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Cardiac surgery. Thoracic surgery.

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https://www.readbyqxmd.com/read/29759739/aortic-valve-bypass-surgery-in-severe-aortic-valve-stenosis-insights-from-cardiac-and-brain-magnetic-resonance-imaging
#1
Cesare Mantini, Massimo Caulo, Daniele Marinelli, Piero Chiacchiaretta, Armando Tartaro, Antonio Raffaele Cotroneo, Gabriele Di Giammarco
OBJECTIVE: To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. METHODS: We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#2
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754790/aortic-clamping-strategy-and-postoperative-stroke
#3
Mohamad Alaeddine, Vinay Badhwar, Maria V Grau-Sepulveda, Lawrence M Wei, Chris C Cook, Michael E Halkos, Vinod H Thourani, Jeffrey P Jacobs, Roland Matsouaka, James Meza, Matthew Brennan, Thomas G Gleason, Danny Chu
OBJECTIVE: The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) technique does not increase incidence of postoperative stroke compared with single clamp (SC) technique for performing proximal coronary anastomoses. METHODS: We identified 52,611 patients who underwent on-pump CABG in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from July 1, 2014 to March 31, 2015...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#4
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29750933/regional-thoracic-surgery-quality-collaboration-formation-providence-thoracic-surgery-initiative
#5
John R Handy, Kimberly Costas, Robert McKenna, Steven Nisco, Raymond Schaerf, Kenton Stephens, Eric Vallières, Kasia Konieczny, Roshanthi Weerasinghe, Mansen Wang, Katherine Lothrop, Cathy Betzer
BACKGROUND: Surgery quality initiatives improve clinical outcomes in cardiac and general surgery. No mature thoracic surgery (TS) regional effort has been described. METHODS: An intramural grant funded the Thoracic Surgery Initiative (TSI). Using professional organization, site specific administrative and clinical databases, surgeons performing TS across a large western health system were identified. Participants were recruited through stakeholder surveys, personal contact and meetings...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29742784/-contra-is-postoperative-epidural-analgesia-the-gold-standard
#6
Hans Jürgen Gerbershagen
As strategy for postoperative pain therapy, epidural analgesia (EDA) is superior to systemic opiate analgesia after abdominal and thoracic surgery. In addition, EDA may significantly reduce the incidence of complications in some large operations, such as, e.g. cardiac (myocardial infarction, atrial fibrillation) and pulmonary complications (pneumonia, atelectasis), and even reduce mortality. Intestinal motility can also be improved. However, these positive effects do not appear in all interventions and not to the same degree...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29742783/-pro-epidural-analgesia-remains-the-gold-standard-for-abdominal-and-thoracic-surgery
#7
Hannah Listing, Daniel Pöpping
Pain relief with epidural analgesia is superior compared to systemic opioid analgesia after major abdominal and thoracic surgery. It remains a safe procedure, as long as it is embedded in a concept covering the whole perioperative period. This includes the knowledge of the anesthesiologist how to operate the process of catheter insertion as well as to treat complications like the hypotension, associated with the application of epidural local anesthetics. A close postoperative monitoring by an acute pain service team is a responsible task and should be available 24/7...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29741482/mortality-risk-after-transcatheter-aortic-valve-implantation-analysis-of-the-predictive-accuracy-of-the-transcatheter-valve-therapy-registry-risk-assessment-model
#8
Pablo Codner, Waqas Malick, Remi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Uri Landes, Torsten Peter Vahl, Isaac George, Tamim Nazif, Ajay J Kirtane, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali
AIMS: Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. METHODS AND RESULTS: Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29738368/anti-apoptotic-effect-of-%C3%AE-1-blockers-in-ascending-thoracic-aortic-smooth-muscle-cells-the-role-of-hsp70-expression
#9
Ioannis K Rizos, James N Tsoporis, Ioannis K Toumpoulis, Vasileios Salpeas, Shehla Izhar, Angelos G Rigopoulos, Eleftherios A Sakadakis, Thomas G Parker
Heat shock proteins (HSP) play an important role in the cellular adaptation to stress, a requisite for cell survival. The aortic wall appears to be a target for increased expression of HSP during surgical stress. We aimed to define the expression and function of aortic HSP70 in 31 patients with normal ascending thoracic aortic diameter who underwent aortic valve replacement due to aortic valve stenosis (AVS) and in 35 patients with dilated ascending thoracic aorta who underwent replacement of an ascending thoracic aortic aneurysm (ATAA)...
May 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29730345/hemiarch-reconstruction-vs-clamped-aortic-anastomosis-for-concomitant-ascending-aortic-aneurysm
#10
Ibrahim Sultan, Valentino Bianco, Ibrahim Yajzi, Arman Kilic, Keith Dufendach, Arturo Cardounel, Andrew D Althouse, Ahmad Masri, Forozan Navid, Thomas G Gleason
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is often avoided in patients with concomitant ascending aortic pathology when treating other cardiac disease to avoid increased risk of morbidity and mortality. We hypothesized that the use of DHCA with retrograde cerebral perfusion (RCP) does not add incremental risk to ascending aortic replacement alone in the setting of concomitant cardiac surgery. METHODS: 408 ascending aortic ± hemiarch replacements and aortic (root)/mitral/tricuspid valve(s), CABG, or MAZE procedures were performed for concomitant cardiac disease...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29729016/revision-thoracic-slide-tracheoplasty-outcomes-following-unsuccessful-tracheal-reconstruction
#11
Douglas R Sidell, Catherine K Hart, Meredith E Tabangin, Roosevelt Bryant, Michael J Rutter, Peter B Manning, Jareen Meinzen-Derr, Karthik Balakrishnan, Christina Yang, Alessandro de Alarcon
OBJECTIVES/HYPOTHESIS: Over the past decade, thoracic slide tracheoplasty (TST) has become the principal operation in the management of congenital tracheal stenosis. The purpose of this report was to describe our experience with revision TST following unsuccessful prior tracheal reconstruction. STUDY DESIGN: Retrospective analysis at an academic children's hospital. METHODS: Patients undergoing TST on cardiopulmonary bypass between January 2005 and May 2014 were reviewed...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29714043/vasomotion-as-an-oscillatory-sign-of-functional-impairment-in-the-human-internal-thoracic-artery-a-study-based-on-risk-factors-and-vessel-reactivity
#12
Diogo A Fonseca, Pedro E Antunes, Manuel J Antunes, Maria Dulce Cotrim
NEW FINDINGS: What is the central question of this study? Vasomotion has been viewed as a rhythmic oscillation of the vascular tone that is physiologically important for optimal tissue perfusion. Also, it has been primarily studied in the microcirculation. However, the precise underlying mechanisms and the physiological significance remain unknown. What is the main finding and its importance? Vasomotion is not specific of the microcirculation, as shown by our findings. In human arteries from patients undergoing cardiac surgery, an increased incidence was associated with endothelial dysfunction settings...
April 30, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29706810/novel-renal-biomarker-evaluation-for-early-detection-of-acute-kidney-injury-after-transcatheter-aortic-valve-implantation
#13
Mani Arsalan, Ethan Ungchusri, Robert Farkas, Melissa Johnson, Rebeca J Kim, Giovanni Filardo, Benjamin D Pollock, Molly Szerlip, Michael J Mack, Elizabeth M Holper
Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated with increased morbidity and mortality. The biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are predictive of AKI after cardiac surgery, but there is little data regarding these biomarkers after TAVI. We evaluated the associations between NGAL, KIM-1, and IL-18 levels and the incidence and severity of AKI and changes in serum creatinine after TAVI...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29706372/preoperative-anemia-versus-blood-transfusion-which-is-the-culprit-for-worse-outcomes-in-cardiac-surgery
#14
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/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#15
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#16
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#17
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697598/a-phase-1-study-of-a-novel-bidirectional-perfusion-cannula-in-patients-undergoing-femoral-cannulation-for-cardiac-surgery
#18
Silvana F Marasco, Elli Tutungi, Shirley A Vallance, Andrew A Udy, Justin C Negri, Adam D Zimmet, David C McGiffin, Vincent A Pellegrino, Randall A Moshinsky
OBJECTIVE: Leg ischemia is a serious complication of femoral artery cannulation. The primary aim of this study was to assess the safety and efficacy of a novel bidirectional femoral arterial cannula (Sorin Group USA, a wholly owned subsidiary of LivaNova PLC, Arvada, CO USA) that provides both antegrade and retrograde flow, in patients undergoing peripheral cannulation for cardiopulmonary bypass during cardiac surgery. METHODS: Patients undergoing routine cardiac surgery requiring femoral artery cannulation for cardiopulmonary bypass were identified preoperatively...
April 24, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29691573/apelin-in-the-hypothalamic-paraventricular-nucleus-improves-cardiac-function-in-surgical-trauma-rats
#19
Huan-Huan Zhang, Ya-Jing Wang, Chao Zheng, Meng-Ya Wang, Da-Nian Zhu
Apelin is a novel endogenous active peptide. The aim of this study is to investigate whether apelin in the paraventricular nucleus (PVN) can improve the cardiac function in rats subjected to thoracic surgery trauma, and whether it is involved in the protective effect of electro-acupuncture (EA). Sprague-Dawley rats were randomly divided into non-stressed group (control), thoracic surgical trauma stressed group (trauma) and bilateral Neiguan EA applied on thoracic surgical trauma stressed group (trauma + EA-PC 6)...
April 25, 2018: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/29689239/unmatched-integrated-cardiothoracic-surgery-program-applicants-where-do-they-end-up
#20
Trevor A Davis, Stephen C Yang
BACKGROUND: With the recent introduction of Integrated Cardiothoracic Surgery Residency Programs (IPs), limited data exists on unmatched applicants. We aimed to determine the dropout rate in individuals who applied IP but did not match. METHODS: An online IRB-approved survey was sent to current residents (n=409), provided by the Thoracic Surgery Directors Association, to evaluate preferences and pathway to Cardiothoracic Surgery (CTS). Descriptive analysis was performed on quantitative data...
April 21, 2018: Annals of Thoracic Surgery
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