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https://www.readbyqxmd.com/read/28935351/impact-of-left-ventricular-assist-device-related-complications-on-posttransplant-graft-survival
#1
Dhaval Chauhan, Alexis K Okoh, Setri Fugar, Rivandra Karanam, David Baran, Mark Zucker, Magarita Camacho, Mark J Russo
BACKGROUND: This study describes the impact of continuous-flow left-ventricular-assist device (CF-LVAD)-related complications on postoperative outcomes. METHODS: The United Network for Organ Sharing (UNOS) heart transplant follow-up data from 2005 to 2015 were obtained. CF-LVAD patients who were bridged to transplant were studied. Device-related complications (DRCs) at patient's last follow-up before transplantation were reported in 5 categories: device thrombosis (B1), infection (B2), device malfunction (B3), life-threatening arrhythmias (B4), and others (B5)...
September 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28934890/hyperglycemic-episodes-are-associated-with-postoperative-infections-after-cardiac-surgery
#2
K M Järvelä, N K Khan, E L Loisa, J A Sutinen, J O Laurikka, J A Khan
BACKGROUND AND AIMS: To describe the incidence of and risk factors for postoperative infections and the correlation between postoperative hyperglycemia despite tight blood glucose control with infectious and other complications after contemporary cardiac surgery. MATERIAL AND METHODS: The study comprised 1356 consecutive adult patients who underwent cardiac surgery between January 2013 and December 2014 and were followed up for 6 months. Patients surviving the first 2 days were included in the analysis...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#3
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927173/the-relationship-between-preoperative-frailty-and-outcomes-following-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#4
Atul Anand, Catherine Harley, Akila Visvanathan, Anoop S V Shah, Joanna Cowell, Alasdair MacLullich, Susan Shenkin, Nicholas L Mills
Aims: Transcatheter aortic valve implantation (TAVI) is an increasingly common intervention for patients with aortic stenosis deemed high risk for major cardiac surgery, but identifying those who will benefit can be challenging. Frailty reflects physiological reserve and may be a useful prognostic marker in this population. We performed a systematic review and meta-analysis of the association between frailty and outcomes after TAVI. Methods and Results: Five databases were searched between January 2000 and May 2015...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#5
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#6
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28919184/clinical-significance-of-failure-to-lose-weight-10-years-after-roux-en-y-gastric-bypass
#7
Robert B Hawkins, J Hunter Mehaffey, Timothy L McMurry, Jennifer Kirby, Steven K Malin, Bruce Schirmer, Peter T Hallowell
BACKGROUND: Although Roux-en-Y gastric bypass (RYGB) induces short-term weight loss and co-morbidity amelioration, long-term data suggest that a subset of patients return to their preoperative body mass index (BMI). OBJECTIVES: To identify the clinical implications of 10-year weight loss failure after RYGB. SETTING: An academic teaching hospital. METHODS: Adults undergoing RYGB (1985-2004) were included in this study (n = 1087)...
August 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28919069/impact-of-discontinuation-of-antiplatelet-therapy-prior-to-isolated-valve-and-combined-coronary-artery-bypass-graft-and-valve-procedures-on-short-and-intermediate-term-outcomes
#8
James Meneguzzi, Matthew Kilpin, Ying Yan Zhu, Atsuo Doi, Christopher Reid, Lavinia Tran, Philip Hayward, Julian Smith
BACKGROUND: A change in cardiac surgery practice over the past decade has seen an increase in urgent or inpatient referrals for surgery, with antiplatelet therapy often continued up until surgery. This study aims to identify the optimal timing for administration of aspirin to minimise risk of perioperative morbidity and mortality. METHODS: From a prospectively compiled database collected by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, we identified 8,294 patients undertaking combined CABG and valve or isolated valve procedures while discontinuing aspirin...
September 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#9
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28912261/preoperative-pectoralis-muscle-quantity-and-attenuation-by-computed-tomography-are-novel-and-powerful-predictors-of-mortality-after-left-ventricular-assist-device-implantation
#10
Levi M Teigen, Ranjit John, Adam J Kuchnia, Emily M Nagel, Carrie P Earthman, Jessica Kealhofer, Cindy Martin, Rebecca Cogswell
BACKGROUND: Skeletal muscle mass decreases in end-stage heart failure and is predictive of clinical outcomes in several disease states. Skeletal muscle attenuation and quantity as quantified on preoperative chest computed tomographic scans may be predictive of mortality after continuous flow (CF) left ventricular assist device (LVAD) implantation. METHODS AND RESULTS: A single-center continuous flow-LVAD database (n=354) was used to identify patients with chest computed tomographies performed in the 3 months before LVAD implantation (n=143)...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28912198/frequency-of-low-value-care-in-alberta-canada-a-retrospective-cohort-study
#11
Finlay A McAlister, Meng Lin, Jeff Bakal, Stafford Dean
OBJECTIVE: To determine how frequently 10 low-value services highlighted by Choosing Wisely are done and what factors influence their provision. METHODS: This is a retrospective cohort study using routinely collected health data from five linked data sets from 2012 to 2015 in the Canadian province of Alberta to determine the frequency with which 10 low-value services were provided. RESULTS: Between 2012 and 2015, 162 143 people (4% of all 3 814 536 adult Albertans and 5% of the 3 423 135 who saw a physician at least once in that time frame) received at least one of the 10 low-value services, including 29...
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28901120/perioperative-stroke-incidence-etiologic-factors-and-prevention
#12
Sher-Lu Pai, R Doris Wang, Stephen Aniskevich
INTRODUCTION: Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcomes. EVIDENCE ACQUISITION: The authors performed a systematic search in PubMed and the Cochrane Central Register. The search aimed to identify studies published between January 1990 and December 2015 related to the common etiologic factors, incidence, risk factors, risk modifiers, and early management of perioperative stroke...
September 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#13
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28891912/postoperative-complications-affecting-survival-after-cardiac-arrest-in-general-surgery-patients
#14
Minjae Kim, Guohua Li
BACKGROUND: Postoperative cardiac arrest is uncommon but associated with a high mortality risk in general surgery patients and is often preceded by postoperative complications. The relationships between previous complications and mortality after cardiac arrest in general surgery patients have not been completely evaluated. METHODS: retrospective, observational cohort of general surgery in patients with cardiac arrest occurring after postoperative day (POD) #0 (and up to POD #30) was obtained from the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28883736/omentum-flap-as-a-salvage-procedure-in-deep-sternal-wound-infection
#15
Nick Spindler, Christian D Etz, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Stefan Langer
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28877308/incidence-of-myocardial-infarction-after-high-risk-vascular-operations-in-adults
#16
Yen-Yi Juo, Aditya Mantha, Ramin Ebrahimi, Boback Ziaeian, Peyman Benharash
Importance: Advances in perioperative cardiac management and an increase in the number of endovascular procedures have made significant contributions to patients and postoperative myocardial infarction (POMI) risk following high-risk vascular procedures. Whether these changes have translated into real-world improvements in POMI incidence remain unknown. Objective: To examine the temporal trends of myocardial infarction (MI) following high-risk vascular procedures...
September 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#17
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873411/preoperative-asymptomatic-leukocytosis-and-postoperative-outcome-in-cardiac-surgery-patients
#18
Eitezaz Mahmood, Ziyad O Knio, Feroze Mahmood, Rabia Amir, Sajid Shahul, Bilal Mahmood, Yanick Baribeau, Ariel Mueller, Robina Matyal
BACKGROUND: Despite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients...
2017: PloS One
https://www.readbyqxmd.com/read/28871334/role-of-percutaneous-veno-arterial-extracorporeal-membrane-oxygenation-as-bridge-to-left-ventricular-assist-device
#19
Koichi Toda, Tomoyuki Fujita, Osamu Seguchi, Masanobu Yanase, Takeshi Nakatani
Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides emergency circulatory support for cardiogenic shock patients and is used as a bridge to a left ventricular assist device (LVAD). The purpose of this study was to determine risk factors for LVAD implantation in patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. We retrospectively investigated 32 consecutive LVAD patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. Twenty-nine patients (91%) were intubated, and their serum creatinine and total bilirubin levels before LVAD implantation were 2...
September 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28865979/comparison-of-30-day-readmission-rates-and-risk-factors-between-carotid-artery-stenting-and-endarterectomy
#20
Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: The aim of this study was to analyze the rates, reasons, and risk factors of 30-day readmission, both planned and unplanned, after carotid revascularization as well as to evaluate major outcomes associated with those readmissions. METHODS: Using the Premier Healthcare database, we retrospectively identified patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) between 2009 and 2015. The primary outcome was 30-day all-cause readmission...
August 30, 2017: Journal of Vascular Surgery
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