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https://www.readbyqxmd.com/read/29226957/pilot-multi-centre-randomised-trial-of-the-impact-of-pre-operative-focused-cardiac-ultrasound-on-mortality-and-morbidity-in-patients-having-surgery-for-femoral-neck-fractures-echonof-2-pilot
#1
D J Canty, J Heiberg, Y Yang, A G Royse, S Margale, N Nanjappa, D Scott, A Maier, D I Sessler, A Chuan, A Palmer, A Bucknill, C French, C F Royse
Hip fracture surgery is common, usually occurs in elderly patients who have multiple comorbidities, and is associated with high morbidity and mortality. Pre-operative focused cardiac ultrasound can alter diagnosis and management, but its impact on outcome remains uncertain. This pilot study assessed feasibility and group separation for a proposed large randomised clinical trial of the impact of pre-operative focused cardiac ultrasound on patient outcome after hip fracture surgery. Adult patients requiring hip fracture surgery in four teaching hospitals in Australia were randomly allocated to receive focused cardiac ultrasound before surgery or not...
December 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29225981/tricuspid-valve-endocarditis-due-to-streptococcus-bovis-in-a-patient-with-ventricular-septal-defect-a-rare-manifestation-case-report-and-review-of-the-literature
#2
J Pushpakumara, G Mudiyanse, A Jayawardana, J Siriwardana, N L A Shyamali, J Indrakumar
Streptococcus bovis endocarditis has 18%-62% association with colonic neoplasms with multivalvular involvement and affects mainly elderly males leading to severe cardiac dysfunction, septic embolization, and neurological complications. The aortic valve is the commonest valve to be affected followed by aortic and mitral valves together. However, involvement of tricuspid valve is extremely rare. There are no reported cases of Streptococcus bovis endocarditis affecting the tricuspid valve in the presence of ventricular septal defect with left to right shunt...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29225254/observational-study-of-infective-endocarditis-at-a-community-based-hospital-dominance-of-elderly-patients-with-comorbidity
#3
Tomoo Nagai, Yoshiyuki Takase, Akira Hamabe, Hirotsugu Tabata
Objective The purpose of this study was to present the recent clinical profiles and the real-world management of infective endocarditis (IE). Methods All medical records of patients with IE were reviewed retrospectively for their clinical data, including clinical presentation, laboratory results, blood cultures, echocardiographic findings, treatments and complications. Using the clinical data collected, we calculated the EuroSCORE II, the European risk score for adult cardiac surgery, the Charlson Comorbidity Index as a surrogate of comordibity, and the Katz Index as a surrogate of frailty...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29223939/-papillary-fibroelastoma-retrospective-analysis-clinical-presentation-and-surgical-results
#4
Pamela Bobadilla, Carlos Vigliano, Jose H Casabé, Eduardo Guevara, Fabián Salmo, José Abud, Eduardo Dulbecco, Roberto R Favaloro
Papillary ibroelastomas are small benign intracardiac tumors known for their embolic potential. Since the introduction of echocardiography with improved resolution and transesophageal imaging techniques, they are being increasingly detected in clinical practice. In recent series, papillary fibroelastoma is considered the most frequent benign tumor of the heart. Our objective was to analyze characteristics and midterm surgical outcome of histologically-confirmed cases of papillary fibroelastoma. We conducted a retrospective study on patients with cardiac tumors submitted to surgical excision between June 1992 and February 2017...
2017: Medicina
https://www.readbyqxmd.com/read/29223872/relationship-between-thrombus-age-in-aspirated-coronary-material-and-mid-term-major-adverse-cardiac-and-cerebrovascular-events-in-patients-with-acute-myocardial-infarction
#5
Kensaku Nishihira, Yoshisato Shibata, Atsushi Yamashita, Nehiro Kuriyama, Yujiro Asada
BACKGROUND AND AIMS: Recent studies have shown that coronary thrombus histopathology is associated with impaired myocardial reperfusion and poor clinical outcome in patients with acute myocardial infarction (AMI). We sought to investigate the age of thrombi aspirated during percutaneous coronary intervention (PCI) in patients with AMI and evaluate the relationship between histopathologic findings and major adverse cardiac and cerebrovascular events (MACCEs) defined as all-cause death, stroke, or myocardial infarction within 6 months of PCI...
December 5, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29223726/computed-tomography-measurement-of-the-left-atrial-appendage-for-optimal-sizing-of-the-watchman-device
#6
Bo Xu, Jorge Betancor, Kimi Sato, Serge Harb, Karim Abdur Rehman, Kunal Patel, Arnav Kumar, Paul C Cremer, Wael Jaber, L Leonardo Rodriguez, Paul Schoenhagen, Oussama Wazni
INTRODUCTION: Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established. OBJECTIVES: We investigated the clinical utility of a standardized imaging protocol, with pre-procedural multi-detector cardiac computed tomography (MDCT), and intra-procedural transesophageal echocardiography (TEE), for Watchman device sizing...
December 5, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#7
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29217234/outcomes-following-three-factor-inactive-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-administration-during-cardiac-surgery
#8
Patrick C Harper, Mark M Smith, Nathan J Brinkman, Melissa A Passe, Darrell R Schroeder, Sameh M Said, Gregory A Nuttall, William C Oliver, David W Barbara
OBJECTIVE: To compare outcomes following inactive prothrombin complex concentrate (PCC) or recombinant activated factor VII (rFVIIa) administration during cardiac surgery. DESIGN: Retrospective propensity-matched analysis. SETTING: Academic tertiary-care center. PARTICIPANTS: Patients undergoing cardiac surgery requiring cardiopulmonary bypass who received either rFVIIa or the inactive 3-factor PCC. INTERVENTIONS: Outcomes following intraoperative administration of rFVIIa (263) or factor IX complex (72) as rescue therapy to treat bleeding...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29216218/stroke-subtype-classification-by-geometrical-descriptors-of-lesion-shape
#9
Bastian Cheng, Christian Knaack, Nils Daniel Forkert, Renate Schnabel, Christian Gerloff, Götz Thomalla
BACKGROUND AND PURPOSE: Inference of etiology from lesion pattern in acute magnetic resonance imaging is valuable for management and prognosis of acute stroke patients. This study aims to assess the value of three-dimensional geometrical lesion-shape descriptors for stroke-subtype classification, specifically regarding stroke of cardioembolic origin. METHODS: Stroke Etiology was classified according to ASCOD in retrospectively selected patients with acute stroke...
2017: PloS One
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#10
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29200087/rapid-explantation-of-rapid-deployment-sutureless-valve-in-case-of-acute-endocarditis-how-to-remove-safely-sutureless-perceval-s-prostheses
#11
Lorenzo Di Bacco, Steffen Pfeiffer, Theodor J M Fischlein, Giuseppe Santarpino
We report a case of infective endocarditis on a Perceval S aortic valve bioprosthesis, and we describe a feasible and useful technique that can help remove the infected valve. These maneuvers consist of an "x-movement" reached with the aid of anatomical forceps. The risk of infective endocarditis in patients with prosthetic valves is a well-known phenomena in cardiac surgery, and it can represent a life-threatening event in many cases. According to guidelines, an emergency surgical intervention is required in case of high risk of embolization, vegetation superior than 1 cm or acute cardiac failure secondary to the acute valve dysfunction...
December 1, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29198992/cardiac-troponin-and-adverse-outcomes-in-atrial-fibrillation-a-meta-analysis
#12
REVIEW
Yichuan Fan, Xingzhi Zhao, Xiaodong Li, Nan Li, Xinhua Hu
BACKGROUND: The prognostic value of cardiac troponin elevation in atrial fibrillation (AF) is unclear. OBJECTIVE: To investigate the association of cardiac troponin elevation with adverse outcomes in AF by conducting a meta-analysis. METHODS: We systematically searched the PubMed and Embase databases until April 2017 for studies assessing the association of cardiac troponin-T (cTnT) or troponin-I (cTnI) elevation with adverse outcomes in AF...
November 30, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29194654/safety-and-efficacy-analysis-of-one-stop-intervention-for-treating-nonvalvular-atrial-fibrillation
#13
Hongde Hu, Kaijun Cui, Jian Jiang, Hua Fu, Rui Zeng
BACKGROUND: Nonvalvular atrial fibrillation (AF) is a common arrhythmia. The treatment strategy for AF mainly includes controlling symptoms and decreasing the rate of complications. Our study aimed to evaluate the safety and efficacy of combination treatment of catheter ablation and left atrial appendage (LAA) closure (one-stop intervention) in patients with nonvalvular AF. METHODS AND RESULTS: Thirty-four patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
November 30, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29189853/-features-management-and-prognosis-of-chilean-patients-with-non-valvular-atrial-fibrillation-garfield-af-registry
#14
Ramón Corbalán, Carlos Conejeros, Carlos Rey, Benjamín Stockins, Germán Eggers, Carlos Astudillo, Fernando Lanas, Sergio Potthoff, César Houzvic, Humberto Montecinos, Gustavo Charme, Claudio Bugueño, Juan Aguilar, Germán Arriagada, Patricio Marín, Martín Larico
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with high rates of death, ischemic stroke and systemic embolism (SE). There is scarce information about clinical characteristics and use of anti-thrombotic therapies in Chilean patients with non-valvular AF. AIM: To describe the characteristics and 1-year outcomes of patients with recently diagnosed AF recruited in Chile into the prospective global GARFIELD-AF registry. MATERIAL AND METHODS: Between 2011-2016, we prospectively registered information of 971 patients recruited at 15 centers, 85% of them from the public system and 15% from the private sector...
August 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29189832/-peripheral-embolization-and-rapid-growth-of-papillary-fibroelastoma-in-a-young-woman
#15
Alessandro Minati, Danilo Ruggiero, Florida Gripshi, Antonella Cherubini, Lorenzo Zandonà, Andrea Di Lenarda, Aniello Pappalardo
Papillary fibroelastoma, a benign cardiac tumor, is a rare clinical condition. Before the echocardiography era, the diagnosis was often occasional, especially during other cardiac procedures; but nowadays it has improved with the advent of higher-resolution imaging technology. The clinical presentation can vary from asymptomatic to severe complications such as cerebrovascular or ischemic events due to tumor embolization.We present the case of a 33-year-old female with a papillary fibroelastoma on the anterior leaflet of the mitral valve undergoing clinical examination for claudicatio intermittens...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29187386/high-incidence-of-atrial-fibrillation-after-embolic-stroke-of-undetermined-source-in-posterior-cerebral-artery-territory
#16
Hisaki Makimoto, Muhammed Kurt, Michael Gliem, John-Ih Lee, Jan Schmidt, Patrick Müller, Lukas Clasen, Christoph Brinkmeyer, Dong-In Shin, Sebastian Jander, Malte Kelm, Alexander Fürnkranz
BACKGROUND: Subclinical atrial fibrillation is one possible cause of embolic stroke of undetermined source (ESUS). It remains to be elucidated if a specific infarction site has a predictive value for detecting subclinical atrial fibrillation. We aimed to investigate the predictive value of infarction site in patients with ESUS for the detection of atrial tachyarrhythmia (AT) using an insertable cardiac monitor. METHODS AND RESULTS: Consecutive 146 patients (84 men; aged 62±12 years) underwent insertable cardiac monitor implantation after diagnosis of ESUS...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29186727/cardiac-air-embolism-in-neonates-a-hemodynamic-perspective
#17
Deepak Louis, Reem Amer, Yasser N Elsayed
No abstract text is available yet for this article.
November 29, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29181220/angio-seal%C3%A2-embolization-a-rare-etiology-of-an-acute-distal-limb-ischemia
#18
Glenmore Lasam, Joshua Brad Oaks, Jeffrey Brensilver
We herein report a serious vascular complication of diagnostic cardiac catheterization due to an embolization of an Angio-Seal closure device causing acute lower limb ischemia. The Angio-Seal was deployed via the right femoral artery following the catheterization which embolized several hours later to the right popliteal artery. Fogarty embolectomy restored perfusion to the right lower limb; however, compartment syndrome subsequently developed which required evacuation of a hematoma and repair of right popliteal artery...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/29177015/clinical-significance-of-atrial-high-rate-episodes-for-thromboembolic-events-in-japanese-population
#19
Hiroshi Kawakami, Takayuki Nagai, Makoto Saito, Shinji Inaba, Fumiyasu Seike, Kazuhisa Nishimura, Katsuji Inoue, Takafumi Okura, Takumi Sumimoto, Shigeki Uemura, Jitsuo Higaki, Shuntaro Ikeda
Objective: The clinical significance of atrial high-rate episodes (AHREs) detected by cardiac devices among patients with implantable pacemakers has recently emerged. However, the relationship between AHREs and ischaemic stroke and systemic embolism (SE) is not well understood in the Japanese population. Methods: This study included 343 patients with pacemakers capable of continuous atrial rhythm monitoring (167 males; mean age, 80±7 years). Atrial tachyarrhythmia detection was programmed to the nominal setting of each device, and AHRE was defined as any episode of sustained atrial tachyarrhythmia lasting for more than 6 min...
2017: Heart Asia
https://www.readbyqxmd.com/read/29174781/utilization-of-veno-arterial-extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism
#20
Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat these patients. METHODS: All patients with a massive pulmonary embolism who were placed on VA-ECMO, as an initial intervention determined by protocol, were retrospectively reviewed...
November 23, 2017: Annals of Thoracic Surgery
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