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Cardiovascular perioperative evaluation

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https://www.readbyqxmd.com/read/28168963/ten-year-experience-of-coronary-endarterectomy-for-the-diffusely-diseased-left%C3%A2-anterior-descending-artery
#1
Kosaku Nishigawa, Toshihiro Fukui, Masataka Yamazaki, Shuichiro Takanashi
BACKGROUND: Coronary endarterectomy (CE) is a surgical option for a diffusely diseased coronary artery. This study evaluated the clinical and angiographic outcomes of CE for a diffusely diseased left anterior descending artery (LAD) using the internal thoracic artery (ITA). METHODS: From September 2004 to September 2014, 188 patients (163 men; mean age, 66.1 years) underwent coronary artery bypass grafting with CE for a diffusely diseased LAD. Forty patients (21...
February 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28164120/coronary-computed-tomography-angiography-in-combination-with-coronary-artery-calcium-scoring-for-the-preoperative-cardiac-evaluation-of-liver-transplant-recipients
#2
REVIEW
Jae Moon Choi, Yu-Gyeong Kong, Joon-Won Kang, Young-Kug Kim
Liver transplantation is the best treatment option for early-stage hepatocellular carcinoma, liver cirrhosis, fulminant liver failure, and end-stage liver diseases. Even though advances in surgical techniques and perioperative care have improved postoperative outcomes, perioperative cardiovascular complications are a leading cause of postoperative morbidity and mortality following liver transplantation. Ischemic coronary artery disease (CAD) and cardiomyopathy are the most common cardiovascular diseases and could be negative predictors of postoperative outcomes in liver transplant recipients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#3
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28111417/guidelines-for-perioperative-cardiovascular-evaluation-and-management-for-noncardiac-surgery-jcs-2014-%C3%A3-digest-version
#4
Shunei Kyo, Kazuhito Imanaka, Munetaka Masuda, Tetsuro Miyata, Kiyozo Morita, Tetsuro Morota, Minoru Nomura, Yoshikatsu Saiki, Yoshiki Sawa, Taijiro Sueda, Yuichi Ueda, Kenji Yamazaki, Ryohei Yozu, Mari Iwamoto, Shunsuke Kawamoto, Isamu Koyama, Mikihiko Kudo, Goro Matsumiya, Kazumasa Orihashi, Hideki Oshima, Satoshi Saito, Yoshimasa Sakamoto, Kunihiro Shigematsu, Tsuyoshi Taketani, Issei Komuro, Shinichi Takamoto, Chuwa Tei, Fumio Yamamoto
No abstract text is available yet for this article.
January 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28110613/adrenomedullin-is-associated-with-surgical-trauma-and-impaired-renal-function-in-vascular-surgery-patients
#5
Hans-Jörg Gillmann, Antje Meinders, Jan Larmann, Bianca Sahlmann, Claudia Schrimpf, Thomas Aper, Ralf Lichtinghagen, Omke E Teebken, Gregor Theilmeier
BACKGROUND: Patients undergoing vascular surgery are prone to perioperative organ injury because of both higher prevalence of cardiovascular risk factors and the extent of surgery. Early detection of organ failure is essential to facilitate appropriate medical care. Midregional pro-adrenomedullin (MR-proADM) has been investigated in acute medical care settings to guide clinical decision-making regarding patient pathways and to identify patients prone to imminent cardiovascular or inflammatory complications...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#6
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28094561/the-perioperative-dental-screening-and-management-of-patients-undergoing-cardiothoracic-vascular-surgery-and-other-cardiovascular-invasive-procedures-a-systematic-review
#7
Elisabetta Cotti, Mariantonietta Arrica, Andrea Di Lenarda, Sara B Serri, Pierpaolo Bassareo, Luigi Padeletti, Giuseppe Mercuro
Background One controversial issue in the relationship between oral care and cardiovascular diseases is how and whether to manage oral infections prior to cardiovascular surgery or other cardiovascular invasive procedures. Design We designed a systematic review to assess the information available on three main questions. Is there an agreement on the need for dental evaluation and treatment before cardiovascular interventions? Are consistent clinical recommendations or protocols available? Is dental treatment prior to cardiovascular interventions effective? Methods A systematic electronic search of MEDLINE, Scopus and Web of Science was performed from the database inceptions up to 31 April 2016...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28089636/influence-of-perioperative-nonsteroidal-anti-inflammatory-drugs-on-complications-after-gastrointestinal-surgery-a-meta-analysis
#8
REVIEW
Fang Peng, Shijiang Liu, Youli Hu, Min Yu, Jing Chen, Cunming Liu
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a key part of multimodal perioperative analgesia. This study aimed to evaluate the influence of perioperative NSAIDs application on complications after gastrointestinal surgery by using meta-analysis. METHODS: A systematic review of published literature was conducted by searching computerized databases including PubMed, CBM, Springer, Chinese Academic Journals, and China Info since the databases were published until June 2015...
January 12, 2017: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/28059917/characterization-of-readmission-by-day-of-rehospitalization-after-colorectal-surgery
#9
Ahmed M Al-Mazrou, Kunal Suradkar, Christine M Mauro, Ravi P Kiran
BACKGROUND: Factors associated with readmission stratified by the day of postdischarge rehospitalization after colorectal surgery have not been characterized previously. OBJECTIVE: The purpose of this study was to identify factors leading to readmission on a day-to-day basis after discharge from colorectal surgery. DESIGN: This was a retrospective analysis of patients readmitted within 30-days after colorectal surgery. Reasons and factors associated with readmission each day after discharge were evaluated...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28056256/-strategies-for-surgical-treatment-of-ischemic-mitral-incompetence
#10
Z B Qiu, X Chen
Treatment of ischemic mitral incompetence (IMI) is an important problem in cardiovascular surgery, and it is arguing to the best strategies for surgical treatment of IMI. IMI can be quantitative assessment precisely by three-dimensional ultrasonic sound. Perioperative transesophageal echocardiography can acquire detailed information about IMI, but it is possible to underestimate the degree of IMI. The effective mitral regurgitation area at resting are the independently prognosis factor in patients with IMI...
1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28045816/risk-factors-predicting-nasoseptal-flap-failure-in-the-endoscopic-endonasal-transsphenoidal-approach
#11
Boo-Young Kim, Ji Hyeon Shin, Sung Won Kim, Yong Kil Hong, Sin-Soo Jeun, Soo Whan Kim, Jin Hee Cho, Yong Jin Park
OBJECTIVE: Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure. STUDY DESIGN: Patient series. SETTING: Retrospective review of medical records at a tertiary referral center...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28030663/perioperative-major-adverse-cardiovascular-and-cerebrovascular-events-associated-with-noncardiac-surgery
#12
Nathaniel R Smilowitz, Navdeep Gupta, Harish Ramakrishna, Yu Guo, Jeffrey S Berger, Sripal Bangalore
Importance: Major adverse cardiovascular and cerebrovascular events (MACCE) are a significant source of perioperative morbidity and mortality following noncardiac surgery. Objective: To evaluate national trends in perioperative cardiovascular outcomes and mortality after major noncardiac surgery and to identify surgical subtypes associated with cardiovascular events using a large administrative database of United States hospital admissions. Design, Setting, Participants: Patients who underwent major noncardiac surgery from January 2004 to December 2013 were identified using the National Inpatient Sample...
February 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#13
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27989068/underlying-rheumatic-disease-an-important-determinant-of-outcome-in-tricuspid-valve-repair
#14
Mandhir Munasur, Datshana Naidoo
BACKGROUND: Tricuspid regurgitation (TR) accompanying severe left-sided valve disease occurs on a functional basis, secondary to pulmonary hypertension and tricuspid annular dilatation. In the context of endemic left-sided rheumatic heart disease, non-recognition of organic disease of the tricuspid valve may adversely influence surgical decision-making, resulting in suboptimal outcomes. METHODS: A retrospective analysis of the perioperative and follow up data of 30 patients who underwent tricuspid valve surgery with concomitant left-sided valve replacement was undertaken...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27958619/evaluation-of-urgent-multivisceral-resections-due-to-complications-resulting-from-an-advanced-ovarian-cancer
#15
Tomasz Miłek, Witold Woźniak, Piotr Porzycki, Alkalayla Habib, Agnieszka Timorek, Piotr Ciostek, Włodzimierz Sawicki, Krzysztof Cendrowski
BACKGROUND: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27935891/-rate-of-in-hospital-cardiovascular-complications-in-patients-with-postoperative-renal-dysfunction-after-surgical-myocardial-revascularization
#16
L V Kremneva, O V Abaturova, S V Shalaev
The study was aimed at revealing the factors associated with renal dysfunction having developed after coronary artery bypass grafting (CABG) and assessing the in-hospital cardiovascular complications rate amongst patients with postoperative renal dysfunction. The study included a total of 99 patients presenting with stable angina pectoris and having indications for CABG. The mean age of the patients amounted to 57±7 years, with the average duration of coronary artery disease (CAD) of 6±5.7 years. A multi-vessel lesion of coronary arteries was revealed in 69...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#17
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27902607/perioperative-complications-following-preoperative-cessation-of-antithrombotic-agents-for-total-knee-arthroplasty-a-retrospective-study
#18
Jin-Young Hwang, Sohee Oh, Chong-Soo Kim, Jee-Eun Chang, Seong-Won Min
The number of elderly patients undergoing total knee arthroplasty (TKA) has steadily increased. Elderly patients undergoing TKA usually have underlying diseases, and some of them take antithrombotic agents for the prevention or treatment of these co-morbidities, including cardiovascular, cerebrovascular, or thromboembolic diseases. When these patients are scheduled to undergo TKA, preoperative cessation of antithrombotic agents is considered on the basis of its risks and benefits. This study was aimed to evaluate the impact of discontinuing antithrombotic agents for primary total knee arthroplasty (TKA) on perioperative complications...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27871236/the-timing-of-administration-of-intravenous-dexmedetomidine-during-lower-limb-surgery-a-randomized-controlled-trial
#19
Eunsu Kang, Ki Hwa Lee, Sang Yoon Jeon, Kyu Won Lee, Myoung Jin Ko, Hyojoong Kim, Yong Han Kim, Jae-Wook Jung
BACKGROUND: Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause a biphasic cardiovascular response, and induce transient hypertension. Hypotension is a common complication of spinal anesthesia. Decreasing anxiety of patients before procedure is important for high quality of procedure. This study aimed to compare the incidence of hypotension and patients' anxiety and comfort levels when dexmedetomidine was intravenously administered before and after spinal anesthesia...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#20
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
January 2017: Canadian Journal of Cardiology
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