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https://www.readbyqxmd.com/read/29778336/implementation-of-the-aortic-no-touch-technique-to-reduce-stroke-after-off-pump-coronary-surgery
#1
Alexander Albert, Jürgen Ennker, Yasser Hegazy, Sebastian Ullrich, Georgi Petrov, Payam Akhyari, Stefan Bauer, Eda Ürer, Ina Carolin Ennker, Artur Lichtenberg, Horst Priss, Alexander Assmann
OBJECTIVES: Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. METHODS: A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29774793/surgical-considerations-in-interrupted-aortic-arch
#2
Damien J LaPar, Christopher W Baird
Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29772320/predictive-factors-of-silent-brain-infarcts-after-asymptomatic-carotid-endarteriectomy
#3
Rémy Pascot, Benjamin Parat, Yann Le Teurnier, Gilles Godet, Jean-Yves Gauvrit, Yann Gouëffic, Eric Steinmetz, Alain Cardon, Adrien Kaladji
BACKGROUND: The optimization of medical treatment regularly challenges the role of carotid surgery for asymptomatic patients. Current research seeks to determine which of these patients will benefit most from surgery. The goal of this study was to identify in a multi-center study, using MRI, the risk factors for postoperative silent cerebral ischemic lesions after carotid surgery for asymptomatic stenosis METHODS: The multicenter, retrospective study included patients with asymptomatic severe carotid stenosis suitable for surgical treatment and who did not have a history of cerebral ischemia...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#4
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#5
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29709469/effect-of-resident-involvement-on-morbidity-and-mortality-following-thoracic-endovascular-aortic-repair
#6
Derrick O Acheampong, Philip Paul, Shanice Guerrier, Percy Boateng, I Michael Leitman
OBJECTIVE: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012...
April 27, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#7
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29701420/lumbar-cerebrospinal-fluid-drainage-in-endovascular-aortic-repair-reference-centre-experience
#8
Ana Margarida Martins, Marisa Silva, Maria de Lurdes Castro, Ana Ferro
INTRODUCTION: Spinal cord ischemia (SCI) and the resulting paraplegia are one of the most feared postoperative complications after thoraco-abdominal aortic surgery, with an incidence 4,3-8,0% after thoracic endovascular aortic repair (TEVAR), increasing patients morbi-mortality. Lumbar cerebrospinal fluid (CSF) drainage catheter is recommended as preventive measure in high risk patients. OBJECTIVE: To evaluate the efficiency and safety of CSF drainage catheter as preventive or therapeutic measure in endovascular aortic repair (EAR)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701343/influence-of-interhospital-transfer-on-outcomes-of-symptomatic-and-ruptured-abdominal-aortic-aneurysms
#9
Nelson Camacho, Frederico Bastos Gonçalves, Gonçalo Rodrigues, Anita Quintas, Rodolfo Abreu, Rita Ferreira, Joana Catarino, Ricardo Correia, Rita Bento, Maria Emília Ferreira
INTRODUCTION: Symptomatic or ruptured abdominal aortic aneurysms (rAAA) maintains a high mortality index despite technical advances in its treatment. The influence of patients' geographic location on rAAA outcomes, when the rupture occurs or when the AAA becomes symptomatic, has not been a commonly studied issue. Due to the lack of research on this matter, the impact of interhospital transfer on mortality is ambiguous. OBJECTIVE: Evaluate the influence of the geographic location of patients with symptomatic AAA or rAAA on AAA mortality...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#10
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29683929/18f-fdg-pet-ct-in-the-evaluation-of-cancer-cervix-where-do-we-stand-today
#11
Shanmuga S Palaniswamy, Chaitanya R Borde, Padma Subramanyam
The incidence of gynecological malignancies is on the rise partly because of the availability of screening programmes, awareness, higher technological advancements, and availability of better medical care. Early diagnosis of any malignancy leads to prompt treatment. Use of 18Fluorine-Fluorodeoxyglucose (F-FDG) PET/CT in the treatment and follow-up of patients with Ca cervix considerably improves patient management. The primary diagnosis of Ca cervix is made either by biopsy of a visible tumor on the cervix or by a cone biopsy of a nonvisible malignant cervical focus...
April 20, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29682454/awake-transcatheter-aortic-valve-replacement-an-anesthesiologist-s-perspective
#12
Jiapeng Huang, Sheng Wang, Jiakai Lu
Transcatheter aortic replacement has become the standard of care for patients with severe aortic valve stenosis. With advancement of technologies, this technique has become much safer and simpler. Both general anesthesia (GA) and monitored anesthesia care (MAC) have been provided for transcatheter aortic valve replacement (TAVR). MAC or awake transcatheter valve replacement was shown to carry similar clinical outcomes with significantly reduced length of stay. We reviewed the literature and presented our practical minimalist anesthesia approach to awake TAVR...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29661286/comparison-of-zone-3-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-abdominal-aortic-and-junctional-tourniquet-in-a-model-of-junctional-hemorrhage-in-swine
#13
Jason M Rall, Theodore T Redman, Elliot M Ross, Jonathan J Morrison, Joseph K Maddry
BACKGROUND: Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. METHODS: Yorkshire swine (n = 10, 70-90 kg) underwent general anesthesia, instrumentation, and surgical isolation of the femoral artery...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#14
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628867/noncardiac-surgery-in-two-severe-aortic-stenosis-patients-general-or-epidural-anesthesia
#15
Nitika Goel, M Ganesh Kumar, Parag Barwad, Goverdhan Dutt Puri
No abstract text is available yet for this article.
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628009/aprotinin-impacts-8-isoprostane-after-coronary-artery-bypass-grafting
#16
V Toikkanen, T Rinne, R Nieminen, E Moilanen, J Laurikka, H Porkkala, M Tarkka, A A Mennander
BACKGROUND AND AIMS: The lungs participate in the modulation of the circulating inflammatory factors induced by coronary artery bypass grafting. We investigated whether aprotinin-which has been suggested to interact with inflammation-influences lung passage of key inflammatory factors after coronary artery bypass grafting. MATERIAL AND METHODS: A total of 40 patients undergoing coronary artery bypass grafting were randomized into four groups according to aprotinin dose: (1) high dose, (2) early low dose, (3) late low dose, and (4) without aprotinin...
April 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29620662/good-outcomes-after-the-delayed-removal-of-an-epidural-hematoma-a-case-report
#17
Yong-Xing Yao, Ming-Xia Li, Lian-Juan Sun
RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29602472/local-anesthesia-for-percutaneous-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-fewer-pulmonary-complications
#18
Kathryn Van Orden, Alik Farber, Marc L Schermerhorn, Philip P Goodney, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Percutaneous endovascular aneurysm repair (EVAR) can be performed with general anesthesia (GA) or local anesthesia (LA). Our goal was to assess perioperative outcomes comparing anesthesia type in percutaneous EVAR. METHODS: The Vascular Quality Initiative database was queried for all exclusively percutaneous EVAR procedures. Univariable analysis was used to compare which patients were offered LA. Multivariable analysis was used to determine the independent effect of anesthesia type...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602249/the-first-transapical-transcatheter-aortic-valve-in-valve-implantation-using-the-j-valve-system-into-a-failed-biophysio-aortic-prosthesis-in-a-patient-with-high-risk-of-coronary-obstruction
#19
Jian Ye, Arthur J Lee, Philipp Blanke, John Webb
We report the first successful valve-in-valve (ViV) implantation into a failed Edwards Biophysio surgical prosthesis (Edwards Lifesciences, Irvine, CA) and also the first use of the J-Valve system (Jie Cheng Medical Technologies, Suzhou, China) in a ViV configuration. A 77-year old male had symptomatic severe aortic stenosis secondary to failure of a 25 mm Biophysio bioprosthetic valve implanted 11 years previously, along with concomitant coronary artery bypass grafting. Transthoracic echocardiography (TTE) revealed calcified leaflets, a mean aortic gradient of 50 mm Hg, and an estimated valve area of 0...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29595665/saddle-embolism-treated-by-thrombolysis-and-thrombus-aspiration-via-bilateral-femoral-artery-puncture-catheter-a-case-report
#20
Jie Min, Guangqiang Zhang
INTRODUCTION: Abdominal aortic saddle embolism is a rare and severe disease with the manifestation of abrupt onset, rapid progression and high mortality. Endovascular therapy becomes a new option for this disease due to its minor trauma, less complications, no requirement for general anesthesia or abdominal incisions, and shorter hospitalization duration. METHODS: A 50-year-old female was diagnosed as abdominal aortic saddle embolism, and thrombus aspiration was given immediately via bilateral femoral artery puncture catheter along with artery indwelling catheter thrombolysis...
March 2018: Medicine (Baltimore)
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