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https://www.readbyqxmd.com/read/28107274/the-sluscore-a-novel-method-for-detecting-hazardous-hypotension-in-adult-patients-undergoing-noncardiac-surgical-procedures
#1
Wolf H Stapelfeldt, Hui Yuan, Jefferson K Dryden, Kristen E Strehl, Jacek B Cywinski, Jesse M Ehrenfeld, Pamela Bromley
BACKGROUND: It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. METHODS: Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#2
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#3
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28096831/predeployed-aortic-extension-cuff-kilt-in-evar-with-hostile-neck-anatomy-using-endurant-ii-system-preliminary-results
#4
Krzysztof Szaniewski, Magdalena Biernacka, Ryszard L Walas, Marian Zembala
INTRODUCTION: Various modifications of standard endovascular aortic aneurysm repair (EVAR) have been developed to solve the problem of difficult neck anatomy. AIM: The authors propose the implantation of a predeployed extension cuff (kilt) using on-shelf Endurant II elements. In a vast majority of cases, the proposed method provides a solution for the hostile neck problem using standard Endurant II elements available in all centers performing subrenal EVAR procedures...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28088221/role-of-pelvic-and-para-aortic-lymphadenectomy-in-abandoned-radical-hysterectomy-in-cervical-cancer
#5
Salim Abraham Barquet-Muñoz, Gabriel Jaime Rendón-Pereira, Denise Acuña-González, Monica Vanessa Heymann Peñate, Luis Alonso Herrera-Montalvo, Lenny Nadia Gallardo-Alvarado, David Francisco Cantú-de León, René Pareja
BACKGROUND: Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#6
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/28077373/determination-of-renal-function-and-injury-using-near-infrared-fluorimetry-in-experimental-cardiorenal-syndrome
#7
Mizuko Ikeda, Rumie Wakasaki, Katie J Schenning, Thomas Swide, Jeong Heon Lee, M Bernie Miller, Hak Soo Choi, Sharon Anderson, Michael P Hutchens
Cardiorenal syndrome type 1 causes acute kidney injury but is poorly understood; animal models and diagnostic aids are lacking. Robust noninvasive measurements of glomerular filtration rate are required for injury models and clinical use. Several have been described but are untested in translational models and suffer from biologic interference. We developed a mouse model of cardiorenal syndrome and tested the novel near-infrared fluorophore, ZW800-1, to assess renal and cardiac function. We performed murine cardiac arrest and cardiopulmonary resuscitation followed by transthoracic echocardiography, 2- and 24h later...
January 11, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28072654/adverse-events-following-vestibular-schwannoma-surgery-a-comparison-of-surgical-approach
#8
Anthony M Tolisano, Philip D Littlefield
OBJECTIVE: Compare complications of vestibular schwannoma (VS) resection by surgical approach. STUDY DESIGN: Retrospective cohort. SETTING: The 2008 to 2013 American College of Surgeons-National Surgical Quality Improvement Program. PATIENTS: Adult patients with VS resection by an otolaryngologist. INTERVENTIONS: VS resection via transtemporal (TT), retrosigmoid (RS), or middle cranial fossa (MCF) approaches...
January 9, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28063271/hybrid-minimally-invasive-approach-for-transvenous-lead-extraction-a-feasible-technique-in-high-risk-patients
#9
Luca Bontempi, Francesca Vassanelli, Manuel Cerini, Gianluigi Bisleri, Alberto Repossini, Laura Giroletti, Lorenza Inama, Francesca Salghetti, Daria Liberto, Daniele Giacopelli, Abdallah Raweh, Claudio Muneretto, Antonio Curnis
INTRODUCTION: Despite the overall safety, transvenous lead extraction (TLE) remains a challenging procedure with inherent risks, where surgery can still be required in elective cases. In this study, we report our experience with a minimally invasive "hybrid" approach, defined as a procedure performed by an electrophysiologist with the support of a cardiac surgeon in the same operative session. METHODS AND RESULTS: We reported 12 cases of planned hybrid lead extraction; minithoracotomy and thoracoscopy were performed on 10 (83%) and 2 (17%) patients, respectively...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28054355/evaluation-of-the-surgical-apgar-score-in-patients-undergoing-ivor-lewis-esophagectomy
#10
Simon Strøyer, Teit Mantoni, Lars Bo Svendsen
BACKGROUND: The Surgical Apgar Score is a simple outcome score based on intraoperative parameters. The scoring system is recently validated in patients undergoing esophagectomy but without comparable results. This study evaluated the ability of the original and modified Surgical Apgar Scores to predict major complications in a patient population undergoing Ivor-Lewis esophagectomy. METHODS: We retrospectively examined 234 patients who successfully underwent Ivor-Lewis esophagectomy at Rigshospitalet, Copenhagen from November 23, 2011 till November 23, 2014...
January 5, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28043462/right-ventricular-outflow-tract-reconstruction-with-a-polytetrafluoroethylene-monocusp-valve-a-20-year-experience
#11
Mohineesh Kumar, Mark W Turrentine, Mark D Rodefeld, Teresa Bell, John W Brown
In patients with tetralogy of Fallot (TOF), pulmonary atresia (PA), and other congenital right ventricular outflow tract (RVOT) malformations, polytetrafluoroethylene (PTFE) monocusp outflow tract patches (MOTP) relieve obstruction and provide pulmonary valve competence. The purpose of this study was to determine whether our PTFE-MOTP was an acceptable short- and mid-term remedy for patients with TOF or PA as assessed by freedom from severe pulmonary regurgitation and freedom from reoperation. From 1994-2014, 171 patients (mean age 1...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043424/phase-of-care-mortality-analysis-a-unique-method-for-comparing-mortality-differences-among-transcatheter-aortic-valve-replacement-and-surgical-aortic-valve-replacement-patients
#12
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Kaushik Mandal, Joel Price, Jon Resar, Matthew Chacko, Rani K Hasan, Glenn Whitman, John V Conte
The objective of this study is based on the phase of care mortality analysis (POCMA), an effective tool to evaluate the root cause of in-hospital mortality in cardiac surgery patients. POCMA has not been used to compare operative mortalities among transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) populations, and may provide insight that could affect patient safety initiatives and improve outcomes in aortic valve surgery. We included patients who underwent TAVR or isolated SAVR between 2011 and March 31, 2015 and did not survive the index hospitalization...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#13
Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28029291/evaluation-of-gastroscopy-and-biopsy-of-the-proventriculus-and-ventriculus-in-pigeons-columba-livia
#14
Izidora Sladakovic, Angela E Ellis, Stephen J Divers
OBJECTIVE To evaluate the efficacy and safety of gastroscopy and biopsy of the proventriculus and ventriculus in pigeons (Columba livia). ANIMALS 15 adult pigeons. PROCEDURES Each pigeon was anesthetized, and the upper gastrointestinal tract (from the cervical portion of the esophagus to the ventriculus) was endoscopically evaluated by use of a rigid endoscope inserted orally. Saline (0.9% NaCl) solution was orally infused to achieve lumen dilation and visibility. Two mucosal biopsy specimens were collected from each of the proventriculus and ventriculus, histologically evaluated, and graded for crush artifacts and depth...
January 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28018730/raman-spectroscopy-detects-distant-invasive-brain-cancer-cells-centimeters-beyond-mri-capability-in-humans
#15
Michael Jermyn, Joannie Desroches, Jeanne Mercier, Karl St-Arnaud, Marie-Christine Guiot, Frederic Leblond, Kevin Petrecca
Surgical treatment of brain cancer is limited by the inability of current imaging capabilities such as magnetic resonance imaging (MRI) to detect the entirety of this locally invasive cancer. This results in residual cancer cells remaining following surgery, leading to recurrence and death. We demonstrate that intraoperative Raman spectroscopy can detect invasive cancer cells centimeters beyond pathological T1-contrast-enhanced and T2-weighted MRI signals. This intraoperative optical guide can be used to detect invasive cancer cells and minimize post-surgical cancer burden...
December 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/28010865/the-modified-operative-technique-of-partial-eversion-carotid-endarterectomy
#16
Richard McBride, Johnathan Porter, Haytham Al-Khaffaf
We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded. The initial 185 patients had carotid duplex ultrasound imaging at 6 weeks and then at 6, 12, and 24 months. Subsequent patients had carotid imaging at 4 to 6 weeks. Indications included stroke (76), transient ischemic attack (153), and amaurosis fugax (33); 58 patients were asymptomatic, and 32 patients had surgery before cardiac surgery...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28009757/frequency-and-outcomes-of-patients-with-increased-mean-pulmonary-artery-pressure-at-the-time-of-liver-transplantation
#17
Erin S DeMartino, Rodrigo Cartin-Ceba, James Y Findlay, Julie K Heimbach, Michael J Krowka
BACKGROUND: Pulmonary hypertension (PH) exists when mean pulmonary artery pressure (mPAP) is 25 mm Hg or greater. mPAP of 35 mm Hg or greater, with increased pulmonary vascular resistance from portopulmonary hypertension, has been associated with increased post-liver transplant (LT) mortality. However, mPAP of 35 mm Hg or greater can also occur in the setting of normal pulmonary vascular resistance from a high flow state and/or increased pulmonary venous volume. We describe the frequency of patients with mPAP of 35 mm Hg or greater at LT and correlate their clinical outcomes with hemodynamic characteristics...
January 2017: Transplantation
https://www.readbyqxmd.com/read/28008469/laparoscopic-common-bile-duct-exploration-a-safe-and-definitive-treatment-for-elderly-patients
#18
Chufa Zheng, Yaokui Huang, E Xie, Dejin Xie, Yunheng Peng, Xiaozhong Wang
BACKGROUND: Common bile duct (CBD) stone is one of the most common diseases among elderly people. In recent decades, there are numerous studies regarding the safety and efficacy of laparoscopic common bile duct exploration (LCBDE). Elderly patients are often regarded as high-risk patients because they are more likely to present with age-specific deterioration of organ function and coexisting chronic diseases, which may reduce their tolerance of laparoscopic surgery. Although laparoscopic surgery for choledocholithiasis is now widely accepted as the treatment for CBD stone, its appropriateness for the treatment of elderly patients or those with coexisting high-risk patients has not been well established...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28004195/the-periprostatic-venous-plexus-an-unusual-source-of-fatal-pulmonary-embolism-during-corporoplasty
#19
Nazario Foschi, Mauro Ragonese, Vincenzo M Grassi, Valentino De Matteis, Fabio De-Giorgio
When a sudden death occurs during a minor surgical intervention, it may require a careful and extensive postmortem investigation. One such case concerns a 61-year-old male patient affected by Peyronie's disease, who died suddenly during a corporoplasty procedure. Autopsy and histologic examinations showed a massive bilateral pulmonary micro-embolism brought on by periprostatic venous plexus thrombosis. The cause of death was attributed to intraoperative fatal pulmonary micro-embolism. Pulmonary thromboembolism is a major cause of death and is known to be a possible complication of surgery...
December 22, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27998861/-risk-factors-for-acute-respiratory-distress-syndrome-following-surgeries-for-pediatric-critical-and-complex-congenital-heart-disease
#20
Shu-Rong Gong, Ying-Rui Zhang, Rong-Guo Yu
OBJECTIVE: To explore the risk factors for acute respiratory distress syndrome (ARDS) in children receiving surgeries for critical and complex congenital heart disease (CCHD). METHODS: According to the 2011's Berlin definition of ARDS, the clinical data were collected from 75 children without ARDS (group I) and 80 children with ARDS (group II) following surgeries for CCHD performed in the Department of Cardiac Surgery of our hospital from January, 2009 to May, 2014...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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