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preoperative cardiac risk

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https://www.readbyqxmd.com/read/28218213/surgical-treatment-of-double-outlet-right-ventricle-complicated-by-pulmonary-hypertension
#1
Qing-Yu Wu, Dong-Hai Li, Hong-Yin Li, Ming-Kui Zhang, Zhong-Hua Xu, Hui Xue
BACKGROUND: Double outlet right ventricle (DORV) is a group of complex congenital heart abnormalities. Preoperative pulmonary hypertension (PH) is considered an important risk factor for early death during the surgical treatment of DORV. The aim of this study was to report our experience on surgical treatment of DORV complicated by PH. METHODS: From June 2004 to November 2016, 61 patients (36 males and 25 females) aged 2 weeks to 26 years (median: 0.67 years and interquartile range: 0...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28218210/optimal-timing-of-surgical-revascularization-for-myocardial-infarction-and-left-ventricular-dysfunction
#2
Rong Wang, Nan Cheng, Cang-Song Xiao, Yang Wu, Xiao-Yong Sai, Zhi-Yun Gong, Yao Wang, Chang-Qing Gao
BACKGROUND: The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results. METHODS: From January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#3
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28215312/prevalence-of-clinical-thiamine-deficiency-in-individuals-with-medically-complicated-obesity
#4
Anand Nath, Tung Tran, Timothy R Shope, Timothy R Koch
Thiamine is a vitamin whose deficient can result in multiorgan symptoms. We described an 18% prevalence of clinical thiamine deficiency after gastric bypass surgery. Our hypotheses are that individuals with medically complicated obesity frequently have clinical thiamine deficiency and that diabetes mellitus is a mechanism for development of clinical thiamine deficiency. This is a single institution, retrospective observational study of consecutive patients with a body mass index of at least 35 kg/m(2) who were evaluated in preoperative gastrointestinal bariatric clinic from 2013 to 2015...
January 2017: Nutrition Research
https://www.readbyqxmd.com/read/28207437/lack-of-association-between-preoperative-statin-use-and-respiratory-and-neurologic-complications-after-cardiac-surgery
#5
Ryu Komatsu, Huseyin Oguz Yilmaz, Jing You, C Allen Bashour, Shobana Rajan, Edward G Soltesz, Daniel I Sessler, Alparslan Turan
BACKGROUND: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. METHODS: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions...
February 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#6
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28197280/predictors-of-permanent-pacemaker-implantation-after-coronary-artery-bypass-grafting-and-valve-surgery-in-adult-patients-in-current-surgical-era
#7
Bandar Al-Ghamdi, Yaseen Mallawi, Azam Shafquat, Alexandra Ledesma, Nadiah AlRuwaili, Mohamed Shoukri, Shahid Khan, Aly Al Sanei
BACKGROUND: Permanent pacemaker (PPM) implantation after cardiac surgery is required in 0.4-6% of patients depending on cardiac surgery type. PPM implantation in the early postoperative period may reduce morbidity and postoperative hospital stay. We performed a retrospective review of electronic medical records of adult patients with coronary artery bypass grafting (CABG), valve surgery, or both, over a 3-year period. Our aim was to identify predictors of PPM requirements and PPM dependency on follow-up in the current surgical era...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194489/the-effect-of-preoperative-anemia-on-the-outcome-after-coronary-surgery
#8
Tuomas Tauriainen, Joni Koski-Vähälä, Eeva-Maija Kinnunen, Fausto Biancari
BACKGROUND: Preoperative anemia is associated with increased morbidity and mortality after cardiac surgery. Since anemia is ultimately treated with red blood cell transfusions, we investigated the independent impact of anemia and transfusion on the outcome after coronary artery bypass grafting (CABG). METHODS: This study included 2761 consecutive patients who underwent isolated CABG. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men...
February 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#9
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28183564/the-effect-of-tramadol-plus-paracetamol-on-consumption-of-morphine-after-coronary-artery-bypass-grafting
#10
Dilek Altun, Özlem Çınar, Emre Özker, Ayda Türköz
STUDY OF OBJECTIVE: To compare the effects of oral tramadol+paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol. DESIGN: A prospective, double-blind, randomized, clinical study. SETTING: Single-institution, tertiary hospital. PATIENTS: Fifty cardiac surgical patients undergoing primary CABG surgery. INTERVENTIONS: After surgery, the patients were allocated to 1 of 2 groups...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28180098/analysis-of-risk-factors-for-conversion-from-off-pump-to-on-pump-coronary-artery-bypass-graft
#11
Junghyeon Lim, Won Yong Lee, Yong Joon Ra, Jae Han Jeong, Ho Hyun Ko
BACKGROUND: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. METHODS: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group)...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28174166/early-rehospitalization-after-prolonged-intensive-care-unit-stay-post-cardiac-surgery-outcomes-and-modifiable-risk-factors
#12
Rizwan A Manji, Rakesh C Arora, Rohit K Singal, Brett M Hiebert, Alan H Menkis
BACKGROUND: Prolonged intensive care unit length of stay (prICULOS) following cardiac surgery (CS) in older adults is increasingly common but rehospitalization characteristics and outcomes are understudied. We sought to describe the rehospitalization characteristics and subsequent non-institutionalized survival of prICULOS (ICULOS ≥5 days) patients and identify modifiable risk factors to decrease 30-day rehospitalization. METHODS AND RESULTS: Consecutive patients from January 1, 2000 to December 31, 2011 were analyzed utilizing linked clinical and administrative databases...
February 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28167877/hypoalbuminemia-is-a-better-predictor-than-obesity-of-complications-after-total-knee-arthroplasty-a-propensity-score-adjusted-observational-analysis
#13
Michael C Fu, Alexander S McLawhorn, Douglas E Padgett, Michael B Cross
BACKGROUND: Obesity is an established risk factor for complications after total knee arthroplasty (TKA) and is often associated with malnutrition. QUESTIONS/PURPOSES: 1. What is the prevalence of hypoalbuminemia in obese patients undergoing TKA? 2. What is the independent morbidity risk of malnutrition relative to obesity? METHODS: TKA cases were identified from the National Surgical Quality Improvement Program from 2005 to 2013. Propensity scores for having preoperative albumin measurements were calculated using demographics, BMI, and modified Charlson Comorbidity Index (CCI)...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28164120/coronary-computed-tomography-angiography-in-combination-with-coronary-artery-calcium-scoring-for-the-preoperative-cardiac-evaluation-of-liver-transplant-recipients
#14
REVIEW
Jae Moon Choi, Yu-Gyeong Kong, Joon-Won Kang, Young-Kug Kim
Liver transplantation is the best treatment option for early-stage hepatocellular carcinoma, liver cirrhosis, fulminant liver failure, and end-stage liver diseases. Even though advances in surgical techniques and perioperative care have improved postoperative outcomes, perioperative cardiovascular complications are a leading cause of postoperative morbidity and mortality following liver transplantation. Ischemic coronary artery disease (CAD) and cardiomyopathy are the most common cardiovascular diseases and could be negative predictors of postoperative outcomes in liver transplant recipients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28154006/sudden-cardiac-death-in-patients-with-ischemic-heart-failure-undergoing-coronary-artery-bypass-grafting-results-from-the-surgical-treatment-for-ischemic-heart-failure-stich-randomized-clinical-trial
#15
Meena P Rao, Sana M Al-Khatib, Sean Pokorney, Lilin She, Alexander Romanov, Jose C Nicolau, Kerry L Lee, Peter E Carson, Craig H Selzman, Janina Stepinska, John G F Cleland, Wiwun Tungsubutra, Patrice M Desvigne-Nickens, Carla Sueta, Matthias Siepe, Irene M Lang, Arthur M Feldman, Michael Yii, Jean L Rouleau, Eric J Velazquez
BACKGROUND: -The risk of sudden cardiac death (SCD) in patients with heart failure following CABG has not been examined in a contemporary clinical trial of surgical revascularization. This analysis describes the incidence, timing and clinical predictors of SCD after CABG. METHODS: -Patients enrolled in the Surgical Treatment of Ischemic Heart Failure (STICH) trial who underwent CABG with or without surgical ventricular reconstruction (SVR) were included. We excluded patients with prior ICD and those randomized only to medical therapy...
February 2, 2017: Circulation
https://www.readbyqxmd.com/read/28151800/comparative-effectiveness-and-risks-of-bowel-preparation-before-elective-colorectal-surgery
#16
Sarah E Koller, Katherine W Bauer, Brian L Egleston, Radhika Smith, Matthew M Philp, Howard M Ross, Nestor F Esnaola
OBJECTIVE: The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND: SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of preoperative bowel preparation to prevent SSI remains controversial. METHODS: We analyzed 32,359 patients who underwent elective colorectal resections in the American College of Surgeons National Surgery Quality Improvement Program database from 2012 to 2014...
February 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28147435/developing-models-to-predict-early-postoperative-patient-deterioration-and-adverse-events
#17
Mitchell K Petersen Tym, Guy L Ludbrook, Arthas Flabouris, Richard Seglenieks, Thomas W Painter
BACKGROUND: Accurate identification of patients at risk of early postoperative deterioration allows needs-based allocation of patients to appropriate levels of care. This study aimed to record the incidence of early postoperative deterioration and identify factors predictive of at-risk patients. Doing so may assist future evidence-based perioperative planning and allocation of patients to high-acuity facilities. METHODS: With ethical approval, data from elective non-cardiac surgical patients were collected between May and August 2013...
February 1, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#18
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28134286/risk-factors-of-acute-kidney-injury-after-orthotopic-liver-transplantation-in-china
#19
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49...
January 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#20
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
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