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https://www.readbyqxmd.com/read/28343443/lacosamide-induced-recurrent-ventricular-tachycardia-in-the-acute-care-setting
#1
Theodore J Berei, Matthew P Lillyblad, Adrian K Almquist
Lacosamide is a new-generation antiepileptic drug (AED) most commonly used adjunctively in the setting of partial-onset seizures refractory to traditional therapy. We describe the first case report, to our knowledge, of a patient who developed recurrent, sustained ventricular tachycardia with multiple administrations of lacosamide in an acute setting. A 70-year-old woman with a history significant for valvular heart disease was admitted to the inpatient cardiology service for worsening heart failure. On hospital day 7, she received a bioprosthetic aortic valve...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28343218/effect-of-l-carnitine-supplementation-on-reverse-remodeling-in-patients-with-ischemic-heart-disease-undergoing-coronary-artery-bypass-grafting-a-randomized-placebo-controlled-trial
#2
Sheila da Silva Guimarães, Wanise de Souza Cruz, Licinio da Silva, Gabrielle Maciel, Ana Beatriz Huguenin, Monicque de Carvalho, Bárbara Costa, Geisiane da Silva, Carlos da Costa, João Alvaro D'Ippolito, Alexandre Colafranceschi, Fernanda Scalco, Gilson Boaventura
During cardiac failure, cardiomyocytes have difficulty in using the substrates to produce energy. L-carnitine is a necessary nutrient for the transport of fatty acids that are required for generating energy. Coronary artery graft surgery reduces the plasma levels of L-carnitine and increases the oxidative stress. This study demonstrates the effect of L-carnitine supplementation on the reverse remodeling of patients undergoing coronary artery bypass graft. Patients with ischemic heart failure who underwent coronary graft surgery were randomized to group A - supplemented with L-carnitine or group B controls...
March 25, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28341473/pneumonia-after-cardiac-surgery-experience-of-the-national-institutes-of-health-canadian-institutes-of-health-research-cardiothoracic-surgical-trials-network
#3
Gorav Ailawadi, Helena L Chang, Patrick T O'Gara, Karen O'Sullivan, Y Joseph Woo, Joseph J DeRose, Michael K Parides, Vinod H Thourani, Sophie Robichaud, A Marc Gillinov, Wendy C Taddei-Peters, Marissa A Miller, Louis P Perrault, Robert L Smith, Lyn Goldsmith, Keith A Horvath, Kristen Doud, Kim Baio, Annetine C Gelijns, Alan J Moskowitz, Emilia Bagiella, John H Alexander, Alexander Iribarne
RATIONALE: Pneumonia remains the most common major infection after cardiac surgery despite numerous preventive measures. OBJECTIVES: To prospectively examine the timing, pathogens, and risk factors, including modifiable management practices, for postoperative pneumonia and estimate its impact on clinical outcomes. METHODS: A total of 5158 adult cardiac surgery patients were enrolled prospectively in a cohort study across 10 centers. All infections were adjudicated by an independent committee...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28341356/mortality-risk-stratification-in-fontan-patients-who-underwent-heart-transplantation
#4
Christopher J Berg, Brenton S Bauer, Abbie Hageman, Jamil A Aboulhosn, Leigh C Reardon
The number of patients who require orthotopic heart transplantation (OHT) for failing Fontan physiology continues to grow; however, the methods and tools to evaluate risk of OHT are limited. This study aimed to identify a set of preoperative variables and characteristics that were associated with a greater risk of postoperative mortality in patients who received OHT for failing Fontan physiology. Thirty-six Fontan patients were identified as having undergone OHT at University of California-Los Angeles Medical Center from 1991 to 2014...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28341033/stress-echocardiographic-evaluation-for-d-transposition-of-the-great-arteries-after-atrial-redirection-unmasking-early-signs-of-myocardial-dysfunction-and-baffle-stenosis
#5
Merav Dvir-Orgad, Meera Anand, Astrid M De Souza, Mary T Zadorsky, Marla C Kiess, James E Potts, George G S Sandor
BACKGROUND: The authors used semisupine cycle ergometry stress echocardiography to assess cardiac function and unmask baffle stenosis in patients with d-transposition of the great arteries after atrial redirection surgery. METHODS: This was a retrospective review of semisupine cycle ergometry stress echocardiography performed in 53 patients (64% male; mean age, 24.0 years; 90% Mustard procedure) and 56 healthy control subjects. Incremental exercise to volitional fatigue was performed...
January 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#6
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28340840/short-term-results-of-heartmate-3-ventricular-assist-device-implantation-for-end-stage-heart-failure
#7
P Ozturk, S Ertugay, C Sahutoglu, C Engin, S Nalbantgil, T Yagdi, M Ozbaran
OBJECTIVE: To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). METHODS: Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre- and early postoperative medical data were noted and statistically analyzed between the 2 groups...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340838/anesthetic-management-for-left-ventricular-assist-device-implantation-through-left-thoracotomy-evaluation-of-on-pump-versus-off-pump
#8
C Sahutoglu, E Turksal, U Bilic, S Kocabas, F Zekiye Askar, P Ozturk, S Ertugay, C Engin, T Yagdi, M Ozbaran
BACKGROUND: Ventricular assist devices (VADs) are alternative approaches to medical treatment in patients with acute or chronic heart failure. The goal of this study was to compare an anesthetic approach in patients undergoing implantation of a VAD with (on-pump) or without (off-pump) cardiopulmonary bypass (CPB) through left thoracotomy. METHODS: A total of 32 patients were divided into 2 groups: on-pump (group 1) and off-pump (group 2). A standard anesthesia protocol was used in all patients...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340810/comparison-of-two-different-inhalation-anesthetics-on-grafted-kidney-function-in-patients-undergoing-renal-transplantation-surgery-desflurane-or-sevoflurane
#9
M S Karadeniz, H S Ciftci, T Tefik, O Mammadov, H Yazıcı, I Nane, A Turkmen, F Oguz, K M Tugrul
BACKGROUND: Anesthetic management of patients during renal transplantation is vitally important for ensuring proper functioning of kidneys that have undergone ischemia-reperfusion damage. The goal of this prospective study was to compare the effects of 2 different inhalation agents (sevoflurane and desflurane) on grafted kidney function in renal transplantation surgery. METHODS: Sixty-five patients who were scheduled for living donor renal transplantation were enrolled in the study...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340182/novel-targets-and-future-strategies-for-acute-cardioprotection-position-paper-of-the-european-society-of-cardiology-working-group-on-cellular-biology-of-the-heart
#10
Derek J Hausenloy, David Garcia-Dorado, Hans Erik Bøtker, Sean M Davidson, James Downey, Felix B Engel, Robert Jennings, Sandrine Lecour, Jonathan Leor, Rosalinda Madonna, Michel Ovize, Cinzia Perrino, Fabrice Prunier, Rainer Schulz, Joost P G Sluijter, Linda W Van Laake, Jakob Vinten-Johansen, Derek M Yellon, Kirsti Ytrehus, Gerd Heusch, Péter Ferdinandy
Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury. During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic - however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing...
March 17, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28338373/risk-of-major-cardiac-events-following-adjuvant-proton-versus-photon-radiation-therapy-for-patients-with-thymic-malignancies
#11
Jennifer Vogel, Liyong Lin, Charles B Simone, Abigail T Berman
BACKGROUND: While often managed with surgery alone, patients with thymic malignancies with high-risk features may benefit from adjuvant radiation therapy but are at risk for late toxicities. Previously, the risk of major cardiac events (MCEs) was reported to increase by 7% per one Gray (Gy) to the heart. In this study, we compare dose to organs at risk (OARs) with intensity-modulated (IMRT) versus proton beam therapy (PBT). We hypothesize a decrease risk of predicted MCEs with PBT. MATERIAL AND METHODS: Patients requiring adjuvant therapy for thymic malignancies were treated with double scattered proton beam therapy (DS-PBT)...
March 24, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28338180/influence-of-dexmedetomidine-to-cognitive-function-during-recovery-period-for-children-with-general-anesthesia
#12
Z-M Jia, H-N Hao, M-L Huang, D-F Ma, X-L Jia, B Ma
OBJECTIVE: We studied the influence of Dexmedetomidine on cognitive function in children during the recovery period of general anesthesia. PATIENTS AND METHODS: Ninety-three children who underwent general anesthesia were selected and randomly divided into (1) the control group, (2) the dexmedetomidine group, and (3) the dezocine group. Fentanyl, propofol, and rocuronium were used in all patients to induce anesthesia, while sevoflurane inhalation and propofol were used to maintain anesthesia...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#13
Samir R Kapadia, Amar Krishnaswamy, E Murat Tuzcu
Functional tricuspid regurgitation (FTR) is common, whether in association with mitral or aortic valve disease or presenting as an isolated valvular disease. Several studies have shown that TR is associated with poor patient outcomes, though a cause-and-effect relationship of TR to mortality has not been proven. Similarly the impact of surgical treatment of TR on outcomes needs well-controlled randomized trials that are under planning. The current professional society guidelines for treatment of TR are based on expert opinions with a level of evidence C for all indications...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336788/transcatheter-treatment-of-severe-tricuspid-regurgitation-with-the-edge-to-edge-mitraclip-technique
#14
Georg Nickenig, Marek Kowalski, Jörg Hausleiter, Daniel Braun, Joachim Schofer, Ermela Yzeiraj, Volker Rudolph, Kai Friedrichs, Francesco Maisano, Maurizio Taramasso, Neil P Fam, Giovanni Bianchi, Francesco Bedogni, Paolo Denti, Ottavio Alfieri, Azeem Latib, Antonio Colombo, Christoph Hammerstingl, Robert Schueler
Background -Current surgical and medical treatment options for severe tricuspid regurgitation (TR) are limited and additional interventional approaches are required. In the present observational study, the safety and feasibility of transcatheter repair of chronic severe TR with the MitraClip system were evaluated. In addition, the effects on clinical symptoms were assessed. Methods -Patients with heart failure symptoms and severe TR on optimal medical treatment were treated with the MitraClip system. Safety, defined as periprocedural adverse events such as death, myocardial infarction, stroke, or cardiac tamponade, and feasibility, defined as successful implantation of one or more MitraClip devices and reduction of TR by at least one grade, were evaluated before discharge and after 30 days...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28335795/gemella-morbillorum-endocarditis-of-pulmonary-valve-a-case-report
#15
Dan Li, Zhicheng Zhu, Xiaomei Zheng, Weitie Wang, Rihao Xu, Kexiang Liu
BACKGROUND: Pulmonary valve infective endocarditis is a rare finding for endocarditis. Infective endocarditis caused by Gemella morbillorum remains a scanty occurrence. CASE PRESENTATION: This is a case reported of a 28-year-old Chinese male with endocarditis caused by pulmonary valve infection of Gemella morbillorum associated with congenital ventricular septal defect, atrial septal defect and double-chambered right ventricle. The patient presented with fever, shortness of breath, progressively worsening exertional fatigue, dyspnea and weight loss for 3 months...
March 23, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28333672/case-report-pediatric-scar-management-after-open-heart-surgery
#16
Ha Phan, Beau Harger, Nick Estrada
Tetralogy of Fallot is a congenital disease caused by structural defects within the heart that can lead to cyanosis. The purpose of this case report is to discuss the use of PracaSil-Plus, a proprietary topical anhydrous silicone base containing pracaxi oil, in scar-management therapy, following open-heart surgery on a pediatric patient with tetralogy of Fallot. The Patient and Observer Scar Assessment Scale was the research instrument used to evaluate for efficacy of the scar therapy. Following 8 weeks of treatment with PracaSil-Plus, reduction in scores were observed for scar color, stiffness, thickness, and irregularity, with improvements of 87...
July 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamic-with-intra-aortic-balloon-pump-business-as-usual
#17
Juliana Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Juliano Almeida, Graziela Ferreira, Ligia Cunha, Ricardo Nogueira, Marcelo Oliveira, Fabio Jatene, Thompson Robinson, Ludhmila Hajjar
Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained i) 5 minutes with IABP ratio 1:3, ii) 5 minutes, starting 1 minute with the IABP-ON, and continuing for another 4 minutes without pump assistance (IABP-OFF)...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#18
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331287/does-remifentanil-attenuate-renal-ischemia-reperfusion-injury-better-than-dexmedetomidine-in-rat-kidney
#19
E Erkılıç, E Kesimci, F Alaybeyoğlu, I Kılınç, R Tural, A Yazgan, T Gümüş, A Sepici Dinçel, E G Dumlu, O Kanbak
BACKGROUND: Ischemia-reperfusion (I/R) injury is a common cause of patient morbidity and mortality in the perioperative period. Patients undergoing long-lasting, abdominal, and urogenital surgeries with risk factors such as advanced age, peripheral artery disease, diabetes mellitus, renovascular disease, and congestive heart failure are candidates for acute kidney injury (AKI) due to impaired renal perfusion and decreased functional renal reserve. Pharmacological agents with multiple functions and anti-oxidative and anti-inflammation properties may be promising preventative strategies for AKI...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#20
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
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