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clamp time impact morbidity mortality

Allan Kjeldsen Hansen, Michael Gejl, Kirsten Bouchelouche, Lars Poulsen Tolbod, Lars Christian Gormsen
PURPOSE: Revascularization strategies in patients with ischemic heart failure (HF) should be based on evidence of reversible perfusion defects and myocardial viability. Myocardial viability assessment is preferably based on dual isotope PET using perfusion and metabolism tracers. However, in a nonnegligible subset of HF patients, reverse mismatch (RM) pattern (reduced glucose uptake relative to perfusion) of unknown origin is observed. We aimed to investigate determinants of RM and the impact of RM on the subsequent improvement in left ventricular function by revascularization...
October 2016: Clinical Nuclear Medicine
Rodrigo C Surjan, Fabio F Makdissi, Tiago Basseres, Denise Leite, Luiz F Charles, Regis O Bezerra, Erik Schadde, Marcel Autran Machado
BACKGROUND: ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) is a new surgical approach for the treatment of liver tumors. It is indicated in cases where the future liver remnant is not sufficient to maintain postoperative liver function. We report a totally laparoscopic ALPPS with selective hepatic artery clamping. Pneumoperitoneum itself results in up to 53% of portal vein flow and selective hepatic artery clamping can reduce blood loss while maintaining hepatocellular function...
July 2016: Medicine (Baltimore)
Jamal Kabeer Khan, Syed Shahabuddin, Sheema Khan, Gulshan Bano, Shiraz Hashmi, Shahid A Sami
BACKGROUND: Outcomes following Coronary artery bypass grafting (GABG) vary between genders, with females having a higher postoperative mortality than males. Most of the studies are on Caucasian or mixed population and it is postulated that Asian population and in particular women have higher morbidity and mortality. In this study we have compared outcomes of elective CABG in men and women of South Asian origin in terms of morbidity and mortality. METHODS: From January 2006 to December 2012, 1970 patients underwent isolated elective CABG at the Aga Khan University Hospital, Pakistan were selected...
August 2016: Annals of Medicine and Surgery
Rouven Berndt, Bernd Panholzer, Katharina Huenges, Jill Jussli-Melchers, Felix Schoeneich, Christine Friedrich, Grischa Hoffmann, Jochen Cremer, Assad Haneya
Background Increasing life expectancy makes cardiac surgery in octogenarians not very uncommon. In this study, the impact of gender on outcome of octogenarians after coronary artery bypass grafting (CABG) was assessed. Materials and Methods We retrospectively studied 485 octogenarians (176 females: mean age 82.4 ± 2.2 years vs. 306 males: mean age 82.2 ± 2.4 years) who underwent isolated CABG using extracorporeal circulation between January 2005 and December 2012. Results No significant differences were noted between both gender groups with regard to preoperative risk factors...
April 25, 2016: Thoracic and Cardiovascular Surgeon
Francesco Onorati, Andrea Perrotti, Daniel Reichart, Giovanni Mariscalco, Ester Della Ratta, Giuseppe Santarpino, Antonio Salsano, Antonio Rubino, Fausto Biancari, Giuseppe Gatti, Cesare Beghi, Marisa De Feo, Carmelo Mignosa, Aniello Pappalardo, Theodor Fischlein, Sidney Chocron, Christian Detter, Francesco Santini, Giuseppe Faggian
OBJECTIVES: Several single-centre experiences have reported significant operative mortality and morbidity after mitral valve surgery in redo scenarios (ReMVS). Several preoperative risk factors outlining 'high-risk' categories have been reported, but scanty data on the impact of different operative techniques for these major challenging procedures have been analysed to date. The aim of the study is to investigate those intraoperative factors and postoperative events affecting early survival after redo mitral procedures...
May 2016: European Journal of Cardio-thoracic Surgery
Miriam Freundt, Michael Ried, Alois Philipp, Claudius Diez, Philipp Kolat, Stephan W Hirt, Christof Schmid, Assad Haneya
Advanced age is a known risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Minimized extracorporeal circulation (MECC) has been shown to reduce the negative effects associated with conventional extracorporeal circulation (CECC). This trial assesses the impact of MECC on the outcome of elderly patients undergoing CABG. Eight hundred and seventy-five patients (mean age 78.35 years) underwent isolated CABG using CECC (n=345) or MECC (n=530). The MECC group had a significantly shorter extracorporeal circulation time (ECCT), cross-clamp time and reperfusion time and lower transfusion needs...
March 2016: Perfusion
Jennifer S Lawton, Jingxia Liu, Kevin Kulshrestha, Marc R Moon, Ralph J Damiano, Hersh Maniar, Michael K Pasque
OBJECTIVE: A diverse group of operative strategies are utilized for treatment of acute Stanford type A aortic dissection. We hypothesized that a surgical strategy to prevent cross-clamp injury or false lumen pressurization would be associated with reduced morbidity, mortality, persistent false lumen patency, and improved survival. This study was designed to determine the differences in outcomes between operative techniques. METHODS: Outcomes and postoperative imaging were compared in patients who underwent surgery for acute type A aortic dissection...
August 2015: Journal of Thoracic and Cardiovascular Surgery
Panagiotis Lainas, Antoine Camerlo, Claudius Conrad, Nayruthia Shivathirthan, David Fuks, Brice Gayet
BACKGROUND: The impact of diaphragmatic invasion in patients with colorectal liver metastases (CRLMs) remains poorly evaluated. We aimed to evaluate feasibility and safety of laparoscopic right hepatectomy (LRH) with or without diaphragmatic resection for CRLM. METHODS: From 2002 to 2012, 52 patients underwent LRH for CRLM. Of them, 7 patients had combined laparoscopic partial diaphragmatic resection ("diaphragm" group). Data were retrospectively collected and short and long-term outcomes analyzed...
July 2015: Surgery
Sasmira Bhatt, Graeme R Polglase, Euan M Wallace, Arjan B Te Pas, Stuart B Hooper
The transition from a fetus to a neonate at birth represents a critical phase in our life. Most infants make this transition without complications, but preterm infants usually require some form of assistance due to immature cardiopulmonary systems that predispose them to lifelong sequelae. As the incidence of preterm birth is increasing, there is now an urgent need for the development of management strategies that facilitate this transition, which will likely include improved strategies for the management of the maternal third stage of labor...
2014: Frontiers in Pediatrics
Leila Asfour, Victoria Asfour, David McCormack, Rizwan Attia
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is there a difference in cardiothoracic surgery outcomes in terms of morbidity or mortality of patients operated on by a sleep-deprived surgeon compared with those operated by a non-sleep-deprived surgeon? Reported search criteria yielded 77 papers, of which 15 were deemed to represent the best evidence on the topic. Three studies directly related to cardiothoracic surgery and 12 studies related to non-cardiothoracic surgery...
September 2014: Interactive Cardiovascular and Thoracic Surgery
Khosrow Hashemzadeh, Mahnaz Dehdilani, Marjan Dehdilani
INTRODUCTION: New-onset postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery that has substantial effects on outcomes. The aim of this study is to analyze the risk factors in the pre, intra, and postoperative periods, and evaluate its impact on patients' outcome. METHODS: In this prospective study, between March 2007 and February 2011, a total of 1254 patients with preoperative sinus rhythm who underwent open cardiac surgery were included of which 177 (13...
2013: Journal of Cardiovascular and Thoracic Research
Brett R Anderson, Adam J Ciarleglio, Denise A Hayes, Jan M Quaegebeur, Julie A Vincent, Emile A Bacha
OBJECTIVES: This study sought to examine the impact of surgical timing on major morbidity and hospital reimbursement for late preterm and term infants with dextrotransposition of the great arteries (d-TGA). BACKGROUND: Neonatal arterial switch operation is the standard of care for d-TGA. Little is known about the effects of age at operation on clinical outcomes or costs for these neonates. METHODS: We conducted a retrospective cohort study of infants at ≥36 weeks' gestation, with d-TGA, with or without ventricular septal defects, admitted to our institution at 5 days of age or younger, between January 1, 2003 and October 1, 2012...
February 11, 2014: Journal of the American College of Cardiology
Sebastian Pagni, Brian L Ganzel, Jaimin R Trivedi, Ramesh Singh, Christopher E Mascio, Erle H Austin, Mark S Slaughter, Matthew L Williams
OBJECTIVE: Surgical repair of acute Type A aortic dissection (AADA) is still associated with high in-hospital mortality. We evaluated the impact of perioperative risk factors on early and midterm survival. METHODS: Retrospective (2002-2011) database analysis at a single institution of 132 consecutive AADA patients (88 male, age 59.8 ± 13.6). All but five patients underwent repair with open distal anastomoses and hypothermic circulatory arrest: aortic valve replacement/root replacement (n=44, 33...
September 2013: Journal of Cardiac Surgery
L Wang, S J Xin, Z Song, J Zhang
OBJECTIVE: To investigate the impact of left renal vein division (LRVD) on the postoperative renal function of abdominal aortic aneurysm (AAA) or aortic occlusive disease (AOD). METHODS: Between January 2000 and January 2012, 238 patients, including 179 AAAs and 59 AODs underwent open surgery in our institution (patients who required suprarenal aortic clamping were excluded). 49 patients (38 AAAs, 11 AODs) required LRVD during the operation. Patients in the LRVD and non-LRVD groups were matched using propensity score method in a 1:2 ratio...
August 2013: European Journal of Vascular and Endovascular Surgery
Priscila Aikawa, Angélica Rossi Sartori Cintra, Cleber Aparecido Leite, Ricardo Henrique Marques, Claudio Tafarel Mackmillan da Silva, Max dos Santos Afonso, Felipe da Silva Paulitsch, Evandro Augusto Oss
OBJECTIVE: To analyze the results of isolated on-pump coronary artery bypass graft surgery (CABG) in patients > 65 years-old. METHODS: Patients undergoing isolated on-pump CABG from December 1st 2010 to July 31th 2012 were divided in two groups: GE (elderly > 65 years-old, n=103) and GA (adults < 65 years-old, n=150). Preoperative data, intraoperative (as cardiopulmonar bypass time, aortic clamping time, time length of stay in mechanical ventilation--MV--and number of grafts), and postoperative variable (as morbidity, mortality and time length of stay in hospital) were analyzed during hospitalization...
March 2013: Revista Brasileira de Cirurgia Cardiovascular
M Hassanain, P Metrakos, A Fisette, S A R Doi, T Schricker, R Lattermann, G Carvalho, L Wykes, H Molla, K Cianflone
BACKGROUND: Postoperative liver dysfunction is the major source of morbidity and mortality in patients undergoing partial hepatectomy. This study tested the benefits of a metabolic support protocol based on insulin infusion, for reducing liver dysfunction following hepatic resection. METHODS: Consecutive consenting patients scheduled for liver resection were randomized to receive preoperative dextrose infusion followed by insulin therapy using the hyperinsulinaemic normoglycaemic clamp protocol (n = 29) or standard therapy (control group, n = 27)...
April 2013: British Journal of Surgery
Zain Khalpey, Wernard Borstlap, Patrick O Myers, Jan D Schmitto, Siobhan McGurk, Ann Maloney, Lawrence H Cohn
BACKGROUND: Reoperations on dysfunctional aortic homografts often require root reconstruction with coronary reanastomosis. This is associated with substantial perioperative morbidity and mortality. Resecting compromised aortic homograft valve leaflets and seating a new valve within the homograft annulus avoids root reconstruction and is a viable alternative. METHODS: We retrospectively evaluated 50 patients undergoing reoperations on dysfunctional homografts between 1999 and 2011...
September 2012: Annals of Thoracic Surgery
Barış Caynak, Zehra Bayramoğlu, Burak Onan, Ismihan Selen Onan, Ertan Sağbaş, Ilhan Sanisoğlu, Belhhan Akpınar
BACKGROUND: We evaluated the results of different types of cardiovascular surgery in patients with chronic renal failure (CRF) (serum creatinine ≥2 mg/dL) who were not dialysis-dependent. METHODS: Eighty-two patients who presented with non-dialysis-dependent CRF were retrospectively evaluated. Patients in Group 1 (n = 12) underwent valvular surgery, those in Group 2 (n = 58) underwent coronary artery bypass grafting (CABG), and those in Group 3 (n = 12) underwent combined CABG and valvular surgery...
August 2011: Heart Surgery Forum
O J Liakopoulos, E W Kuhn, Y H Choi, W Chang, T Wittwer, N Madershahian, G Wassmer, T Wahlers
AIM: The aim of this study was to evaluate the impact of intermittent warm (IWC) versus intermittent cold blood cardioplegia (ICC) in high-risk patients that require prolonged periods of aortic cross-clamping during on-pump cardiac surgery. METHODS: From 3527 consecutive patients undergoing on-pump cardiac surgery, 520 patients were retrospectively identified that required prolonged aortic cross-clamp ≥ 75 min. Myocardial protection was performed with ICC (N.=280) or IWC (N...
December 2010: Journal of Cardiovascular Surgery
A Assmann, U Boeken, P Feindt, P Schurr, P Akhyari, A Lichtenberg
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a serious complication after cardiac surgery. The aim of the present study was to identify pre- and intraoperative predictors for the postoperative occurrence of HIT. The study additionally focused on the impact of HIT on postoperative outcome. METHODS: Retrospective analysis was performed for 5073 patients who had required extracorporeal circulation during cardiac surgery. Patients were divided into 3 groups: 1) patients who had postoperative HIT (HIT+); 2) patients with postoperative thrombocytopenia but without HIT (HIT-); and 3) patients with normal platelet count (C)...
December 2010: Thoracic and Cardiovascular Surgeon
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