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non-cardiac surgery

Osama Mosa, Milan Skitek, Ales Jerin
CONTEXT AND OBJECTIVE: Acute kidney injury (AKI) is still a headache for clinicians and scientists as a possible reason for increased death among intensive care unit (ICU) patients after invasive cardiac surgery. Furthermore, the diagnostic process for AKI using conventional biomarkers is not sufficient to ensure early warning of this condition because of the morbid influence of non-renal factors that definitively delay the time for the prognosis. These imposed limitations have led to significant amounts of research targeted towards identifying novel biomarkers for AKI with a sustained degree of sensitivity and specificity...
October 13, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
Martin Möckel, Julia Searle, Henning Thomas Baberg, Peter Dirschedl, Benny Levenson, Jürgen Malzahn, Thomas Mansky, Christian Günster, Elke Jeschke
OBJECTIVES: We aimed to analyse the short-term and long-term outcome of patients with end-stage renal disease (ESRD) undergoing percutaneous intervention (PCI) as compared to coronary artery bypass surgery (CABG) to evaluate the optimal coronary revascularisation strategy. DESIGN: Retrospective analysis of routine statutory health insurance data between 2010 and 2012. MAIN OUTCOME MEASURES: Primary outcome was adjusted all-cause mortality after 30 days and major adverse cardiovascular and cerebrovascular events at 1 year...
2016: Open Heart
Harmke Nijboer, Geert Lefeber, Alidair McLullich, Barbara van Munster
BACKGROUND: Haloperidol, frequently used for delirium, can lead to serious side effects, of which QTc prolongation is the most worrisome since it is associated with an increased risk of fatal cardiac arrhythmia. OBJECTIVES: The aim of this study was to measure the frequency of haloperidol use after procedures in patients aged ≥65 years in a hospital in the Netherlands. METHODS: This was a retrospective study among patients hospitalized in the Netherlands who were aged ≥65 years and who underwent a procedure between January 2008 and January 2009...
March 2016: Drugs—Real World Outcomes
Suvitesh Luthra, Miguel M Leiva Juárez, Eshan Senanayake, Heyman Luckraz, John S Billing, James Cotton, Michael S Norell
BACKGROUND: This retrospective propensity-matched study investigated the impact of prior percutaneous coronary intervention (PCI) on short-term and long-term survival after coronary artery bypass graft surgery (CABG). METHODS: A total of 4,634 patients underwent isolated first-time CABG between April 2004 and March 2014. Among these, 424 (9.2%) had PCI. Propensity score analysis yielded 1:1 risk-adjusted matched groups: PCI (330 patients) and non-PCI (330 patients)...
October 12, 2016: Annals of Thoracic Surgery
Junnan Zheng, Liangwei Chen, Linfeng Qian, Jianjie Jiang, Yinglian Chen, Jue Xie, Liping Shi, Yiming Ni, Haige Zhao
We aimed to evaluate whether blood conservation strategies including intraoperative autologous donation (IAD) could reduce perioperative blood transfusion for patients undergoing cardiac valve replacement including mitral valve replacement, aortic valve replacement (AVR), and double valve replacement (DVR).A total of 726 patients were studied over a 3-year period (2011-2013) after the implementation of IAD and were compared with 919 patients during the previous 36-month period (January 2008-December 2010). The method of small-volume retrograde autologous priming, strict blood transfusion standard together with IAD constituted a progressive blood-saving strategy...
October 2016: Medicine (Baltimore)
Anirban Som, Souvik Maitra, Sulagna Bhattacharjee, Dalim K Baidya
BACKGROUND AND AIMS: Optimum perioperative fluid administration may improve postoperative outcome after major surgery. This meta-analysis and systematic review has been aimed to determine the effect of dynamic goal directed fluid therapy (GDFT) on postoperative morbidity and mortality in non-cardiac surgical patients. MATERIAL AND METHODS: Meta-analysis of published prospective randomized controlled trials where GDFT based on non-invasive flow based hemodynamic measurement has been compared with a standard care...
October 13, 2016: Journal of Anesthesia
A Ollila, L Vikatmaa, J Virolainen, P Vikatmaa, A Leppäniemi, A Albäck, M Salmenperä, V Pettilä
BACKGROUND AND AIMS: Perioperative myocardial infarction is an underdiagnosed complication causing morbidity, mortality, and considerable costs. However, evidence of preventive and therapeutic options is scarce. We investigated the incidence and outcome of perioperative myocardial infarction in non-cardiac surgery patients in order to define a target population for future interventional trials. MATERIAL AND METHODS: We conducted a prospective single-center study on non-cardiac surgery patients aged 50 years or older...
October 13, 2016: Scandinavian Journal of Surgery: SJS
Newton B Wiggins, Daniel T Chong, Penny L Houghtaling, Ayman A Hussein, Walid Saliba, Joseph F Sabik, Oussama Wazni, Bruce L Wilkoff, Khaldoun G Tarakji
AIMS: The incidence, indications, and risk factors for cardiac implantable electronic device (CIED) implantation after cardiac surgery in an era with an aging population are not well described. There are limited data about the survival of these patients compared with a non-device group. We aimed to evaluate the incidence, indications, and risk factors for postoperative CIED implantation. We also assessed survival of these patients compared with a non-device group. METHODS: We included all patients without prior CIED implantation who underwent cardiac surgery at our institution from 1996 to 2008...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Javier A Valle, Laura Graham, Aerin DeRussy, Kamal Itani, Mary T Hawn, Thomas M Maddox
BACKGROUND: Triple therapy, or the use of anticoagulants with dual antiplatelet therapy (DAPT), is often used to protect against ischemic events in post-percutaneous coronary intervention (PCI) patients with indications for anticoagulation, but is associated with increased bleeding. As both ischemic and bleeding risks increase in the perioperative period, the impact of triple therapy may be especially pronounced in patients undergoing surgery. Outcomes in this population are currently unknown...
October 12, 2016: World Journal of Surgery
Kadri Murat Gurses, Fusun Ozmen, Duygu Kocyigit, Nilgun Yersal, Elif Bilgic, Erkan Kaya, Cagla Zubeyde Kopru, Tolga Soyal, Suat Doganci, Lale Tokgozoglu, Petek Korkusuz
BACKGROUND: Inflammatory activity originating from the epicardial adipose tissue (EAT) may have a role in coronary artery disease (CAD) pathogenesis. The relationship between macrophage infiltration, polarization in the EAT, and netrin-1 gene expression was investigated. METHODS: Macrophage infiltration and polarization were examined by immunohistochemical methods and expression levels of netrin-1, Unc5b, and cytokines related with M1-macrophage subtype (IL-12 and IL-18) were determined by quantitative polymerase chain reaction in subcutaneous and epicardial adipose tissue obtained from patients undergoing coronary artery bypass grafting and non-coronary cardiac surgery...
October 7, 2016: Journal of Cardiology
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Katsuyuki Hoshina, Kota Yamamoto, Tetsuro Miyata, Toshiaki Watanabe
BACKGROUND: Distal bypass is the first-line treatment for patients with critical limb ischemia (CLI). In Japanese high-volume centers, approximately half of these patients are on hemodialysis (HD). We have treated such patients first with bypass using a multidisciplinary perioperative strategy. We reveal the recent characteristics of patients who underwent distal bypass and the surgical outcomes in Japan, especially focusing on the foot conditions by using the wound, ischemia, and foot infection (WIfI) classification...
October 4, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Mariana Mirabel, Matthias Lachaud, Lucile Offredo, Cécile Lachaud, Benjamin Zuschmidt, Beatriz Ferreira, Daniel Sidi, Sylvain Chauvaud, Phang Sok, Alain Deloche, Eloi Marijon, Xavier Jouven
BACKGROUND: Access to cardiac surgery is limited in low-income settings, and data on patient outcomes are scarce. AIMS: To assess characteristics, surgical procedures and outcomes in patients undergoing open-heart surgery in low-income settings. METHODS: This was a cohort study (2001-2011) in two low-income countries, Cambodia and Mozambique, where cardiac surgery had been promoted by visiting non-governmental organizations. RESULTS: In Cambodia and Mozambique, respectively, 1332 and 767 consecutive patients were included; 547 (41...
October 3, 2016: Archives of Cardiovascular Diseases
Rikard Ambrus, Rune B Strandby, Niels H Secher, Kim Rünitz, Morten B S Svendsen, Lonnie G Petersen, Michael P Achiam, Lars B Svendsen
BACKGROUND: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig. METHODS: Splanchnic microcirculation was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI)...
October 6, 2016: BMC Anesthesiology
Cécile Aubron, Joris DePuydt, François Belon, Michael Bailey, Matthieu Schmidt, Jayne Sheldrake, Deirdre Murphy, Carlos Scheinkestel, D Jamie Cooper, Gilles Capellier, Vincent Pellegrino, David Pilcher, Zoe McQuilten
BACKGROUND: Bleeding is the most frequent complication associated with extracorporeal membrane oxygenation (ECMO) support in critically ill patients. Nonetheless, risk factors for bleeding have been poorly described especially those associated with coagulation anomalies and anticoagulant therapy during ECMO support. The aim of this study is to describe bleeding complications in critically ill patients undergoing ECMO and to identify risk factors for bleeding events. METHODS: We retrospectively analysed ICU charts of adults who received either veno-venous (VV) or veno-arterial (VA) ECMO support in two participating ICUs between 2010 and 2013...
December 2016: Annals of Intensive Care
Hyung Yoon Kim, Shin Yi Jang, Ju Ryoung Moon, Eun Kyoung Kim, Sung A Chang, Jinyoung Song, June Huh, I Seok Kang, Ji Hyuk Yang, Tae Gook Jun, Seung Woo Park
The objectives of this study were to assess the clinical outcomes of adults with Ebstein Anomaly (EA) according to their treatment modalities. All adult EA patients diagnosed between October 1994 and October 2014 were retrospectively evaluated by medical record review. Total 60 patients were categorized into 3 groups according to their treatment strategy, i.e. non-operative treatment (Group I, n = 23), immediate operative treatment (Group II, n = 27), and delayed operative treatment (Group III, n = 10). A composite of major adverse cardiac and cerebrovascular events (MACCE) and factors associated with MACCE were assessed in each treatment group...
November 2016: Journal of Korean Medical Science
Jose V Venero, Mark Doyle, Moneal Shah, Vikas K Rathi, June A Yamrozik, Ronald B Williams, Diane A Vido, Geetha Rayarao, Raymond Benza, Srinivas Murali, Jerry Glass, Peter Olson, George Sokos, Robert W W Biederman
BACKGROUND: Patients with newly diagnosed dilated cardiomyopathy (DCM) and advanced heart failure have a very high morbidity and mortality with an unpredictable clinical course. We investigated the role of cardiovascular magnetic resonance (CMR) imaging using late gadolinium enhancement (LGE) in this cohort of high-risk patients. We hypothesized that LGE has high prognostic value in primary DCM patients referred for possible transplantation/left ventricular assist device (LVAD) consideration...
December 2015: ESC Heart Failure
A I Macfarlane, D Rudd, E Knight, L A G Marshman, E P Guazzo, D S Anderson
: Prior studies have suggested that elevated serum Troponin-I (TnI) levels immediately after non-cardiac surgical procedures (8-40%) represent subclinical cardiac stress which independently predicts increased 30-day mortality. Routine post-operative TnI monitoring has therefore been suggested as a standard of care. However, no prior studies have focussed on elective degenerative spine surgery, whilst few have measured pre-op TnI. Further, prolonged prone positioning could represent an additional, independent, cardiac stress...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
September 29, 2016: Brazilian Journal of Physical Therapy
Henrique Palomba, Isac Castro, Luis Yu, Emmanuel A Burdmann
BACKGROUND: Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. METHODS: A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up...
October 4, 2016: Journal of Nephrology
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