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https://www.readbyqxmd.com/read/29036976/-comparison-of-perioperative-serum-thrombomodulin-levels-in-patients-underwent-off-pump-coronary-artery-bypass-grafting-with-and-without-cardiogenic-shock
#1
L Zhang, C Wang, T X Gu, C M Lu, Z W Wang
Objective: To observe the perioperative changes of serum thrombomodulin in patients with and without cardiogenic shock undergoing off-pump coronary artery bypass grafting surgery. Methods: A total of 66 patients with coronary artery disease who underwent off-pump coronary artery bypass grafting surgery between June and December 2015 in our hospital were included in this study.The patients were divided into non-cardiogenic shock group (n=51) and shock group (n=15) according to the absence or presence of cardiogenic shock...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29020341/percutaneous-short-term-active-mechanical-support-devices-in-cardiogenic-shock-a-systematic-review-and-collaborative-meta-analysis-of-randomized-trials
#2
Holger Thiele, Alexander Jobs, Dagmar M Ouweneel, Jose P S Henriques, Melchior Seyfarth, Steffen Desch, Ingo Eitel, Janine Pöss, Georg Fuernau, Suzanne de Waha
Aims: Evidence on the impact on clinical outcome of active mechanical circulatory support (MCS) devices in cardiogenic shock (CS) is scarce. This collaborative meta-analysis of randomized trials thus aims to investigate the efficacy and safety of percutanzeous active MCS vs. control in CS. Methods and results: Randomized trials comparing percutaneous active MCS to control in patients with CS were identified through searches of medical literature databases. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated to analyse the primary endpoint of 30-day mortality and device-related complications including bleeding and leg ischaemia...
July 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28988424/maintenance-of-valvular-integrity-with-impella-left-heart-support-results-from-the-multicenter-protect-ii-randomized-study
#3
James A Goldstein, Simon R Dixon, Pamela S Douglas, E Magnus Ohman, Jeffrey Moses, Jeffrey J Popma, William W O'Neill
BACKGROUND: The Impella 2.5 axial flow pump, which is positioned across the aortic valve, is widely employed for hemodynamic support. The present study compared structural and functional integrity of the left heart valves in patients undergoing Impella vs intra-aortic balloon pump in the randomized PROTECT II trial. METHODS AND RESULTS: Transthoracic echocardiograms were performed at baseline, 1 and 3 months in 445 patients in the PROTECT II trial. Serial studies were analyzed by an independent echocardiography core laboratory for aortic and mitral valve structure and function, and left ventricular ejection fraction (LVEF)...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28975854/clinical-application-of-intra-aortic-balloon-counterpulsation-in-high-risk-patients-undergoing-cardiac-surgery
#4
Dengbang Hou, Feng Yang, Xiaotong Hou
The intra-aortic balloon pump (IABP) has been the most commonly used mechanical circulatory support device for nearly five decades. In theory, the IABP can increase the blood and oxygen supply of the coronary artery by increasing the diastolic pressure in the aortic root when the balloon is inflated and reduce left ventricular afterload by rapidly deflating the balloon during the systolic phase. Therefore, some researchers put forward the idea of preoperative prophylactic use of an IABP, which has been frequently performed in high-risk patients undergoing elective percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG)...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28973669/transcranial-doppler-waveforms-during-intra-aortic-balloon-pump-counterpulsation-for-vasospasm-detection-after-subarachnoid-hemorrhage
#5
Nicholas A Morris, Nathan Manning, Randolph S Marshall, E Sander Connolly, Jan Claassen, Sachin Agarwal, David J Roh, J Michael Schmidt, Soojin Park
BACKGROUND: Transcranial Doppler ultrasound is a standard screening tool for vasospasm after subarachnoid hemorrhage. Prevention of vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage depends on optimization of cerebral perfusion pressure, which can be challenged by neurogenic stress cardiomyopathy. Intra-aortic balloon pumps have been utilized to augment cerebral perfusion, but they change the transcranial Doppler waveform, altering its interpretability for vasospasm screening...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966325/rotational-atherectomy-followed-by-drug-coated-balloon-dilation-for-left-main-in-stent-restenosis-in-the-setting-of-acute-coronary-syndrome-complicated-with-right-coronary-chronic-total-occlusion
#6
Jun Shiraishi, Keisuke Shoji, Takashi Yanagiuchi, Masaki Yashige, Akira Shikuma, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support...
September 30, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28963749/chronic-total-occlusion-in-non-infarct-related-artery-is-associated-with-increased-short-and-long-term-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-complicated-by-cardiogenic-shock-from-the-credo-kyoto-ami-registry
#7
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Tetsuma Kawaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
OBJECTIVES: We aimed to investigate the effect of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on short- and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock (CS). BACKGROUND: Previous studies show contradictory results about the clinical effect of CTO in non-IRA on short-term mortality in STEMI patients with CS. METHODS: From the CREDO-Kyoto AMI registry enrolling 5429 patients, the current study population consisted of 313 STEMI patients with multivessel disease complicated by CS who underwent primary PCI for the nonleft main coronary artery culprit lesion within 24 hr after onset...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28962495/is-there-a-role-for-upper-extremity-intra-aortic-balloon-counterpulsation-as-a-bridge-to-recovery-or-a-bridge-to-transplant-in-the-treatment-of-end-stage-heart-failure
#8
Nnamdi Nwaejike, Andre Y Son, Carmelo A Milano, Mani A Daneshmand
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is there a role for upper-extremity intra-aortic balloon pump counterpulsation (UE-IABP) in the treatment of end-stage heart failure? Altogether 230 papers were found using the reported search, of which 6 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958345/intermacs-analysis-of-stroke-during-support-with-continuous-flow-left%C3%A2-ventricular-assist-devices-risk-factors-and-outcomes
#9
Deepak Acharya, Renzo Loyaga-Rendon, Charity J Morgan, Kara A Sands, Salpy V Pamboukian, Indranee Rajapreyar, William L Holman, James K Kirklin, José A Tallaj
OBJECTIVES: This study sought to evaluate predictors of stroke during left ventricular assist device (LVAD) support from data available prior to implantation, and quantify stroke-related morbidity and mortality. BACKGROUND: Stroke is a major complication after LVAD. Pre-implant factors that influence stroke are not well understood. METHODS: We evaluated all patients in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with continuous flow LVADs from May 1, 2012, to March 31, 2015...
October 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28955074/internal-mammary-artery-flow-in-different-racial-groups-of-pakistan
#10
Mudassir Iqbal Dar, Asim Hassan Dar, Mansoor Ahmed, Abdul Haseeb, Muhammad Bilal
OBJECTIVE: To find out any differences in free flow of internal mammary artery among different ethnic groups. METHODS: This observational, cross-sectional study was conducted at the Civil Hospital, Karachi, from January 2013 to December 2015, and comprised patients who underwent coronary artery bypass grafting. The participants were divided into 5 groups, i.e. Sindhi, Muslim migrants from India, Punjabi, Pathan and Balochi patients. Free flow of internal mammary artery was measured immediately after harvesting within a syringe, and its flow was measured in 30 seconds...
October 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28948299/-cardiogenic-shock-current-evidence
#11
H Thiele
This CME article addresses the pathophysiology, incidence, current survival outcome and treatment options for patients with cardiogenic shock as a complication of acute myocardial infarction. The shock spiral of left heart failure due to cardiac infarction, subsequent vasoconstriction and paradoxical vasodilation due to the systemic inflammation response syndrome (SIRS) is a vicious circle which must be interrupted. Treatment focuses on the evidence from randomized clinical trials and the current guideline recommendations...
September 25, 2017: Herz
https://www.readbyqxmd.com/read/28942979/differences-and-similarities-in-risk-factors-for-postoperative-acute-kidney-injury-between-younger-and-older-adults-undergoing-cardiac-surgery
#12
Nadim Saydy, Amine Mazine, Louis-Mathieu Stevens, Hughes Jeamart, Philippe Demers, Pierre Pagé, Yoan Lamarche, Ismail El-Hamamsy
OBJECTIVES: Acute kidney injury is a frequent complication after cardiac surgery. The purpose of this study was to assess the risk factors for acute kidney injury in patients ≤60 years of age undergoing cardiac surgery and to compare these risk factors with those identified in patients ≥65 years of age. METHODS: From 2010 to 2012, 1253 patients ≤60 years (mean age 52 ± 9 years) and 2488 patients ≥65 years (mean age 74 ± 6 years) underwent cardiac surgery...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28941480/a-double-crossover-technique-in-an-obese-patient-undergoing-transfemoral-transcatheter-aortic-valve-implantation-how-to-accomplish-hemostasis-percutaneously
#13
Hirokazu Onishi, Toru Naganuma, Sunao Nakamura
Percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI) is generally an acceptable procedure but may be associated with vascular complications at femoral access sites, particularly in obese patients. This report aimed to describe a case of successful performance of our "double crossover technique" in an obese patient undergoing TF-TAVI with a percutaneous transfemoral intra-aortic balloon pump (TF-IABP). A 75-year-old man presented with heart failure due to a left ventricular ejection fraction of 35% and low-flow, low-gradient severe aortic stenosis...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28941078/the-effectiveness-and-safety-of-the-impella-ventricular-assist-device-for-high-risk-percutaneous-coronary-interventions-a-systematic-review
#14
Jamal Ait Ichou, Natasha Larivée, Mark J Eisenberg, Karine Suissa, Kristian B Filion
BACKGROUND: Small randomized controlled trials (RCTs) and observational studies have examined the effectiveness and safety of the Impella device, a percutaneous left ventricular assist device, in the setting of high-risk percutaneous coronary intervention (PCI). However, data are sparse and results are conflicting. Our objective was to evaluate the effectiveness and safety of the Impella device in high-risk patients undergoing PCI via a systematic review of the literature. METHODS: We searched Medline, EMBASE, and the Cochrane Library for RCTs and observational studies that evaluated the Impella device in high-risk patients undergoing PCI...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28935461/short-and-long-term-outcome-in-very-old-patients-with-st-elevation-myocardial-infarction-after-primary-percutaneous-coronary-intervention
#15
Roberta Sappa, Maria Teresa Grillo, Martino Cinquetti, Giulio Prati, Leonardo Spedicato, Gaetano Nucifora, Andrea Perkan, Davide Zanuttini, Gianfranco Sinagra, Alessandro Proclemer
BACKGROUND: Although octogenarians constitute a fast-growing portion of cardiovascular patients, few data are available on the outcome of patients aged ≥85 years with ST-Elevation Myocardial Infarction (STEMI). METHODS AND RESULTS: We analyzed 126 consecutive patients aged ≥85 years (age 88±2 years) with STEMI, undergoing primary percutaneous coronary intervention (pPCI) within 12 hours from symptoms onset. Long-term follow-up (median 898 days) was obtained for the 102 patients surviving the index-hospitalization...
September 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#16
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28857849/advanced-percutaneous-mechanical-circulatory-support-devices-for-cardiogenic-shock
#17
P Elliott Miller, Michael A Solomon, Dorothea McAreavey
OBJECTIVES: To review temporary percutaneous mechanical circulatory support devices for the treatment of cardiogenic shock, including current evidence, contraindications, complications, and future directions. DATA SOURCES: A MEDLINE search was conducted with MeSH terms: cardiogenic shock, percutaneous mechanical circulatory support, extracorporeal membrane oxygenation, Impella, and TandemHeart. STUDY SELECTION: Selected publications included randomized controlled trial data and observational studies describing experience with percutaneous mechanical circulatory support in cardiogenic shock...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28856523/hemodynamic-support-devices-for-shock-and-high-risk-pci-when-and-which-one
#18
REVIEW
George W Vetrovec
PURPOSE OF REVIEW: This article addresses evolving devices and uses of hemodynamic support in the management of high-risk PCI and AMI with cardiogenic shock. RECENT FINDINGS: Recent publications question the benefit of Intra-aortic Balloon Pump support for AMI Shock. Furthermore, in high-risk PCI, the Impella support system provides better late outcomes than does the intra-aortic balloon pump. We have entered a new era in which larger, higher flow devices that increase cardiac output while unloading the left ventricle provide better outcome...
August 31, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28833503/persistent-acute-kidney-injury-following-transcatheter-aortic-valve-replacement
#19
Charat Thongprayoon, Wisit Cheungpasitporn, Michael A Mao, Narat Srivali, Wonngarm Kittanamongkolchai, Andrew M Harrison, Kevin L Greason, Kianoush B Kashani
BACKGROUND: Acute kidney injury (AKI) and its severity after transcatheter aortic valve replacement (TAVR) have been associated with worse outcomes. Studies have shown that AKI duration (transient or persistent) affects outcomes independently of AKI severity. This study was undertaken to determine the association, risk factors, and outcomes associated with persistent AKI (pAKI) after TAVR. METHODS: Adult patients undergoing TAVR at Mayo Clinic between January 1, 2008 and June 30, 2014 were enrolled...
August 22, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28832791/techniques-timing-prognosis-of-post-infarct-ventricular-septal-repair-a-re-look-at-old-dogmas
#20
Amber Malhotra, Kartik Patel, Pranav Sharma, Vivek Wadhawa, Tarun Madan, Jagdish Khandeparkar, Komal Shah, Sanjay Patel
Objective: The study aimed to identify the factors affecting the prognosis of post myocardial infarction (MI) ventricular septal rupture (VSR) and to develop a protocol for its management. Methods: This was a single center, retrospective-prospective study (2009-2014), involving 55 patients with post MI VSR. The strengths of association between risk factors and prognosis were assessed using multivariate logistic regression analysis. The UNM Post MI VSR management and prognosis scoring systems (UPMS & UPPS) were developed...
May 2017: Brazilian Journal of Cardiovascular Surgery
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