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Perioperative stroke

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https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#1
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#2
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29325846/hospital-outcome-and-risk-indices-of-mortality-in-potential-candidates-for-transcatheter-procedures-results-from-a-european-registry
#3
Francesco Onorati, Giovanni Mariscalco, Daniel Reichart, Andrea Perrotti, Giuseppe Gatti, Marisa De Feo, Antonio Rubino, Giuseppe Santarpino, Fausto Biancari, Christian Detter, Francesco Santini, Giuseppe Faggian
OBJECTIVE: Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. DESIGN: Retrospective multicenter registry. SETTING: Tertiary university and community hospitals. PARTICIPANTS: Two-hundred and sixty patients (out of 920 enrolled) who are potentially candidates for TM-VIVoR undergoing redo-surgery...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29325349/-introduction-and-interpretation-of-guidelines-on-thromboprophylaxis-in-the-perioperative-period-of-urological-surgery
#4
X Wang, Z Y Liu
Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29322961/perioperative-strokes-following-combined-coronary-artery-bypass-grafting-and-carotid-endarterectomy-a-nationwide-perspective
#5
REVIEW
Reshmi Udesh, Hannah Cheng, Amol Mehta, Parthasarathy D Thirumala
BACKGROUND: To assess the risk of perioperative stroke on in-hospital morbidity and mortality following combined coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA). MATERIALS AND METHODS: Data from the National Inpatient Sample (NIS) database for all patients who underwent CABG with CEA were identified using ICD-9 codes. Combined procedures were identified as CEA and CABG procedures that happened on the same day. Various preoperative and perioperative risk factors and their association with in-hospital mortality and morbidity were studied...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#6
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
January 10, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29313713/ischemic-and-bleeding-outcomes-after-coronary-artery-bypass-grafting-among-patients-initially-treated-with-a-p2y12-receptor-antagonist-for-acute-coronary-syndromes-insights-on-timing-of-discontinuation-of-ticagrelor-and-clopidogrel-prior-to-surgery
#7
Juan J Russo, Tyler E James, Marc Ruel, Jean-Yves Dupuis, Kuljit Singh, Daniel Goubran, Nikita Malhotra, Fraser Rubens, Aun-Yeong Chong, Benjamin Hibbert, Paul Boland, Diem Tt Tran, Jean-Francois Tanguay, Marie Lordkipanidzé, Louis Perrault, George A Wells, Michael Bourke, Vincent Chan, Derek Yf So
BACKGROUND: Clinical outcomes in acute coronary syndrome patients treated with P2Y12 inhibitors who require urgent coronary artery bypass grafting (CABG) have not been well studied. METHODS: We examined clinical outcomes in acute coronary syndrome patients in relation to the timing of CABG following P2Y12 inhibitor discontinuation (<72 h, 72 h to five days, >5 days). The primary ischemic outcome was a composite of death, reinfarction, need for revascularization, or stroke...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29313100/burr-hole-trepanation-for-chronic-subdural-hematomas-is-surgical-education-safe
#8
Nicolai Maldaner, Marketa Sosnova, Johannes Sarnthein, Oliver Bozinov, Luca Regli, Martin N Stienen
BACKGROUND: There is a paucity of data concerning the safety and efficacy of surgical education for neurosurgical residents in the evacuation of chronic subdural hematomas (cSDH) by burr hole trepanation. METHODS: This is a retrospective analysis of prospectively collected data on consecutive patients receiving burr hole trepanation for uni- or bilateral cSDH. Patients operated by a supervised neurosurgery resident (teaching cases) were compared to patients operated by a board-certified faculty neurosurgeon (BCFN; non-teaching cases)...
January 8, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29309950/management-of-antiplatelet-therapy-in-patients-undergoing-elective-invasive-procedures-proposals-from-the-french-working-group-on-perioperative-hemostasis-gihp-and-the-french-study-group-on-thrombosis-and-hemostasis-gfht-in-collaboration-with-the-french-society
#9
Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet
The French Working Group on Perioperative Hemostasis (GIHP) and the French Study Group on Hemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anesthesia and Intensive Care (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29307224/-thoracic-aortic-stentgraft-implantations-in-hungary-from-2012-to-2016
#10
Daniele Mariastefano Fontanini, Gábor Fazekas, Gábor Vallus, György Juhász, Rita Váradi, Zsolt Kövesi, Márton Kolossváry, Zoltán Szeberin
Thoracic aortic endograft implantation has become a widespread procedure in recent years, yet no report is available about Hungarian outcomes. Examination of our results is crucial to define further treatment strategies. Analysis of perioperative data from Hungarian thoracic endograft implantations based on the experience of 5 years is presented. Our retrospective, multicentric study analysed voluntarily reported data from all Hungarian institutions where thoracic endograft implantations are performed. Information was collected from every procedure performed in 5 years...
January 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29305561/trends-in-cardiovascular-risk-factor-and-disease-prevalence-in-patients-undergoing-non-cardiac-surgery
#11
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Joshua A Beckman, Sripal Bangalore, Jeffrey S Berger
OBJECTIVES: Cardiovascular risk factors are prevalent in the population undergoing non-cardiac surgery. Changes in perioperative cardiovascular risk factor profiles over time are unknown. The objective of this study was to evaluate national trends in cardiovascular risk factors and atherosclerotic cardiovascular disease (ASCVD) among patients undergoing non-cardiac surgery. METHODS: Adults aged ≥45 years old who underwent non-cardiac surgery were identified using the US National Inpatient Sample from 2004 to 2013...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29303985/desphospho-uncarboxylated-matrix-gla-protein-is-increased-postoperatively-in-cardiovascular-risk-patients
#12
Sofia Dahlberg, Jacob Ede, Leon Schurgers, Cees Vermeer, Thomas Kander, Bengt Klarin, Ulf Schött
BACKGROUND: Matrix Gla protein (MGP) is an extrahepatic protein that is dependent on glutamate carboxylation, a vitamin K-dependent process. Its dysfunctional form, desphospho-uncarboxylated-MGP, has been associated with increased arterial calcification and stiffness. The aim of this study was to measure the degree of postoperative carboxylation of MGP and two other Gla proteins in patients scheduled for abdominal or orthopaedic surgery. METHODS: Forty patients undergoing abdominal or orthopaedic surgery were included...
January 5, 2018: Nutrients
https://www.readbyqxmd.com/read/29301583/which-factor-is-the-most-effective-one-in-metabolic-sydrome-on-the-outcomes-after-coronary-artery-bypass-graft-surgery-a-cohort-study-of-5%C3%A2-years
#13
Lijuan Wang, Xiangyang Qian, Mingya Wang, Xinran Tang, Hushan Ao
BACKGROUND: Metabolic Syndrome and diabetes mellitus are risk factors for cardiovascular disease. However, the effects of Metabolic Syndrome with or without diabetes on perioperative and long-term morbidity and mortality after Coronary Artery Bypass Graft remain unclear. METHODS: An retrospective study was performed on 1166 patients who received isolated primary Coronary Artery Bypass Graft in Fuwai hospital. They were divided into three groups: control, Metabolic Syndrome of three factors together with diabetes and Metabolic Syndrome of three factors without diabetes (n = 868, 76 and 222 respectively)...
January 4, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29300906/postoperative-left-ventricular-function-in-different-types-of-pulmonary-hypertension-a-comparative-study
#14
Tom Verbelen, Alexander Van De Bruaene, Bjorn Cools, Dirk Van Raemdonck, Marion Delcroix, Filip Rega, Bart Meyns
OBJECTIVES: Left ventricular dysfunction after pulmonary endarterectomy is well described. Left ventricular failure has only been described after lung transplantation for pulmonary arterial hypertension (PAH). We sought to identify factors that contribute to this failure and hypothesized that atrial septostomy before transplantation could prevent this complication. METHODS: From our database, all bilateral lung transplants for PAH (n = 24) and all pulmonary endarterectomies, with a minimal reduction of 800 dyn⋅s⋅cm-5 (n = 27), were selected...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#15
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#16
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29279996/postoperative-mortality-and-morbidity-following-non-cardiac-surgery-in-a-healthy-patient-population
#17
Rodney A Gabriel, Jacklynn F Sztain, Alison M A'Court, Diana J Hylton, Ruth S Waterman, Ulrich Schmidt
PURPOSE: Perioperative mortality ranges from 0.4% to as high as nearly 12%. Currently, there are no large-scale studies looking specifically at the healthy surgical population alone. The primary objective of this study was to report 30-day mortality and morbidity in healthy patients and define any risk factors. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) dataset, all patients assigned an American Society of Anesthesiologists physical status (ASA PS) classification score of 1 or 2 were included...
December 26, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29273200/long-term-survival-prediction-for-cabg-validation-of-the-ascert-model-with-comparison-to-sts-prom
#18
Timothy S Lancaster, Matthew R Schill, Jason W Greenberg, Chawannuch Ruaengsri, Richard B Schuessler, Jennifer S Lawton, Hersh S Maniar, Michael K Pasque, Marc R Moon, Ralph J Damiano, Spencer J Melby
BACKGROUND: The recently developed STS/ACC ASCERT Long-Term Survival Probability Calculator is a valuable addition to existing short-term risk prediction tools for cardiac surgical procedures, but has yet to be externally validated. METHODS: Institutional data were reviewed on 654 patients ≥65 yr of age undergoing isolated CABG between 2005-2010. Predicted survival probabilities were calculated using the ASCERT model. Survival data were collected using the Social Security Death Index and institutional medical records...
December 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29262474/-clinical-application-of-electrical-velocimetry-in-monitoring-pediatric-blood-volume-after-cardiopulmonary-bypass
#19
J R Xue, B Li
Objective: To investigate the clinical applicability of electrical velocimetry (EV) in monitoring pediatric blood volume after cardiopulmonary bypass. Method: Between July 2016 and November 2016, 60 children with congenital heart disease were divided into EV group and traditional central venous pressure (CVP) group randomly. For EV group, the volume of fluid and vascular active medicine was adjusted according to the monitoring stroke volume variation (SVV) hemodynamic parameters. Whereas for CVP group empirical volume of fluid infusion was managed by the monitoring traditional hemodynamic parameters such as CVP, blood pressure, heart rate, urine volume and blood gas analysis...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29258677/sixteen-year-experience-of-david-and-bentall-procedures-in-acute-type-a-aortic-dissection
#20
Bo Yang, Himanshu J Patel, Claire Sorek, Whitney E Hornsby, Xiaoting Wu, Sarah Ward, Marc Thomas, Anisa Driscoll, Victoria A Waidley, Elizabeth L Norton, Donald S Likosky, G Michael Deeb
BACKGROUND: To examine short-term and midterm outcomes after the David and Bentall procedures in patients with an acute type A aortic dissection. METHODS: Between 2001 and 2017, patients (n = 135) with acute type A aortic dissection underwent an aortic root replacement with either the David (n = 40) or Bentall (n = 95) procedure. Perioperative outcome, reoperation rate, aortic valve function, and long-term survival were evaluated. RESULTS: The median age of the entire cohort was 56 years...
December 16, 2017: Annals of Thoracic Surgery
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