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preoperative cardiac risk

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https://www.readbyqxmd.com/read/28106000/left-bundle-branch-block-after-sutureless-transcatheter-and-stented-biological-aortic-valve-replacement-for-aortic-stenosis
#1
Madelien V Regeer, Lisanne R Merkestein, Arend de Weger, Vasileios Kamperidis, Frank van der Kley, Philippe J van Rosendael, Nina Ajmone Marsan, Robert J M Klautz, Martin J Schalij, Jeroen J Bax, Victoria Delgado
AIMS: Conventional aortic valve replacement (AVR), sutureless AVR (su-AVR) and transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) are associated with conduction abnormalities. The aim of the present study was to assess the incidence of left bundle branch block (LBBB) after su-AVR and TAVI, in comparison to conventional AVR. METHODS AND RESULTS: A total of 501 patients (mean age 74±8 years, 53% male) without preoperative cardiac conduction disturbances who underwent AVR or TAVI were included in the study...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105997/first-successful-transcatheter-double-valve-replacement-from-a-transapical-access-and-nine-month-follow-up
#2
Robert Bauernschmitt, Stefan Bauer, Christian Liewald, Ramiz Emini, Wolfgang Oechsner, Meinrad Beer, Ralf Sodian, Andreas Liebold
AIMS: While TAVI is the treatment of choice in patients with aortic stenosis considered inoperable or at high risk, interventional replacement of the mitral valve is still in the preclinical or early clinical phase. Our aim was to report on the first transcatheter double valve replacement into native valves from a transapical access. METHODS AND RESULTS: A 67-year-old, highly symptomatic female patient considered inoperable due to severe calcification of the mitral annulus and comorbidities was scheduled for transcatheter double valve replacement by the local Heart Team...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28101755/does-n-terminal-pro-brain-type-natriuretic-peptide-predict-cardiac-complications-after-hip-fracture-surgery
#3
Hiroki Ushirozako, Tsuyoshi Ohishi, Tomotada Fujita, Daisuke Suzuki, Kazufumi Yamamoto, Tomohiro Banno, Hiroyuki Takase, Yukihiro Matsuyama
BACKGROUND: Elderly patients with hip fracture are at risk for cardiac complications. N-terminal pro-brain type natriuretic peptide (NT-proBNP) has been shown to predict cardiac complications in surgical patients; however, to our knowledge, only two studies have evaluated the utility of this test in patients with hip fracture. We believe it is important to assess a more accurate cutoff value of NT-proBNP with exclusion of patients with renal failure. QUESTIONS/PURPOSES: To assess the association between preoperative NT-proBNP and cardiac complications after hip fracture surgery...
January 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#4
David F Vener, Sara K Pasquali, Emad B Mossad
Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099244/presepsin-scd14-st-is-a-novel-marker-for-risk-stratification-in-cardiac-surgery-patients
#5
Hagen Bomberg, Matthias Klingele, Stefan Wagenpfeil, Eberhard Spanuth, Thomas Volk, Daniel I Sessler, Hans-Joachim Schäfers, Heinrich Volker Groesdonk
BACKGROUND: Presepsin (soluble cluster-of-differentiation 14 subtype [sCD14-ST]) is a humoral risk stratification marker for systemic inflammatory response syndrome and sepsis. It remains unknown whether presepsin can be used to stratify risk in elective cardiac surgery. The authors therefore determined the usefulness of presepsin for risk stratification in patients having elective cardiac surgery. METHODS: Eight hundred fifty-six cardiac surgical patients were prospectively studied...
January 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28096825/determination-of-the-value-of-glycated-hemoglobin-hba1c-and-fructosamine-in-assessing-the-risk-of-perioperative-complications-after-cardiac-surgery-in-patients-with-type-2-diabetes
#6
Anetta M Kowalczuk-Wieteska, Marta Wróbel, Dominika Rokicka, Aleksandra Szymborska-Kajanek, Jerzy Foremny, Paweł Nadziakiewicz, Marian Zembala, Krzysztof Strojek
INTRODUCTION: Patients with diabetes have a worse postoperative course and longer length of hospital stay after surgery. A good indicator of proper long-term (3 months) glycemic control is glycated hemoglobin (HbA1c), and fructosamine in the short term (2-3 weeks). AIM: To determine the degree of glycemic control evaluated preoperatively by HbA1c and/or fructosamine influence on the postoperative course of patients with diabetes undergoing coronary artery bypass grafting (CABG) in 2014-2015...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28096572/current-and-emerging-treatments-for-hypercholesterolemia-a-focus-on-statins-and-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-for-perioperative-clinicians
#7
REVIEW
Terrence L Trentman, Steven G Avey, Harish Ramakrishna
Statins are a mainstay of hyperlipidemia treatment. These drugs inhibit the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase and have beneficial effects on atherosclerosis including plaque stabilization, reduction of platelet activation, and reduction of plaque proliferation and inflammation. Statins also have a benefit beyond atherosclerotic plaque, including anticoagulation, vasodilatation, antioxidant effects, and reduction of mediators of inflammation. In the perioperative period, statins appear to contribute to improved outcomes via these mechanisms...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28093920/inspiratory-muscle-training-is-effective-to-reduce-postoperative-pulmonary-complications-and-length-of-hospital-stay-a-systematic-review-and-meta-analysis
#8
Filipa Kendall, José Oliveira, Bárbara Peleteiro, Paulo Pinho, Pedro Teixeira Bastos
PURPOSE: This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS), both in the preoperative and/or postoperative periods of cardiac, pulmonary, and abdominal surgical patients. Sensitive analysis was performed to examine which patients benefit more from IMT according to methodological features (quality of studies and sample size), patient's characteristics (pulmonary risk stratification, age, and body mass index), type of surgery, period of training, and training protocols (training doses and level of supervision)...
January 17, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28093814/management-of-sickle-cell-disease-in-patients-undergoing-cardiac-surgery
#9
REVIEW
Todd C Crawford, Michael V Carter, Rina K Patel, Alejandro Suarez-Pierre, Sophie Z Lin, Jonathan Trent Magruder, Joshua C Grimm, Duke E Cameron, William A Baumgartner, Kaushik Mandal
Sickle cell disease is a life-limiting inherited hemoglobinopathy that poses inherent risk for surgical complications following cardiac operations. In this review, we discuss preoperative considerations, intraoperative decision-making, and postoperative strategies to optimize the care of a patient with sickle cell disease undergoing cardiac surgery.
January 16, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#10
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28091794/the-impact-of-liver-disorders-on-perioperative-management-of-reoperative-cardiac-surgery-a-retrospective-study-in-adult-congenital-heart-disease-patients
#11
Koko Adachi, Hiroaki Toyama, Yu Kaiho, Osamu Adachi, Hiroto Hudeta, Masanori Yamauchi
PURPOSE: We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients. METHODS: This retrospective study included 32 ACHD patients who underwent reoperative cardiac surgery. RESULTS: Preoperatively, 38% of the study patients had risk factors, including congestive liver (CL) due to right heart failure (31%), chronic hepatitis C (HC) (22%), and both CL and HC (16%)...
January 16, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#12
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/28077124/important-patient-characteristics-differ-prior-to-total-knee-arthroplasty-and-total-hip-arthroplasty-between-switzerland-and-the-united-states
#13
Patricia D Franklin, Hermes Miozzari, Panayiotis Christofilopoulos, Pierre Hoffmeyer, David C Ayers, Anne Lübbeke
BACKGROUND: Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. METHODS: Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample...
January 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#14
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074703/early-surgery-after-angiography-in-patients-scheduled-for-valve-replacement
#15
Victor Dayan, Roberto Stanham, Gerardo Soca, Fernando Genta, Jorge Mariño, Alvaro Lorenzo
Background There are limited data regarding the risks of cardiac surgery early after coronary angiography in patients scheduled for isolated aortic and/or mitral valve replacement. Our aim was to evaluate the risk of early surgery after coronary angiography in these patients. Methods We retrospectively analyzed data of 1044 patients who underwent isolated aortic and/or mitral valve replacement from 2006 to 2014. Baseline, operative, and postoperative variables were collected. The patients were divided into 3 groups based on the interval between coronary angiography and surgery: ≤3 days ( n = 216), 4-7 days ( n = 109), and ≥8 days ( n = 719)...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28073987/neutrophil-lymphocyte-ratio-and-risk-of-atrial-fibrillation-after-thoracic-surgery
#16
Kevin J Walsh, Kay See Tan, Hao Zhang, David Amar
OBJECTIVES: Postoperative atrial fibrillation (POAF) occurs frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke. Recent studies have shown conflicting results on the role of neutrophil-lymphocyte ratio (NLR) and its association with the development of POAF after cardiac surgery. Our goal was to determine whether an association exists between NLR and the incidence of POAF after non-cardiac thoracic surgery. METHODS: Using a database of 259 consecutive patients age 60 or older who had anatomic lung resection or oesophagectomy for oncologic resection, we compared preoperative, postanaesthesia care unit and postoperative day 1 NLR between patients who did and did not develop POAF during their hospitalization using Fisher's exact test or logistic regression...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073619/cytomegalovirus-serostatus-as-predictor-for-adverse-events-after-cardiac-surgery-a-prospective-observational-study
#17
Malte Ziemann, Matthias Heringlake, Philipp Lenor, David Juhl, Thorsten Hanke, Michael Petersen, Julika Schön, Hermann Heinze, Heinrich V Groesdonk, Hauke Paarmann, Holger Hennig
OBJECTIVE: To clarify whether reactivated cytomegalovirus (CMV) infections in critically ill patients lead to worse outcome or just identify more severely ill patients. If CMV has a pathogenic role, latently infected (CMV-seropositive) patients should have worse outcome than seronegative patients because only seropositive patients can experience a CMV reactivation. DESIGN: Post-hoc analysis of a prospective observational study. SETTING: Single university hospital...
October 20, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28072699/prevention-preferable-to-treatment-3-case-reports-of-patients-experiencing-right-sided-heart-failure-after-ebstein-anomaly-correction
#18
Ming Luo, Jing Lin, Zhen Qin, Lei Du
RATIONALE: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. PATIENT CONCERNS: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069729/systematic-review-on-the-predictive-ability-of-frailty-assessment-measures-in-cardiac-surgery
#19
REVIEW
Yusuf S Abdullahi, Leonidas V Athanasopoulos, Roberto P Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou
OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included...
January 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28069624/external-validation-of-the-revised-cardiac-risk-index-and-update-of-its-renal-variable-to-predict-30-day-risk-of-major-cardiac-complications-after-non-cardiac-surgery-rationale-and-plan-for-analyses-of-the-vision-study
#20
Pavel S Roshanov, Michael Walsh, P J Devereaux, S Danielle MacNeil, Ngan N Lam, Ainslie M Hildebrand, Rey R Acedillo, Marko Mrkobrada, Clara K Chow, Vincent W Lee, Lehana Thabane, Amit X Garg
INTRODUCTION: The Revised Cardiac Risk Index (RCRI) is a popular classification system to estimate patients' risk of postoperative cardiac complications based on preoperative risk factors. Renal impairment, defined as serum creatinine >2.0 mg/dL (177 µmol/L), is a component of the RCRI. The estimated glomerular filtration rate has become accepted as a more accurate indicator of renal function. We will externally validate the RCRI in a modern cohort of patients undergoing non-cardiac surgery and update its renal component...
January 9, 2017: BMJ Open
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