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preoperative cardiac risk

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https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#1
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#2
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29773577/determinants-and-outcomes-of-vasoplegia-following-left-ventricular-assist-device-implantation
#3
Kristen M Tecson, Brian Lima, Andy Y Lee, Fayez S Raza, Grace Ching, Cheng-Han Lee, Joost Felius, Ronald D Baxter, Sasha Still, Justin D G Collier, Shelley A Hall, Susan M Joseph
BACKGROUND: Vasoplegia is associated with adverse outcomes following cardiac surgery; however, its impact following left ventricular assist device implantation is largely unexplored. METHODS AND RESULTS: In 252 consecutive patients receiving a left ventricular assist device, vasoplegia was defined as the occurrence of normal cardiac function and index but with the need for intravenous vasopressors within 48 hours following surgery for >24 hours to maintain a mean arterial pressure >70 mm Hg...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29761271/multiple-coronary-stenting-negatively-affects-myocardial-recovery-after-coronary-bypass-grafting
#4
Shin Yajima, Daisuke Yoshioka, Satsuki Fukushima, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Shunsuke Saito, Keitaro Domae, Yoshiki Sawa
OBJECTIVES: We aimed to elucidate the relationship between the magnitude of myocardial recovery after coronary artery bypass grafting (CABG) and the prognosis and to explore the predictors of myocardial non-recovery. METHODS: Eighty-one patients with a preoperative left ventricular ejection fraction (LVEF) ≤ 40% who underwent isolated CABG between 2002 and 2015 and had undergone echocardiographic follow-up (median follow-up, 3.1 years; interquartile range 1...
May 14, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29759735/preoperative-serum-st2-level-predicts-acute-kidney-injury-after-adult-cardiac-surgery
#5
Kevin W Lobdell, Devin M Parker, Donald S Likosky, Michael Rezaee, Moritz Wyler von Ballmoos, Shama S Alam, Sherry Owens, Heather Thiessen-Philbrook, Todd MacKenzie, Jeremiah R Brown
OBJECTIVE: The purpose of this study was to evaluate the relationship between preoperative levels of serum soluble ST2 (ST2) and acute kidney injury (AKI) after cardiac surgery. Previous research has shown that biomarkers facilitate the prediction of AKI and other complications after cardiac surgery. METHODS: Preoperative ST2 proteins were measured in 1498 patients undergoing isolated coronary artery bypass graft surgery at 8 hospitals participating in the Northern New England Biomarker Study from 2004 to 2007...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29756690/preoperative-predictive-model-for-acute-kidney-injury-after-elective-cardiac-surgery-a-prospective-multicentre-cohort-study
#6
Raquel Callejas, Alfredo Panadero, Marc Vives, Paula Duque, Gemma Echarri, Pablo Monedero
BACKGROUND: Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS: A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754693/preoperative-6-minute-walk-distance-is-associated-with-postoperative-cognitive-dysfunction
#7
Kazuhiro Hayashi, Hideki Oshima, Miho Shimizu, Kiyonori Kobayashi, Shigeyuki Matsui, Yoshihiro Nishida, Akihiko Usui
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation...
April 25, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#8
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29748956/neurobehavioral-evaluation-of-neonates-with-congenital-heart-disease-a-cohort-study
#9
Whitnee J Hogan, Sarah Winter, Nelangi M Pinto, Cindy Weng, Xiaoming Sheng, Elisabeth Conradt, Janine Wood, Michael D Puchalski, Lloyd Y Tani, Thomas A Miller
AIM: To describe neurobehavioral patterns in neonates with congenital heart disease (CHD). METHOD: A cohort study describing neurobehavioral performance of neonates with CHD requiring cardiac surgery. The neonates were evaluated preoperatively and postoperatively with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and scores were compared with published normative values. Clinical factors were obtained by chart review to assess their association with behavior...
May 10, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29747289/-an-analysis-of-the-characteristics-of-perioperative-cardiac-troponin-elevation-in-orthopaedic-surgical-patients
#10
W L Hu, Y Z Chen, J H Wang, X L Hao, D X Zhai, H Y Sun, X S Zhao
Objective: Perioperative myocardial infarction remains a severe complication in non-cardiac surgery and is one of the major causes of death. Cardiac troponin (cTn) I elevation is associated with short-term and long-term mortality. The aim of the study was to assess the proportion rate of cTnI elevation and its clinical characteristics among patients admitted for orthopaedic surgery with or without cardiovascular events. Methods: This is a retrospective study including 27 744 patients aged 50 years or older who admitted for orthopaedic surgery from 2009-2015 in Beijing Jishuitan Hospital...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29733822/cardiopulmonary-bypass-glial-fibrillary-acidic-protein-correlates-with-neurocognitive-skills
#11
Luca Vedovelli, Massimo Padalino, Agnese Suppiej, Stefano Sartori, Gianclaudio Falasco, Manuela Simonato, Virgilio P Carnielli, Giovanni Stellin, Paola Cogo
BACKGROUND: Neuro-cognitive deficits at school starting age may affect as many as 50% of children who underwent cardiac surgery for complex congenital heart diseases (CHD). The aim of this study was to identify which phases of cardiopulmonary bypass (CPB) are associated with an increased risk of impaired neurodevelopmental skills in children with complex CHD. This was assessed by means of glial fibrillary acidic protein (GFAP) plasma levels during CPB for CHD surgery, as a marker of neurological insult...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29731076/application-of-the-revised-cardiac-risk-index-to-the-model-for-end-stage-liver-disease-score-improves-the-prediction-of-cardiac-events-in-patients-undergoing-liver-transplantation
#12
Y-S Park, Y-J Moon, I-G Jun, J-G Song, G-S Hwang
INTRODUCTION: Although the revised cardiac risk index (RCRI) is a useful tool for estimating the risk of postoperative cardiac events, whether it improves the prediction of cardiac events in patients undergoing liver transplantation (LT) has not been sufficiently demonstrated. METHODS: We retrospectively analyzed 1429 patients who underwent LT. Cardiac events were defined as myocardial infarction, death, or combined events within 30 days after surgery. The RCRI was defined as the number of independent predictors including high-risk surgery, ischemic heart disease, congestive heart failure, cerebrovascular disease, insulin treatment, and creatinine level >2 mg/dL...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29730947/vitamin-d-and-postoperative-vasopressor-use-in-cardiopulmonary-bypass
#13
Michael J Javorski, Mina M Kerolos, Jawed Fareed, R Anthony Perez-Tamayo
The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29726039/relationship-between-intraoperative-serum-lactate-and-hemoglobin-levels-on-postoperative-renal-function-in-patients-undergoing-elective-cardiac-surgery
#14
Steven C Mitchell, Anirudh Vinnakota, Salil V Deo, Alan H Markowitz, Basar Sareyyupoglu, Yakov Elgudin, Benjamin Medalion, Adam Tzagournis, Joseph Sabik, Soon J Park
BACKGROUND AND AIM: We examined the relationship between serum lactate and hemoglobin levels on renal function and postoperative outcome in low-risk elective coronary artery bypass graft (CABG) patients. METHODS: Intraoperative hemoglobin and lactate levels were measured in elective isolated CABG patients. Patients with renal dysfunction (baseline creatinine>2 mg/dL) were excluded. Multivariate logistic regression was used to determine associations between lactate, hemoglobin, and acute kidney injury (AKI)...
May 3, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29725383/therapeutic-effect-of-radiofrequency-ablation-on-children-with-supraventricular-tachycardia-and-the-risk-factors-for-postoperative-recurrence
#15
Chunli Li, Libo Jia, Zhenzhou Wang, Ling Niu, Xinjiang An
The present study investigated the therapeutic effect of radiofrequency ablation on children with supraventricular tachycardia (SVT), and explored the risk factors for postoperative recurrence. A total of 312 patients with pediatric SVT were selected in the Affiliated Children's Hospital of Xuzhou Medical University from April, 2011 to March, 2017. All the patients were subjected to radiofrequency ablation, and clinical data were retrospectively analyzed. Tilt table test was performed before and after treatment, and heart rate, systolic and diastolic blood pressure before and after treatment were compared...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29721000/association-between-preoperative-high-sensitive-troponin-i-levels-and-cardiovascular-events-after-hip-fracture-surgery-in-the-elderly
#16
Bum Sung Kim, Tae-Hoon Kim, Jeong-Hwan Oh, Chang Hee Kwon, Sung Hea Kim, Hyun-Joong Kim, Heung Kon Hwang, Sang-Man Chung
Objective: Cardiovascular complications contribute to postoperative morbidity and mortality in elderly hip fracture patients. Limited data are available regarding which preoperative risk factors predict cardiovascular course following hip fracture surgery (HFS). We used high sensitive troponin I (hs-TnI) assays and clinical parameters to identify preoperative risk factors associated with major adverse cardiac events (MACE) in elderly hip fracture patients. Method: From August 2014 to November 2016, 575 patients with hip fracture were enrolled in a retrospective, single-center registry...
March 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29720115/biomarker-enhanced-risk-prediction-for-development-of-aki-after-cardiac-surgery
#17
Michael L Merchant, Michael E Brier, Mark S Slaughter, Jon B Klein, Kenneth R McLeish
BACKGROUND: Acute kidney injury (AKI) is a common post-cardiac surgery complication and influences patient morbidity and prognosis. This study was designed to identify preoperative candidate urine biomarkers in patients undergoing cardiac surgery. METHODS: A prospective cohort study of adults undergoing cardiac surgery at increased risk for AKI at a single hospital between July 2010 and September 2012 was performed. The primary outcome was the development of AKI, defined as an absolute serum creatinine (SCr) level increase ≥ 0...
May 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29707309/prognostic-value-of-pre-transplant-mean-pulmonary-arterial-pressure-in-lung-transplant-recipients-a-single-institution-experience
#18
Chi Young Kim, Ji Eun Park, Ah Young Leem, Joo Han Song, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Joon Chang, Jin Gu Lee, Hyo Chae Paik, Moo Suk Park
Background: Currently, lung transplantation (LTX) is considered to be a curative treatment option in patients with end-stage lung disease. Although pulmonary hypertension (PH), confirmed by cardiac catheterization, is a prognostic factor in patients undergoing LTX, the prognostic value of PH in Asian lung transplant recipients remains uncertain. In this study, we aimed to determine whether PH before LTX may serve as a prognostic factor for survival in Asian patients. Methods: The medical records of 50 patients [male, 27; female, 23; mean age, 51...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29706372/preoperative-anemia-versus-blood-transfusion-which-is-the-culprit-for-worse-outcomes-in-cardiac-surgery
#19
Damien J LaPar, Robert B Hawkins, Timothy L McMurry, James M Isbell, Jeffrey B Rich, Alan M Speir, Mohammed A Quader, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Reducing blood product utilization after cardiac surgery has become a focus of perioperative care as studies have suggested improved outcomes. The relative impact of preoperative anemia versus packed red blood cells (PRBC) transfusion on outcomes remains poorly understood, however. In this study, we investigated the relative association between preoperative hematocrit (Hct) level and PRBC transfusion on postoperative outcomes after coronary artery bypass grafting (CABG) surgery...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29705369/essential-thrombocythemia-and-cardiac-surgery-a-case-series-and-review-of-the-literature
#20
Carmelina Gurrieri, Bradford B Smith, Gregory A Nuttall, Rajiv K Pruthi, Sameh M Said, Mark M Smith
BACKGROUND: Essential thrombocythemia (ET) is a rare myeloproliferative disorder characterized by an unexplained thrombocytosis (>450 x109 /L) and associated vasomotor, thrombotic and hemorrhagic manifestations. While the literature detailing the perioperative management of patients with ET undergoing cardiac surgery is sparse, major perioperative complications have been reported, particularly in poorly controlled patients presenting with platelet counts ≥800 x 109 /L. The purpose of this study was to provide the experience at a large tertiary medical center in managing patients with ET undergoing cardiac surgery, and to summarize the available literature...
April 26, 2018: Annals of Thoracic Surgery
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