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https://www.readbyqxmd.com/read/27922257/european-implementation-of-the-2014-esc-esa-guideline-on-non-cardiac-surgery-cardiovascular-assessment-and-management
#1
Lena Koers, Wolfgang S Schlack, Markus W Hollmann, Stefan DE Hert, Benedikt Preckel
BACKGROUND: Substandard implementation of a guideline is a major factor contributing to poor guideline adherence and has the potential to result in preventable patient harm. This study aims to quantify the uptake of the European guideline on non-cardiac surgery1,2 by European anaesthetists. METHODS: This is a questionnaire-based cross-sectional study. Data was collected during Euroanaesthesia, the annual congresses of the Dutch Society of Anaesthesiology, European Association of Cardiothoracic Anaesthesiologists and European Society for Regional Anaesthesia and Pain Therapy in 2015...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27918254/clinical-implications-of-mycobacterium-chimaera-detection-in-thermoregulatory-devices-used-for-extracorporeal-membrane-oxygenation-ecmo-germany-2015-to-2016
#2
Franziska C Trudzinski, Uwe Schlotthauer, Annegret Kamp, Kai Hennemann, Ralf M Muellenbach, Udo Reischl, Barbara Gärtner, Heinrike Wilkens, Robert Bals, Mathias Herrmann, Philipp M Lepper, Sören L Becker
Mycobacterium chimaera, a non-tuberculous mycobacterium, was recently identified as causative agent of deep-seated infections in patients who had previously undergone open-chest cardiac surgery. Outbreak investigations suggested an aerosol-borne pathogen transmission originating from water contained in heater-cooler units (HCUs) used during cardiac surgery. Similar thermoregulatory devices are used for extracorporeal membrane oxygenation (ECMO) and M. chimaera might also be detectable in ECMO treatment settings...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27914275/inter-observer-agreement-of-the-general-movements-assessment-with-infants-following-surgery
#3
Cathryn Crowle, Claire Galea, Catherine Morgan, Iona Novak, Karen Walker, Nadia Badawi
BACKGROUND: The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery. AIMS: The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population. STUDY DESIGN: Reliability and agreement study. SUBJECTS: This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#4
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903589/impact-of-left-atrial-appendage-closure-during-cardiac-surgery-on-the-occurrence-of-early-postoperative-atrial-fibrillation-stroke-and-mortality-a-propensity-score-matched-analysis-of-10-633-patients
#5
Rowlens M Melduni, Hartzell V Schaff, Hon-Chi Lee, Bernard J Gersh, Peter A Noseworthy, Kent R Bailey, Naser M Ammash, Stephen S Cha, Kaniz Fatema, Waldemar E Wysokinski, James B Seward, Douglas L Packer, Charanjit S Rihal, Samuel J Asirvatham
BACKGROUND: -Prophylactic exclusion of the left atrial appendage (LAA) is often performed during cardiac surgery ostensibly to reduce the risk of stroke. However, the clinical impact of LAA closure in humans remains inconclusive. METHODS: -Out of 10,633 adults who underwent CABG and/or valve surgery between January 2000 and December 2005, 9,792 patients with complete baseline characteristics, surgery procedure and follow-up data were included in this analysis. A propensity-score matching analysis based on 28 pretreatment covariates was performed and 461 matching pairs were derived and analyzed to estimate the association of LAA closure with early postoperative atrial fibrillation (POAF) (AF ≤30 days of surgery), ischemic stroke and mortality...
November 30, 2016: Circulation
https://www.readbyqxmd.com/read/27901332/safety-and-efficacy-of-non-continuous-echocardiographic-guided-pericardiocentesis-a-single-center-study-of-478-patients
#6
Ilaria Battistoni, Marco Marini, Luca Angelini, Matteo Francioni, Alberto Gili, Stefano Moretti, Carlo Costantini, Christian Corinaldesi, Marica Bordicchia, Gian P Perna
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis in Italy. The aim of the study was to evaluate safety and efficacy of pericardiocentesis, performed with non-continuous echocardiography monitoring. All the procedures performed at Department of Cardiovascular Disease, Ospedali Riuniti Ancona, from January 2001 to June 2013, were retrospectively analyzed to determine risks connected to the procedure and its success rate. Epidemiological data, procedure indications and etiology of the effusions were also recorded...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900414/-comment-on-dexmedetomidine-for-delirium-prophylaxis-in-elderly-patients-after-non-cardiac-surgery-in-the-intensive-care-unit
#7
J Van Waesberghe, A Eisert, M Coburn
No abstract text is available yet for this article.
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27893054/outcomes-and-temporal-trends-of-inpatient-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-cardiac-surgery-in-the-united-states
#8
Kashish Goel, Tanush Gupta, Dhaval Kolte, Sahil Khera, Gregg C Fonarow, Deepak L Bhatt, Mandeep Singh, Charanjit S Rihal
Importance: There are concerns whether percutaneous coronary intervention (PCI) at centers without on-site cardiac surgery is safe outside of a tightly regulated research environment. Objective: To analyze the outcomes and temporal trends of inpatient PCI at centers without on-site cardiac surgery in an unselected and nationally representative population of the United States. Design, Setting, and Participants: A national inpatient sample (N = 6 912 232) was used to identify patients who underwent inpatient PCI in the United States from January 1, 2003, to December 31, 2012...
November 23, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27888756/isolated-heart-transplant-and-combined-heart-liver-transplant-in-adult-congenital-heart-disease-patients-insights-from-the-united-network-of-organ-sharing
#9
Elisa A Bradley, Krong-On Pinyoluksana, Melissa Moore-Clingenpeel, Yongjie Miao, Curt Daniels
BACKGROUND/METHODS: The aging patient with severe congenital heart disease (CHD) faces many challenges: heart failure, arrhythmia, and in the Fontan patient, liver disease. Our goal was to define combined heart liver transplant (CHLT) and isolated orthotopic heart transplant (OHT) outcomes in U.S. adult CHD patients. The U.S. United Network for Organ Sharing (UNOS) thoracic and liver databases were queried for cardiac and CHD diagnoses, from inception-2014. RESULTS: In CHLT, CHD made up 22% of waitlist patients (non-CHD n=262 vs...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27882155/clinical-value-of-diagnosing-aortico-left-ventricular-tunnel-by-echocardiography
#10
Manying Xie, Jiabao Yin, Qing Lv, Jing Wang
In order to assess the clinical value of echocardiography in the diagnosis of aortico-left ventricular tunnel (ALVT) the echocardiographic data and clinical manifestations of six patients with ALVT were analyzed in the present study. Based on the results, a comprehensive study was conducted regarding 147 cases from related documents. Six patients were confirmed with ALVT by surgery. The echocardiographic images of the patients revealed an abnormal communication beginning in the ascending aorta above the coronary arteries, bypassing the aortic valve, and ending in the left ventricle...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27879647/neuroprotective-strategies-during-cardiac-surgery-with-cardiopulmonary-bypass
#11
REVIEW
Aida Salameh, Stefan Dhein, Ingo Dähnert, Norbert Klein
Aortocoronary bypass or valve surgery usually require cardiac arrest using cardioplegic solutions. Although, in principle, in a number of cases beating heart surgery (so-called off-pump technique) is possible, aortic or valve surgery or correction of congenital heart diseases mostly require cardiopulmonary arrest. During this condition, the heart-lung machine also named cardiopulmonary bypass (CPB) has to take over the circulation. It is noteworthy that the invention of a machine bypassing the heart and lungs enabled complex cardiac operations, but possible negative effects of the CPB on other organs, especially the brain, cannot be neglected...
November 21, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27878804/assessment-of-cardiovascular-risk-in-patients-undergoing-total-joint-alloplasty-the-crash-joint-study
#12
Pawel Legosz, Marcin Kotkowski, Anna E Platek, Pawel Maldyk, Bartosz Krzowski, Anna Rys, Karolina Semczuk, Filip M Szymanski, Krzysztof J Filipiak
BACKGROUND: Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopedic procedures, especially total joint alloplasty are major procedure associated with high perioperative risk, as well as one of the highest rates of complications. The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty. METHODS: The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27875729/-seesaw-balloon-wire-cutting-technique-is-superior-to-tornus-catheter-in-balloon-uncrossable-chronic-total-occlusions
#13
Jingyi Xue, Jianqiang Li, Hongjun Wang, Li Sheng, Yongtai Gong, Danghui Sun, Shuang Li, Weimin Li, Dingyu Wang, Yue Li
BACKGROUND: Inability to advance a balloon is a well-recognized cause leading to a failure in recanalization of chronic total occlusions (CTOs) despite successfully passing a guidewire. A few techniques and devices have been introduced to facilitate balloon passage, especially the use of Tornus catheter. However, complex manipulation, expensive cost, and availability limit the application of these methods. This study was to evaluate the efficiency and safety of "seesaw balloon-wire cutting" technique in comparison with Tornus catheter for balloon uncrossable CTOs...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27875636/evaluation-of-coronary-artery-disease-in-potential-liver-transplant-recipients
#14
REVIEW
Brian J Hogan, Enoka Gonsalkorala, Michael A Heneghan
Improvements in the management of patients undergoing Liver Transplantation (LT) have resulted in a significant increase in survival over recent years. Cardiac disease is now the leading cause of early mortality and the stress of major surgery, haemodynamic shifts, the possibility of haemorrhage or reperfusion syndrome require the recipient to have good baseline cardiac function. The prevalence of coronary artery disease (CAD) is increasing in liver transplant candidates, especially in those with Non-Alcohol related Fatty Liver Disease (NAFLD)...
November 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#15
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#16
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27867583/acute-respiratory-distress-syndrome-after-cardiac-surgery
#17
REVIEW
Lisa Q Rong, Antonino Di Franco, Mario Gaudino
Acute respiratory distress syndrome (ARDS) is a leading cause of postoperative respiratory failure, with a mortality rate approaching 40% in the general population and 80% in the subset of patients undergoing cardiac surgery. The increased risk of ARDS in these patients has traditionally been associated with the use of cardiopulmonary bypass (CPB), the need for blood product transfusions, large volume shifts, mechanical ventilation and direct surgical insult. Indeed, the impact of ARDS in the cardiac population is substantial, affecting not only survival but also in-hospital length of stay and long-term physical and psychological morbidity...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867455/diagnostic-accuracy-of-computed-tomography-angiography-as-compared-to-conventional-angiography-in-patients-undergoing-noncoronary-cardiac-surgery
#18
Hasit Joshi, Ronak Shah, Jayesh Prajapati, Vipin Bhangdiya, Jayal Shah, Yogini Kandre, Komal Shah
OBJECTIVE: To compare the diagnostic accuracy of multi-slice computed tomography (MSCT) angiography with conventional angiography in patients undergoing major noncoronary cardiac surgeries. MATERIALS AND METHODS: We studied fifty major noncoronary cardiac surgery patients scheduled for invasive coronary angiography, 29 (58%) female and 21 (42%) male. Inclusion criteria of the study were age of the patients ≥40 years, having low or intermediate probability of coronary artery disease (CAD), left ventricular ejection fraction (LVEF) >35%, and patient giving informed consent for undergoing MSCT and conventional coronary angiography...
July 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27862979/cerebral-tissue-oxygenation-index-and-lactate-at-24-hours-postoperative-predict-survival-and-neurodevelopmental-outcome-after-neonatal-cardiac-surgery
#19
Safwat A Aly, David Zurakowski, Penny Glass, Kami Skurow-Todd, Richard A Jonas, Mary T Donofrio
IMPORTANCE: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS). OBJECTIVE: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery...
November 10, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27862029/creatinine-neutrophil-gelatinase-associated-lipocalin-and-cystatin-c-in-determining-acute-kidney-injury-after-heart-operations-using-cardiopulmonary-bypass
#20
Jurij Matija Kališnik, Eva Hrovat, Alenka Hrastovec, Janez Žibert, Aleš Jerin, Milan Skitek, Giuseppe Santarpino, Tomislav Klokocovnik
Acute kidney injury (AKI) represents frequent complication after cardiac surgery using cardiopulmonary bypass (CPB). In the hope to enhance earlier more reliable characterization of AKI, we tested the utility of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) in addition to standard creatinine for early determination of AKI after cardiac surgery using CPB. Forty-one patients met the inclusion criteria. Arterial blood samples collected after induction of general anesthesia were used as baseline, further sampling occurred at CPB termination, 2 h after CPB, on the first and second day after surgery...
November 8, 2016: Artificial Organs
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