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Cardiac surgery. Thoracic surgery.

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https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#1
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28314530/objective-analysis-of-midterm-outcomes-of-conventional-and-hybrid-aortic-arch-repair-by-propensity-score-matching
#2
Arudo Hiraoka, Genta Chikazawa, Toshinori Totsugawa, Kentaro Tamura, Atsuhisa Ishida, Taichi Sakaguchi, Hidenori Yoshitaka
OBJECTIVE: The aim of this study is to evaluate the objective outcomes of conventional total aortic arch repair (CTAR) and hybrid arch repair by using propensity-score matching to reduce selection bias. METHODS: Between January 2006 and April 2016, 470 consecutive patients underwent isolated aortic arch repair (excluding hemiarch or partial arch reconstruction, and cases with concomitant cardiac surgeries) at a single cardiovascular institute. We categorized 337 total aortic arch repair with antegrade cerebral perfusion under circulatory arrest as the CTAR group and 58 hybrid aortic arch repair (HAR) with thoracic endovascular aortic repair as the HAR group...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#3
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28292748/unwarranted-variation-in-the-quality-of-care-for-patients-with-diseases-of-the-thoracic-aorta
#4
Alex Bottle, Giovanni Mariscalco, Matthew A Shaw, Umberto Benedetto, Athanasios Saratzis, Silvia Mariani, Mohamad Bashir, Paul Aylin, David Jenkins, Aung Y Oo, Gavin J Murphy
BACKGROUND: Thoracic aortic disease has a high mortality. We sought to establish the contribution of unwarranted variation in care to regional differences in outcomes observed in patients with thoracic aortic disease in England. METHODS AND RESULTS: Data from the Hospital Episode Statistics (HES) and the National Adult Cardiac Surgery Audit (NACSA) were extracted. A parallel systematic review/meta-analysis through December 2015, and structure and process questionnaire of English cardiac surgery units were also accomplished...
March 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28275064/obesity-increases-risk-adjusted-morbidity-mortality-and-cost-following-cardiac-surgery
#5
Ravi K Ghanta, Damien J LaPar, Qianzi Zhang, Vishal Devarkonda, James M Isbell, Leora T Yarboro, John A Kern, Irving L Kron, Alan M Speir, Clifford E Fonner, Gorav Ailawadi
BACKGROUND: Despite the epidemic rise in obesity, few studies have evaluated the effect of obesity on cost following cardiac surgery. We hypothesized that increasing body mass index (BMI) is associated with worse risk-adjusted outcomes and higher cost. METHODS AND RESULTS: Medical records for 13 637 consecutive patients who underwent coronary artery bypass grafting (9702), aortic (1535) or mitral (837) valve surgery, and combined valve-coronary artery bypass grafting (1663) procedures were extracted from a regional Society of Thoracic Surgeons certified database...
March 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28262296/duration-of-mechanical-ventilation-and-perioperative-care-quality-after-neonatal-cardiac-operations
#6
Joshua J Blinder, Ravi Thiagarajan, Kathryn Williams, Meena Nathan, John Mayer, Thomas J Kulik
BACKGROUND: This study was conducted to determine whether the duration of mechanical ventilation (DOMV) could be used to benchmark the overall quality of care after neonatal congenital heart operations. METHODS: Children aged younger than 30 days undergoing cardiac operations were reviewed. Technical adequacy was assessed using the Technical Performance Score (TPS), a previously validated tool for determining the adequacy of a palliative or corrective surgical procedure that uses echocardiography criteria and need for unplanned reintervention to determine technical adequacy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#7
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28239802/anesthetic-management-of-patients-with-dilated-cardiomyopathy-for-noncardiac-surgery
#9
C-Q Chen, X Wang, J Zhang, S-M Zhu
Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesia considerations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28238200/left-cardiac-sympathetic-denervation-case-series-and-technical-report
#10
C McNamara, P Cullen, M Rackauskas, R Kelly, K E O'Sullivan, J Galvin, D Eaton
BACKGROUND: Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay...
February 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28224448/comparison-of-esc-and-acc-aha-guidelines-for-myocardial-revascularization
#11
Jim Stirrup, Alejandro Velasco, Fadi G Hage, Eliana Reyes
In 2014, the Task Force on Myocardial Revascularization of the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery with the special contribution of the European Association of Percutaneous Cardiovascular Interventions published a comprehensive set of recommendations on myocardial revascularization in patients presenting with acute or chronic coronary artery disease. In the United States, pertinent guidance on this topic has been published by the American College of Cardiology, American Heart Association and other relevant societies in multiple guideline documents that have been published in recent years...
February 21, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28219544/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2017-update-on-outcomes-and-quality
#12
Jeffrey P Jacobs, John E Mayer, Constantine Mavroudis, Sean M O'Brien, Erle H Austin, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, Tara Karamlou, Christian Pizarro, Jennifer C Hirsch-Romano, Donna McDonald, Jane M Han, Susan Becker, Christo I Tchervenkov, Francois Lacour-Gayet, Carl L Backer, Charles D Fraser, James S Tweddell, Martin J Elliott, Hal Walters, Richard A Jonas, Richard L Prager, David M Shahian, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This report summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219541/retraction-notice-to-six-different-hemofiltration-devices-for-blood-conservation-in-cardiac-surgery-ann-thorac-surg-1991-51-5-747-753
#13
J Boldt, B Zickmann, B Fedderson, C Herold, F Dapper, G Hempelmann
No abstract text is available yet for this article.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#14
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#15
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190549/comparing-del-nido-and-conventional-cardioplegia-in-infants-and-neonates-in-congenital-heart-surgery
#16
Kamal K Pourmoghadam, Mark Ruzmetov, Michael C O'Brien, Kurt D Piggott, Gary Plancher, Sukumar Suguna Narasimhulu, Tavya Benjamin, William M Decampli
BACKGROUND: The aim of this study was to evaluate outcome measures after the use of del Nido (dN) cardioplegia compared with conventional multidose high-potassium (non-dN) cardioplegia in neonates and infants. METHODS: We retrospectively analyzed data in patients, aged younger than 1 year, undergoing cardiopulmonary bypass (CPB) from January 2012 to August 2015. We changed our cardioplegia protocol from non-dN to dN administered in a single or infrequently dosed strategy in September 2013...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28174394/-past-present-and-future-of-national-clinical-database
#17
Tadashi Iwanaka
The National Clinical Database of Japan( NCD) was established in April 2010 in the collaboration of 9 surgical subspecialty societies on the platform of the Japan Surgical Society(JSS). Registrations began in 2011, and because NCD is strongly linked to the board certification system by JSS, the ratio of registration of surgical procedures is very high, over than 97%. To date, more than 4,000 facilities have enrolled and over 7 million cases were registered over a 5-year period. The analyses of NCD are compared to the foreign database, such as American College of Surgeon National Surgical Quality Improvement Program in the gastrointestinal (GI) surgical field, and the Society of Thoracic Surgeons National Adult Cardiac Database in the cardiovascular surgical field, with a goal of creating a standardized surgery database for quality improvement...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#18
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149811/usefulness-of-cbct-and-guidance-software-for-percutaneous-embolization-of-a-lymphatic-leakage-after-thyroidectomy-for-cancer
#19
Anna Maria Ierardi, Vincenzo Pappalardo, Xiaoli Liu, Che-Wei Wu, Angkoon Anuwong, Hoon Yub Kim, Renbin Liu, Matteo Lavazza, Davide Inversini, Andrea Coppola, Chiara Floridi, Luigi Boni, Gianpaolo Carrafiello, Gianlorenzo Dionigi
Lymphatic leakage can develop as an iatrogenic complication of thoracic, cardiac, and neck surgery. The management of this complication may be challenging and involves more specialists. Percutaneous, image-guided techniques may offer two advantages: mini-invasivity and ability to image and identify the anatomy and the site of the leakage. We report a case of refractory cervical chylous leakage after thyroidectomy and lymphadenectomy for cancer that was successfully treated with an ultrasound-guided intranodal lymphangiography and a percutaneous puncture of the leak performed using CBCT as imaging guidance...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28148324/training-in-paediatric-cardiac-surgery-and-the-american-board-of-thoracic-surgery
#20
Edward L Bove
Congenital heart surgery has evolved into its own specialty requiring unique techniques and skills. Recognizing the need to establish a special certification in congenital heart surgery, the American Board of Thoracic Surgery began the process in 2005, eventually granting the first certifications to qualified applicants in 2009. The American Council for Graduate Medical Education and the Thoracic Surgery Residency Review Committee have now approved specific training programs throughout the United States that will help to ensure the proper training of congenital heart surgeons for the future...
December 2016: Cardiology in the Young
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