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https://www.readbyqxmd.com/read/29908198/in-hospital-delays-result-in-worse-patient-outcomes-and-higher-cost-after-cardiac-surgery
#1
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29908189/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery-commentary
#2
Nina A Guzzetta
No abstract text is available yet for this article.
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29908036/acquired-von-willebrand-syndrome-in-congenital-heart-disease-surgery-results-from-an-observational-case-series
#3
Vanya Icheva, Martina Nowak-Machen, Ulrich Budde, Karl Jaschonek, Felix Neunhoeffer, Matthias Kumpf, Michael Hofbeck, Christian Schlensak, Gesa Wiegand
BACKGROUND: Cardiac surgery of the newborn and infant with complex congenital heart disease (CHD) is associated with a high rate of intraoperative bleeding complications. CHD-related anatomic features such as valve stenoses or patent arterial ducts can lead to enhanced shear stress in blood stream and thus cause acquired von Willebrand syndrome (aVWS). OBJECTIVE: To evaluate the intraoperative incidence and impact of aVWS after cardiopulmonary bypass (CPB) in neonates and infants with complex CHD...
June 16, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29907211/comparison-of-dexmedetomidine-versus-propofol-on-hemodynamics-in-surgical-critically-ill-patients
#4
Ya-Fei Chang, Anne Chao, Po-Yuan Shih, Yen-Chun Hsu, Chen-Tse Lee, Yu-Wen Tien, Yu-Chang Yeh, Lee-Wei Chen
BACKGROUND: Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. MATERIALS AND METHODS: Enrolled patients were randomly allocated to the dexmedetomidine or propofol group. Cardiac index was measured using a continuous noninvasive cardiac output monitor on the basis of chest bioreactance...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29906523/ventricular-fibromas-in-children-arrhythmia-risk-and-outcomes-a-multicentre-study
#5
John P Jones, Tristan Ramcharan, Milind Chaudhari, Vinay Bhole, Karen Mcleod, Shankar Sadagopan, Orhan Uzun, Andrew Parry, Jan Till, Colin J McMahon, Alan G Stuart, Mark A Walsh
BACKGROUND: Although ventricular fibromas are a rare, they are the second most common type of cardiac tumor in children. While histologically benign, they have a propensity to cause malignant arrhythmias, with cardiac arrest often being the first presentation.; OBJECTIVE: To evaluate the arrhythmia risk, and management strategies for pediatric ventricular fibromas. METHODS: Fifteen centers in the British Paediatric Arrhythmia Group network were contacted to partake in the study to contribute cases...
June 12, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29906264/the-syntax-ii-score-predicts-mortality-at-4-years-in-patients-undergoing-percutaneous-coronary-intervention
#6
Sorin J Brener, Venkatesh Alapati, Doris Chan, Akanibo Da-Wariboko, Yousef Kaid, Yevgeniy Latyshev, Amr Moussa, Chockalingham A Narayanan, John P O'Laughlin, Amol Raizada, Gautam Verma, Terrence J Sacchi
BACKGROUND: Short-term outcome after percutaneous coronary intervention (PCI) has improved dramatically, but the association between clinical or angiographic characteristics and long-term outcome remains less well described. The SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) II score has been designed to overcome the limitations of the purely angiographic SYNTAX I score by including clinical parameters and comorbidities. It has not been tested extensively in "real-world" PCI patients, outside of randomized clinical studies...
June 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29905786/european-heart-rhythm-association-ehra-consensus-document-on-management-of-arrhythmias-and-cardiac-electronic-devices-in-the-critically-ill-and-post-surgery-patient-endorsed-by-endorsed-by-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-cardiac
#7
Giuseppe Boriani, Laurent Fauchier, Luis Aguinaga, James M Beattie, Carina Blomstrom Lundqvist, Ariel Cohen, Gheorghe-Andrei Dan, Simonetta Genovesi, Carsten Israel, Boyoung Joung, Zbigniew Kalarus, Rachel Lampert, Vincenzo L Malavasi, Jacques Mansourati, Lluis Mont, Tatjana Potpara, Andrew Thornton, Gregory Y H Lip
No abstract text is available yet for this article.
June 13, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29905629/local-vancomycin-effectively-reduces-surgical-site-infection-at-implant-site-in-rodents
#8
Jeffrey S Kroin, Jinyuan Li, Sasha Shafikhani, Kajal H Gupta, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Infected implantable devices represent a clinical challenge, because the customary option is to surgically remove the device, and that is associated with substantial cost and morbidity to the patient, along with patient dissatisfaction with the physician. Although prophylactic systemic antibiotics and sterile technique are the mainstay of prevention of surgical site infection (SSI) after implant, the incidence of SSI remains relatively high. Although some surgeons add local antibiotic at implant site during surgery, there is no scientific research to demonstrate if there is a benefit...
June 13, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29905587/a-novel-approach-using-computed-tomography-angiograms-to-predict-sternotomy-or-complicated-anastomosis-in-patients-undergoing-robotically-assisted-minimally-invasive-direct-coronary-artery-bypass
#9
Richard C Cook, Anthony Y Fung, Edward D Percy, John R Mayo
OBJECTIVE: Robotically assisted minimally invasive direct coronary artery bypass is an alternative to sternotomy-based surgery in properly selected patients. Identifying the left anterior descending artery when it is deep in the epicardial fat can be particularly challenging through a 5- to 6-cm mini-thoracotomy incision. The objective of this study was to evaluate a technique for predicting conversion to sternotomy or complicated left anterior descending artery anastomosis using preoperative cardiac-gated computed tomography angiograms...
June 14, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29905016/examining-the-july-effect-on-patients-undergoing-pituitary-surgery
#10
Bassel Bashjawish, Shreya Patel, Suat Kılıç, Wayne D Hsueh, James K Liu, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Our aim in this study was to assess the impact of the turnover of residents in July on patients undergoing pituitary surgery. METHODS: This work was a retrospective cohort study of cases from the National Inpatient Sample (NIS). Patients who underwent pituitary surgery from 2005 to 2012 were selected in the NIS. Patients undergoing surgery in July and in non-July months were compared to determine differences in demographics, comorbidities, and complications...
June 15, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29905015/investigation-of-raphe-function-in-the-bicuspid-aortic-valve-and-its-influence-on-clinical-criteria-a-patient-specific-finite-element-study
#11
Jérémy Dallard, Michel R Labrosse, Benjamin Sohmer, Carsten J Beller, Munir Boodhwani
The aortic valve is normally composed of three cusps. In one common lesion, two cusps are fused together. The conjoined area of the fused cusps is termed raphe. Occurring in 1-2% of the population, the bicuspid aortic valve (BAV) is the most common congenital cardiac malformation. The majority of BAV patients eventually require surgery. There is a lack in the literature regarding modeling of the raphe (geometry and material properties), its role and its influence on BAV function. The present study aims to propose improvements on these aspects...
June 14, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29904579/advanced-imaging-improves-the-diagnosis-of-infective-endocarditis
#12
REVIEW
Daniel Harding, Bernard Prendergast
Infective endocarditis is a heterogeneous condition whose incidence is rising. Despite advances in surgery and diagnostic methods, one-year mortality has not changed and it remains at 30%. Patients with prosthetic valve and intra-cardiac device-related endocarditis are being seen more frequently and this condition is difficult to diagnose with conventional microbiological and imaging techniques. The modified Duke criteria lack sensitivity in this group and should be supplemented with newer imaging techniques, including 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) and single-photon emission computed tomography (SPECT)...
2018: F1000Research
https://www.readbyqxmd.com/read/29903683/correlating-oxygen-delivery-during-cardiopulmonary-bypass-with-the-neurologic-injury-biomarker-ubiquitin-c-terminal-hydrolase-l1-uch-l1
#13
J Trent Magruder, Charles D Fraser, Joshua C Grimm, Todd C Crawford, Claude A Beaty, Alejandro Suarez-Pierre, Ronald L Hayes, Michael V Johnston, William A Baumgartner
OBJECTIVE: The authors sought to assess the relationship between low oxygen delivery (DO2 ) during cardiopulmonary bypass (CPB) and a neuron-specific biomarker of neurologic injury, ubiquitin C-terminal hydrolase L1 (UCH-L1). DESIGN: Retrospective analysis of patient charts and prospectively collected blood samples. SETTING: University-affiliated tertiary care hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery on CPB...
June 11, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29903680/-non-infective-endocarditis
#14
A Le Bot, P Jégo, E Donal, E Flécher, M Revest, P Tattevin
Non-infective endocarditis, also referred to as non-bacterial thrombotic endocarditis, represent a wide range of rare pathologies, often severe. This review gathered the data available in the literature, to decipher the major information collected on the pathophysiology, the diagnosis and the treatment of these heterogeneous diseases, often misdiagnosed. Characteristics of non-infective endocarditis are similar to infective endocarditis in terms of valvular lesions (mostly left-sided, with regurgitations and vegetations), and their complications (embolism)...
June 11, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29903030/diastolic-dysfunction-is-common-and-predicts-outcome-after-cardiac-surgery
#15
Thomas S Metkus, Alejandro Suarez-Pierre, Todd C Crawford, Jennifer S Lawton, Lee Goeddel, Jeffrey Dodd-O, Monica Mukherjee, Theodore P Abraham, Glenn J Whitman
BACKGROUND: Diastolic dysfunction (DD) identified on echocardiography predicts mortality after cardiac surgery, however the most useful diastolic parameters for assessment and the association of DD with prolonged mechanical ventilation, ICU re-admission, and hospital length of stay are not established. METHODS: We included patients that underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or a combined procedure (CAB-AVR) from 2010 to 2016, and who had preoperative transthoracic echocardiography (TTE) at our institution within 6 months of the operation...
June 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29903028/feasibility-of-a-novel-synthetic-self-assembling-peptide-for-suture-line-haemostasis-in-cardiac-surgery
#16
Suresh Giritharan, Kareem Salhiyyah, Geoffrey M Tsang, Sunil K Ohri
BACKGROUD: To assess the feasibility and efficacy of PuraStat®, a novel haemostatic agent, in achieving suture line haemostasis in a wide range of cardiac surgical procedures and surgery of the thoracic aorta. METHODS: A prospective, non-randomised study was conducted at our institution. Operative data on fifty consecutive patients undergoing cardiac surgery where PuraStat® was utilised in cases of intraoperative suture line bleeding was prospectively collected...
June 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29901910/concordance-in-the-measurement-of-cardiac-output-vigileo-vs-capstesia
#17
Janaí Santiago-López, Víctor León-Ramírez, Sheila Hernández-Ramírez, Petra Isidora Vásquez-Márquez, Antonio Castellanos-Olivares
Background: Capstesia is an app for smartphones that can serve as a simple, accessible and affordable alternative to current advanced hemodynamic monitoring devices. The aim of this paper was to establish the degree of concordance between the Vigileo monitor and the Capstesia app in the measurement of cardiac output in patients undergoing cardiac surgery. Methods: A process study was conducted that included 30 patients whose cardiac output was measured simultaneously with the Capstesia app and the Vigileo monitor...
March 2018: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29901637/extracranial-intracranial-bypass-in-medial-sphenoid-ridge-meningioma-associated-with-severe-stenosis-of-the-intracranial-segments-of-the-internal-carotid-artery-a-case-report
#18
Yabo Huang, Zhong Wang, Qingdong Han
RATIONALE: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. PATIENT CONCERNS: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29900874/dabigatran-in-patients-with-myocardial-injury-after-non-cardiac-surgery-manage-an-international-randomised-placebo-controlled-trial
#19
P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, Purnima Rao-Melacini, Andreas Hoeft, Salim Yusuf
BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential of dabigatran to prevent major vascular complications among such patients. METHODS: In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries...
June 9, 2018: Lancet
https://www.readbyqxmd.com/read/29899389/calcitriol-trend-following-pediatric-cardiac-surgery-and-association-with-clinical-outcome
#20
Nina Acharya, Dermot R Doherty, Nick Barrowman, Gyaandeo Maharajh, Tara Girolamo, Katie O'Hearn, J Dayre McNally
BACKGROUND: Consistent with accepted practice in stable ambulatory populations, the majority of ICU research has evaluated vitamin D status using a single blood 25-hydroxyvitamin D (25(OH)D) level. Only a limited number of ICU studies have measured the active hormone, 1,25-dihydroxyvitamin D (calcitriol) and none have used change in calcitriol levels to evaluate axis functioning. The objective of this study was to describe the impact of Congenital Heart Disease (CHD) surgery on calcitriol levels and evaluate the relationship between change in postoperative levels and clinical course...
June 13, 2018: Pediatric Research
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