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cardiology, cardiac surgery

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https://www.readbyqxmd.com/read/29754203/prospective-analysis-of-decision-making-during-joint-cardiology-cardiothoracic-conference-in-treatment-of-107-consecutive-children-with-congenital-heart-disease
#1
Sophie Duignan, Aedin Ryan, Dara O'Keeffe, Damien Kenny, Colin J McMahon
The complexity and potential biases involved in decision making have long been recognised and examined in both the aviation and business industries. More recently, the medical community have started to explore this concept and its particular importance in our field. Paediatric cardiology is a rapidly expanding field and for many of the conditions we treat, there is limited evidence available to support our decision-making. Variability exists within decision-making in paediatric cardiology and this may influence outcomes...
May 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29744013/pregnancy-in-women-with-cardiovascular-diseases
#2
REVIEW
Karolina Adam
Patients with cardiovascular disease represent a significant cohort at risk for complications during pregnancy. The normal physiologic changes of pregnancy could further compromise the hemodynamics of various cardiovascular conditions, resulting in clinical deterioration and even death. The fetus of a gravida with cardiovascular disease also has an increased risk of morbidity, including an increased risk of inherited cardiac genetic disorders, fetal growth restriction, and premature delivery. These complications also increase the risk for antenatal and perinatal mortality...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29741482/mortality-risk-after-transcatheter-aortic-valve-implantation-analysis-of-the-predictive-accuracy-of-the-transcatheter-valve-therapy-registry-risk-assessment-model
#3
Pablo Codner, Waqas Malick, Remi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Uri Landes, Torsten Peter Vahl, Isaac George, Tamim Nazif, Ajay J Kirtane, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali
AIMS: Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. METHODS AND RESULTS: Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29735354/prediction-of-sudden-death-risk-in-obstructive-hypertrophic-cardiomyopathy-potential-for-refinement-of-current-criteria
#4
Milind Y Desai, Nicholas G Smedira, Ashwat Dhillon, Ahmad Masri, Oussama Wazni, Mohamad Kanj, Kimi Sato, Maran Thamilarasan, Zoran B Popovic, Harry M Lever
BACKGROUND: In patients with hypertrophic cardiomyopathy (HCM), the use of an implantable cardioverter defibrillator (ICD) can prevent sudden cardiac death (SCD). In patients with obstructive HCM, we sought to determine the prognostic utility of European Society of Cardiology (ESC) SCD risk score and to evaluate whether additional factors modulate SCD risk. METHODS: We studied 1809 consecutive patients with obstructive HCM (mean age, 50 ± 14 years; 63% males; mean maximal outflow tract gradient, 93 ± 40 mm Hg)...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29726003/limitations-of-current-near-infrared-spectroscopy-configuration-in-detecting-focal-cerebral-ischemia-during-cardiac-surgery-an-observational-case-series-study
#5
Gabor Erdoes, Christian Rummel, Reto M Basciani, Rajeev Verma, Thierry Carrel, Yara Banz, Balthasar Eberle, Gerhard Schroth
Cerebral oximetry using near-infrared spectroscopy (NIRS) allows for continuous monitoring of cerebral perfusion and immediate treatment of hemodynamic perturbations. In configurations used in current clinical practice, NIRS optodes are placed on the patient`s forehead and cerebral oxygen saturation (ScO2 ) is determined in bilateral frontal cortical samples. However, focal cerebral ischemic lesions outside of the NIRS field of view may remain undetected. The objective of this observational case-series study was to investigate ScO2 measurements in patients with acute iatrogenic stroke not located in the frontal cortical region...
May 3, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29717636/importance-of-cardiovascular-examination-in-patients-with-multiple-lentigines-two-cases-of-leopard-syndrome-with-hypertrophic-cardiomyopathy
#6
Tomas Jurko, Alexander Jurko, Jana Krsiakova, Alexander Jurko, Milan Minarik, Michal Mestanik
Introduction LEOPARD syndrome is a rare genetic disorder characterised by lentigines, electrocardiographic conduction abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth and sensorineural deafness. Clinical manifestations are often mild, which may result in difficult and late diagnosis. Cardiac involvement may have a significant impact on the prognosis, however, appearance of severe abnormalities such as hypertrophic cardiomyopathy usually precedes the occurrence of multiple lentigines and may be asymptomatic...
May 2, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29716732/different-nuss-procedures-and-risk-management-for-pectus-excavatum-after-surgery-for-congenital-heart-disease
#7
Chenghao Chen, Xiaofeng Li, Na Zhang, Jie Yu, Dong Yan, Changqi Xu, Qi Zeng, Zhongzhi Li
PURPOSE: In Nuss procedure for pectus excavatum (PE) after surgery for congenital heart disease (CHD), retrosternal adhesion may increase the risk of cardiac injury. This study aimed to explore different Nuss procedures and their implications for reducing the incidence of serious complications and improving surgical safety. METHODS: We retrospectively reviewed 49 cases (29 male and 20 female) of Nuss procedures for PE after surgery for CHD that were performed between April 2003 and December 2016...
April 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29706438/-current-situation-of-the-organisation-resources-and-activity-in-paediatric-cardiology-in-spain
#8
Francisco Sánchez Ferrer, Francisco José Castro García, Javier Pérez-Lescure Picarzo, Ferrán Roses Noguer, Fernándo Centeno Malfaz, María Dolores Grima Murcia, Dimpna Albert Brotons
INTRODUCTION: The results are presented on the «current situation of the organisation, resources and activity in paediatric cardiology in Spain». It was promoted by the Spanish Society of Paediatric Cardiology and Congenital Heart disease. MATERIAL AND METHODS: An analysis was carried out on the results obtained from a specifically designed questionnaire, prepared by the Spanish Society of Paediatric Cardiology and Congenital Heart disease, that was sent to all hospitals around the country that offer the speciality of paediatric cardiology...
April 26, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29704905/the-development-of-a-consensus-based-nutritional-pathway-for-infants-with-chd-before-surgery-using-a-modified-delphi-process
#9
Luise V Marino, Mark J Johnson, Nigel J Hall, Natalie J Davies, Catherine S Kidd, M Lowri Daniels, Julia E Robinson, Trevor Richens, Tara Bharucha, Anne-Sophie E Darlington
IntroductionDespite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.Materials and methodsThe modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation...
April 29, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29694994/predicting-the-future-delivery-room-planning-of-congenital-heart-disease-diagnosed-by-fetal-echocardiography
#10
Mary T Donofrio
Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29678618/concomitant-surgical-atrial-fibrillation-ablation-is-safe-and-efficacious-in-patients-undergoing-double-valve-replacement-a-cohort-study
#12
Guang Tong, Hao Yu, Xuan Zhou, Ben Zhang, Shenghui Bi, Lin Luo, Tao Yan, Xianyue Wang, Hua Lu, Tao Ma, Xiaowu Wang, Zhongchan Sun, Weida Zhang
BACKGROUND: Current European Society of Cardiology Guidelines recommend concomitant atrial fibrillation (AF) ablation for all symptomatic patients undergoing other cardiac surgeries, but the safety and potential benefits of concomitant atrial fibrillation (AF) ablation at the time of double valve replacement (DVR: aortic and mitral valve replacement) remains unexamined. MATERIALS AND METHODS: We conducted a retrospective review of 238 patients with AF who underwent DVR with or without concomitant surgical ablation (Ablation group, n=113; Non-ablation group, n=125) at a single institute from April 2006 to September 2011...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29656776/purulenta-pericarditis-and-pasteurella-multocida-an-extremely-rare-entity
#13
Raquel Ferreira, José Martins, Tiago Adrega, Sara Pinto, Sofia Nunes, Rita Pancas, Anabela Gonzaga, José Santos
Purulent pericarditis is a rare entity, defined as the presence of neutrophilic pericardial effusion which is infected by a bacterial, fungus or parasite agent. The diagnosis can be challenging, especially if patients have taken previous antibiotic therapy; on the other hand the recognition of this pathology is often made late, with the onset of severe symptoms or signs of cardiac tamponade or even only at the autopsy. The authors describe the case of a 82-year-old woman with history of extensive laceration of the right lower limb from a dog bite in July 2016, admitted to the Cardiology Department one month later for Acute Pericarditis...
April 12, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#14
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29643869/neurological-complications-are-avoidable-during-cabg
#15
Zulfiqar Haider, Anjum Jalal, Asif Rashid Alamgir, Irfan Rasheed
Objective: To review the incidence of stroke in patients undergoing CABG and the impact of a preventive strategy adopted at tertiary care unit of cardiac surgery. Methods: The data of all patients who underwent isolated CABG (N= 722) from July 2016 to August 2017 at Faisalabad Institute of Cardiology was retrieved for this retrospective study. All operations were done on cardiopulmonary bypass and cold blood cardioplegia. Numeric data was summarized as Mean ± Standard Deviation while categoric variables were summarized into frequency and percentage...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29614534/-current-concepts-of-cardiologic-therapies-in-the-elderly
#16
Ursula Müller-Werdan, Kristina Norman
MYOCARDIAL INFARCTION IN THE OLD PATIENT: Even old patients may crucially benefit from reopening the occluded coronary artery by percutaneous coronary intervention with stent implantation. Bleeding complications can be reduced by choosing the radial instead of the femoral vascular approach for cardiac catheterization. STATINS FOR THE ELDERLY: WHEN TO START UND WHEN TO STOP?: Elderly benefit no less than the younger from statins. "Goal-oriented statin therapy" is preferable to the "statin strategy of fixed dose"...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29589418/myocardial-injury-after-non-cardiac-surgery-a-perioperative-affair
#17
Viviana Miccichè, Cesare Baldi, Edoardo DE Robertis, Ornella Piazza
Myocardial injury after non cardiac surgery (MINS) is a rather new nosological entity and an unfortunately common perioperative complication. The diagnostic criteria for MINS, also indicated as isolated myocardi- al injury (IMI), are an elevated postoperative high sensitivity Troponin T (hsTnT level ranging between 20 and 65 ng/L with an absolute change of at least 5 ng/L or hsTnT level > 65 ng/L), in absence of symptoms and/or EKG findings suggestive of ischemia and without a non ischemic aetiology causing Troponin eleva- tion...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29588742/expert-opinion-guidelines-for-the-management-of-patients-with-aortic-stenosis-undergoing-non-cardiac-surgery-out-of-date-and-overly-prescriptive
#18
Simon Kennon, Andrew Archbold
Patients with severe aortic stenosis who require non-cardiac surgery present a difficult clinical problem. The most recent clinical practice guidelines from the American College of Cardiology/American Heart Association and the European Society of Cardiology for the perioperative cardiovascular assessment and management of patients undergoing noncardiac surgery were both published in 2014. These guidelines are reviewed in the light of recently published randomised controlled trial data regarding the efficacy of transcatheter aortic valve implantation to treat aortic stenosis...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29549136/sequential-cataract-surgeries-in-a-patient-with-a-left-ventricular-assist-device-lvad
#19
Alina Yang, Ji Liu
The population of patients on left ventricular assist devices (LVADs) has increased significantly since the 1990s, and with it, need for non-cardiac elective surgeries. Presence of an LVAD or heart failure, however, can cause physicians to perceive these patients to be at prohibitively high risk for elective surgery. Nevertheless, as one of the most common causes of poor vision in the elderly, cataracts can significantly limit improvements in quality of life that a patient may have otherwise gained from LVAD support...
March 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29531770/critical-appraisal-of-cardiology-guidelines-on-revascularisation-clinical-practice
#20
REVIEW
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
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