
The optimal decision regarding whether to repair or replace the tricuspid valve (TV) remains controversial in patients with very severe functional tricuspid regurgitation (TR). We sought to compare clinical outcomes of TV repair versus replacement for very severe TR associated with severe TV tethering. We included 96 consecutive patients (20 men, 58 ± 11 years of age) who had both severe tethering of TV and very severe functional TR and consequently underwent TV surgery during left-sided valve surgery. TV repair was performed on 79 patients (repair group), whereas 17 patients underwent TV replacement (replacement group)...
January 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28211296/recommendations-for-the-medical-management-of-chronic-venous-disease-the-role-of-micronized-purified-flavanoid-fraction-mpff
#10
Ronald Bush, Anthony Comerota, Mark Meissner, Joseph D Raffetto, Steven R Hahn, Katherine Freeman
Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema...
April 2017: Phlebology
https://www.readbyqxmd.com/read/28209264/patient-travel-for-bariatric-surgery-does-distance-matter
#11
J Hunter Mehaffey, Alex D Michaels, Mathew G Mullen, Max O Meneveau, John R Pender, Peter T Hallowell
BACKGROUND: Increasingly, patients are faced with greater travel distances to undergo bariatric surgery at high-volume centers. OBJECTIVES: This study sought to evaluate the impact of travel distance on access to care and outcomes after bariatric surgery. SETTING: Patients who underwent Roux-en-Y gastric bypass at an academic bariatric surgery center from 1985 to 2004 were examined and stratified by patient travel distance. METHODS: Univariate analyses were performed for preoperative risk factors, 30-day complications, and long-term (10-yr) weight loss between "local," defined as<1 hour of travel time, and "regional," defined as>1 hour of travel time...
December 28, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28208977/comparison-of-levosimendan-milrinone-and-dobutamine-in-treating-low-cardiac-output-syndrome-following-valve-replacement-surgeries-with-cardiopulmonary-bypass
#12
Sunny, Mohd Yunus, Habib Md Reazaul Karim, Manuj Kumar Saikia, Prithwis Bhattacharyya, Samarjit Dey
INTRODUCTION: Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. AIM: To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. MATERIALS AND METHODS: Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#13
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#14
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206727/results-of-tricuspid-valve-surgery-for-functional-tricuspid-regurgitation-acute-and-long-term-outcomes-and-predictors-of-failure
#15
Alberto Pozzoli, Nicola Buzzatti, Luca Vicentini, Michele De Bonis, Ottavio Alfieri
The assessment and management of tricuspid valve disease evolved significantly in the last decade. Tricuspid regurgitation is a frequent heart valve disease and it is most often secondary, due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery are several and mainly related to the underlying disease, to the severity of the regurgitation and to the right ventricular function. Moreover, surgical tricuspid repair has been avoided for years, because of the erroneous concept that tricuspid regurgitation should disappear once the primary pathology on the left heart has been resolved...
February 15, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28201842/minimally-invasive-aortic-root-replacement-with-valved-conduits-through-partial-upper-sternotomy
#16
Julia Hillebrand, Mosab Alshakaki, Sven Martens, Mirela Scherer
Background Minimally invasive surgical access through limited sternotomy reduces trauma and morbidity in cardiosurgical patients. However, until now, it is not the standard access for aortic root replacement. This study details our clinic's experience with minimally invasive implantation of valved conduits through partial upper sternotomy and the comparison to conventional full median sternotomy. Methods Between January 2012 and March 2016, a total of 187 patients underwent aortic root replacement with valved conduits in our department...
February 15, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#17
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195882/the-in-hospital-cost-of-ventricular-assist-device-therapy-implications-for-patient-selection
#18
Amit Iyengar, Oh Jin Kwon, Msgana Tamrat, Anthony Salimbangon, Nancy Satou, Peyman Benharash, Abbas Ardehali, Richard J Shemin, Murray H Kwon
Ventricular Assist Device (VAD) therapy is increasingly utilized to support patients in end-stage heart failure. However, VAD programs are resource intensive and demand active monitoring in order to ensure long term sustainability. The purpose of this study was to analyze total cost trends of the VAD program at our academic medical center.Retrospective analysis of UCLA's VAD program between years 2013-2014 was performed. Total in-hospital costs from the date of VAD surgery admission were queried and normalized to a Z-score...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28194628/association-between-ck-mb-area-under-the-curve-and-tranexamic-acid-utilization-in-patients-undergoing-coronary-artery-bypass-surgery
#19
Sean van Diepen, Peter D Merrill, Michel Carrier, Jean-Claude Tardif, Mihai Podgoreanu, John H Alexander, Renato D Lopes
Myonecrosis after coronary artery bypass graft (CABG) surgery is associated with excess mortality. Tranexamic acid (TA), an anti-fibrinolytic agent, has been shown to reduce peri-operative blood loss without increasing the risk of myocardial infarction (MI); however, no large study has examined the association between TA treatment and post-CABG myonecrosis. In the MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery II trial, inverse probability weighting of the propensity to receive TA was used to test for differences among the 656 patients receiving and 770 patients not receiving TA...
February 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#20
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
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