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Cardiac surgery. Thoracic surgery.

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https://www.readbyqxmd.com/read/29329802/can-use-of-an-administrative-database-improve-accuracy-of-hospital-reported-readmission-rates
#1
James R Edgerton, Morley A Herbert, Baron L Hamman, W Steves Ring
OBJECTIVES: Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29325843/preoperative-intra-aortic-counterpulsation-in-cardiac-surgery-insights-from-a-retrospective-series-of-588-consecutive-high-risk-patients
#2
Giuseppe Gatti, Laura Morra, Gianluca Castaldi, Luca Maschietto, Florida Gripshi, Enrico Fabris, Andrea Perkan, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: To support a rational use of preoperative intra-aortic balloon pump (IABP) in cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single university hospital. PARTICIPANTS: The study included 588 (mean age 68.5 ± 9.6 yr) consecutive patients who received IABP before cardiac surgery from 1999 to 2016. INTERVENTIONS: Coronary surgery was performed in 573 (97.4%) cases...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29321443/a-new-arena-in-cardiac-surgery-pediatric-coronary-artery-bypass-surgery
#3
Soichiro Kitamura
Prior to the 1970s, pediatric coronary artery bypass surgery (PCABS) was seldomly performed due to the lack of compelling surgical indications. The advent of coronary sequelae secondary to Kawasaki disease (KD) and the occurrence of coronary artery complications due to newly developed procedures, such as the arterial switch operation and early repair for intrinsic congenital coronary malformations, necessitated the development of PCABS. Because children grow rapidly and their life expectancy is very long, with increasing exercise capability requirements, the strategy for PCABS should differ from that for bypass surgery in adults...
2018: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
https://www.readbyqxmd.com/read/29317589/successful-treatment-in-a-patient-with-sudden-cardiac-arrest-due-to-anomalous-left-coronary-artery-arising-from-pulmonary-artery
#4
Liping Zhou, Xiaogang Li, Min Qi, Aimin Wang
To enhance the understanding of the left coronary artery originating from the pulmonary artery, we report a case of sudden cardiac arrest during exercise. After successful cardiopulmonary resuscitation, the patient underwent echocardiography and selective coronary angiography, and the disease was firmly diagnosed. Consequently, a thoracic surgery was performed. During the operation, the left coronary artery was transplanted to the root of the aorta and the pulmonary valve and artery were reconstructed. Finally, the surgery was successful...
December 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29315152/impact-of-surgeon-self-evaluation-and-positive-deviance-on-postoperative-adverse-events-after-non-cardiac-thoracic-surgery
#5
Jelena Ivanovic, Fargol Mostofian, Caitlin Anstee, Sebastien Gilbert, Donna E Maziak, Farid M Shamji, Ramanadhan Sudhir Sundaresan, Patrick James Villeneuve, Andrew J E Seely
As an innovative approach to improve quality of surgical care, we combined surgeon self-assessment and anonymized peer comparison with continuous quality improvement seminars using positive deviance (CQI/PD) to identify surgeon(s) with the lowest rates of adverse events (AEs) to guide group practice recommendations. Our objective was to quantify the impact these interventions on postoperative AEs rates after major non-cardiac chest operations. All postoperative AEs after all thoracic operations (n = 1,084, March, 2013 to February, 2016, single-center) were prospectively collected using the thoracic morbidity and mortality system, based on Clavien-Dindo schema...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29312737/perforation-of-myocardial-wall-and-great-vessels-after-cardiovascular-interventions-a-5-year-analysis
#6
Zdenek Provaznik, Andreas Holzamer, Daniele Camboni, Leopold Rupprecht, Markus Resch, Sigrid Wittmann, Christof Schmid, Bernhard Floerchinger
Background: Less invasive procedures have replaced open surgical treatment in many cardiovascular disorders. During these interventions, iatrogenic cardiac perforation may ensue, which is a severe complication and requires immediate diagnostic assessment and treatment. Methods: From March 2011 to April 2016, all patients referred to the Dept. of Cardio-thoracic Surgery with the diagnosis of iatrogenic perforation of myocardial wall or great vessels were included into the retrospective study...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29303608/histidine-metabolism-after-bretschneider-cardioplegia-in-cardiac-surgical-patients
#7
J K Teloh, L Ansorge, M Petersen, E Demircioglu, I N Waack, S Brauckmann, H Jakob, D-S Dohle
Bretschneider (histidine-tryptophan-ketoglutarate) solution with its high histidine concentration (198 mM) is one of many cardioplegic solutions, which are routinely used for cardiac arrest. The aim of this study was to evaluate the physiological biochemical degradation of administered histidine to histamine and its major urinary metabolite N methylimidazole acetic acid. A total number of thirteen consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in the prospective observational designed study at the Department of Thoracic and Cardiovascular Surgery between 04/2016 and 06/2016...
January 5, 2018: Physiological Research
https://www.readbyqxmd.com/read/29289988/rerouting-the-internal-thoracic-pedicle-a-novel-solution-for-maxillofacial-reconstruction-in-vessel-depleted-situations-a-preliminary-anatomic-study
#8
François Morel, Frédéric Crampon, Jérôme Adnot, Pierre-Yves Litzler, Fabrice Duparc, Olivier Trost
PURPOSE: Microsurgical reconstruction in a vessel-depleted neck is a challenge due to the lack of reliable vessels in or nearby the host site. The use of the internal thoracic pedicle (ITP) by rib section or sparring is a limited option due to the small length of the pedicle of some flaps. However, in cardiac surgery, the internal thoracic artery (ITA) is widely used for myocardial revascularization, providing a long and versatile pedicle. We aimed at determining precise anatomical bases for the use of the ITP, approached by sternotomy and rerouted in the neck, as recipient vessels for free-flap facial reconstructions...
December 30, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29284509/should-high-risk-patients-with-concomitant-severe-aortic-stenosis-and-mitral-valve-disease-undergo-double-valve-surgery-in-the-tavr-era
#9
Pey-Jen Yu, Allan Mattia, Hugh A Cassiere, Rick Esposito, Frank Manetta, Nina Kohn, Alan R Hartman
BACKGROUND: Significant mitral regurgitation in patients undergoing transcatheter aortic valve replacement (TAVR) is associated with increased mortality. The aim of this study is to determine if surgical correction of both aortic and mitral valves in high risk patients with concomitant valvular disease would offer patients better outcomes than TAVR alone. METHODS: A retrospective analysis of 43 high-risk patients who underwent concomitant surgical aortic valve replacement and mitral valve surgery from 2008 to 2012 was performed...
December 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#10
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29248284/cost-of-individual-complications-following-coronary-artery-bypass-grafting
#11
J Hunter Mehaffey, Robert B Hawkins, Matthew Byler, Eric J Charles, Clifford Fonner, Irving Kron, Mohammed Quader, Alan Speir, Jeff Rich, Gorav Ailawadi
OBJECTIVE: The financial implications of postoperative complications in cardiac surgery remain poorly understood. The purpose of this study was to define the cost of surgery without complications and demonstrate the incremental cost of each complication. METHODS: All patients undergoing isolated coronary artery bypass grafting (CABG) were evaluated (2006-2015) from a statewide Society of Thoracic Surgeons database collaborative (N = 36,588). Patients were stratified by presence of postoperative complications, including major morbidities as defined by the Society of Thoracic Surgeons (ie, prolonged ventilation, renal failure, reoperation, stroke, and deep sternal wound infection)...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29246552/the-use-of-del-nido-cardioplegia-in-adult-cardiac-surgery-a-prospective-randomized-trial
#12
Niv Ad, Sari D Holmes, Paul S Massimiano, Anthony J Rongione, Lisa M Fornaresio, David Fitzgerald
OBJECTIVES: The del Nido cardioplegia solution has been used extensively in congenital heart surgery for more than 20 years and more recently for adults. This randomized controlled trial examined whether expanding this technique to adult cardiac surgery confers benefits in surgical workflow and clinical outcome compared with blood-based cardioplegia. METHODS: Adult first-time coronary artery bypass grafting (CABG), valve, or CABG/valve surgery patients requiring cardiopulmonary bypass (CPB) were randomized to del Nido cardioplegia (n = 48) or whole blood cardioplegia (n = 41)...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29242071/impact-of-acute-postoperative-limb-ischemia-after-cardiac-and-thoracic-aortic-surgery
#13
Ian W Folkert, Paul J Foley, Grace J Wang, Benjamin M Jackson, Joseph E Bavaria, Nimesh D Desai, Ronald M Fairman, Scott M Damrauer
OBJECTIVE: Acute limb ischemia (ALI) is the cause of significant morbidity and mortality. Although ALI after cardiac surgery is associated with high rates of morbidity and mortality, there are no robust, controlled analyses of the risk factors and outcomes of ALI in this setting. We aimed to identify risk factors for and to delineate outcomes after ALI in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of prospectively collected data on patients undergoing cardiac surgery at our institution between 2002 and 2012...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29240502/should-thoracic-epidurals-be-routinely-sited-in-patients-having-cardiac-surgery
#14
Zhihao Oon, Adam Woo
No abstract text is available yet for this article.
December 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29233331/the-society-of-thoracic-surgeons-adult-cardiac-surgery-database-2018-update-on-outcomes-and-quality
#15
Richard S D'Agostino, Jeffrey P Jacobs, Vinay Badhwar, Felix G Fernandez, Gaetano Paone, David W Wormuth, David M Shahian
Through nearly 3 decades of iterative refinement, The Society of Thoracic Surgeons Adult Cardiac Surgery Database has evolved into one of the most comprehensive and respected clinical data registries in health care. It is a widely acknowledged exemplar for accurately benchmarking risk-adjusted outcomes in cardiac surgery and underpins all quality measurement and improvement activities of The Society of Thoracic Surgeons. This is the latest in a series of annual reports that outlines current national aggregate outcomes and volume trends in cardiac surgery and summarizes database-related work in quality measurement and performance improvement during the past year...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29232300/three-dimensional-printing-of-life-like-models-for-simulation-and-training-of-minimally-invasive-cardiac-surgery
#16
Toshiyuki Yamada, Motohiko Osako, Tomoya Uchimuro, Ryogen Yoon, Toshiaki Morikawa, Maki Sugimoto, Hisao Suda, Hideyuki Shimizu
OBJECTIVE: As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. METHODS: Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29217969/severity-of-hyperoxia-as-a-risk-factor-in-patients-undergoing-on-pump-cardiac-surgery
#17
Gabrielius Jakutis, Ieva Norkienė, Donata Ringaitienė, Tomas Jovaiša
Background: Hyperoxia has long been perceived as a desirable or at least an inevitable part of cardiopulmonary bypass. Recent evidence suggest that it might have multiple detrimental effects on patient homeostasis. The aim of the study was to identify the determinants of supra-physiological values of partial oxygen pressure during on-pump cardiac surgery and to assess the impact of hyperoxia on clinical outcomes. Materials and methods: Retrospective data analysis of the institutional research database was performed to evaluate the effects of hyperoxia in patients undergoing elective cardiac surgery with cardiopulmonary bypass, 246 patients were included in the final analysis...
2017: Acta Medica Lituanica
https://www.readbyqxmd.com/read/29214375/review-surgical-treatment-of-giant-coronary-aneurysms-in-pediatric-patients-with-kawasaki-disease
#18
Masami Ochi
In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential...
December 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29212513/cardiac-amyloidosis-is-prevalent-in-older-patients-with-aortic-stenosis-and-carries-worse-prognosis
#19
João L Cavalcante, Shasank Rijal, Islam Abdelkarim, Andrew D Althouse, Michael S Sharbaugh, Yaron Fridman, Prem Soman, Daniel E Forman, John T Schindler, Thomas G Gleason, Joon S Lee, Erik B Schelbert
BACKGROUND: Non-invasive cardiac imaging allows detection of cardiac amyloidosis (CA) in patients with aortic stenosis (AS). Our objective was to estimate the prevalence of clinically suspected CA in patients with moderate and severe AS referred for cardiovascular magnetic resonance (CMR) in age and gender categories, and assess associations between AS-CA and all-cause mortality. METHODS: We retrospectively identified consecutive AS patients defined by echocardiography referred for further CMR assessment of valvular, myocardial, and aortic disease...
December 7, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29207812/prediction-of-major-adverse-cardiovascular-and-cerebrovascular-events-macce-after-thoracic-surgery-the-role-of-estimated-gfr
#20
Shibani Padhy, Prachi Kar, Gopinath Ramachandran
Introducton: Little is known about the prognostic utility of preoperative estimated GFR (eGFR) on perioperative Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) in apparently lower risk patients undergoing moderate risk surgeries like thoracotomy. Aim: The current study sought to identify a clinically relevant cut-off value of eGFR for identifying thoracotomy patients at higher risk for MACCE. Materials and Methods: Between July 2012 and July 2016, 436 consecutive patients were retrospectively studied after elective thoracotomy in a single institution...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
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