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preoperative cardiac risk

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https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#1
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28319568/predictive-value-of-intraoperative-troponin-i-elevation-in-pediatric-living-donor-liver-transplant-recipients-with-biliary-atresia
#2
Mingwei Sheng, Yuanbang Lin, Yiqi Weng, Rubin Xu, Ying Sun, Wenli Yu, Hongyin Du
BACKGROUND: Pediatric living donor liver transplantation is associated with slight alteration in cardiac enzymes without ongoing acute cardiac injury, but available information about the significance of these changes is limited. The aims of this study were to analyze the link between the anomalies of intraoperative serum cardiac troponin I (cTnI) and acute lung injury during the first week after liver transplantation. METHODS: In this retrospective study, 123 children suffered from biliary atresia were enrolled...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#3
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28315287/elective-primary-or-secondary-delayed-sternal-closure-improves-outcome-in-severely-compromised-patients
#4
Antonio M Calafiore, Azmat A Sheikh, Juan J Alfonso, Tarek Tantawi, Belgeit Maklouf, Ahmed Shawki, Ahmed Allam, Mohammed O Awadi, Ahmed A Osman, Aly M Habib, Michele Di Mauro
Background Delayed sternal closure (DSC) in patients with severely compromised preoperative hemodynamics can be helpful as the chest sometimes cannot be able to contain both lungs and heart. We report our experience to evaluate the midterm results of this strategy in an adult population. Materials and Methods From May 2009 till July 2015, 33 patients had DSC as first treatment of severe hemodynamic deterioration after cardiac surgery. Surgical procedures were valvular (9.27%) or coronary artery bypass grafting + others (24...
March 17, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#5
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28302078/early-serum-creatinine-accurately-predicts-acute-kidney-injury-post-cardiac-surgery
#6
Keren Grynberg, Kevan R Polkinghorne, Sharon Ford, Fiona Stenning, Thomas E Lew, Jonathan A Barrett, Shaun A Summers
BACKGROUND: Acute Kidney Injury (AKI) is a well recognized complication of cardiac surgery. It is associated with significant morbidity and mortality. The aims of our study are twofold; 1. To define the incidence of AKI post cardiac surgery. 2. To identify pre-morbid and operative risk factors for developing AKI and to determine if immediate post operative serum creatinine (IPOsCr) accurately predicts the development of AKI. METHODS: We prospectively studied 196 consecutive patients undergoing elective (on-pump) cardiac surgery...
March 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28302002/preoperative-cardiac-risk-assessment-in-patients-undergoing-liver-transplant-due-to-hepatocellular-carcinoma-should-it-be-different
#7
Haldun Muderrisoglu, Kerem Can Yilmaz, Emir Karacaglar, Ugur Bal, Alp Aydinalp, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Liver transplant is a high-risk surgery for cardiac events. The risk of 30-day major cardiac adverse events is estimated at more than 5%. In this retrospective study, we evaluated our preoperative cardiac risk assessment approach. MATERIALS AND METHODS: We evaluated 58 adult patients who underwent liver transplant between May 2011 and May 2015. Preoperative cardiac risk factors and results of diagnostic tests were noted. Patients were divided into 2 groups: patients with or without hepatocellular carcinoma...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28296531/risk-factors-associated-with-acute-kidney-injury-in-a-cohort-of-20-575-arthroplasty-patients
#8
Pyry Jämsä, Esa Jämsen, Leo-Pekka Lyytikäinen, Jarkko Kalliovalkama, Antti Eskelinen, Niku Oksala
Background and purpose - Patients developing postoperative acute kidney injury (AKI) are at risk of higher morbidity and mortality. In arthroplasty patients, many pre- and perioperative factors are associated with AKI but some of the risk factors are unclear. We report the incidence of postoperative AKI, the conditions associated with it, and survival rates in AKI patients. Patients and methods - We obtained data from 20,575 consecutive hip or knee arthroplasties. Postoperative AKI, occurring within 7 days after the operation, was defined using the risk, injury, failure, loss, and end-stage (RIFLE) criteria...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28291723/cardiac-surgery-in-systemic-lupus-erythematosus-patients-clinical-characteristics-and-outcomes
#9
Javier Tejeda-Maldonado, Lauro Quintanilla-González, Jaime Galindo-Uribe, Andrea Hinojosa-Azaola
OBJECTIVES: To study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery. METHODS: Retrospective analysis of 30 SLE patients who underwent cardiac surgery at a single center. Demographics, comorbidities, clinical and serologic characteristics, cardiovascular risk scores and treatment were recorded. Type of surgery, postoperative complications, mortality and histology were analyzed. RESULTS: Disease duration at surgery was 2 years...
March 11, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28288889/cardiac-stress-testing-during-workup-for-abdominal-aortic-aneurysm-repair-is-not-associated-with-improved-patient-outcomes
#10
Benjamin S Brooke, Mark R Sarfati, Yingying Zhang, Yue Zhang, Angela P Presson, Tom H Greene, Larry W Kraiss
BACKGROUND: Cardiac stress testing (CST) is commonly used to help determine whether patients with abdominal aortic aneurysms (AAA) are better candidates for open vs. endovascular repair, although it is unknown whether use of CST achieves its goal of optimizing patient selection and postoperative outcomes. METHODS: We retrospectively identified 3,635 patients in the Vascular Quality Initiative (VQI) database (2010- 2012) with an AAA ≥ 5.0cm who were candidates for either open or endovascular AAA repair...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28286753/preoperative-antihypertensive-medication-in-relation-to-postoperative-atrial-fibrillation-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#11
REVIEW
Ai-Guo Zhou, Xian-Xue Wang, Dao-Bo Pan, An-Ji Chen, Xiong-Fei Zhang, Hui-Wei Deng
Background. We undertake a systematic review and meta-analysis to evaluate the effect of preoperative hypertension and preoperative antihypertensive medication to postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. Methods. We searched PubMed, Embase, and Cochrane Library (from inception to March 2016) for eligible studies. The outcomes were the effects of preoperative hypertension, preoperative calcium antagonists regimen, preoperative ACE inhibitors regimen, and preoperative beta blocking agents regimen with POAF...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#12
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28275064/obesity-increases-risk-adjusted-morbidity-mortality-and-cost-following-cardiac-surgery
#13
Ravi K Ghanta, Damien J LaPar, Qianzi Zhang, Vishal Devarkonda, James M Isbell, Leora T Yarboro, John A Kern, Irving L Kron, Alan M Speir, Clifford E Fonner, Gorav Ailawadi
BACKGROUND: Despite the epidemic rise in obesity, few studies have evaluated the effect of obesity on cost following cardiac surgery. We hypothesized that increasing body mass index (BMI) is associated with worse risk-adjusted outcomes and higher cost. METHODS AND RESULTS: Medical records for 13 637 consecutive patients who underwent coronary artery bypass grafting (9702), aortic (1535) or mitral (837) valve surgery, and combined valve-coronary artery bypass grafting (1663) procedures were extracted from a regional Society of Thoracic Surgeons certified database...
March 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28267944/changes-in-cerebral-oxygen-saturation-and-haemoglobin-concentration-during-paediatric-cardiac-surgery
#14
T Suemori, S B Horton, S Bottrell, J J Skowno, A Davidson
Although near-infrared spectroscopy (NIRS) enables bedside assessment of cerebral oxygenation, it provides little information on the cause of deoxygenation. The authors aimed to investigate the changes in cerebral oxygenation and haemoglobin concentration and their associations during paediatric cardiac surgery in order to elucidate the physiology underlying cerebral deoxygenation. An observational retrospective study on 399 patients who underwent paediatric cardiac surgery was conducted. With use of NIRS, cerebral oxygen saturation as expressed by tissue oxygen index (TOI) before and after surgery, concentration changes in oxygenated haemoglobin (Δ[HbO<sub>2</sub>]) and deoxygenated haemoglobin (Δ[HHb]) after surgery were studied as were the associations between these values and clinical variables...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28267942/a-pilot-study-using-preoperative-cerebral-tissue-oxygen-saturation-to-stratify-cardiovascular-risk-in-major-non-cardiac-surgery
#15
Syb Wen, Azy Peng, S Boyle, S Cai, L Pope, M T Tran, T G Short, A Aneman, M Jaeger, A Chuan
This prospective pilot study evaluated whether low preoperative cerebral tissue oxygen saturation is associated with unfavourable outcomes after major elective non-cardiac surgery. Eighty-one patients over 60 years of age, American Society of Anesthesiologists physical status 3 or 4, were recruited. Resting cerebral tissue oxygen saturation was recorded on room air, and after oxygen supplementation, using cerebral oximetry. The primary outcome was 30-day major adverse event of combined mortality or severe morbidity, and the secondary outcome was 30-day new disability...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28264675/sequential-organ-failure-assessment-score-predicts-mortality-after-coronary-artery-bypass-grafting
#16
Chih-Hsiang Chang, Shao-Wei Chen, Pei-Chun Fan, Cheng-Chia Lee, Huang-Yu Yang, Su-Wei Chang, Heng-Chih Pan, Feng-Chun Tsai, Chih-Wei Yang, Yung-Chang Chen
BACKGROUND: Mortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality. METHODS: Between January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled...
March 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28262296/duration-of-mechanical-ventilation-and-perioperative-care-quality-after-neonatal-cardiac-operations
#17
Joshua J Blinder, Ravi Thiagarajan, Kathryn Williams, Meena Nathan, John Mayer, Thomas J Kulik
BACKGROUND: This study was conducted to determine whether the duration of mechanical ventilation (DOMV) could be used to benchmark the overall quality of care after neonatal congenital heart operations. METHODS: Children aged younger than 30 days undergoing cardiac operations were reviewed. Technical adequacy was assessed using the Technical Performance Score (TPS), a previously validated tool for determining the adequacy of a palliative or corrective surgical procedure that uses echocardiography criteria and need for unplanned reintervention to determine technical adequacy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28259602/perioperative-strokes-and-early-outcomes-in-mitral-valve-surgery-a-nationwide-analysis
#18
Reshmi Udesh, Amol Mehta, Thomas G Gleason, Lawrence Wechsler, Parthasarathy D Thirumala
OBJECTIVE: To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. DESIGN: Using data from the National Inpatient Sample database for analysis, all patients who underwent isolated mitral valve procedures were identified using International Classification of Diseases-Ninth Revision codes...
December 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28256429/risk-factors-for-post-tavi-bleeding-according-to-the-varc-2-bleeding-definition-and-effect-of-the-bleeding-on-short-term-mortality-a-meta-analysis
#19
REVIEW
Jiayang Wang, Wenyuan Yu, Qi Jin, Yaqiong Li, Nan Liu, Xiaotong Hou, Yang Yu
BACKGROUND: In this study we investigated the effect of post-transcatheter aortic valve implantation (TAVI) bleeding (per Valve Academic Research Consortium-2 [VARC-2] bleeding criteria) on 30-day postoperative mortality and examined the correlation between pre- or intraoperative variables and bleeding. METHODS: Multiple electronic literature databases were searched using predefined criteria, with bleeding defined per Valve Academic Research Consortium-2 criteria...
December 8, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28252556/predictors-for-patient-discharge-destination-following-elective-anterior-cervical-discectomy-and-fusion
#20
John Di Capua, Sulaiman Somani, Jun S Kim, Nathan J Lee, Parth Kothari, Kevin Phan, Nahyr Lugo-Fagundo, Samuel K Cho
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To identify risk factors for non-home patient discharge following elective anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is one of the most performed spinal procedures and this is expected to increase in the coming years. In order to effectively deal with an increasing patient volume, identifying variables associated with patient discharge destination can expedite placement applications and subsequently reduce hospital length of stay...
March 1, 2017: Spine
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