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https://www.readbyqxmd.com/read/29759717/low-level-vagus-nerve-stimulation-suppresses-post-operative-atrial-fibrillation-and-inflammation-a-randomized-study
#1
Stavros Stavrakis, Mary Beth Humphrey, Benjamin Scherlag, Omer Iftikhar, Purvi Parwani, Mubasher Abbas, Adrian Filiberti, Christian Fleming, Yanqing Hu, Paul Garabelli, Arthur McUnu, Marvin Peyton, Sunny S Po
OBJECTIVES: This study sought to examine the efficacy of low-level vagus nerve stimulation (LLVNS) in suppressing post-operative atrial fibrillation (POAF) and inflammatory cytokines in patients undergoing cardiac surgery. BACKGROUND: POAF often complicates cardiac surgery. METHODS: Patients undergoing cardiac surgery were randomized to active or sham LLVNS. In all patients, a bipolar wire was sutured to the vagus nerve pre-ganglionic fibers alongside the lateral aspect of the superior vena cava...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29751986/delirium-after-cardiac-surgery-incidence-phenotypes-predisposing-and-precipitating-risk-factors-and-effects
#2
Gianfranco Sanson, Yuliya Khlopenyuk, Sara Milocco, Massimiliano Sartori, Lorella Dreas, Adam Fabiani
BACKGROUND: In cardiac surgical patients little is known about different phenotypes of delirium and how the symptoms fluctuate over time. OBJECTIVES: Evaluate risk factors, incidence, fluctuations, phenotypic characteristics and impact on patients' outcomes of delirium. METHODS: Prospective longitudinal study. In postoperative intensive care unit 199 patient were assessed three-times a day through an adapted versions of the Intensive Care Delirium Screening Checklist...
May 8, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29726986/propensity-matched-analysis-of-a-side-clamp-versus-an-anastomosis-assist-device-in-cases-of-isolated-coronary-artery-bypass-grafting
#3
Aya Saito, Hiraku Kumamaru, Minoru Ono, Hiroaki Miyata, Noboru Motomura
OBJECTIVES: The use of an anastomosis assist device during coronary artery bypass grafting (CABG) is considered less invasive for the ascending aorta than the use of a side-biting clamp (Side-clamp) and to possibly be associated with a lower incidence of postoperative stroke. However, this benefit has not yet been clearly demonstrated. This study was to evaluate whether the use of an anastomosis assist device will minimize the postoperative stroke and other complications in patients undergoing off-pump CABG in comparison with the use of the Side-clamp...
May 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#4
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701354/isolated-tricuspid-valve-surgery-repair-versus-replacement
#5
Manuela Silva, Rui Cerejo, Pedro Coelho, José Fragata
INTRODUCTION: Isolated tricuspid valve surgery (ITVS) is an uncommon procedure with few studies published. We report our series of ITVS and compare surgical outcomes and mortality in patients undergoing valve repair (TVR) versus replacement (TVRep). METHODS: Retrospective study including all patients who underwent ITVS (n = 34) between July 2008 and June 2017, divided in two groups according to type of procedure: TVR 20 patients and TVRep 14 patients. We reviewed preoperative characteristics and analysed operative data, outcomes and mortality in both groups...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701350/rapid-deployment-aortic-valves-in-elderly-patients-age-is-not-just-a-number
#6
Tiago Velho, Hugo Ferreira, Nuno Guerra, Catarina Carvalheiro, André Sena, Nádia Junqueira, Joana Silva, Ricardo Ferreira, Javier Gallego, Ângelo Nobre
INTRODUCTION: Aortic valve stenosis (AS) is the most common valvular pathology in the elderly. Surgical aortic valve replacement (AVR) remains the gold-standard of treatment for AS. However, emerging transcatheter aortic valve replacement (TAVR) has become an increasing alternative to surgery. In a recent survey from the European Society of Cardiology, 9,4% of the physicians stated that age was the main reason to propose for a TAVR instead of surgery. METHODS: We performed a single-center retrospective study including 353 patients (149 patients over 80 years-old, compared to 204 patients between 60-69 years-old) consecutively submitted to AVR between January 1, 2013, and December 31, 2016, to compare the results of both groups in AVR surgery and how we can improve surgery outcome in older patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697597/epicardial-biatrial-ablation-with-integrated-uni-bipolar-radiofrequency-technology-in-stand-alone-persistent-atrial-fibrillation
#7
Fabrizio Rosati, Claudio Muneretto, Elisa Merati, Gianluca Polvani, Massimo Moltrasio, Claudio Tondo, Antonio Curnis, Manuel Cerini, Alexandre Metras, Gianluigi Bisleri
OBJECTIVE: Although minimally invasive approaches for surgical treatment of stand-alone atrial fibrillation have gained popularity for the past decade, ablation technology and extensive lesion sets play a major role in the achievement of a successful procedure, especially in presence of persistent and long-standing persistent atrial fibrillation. We evaluated clinical outcomes after totally endoscopic biatrial epicardial ablation of persistent atrial fibrillation with a novel integrated uni-bipolar radiofrequency device...
March 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29686877/how-to-manage-various-arrhythmias-and-sudden-cardiac-death-in-the-cardiovascular-intensive-care
#8
REVIEW
Yoshinori Kobayashi
In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed. The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29673407/hypercalcemia-as-a-rare-presentation-of-angioimmunoblastic-t-cell-lymphoma-a-case-report
#9
Sana Chams, Inaya Hajj Hussein, Skye El Sayegh, Nour Chams, Khalid Zakaria
BACKGROUND: Angioimmunoblastic T cell lymphoma is a rare malignancy, accounting for only 2% of all non-Hodgkin lymphomas, first described in the 1970s and subsequently accepted as a distinct entity in the current World Health Organization classification. Due to the paucity of this disease, there is still no identifiable etiology, no consistent risk factors, and the pathogenesis remains unclear. CASE PRESENTATION: An 83-year-old Caucasian man presented to an emergency department with palpitations and was found to have atrial fibrillation...
April 20, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29663995/-risk-factors-of-atrial-fibrillation-in-critical-ill-patients
#10
Jianyu Fu, Hongying Bi, Yunsong Xia, Hui Fang, Xu Liu, Yan Tang, Difen Wang
OBJECTIVE: To observe the clinical features of atrial fibrillation (AF) patients, and to explore the correlation between the routine detection index and the new-onset AF and to find out risk factors for new AF in critically ill patients. METHODS: A prospective observational study was conducted. The patients with AF admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from March 2016 to June 2017 were enrolled. The patients were divided into new-onset AF group and past-existed AF group according to their past history of AF (including persistent AF, paroxysmal AF or permanent AF)...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#11
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/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#12
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628586/postoperative-cardiac-surgery-outcomes-in-a-statin-native-population
#13
Sameh Aboulnaga, Ahmed Mahfouz, Hesham A Ewila, Alejandro Kohn Tuli, Rajvir Singh, Amr S Omar, Abdulaziz Al Khualifi
Background: Statin utilization had been associated with improved survival after cardiac surgery. We aim to study whether perioperative treatment with statin could be associated with increased postoperative complications. Design: This was a retrospective, descriptive, single-center study. Settings: We analyzed morbidity after cardiac surgery as well as the outcome related to statin therapy in a tertiary cardiac center. Patients: A total of 202 consecutive patients were enrolled over 1 year after cardiac surgery...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627355/contemporary-reviews-in-critical-care-medicine-atrial-fibrillation-in-the-intensive-care-unit
#14
REVIEW
Nicholas A Bosch, Jonathan Cimini, Allan J Walkey
Atrial fibrillation (AF) is the most common arrhythmia encountered in the intensive care unit. Pre-existing AF is highly prevalent among older patients with chronic conditions who are at risk for critical illness, while new-onset AF can be triggered by accelerated atrial remodeling and arrhythmogenic triggers encountered during critical illness. The acute loss of atrial systole and onset of rapid ventricular rates that characterize new-onset AF often lead to decreased cardiac output and hemodynamic compromise...
April 5, 2018: Chest
https://www.readbyqxmd.com/read/29627171/comparison-of-nicardipine-with-clevidipine-in-the-management-of-hypertension-in-acute-cerebrovascular-diseases
#15
Zachary Rosenfeldt, Katelyn Conklen, Breck Jones, Don Ferrill, Maithili Deshpande, Fazeel M Siddiqui
BACKGROUND AND PURPOSE: In acute stroke, hypertension worsens outcomes. Guidelines do not mention a preferred antihypertensive agent. This present study aimed to compare the efficacy and safety of nicardipine and clevidipine in acute stroke. METHODS: This retrospective review compared nicardipine with clevidipine for hypertension in acute stroke patients from March 17, 2015 to December 23, 2016. Ischemic and hemorrhagic stroke types were evaluated. Patients were excluded if under 18 years, had traumatic brain injury, had intracranial neoplasm, were on dialysis, had both study drugs during the stroke admission, or the study drug was infused for less than 1 hour...
April 4, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29603289/sole-and-combined-vitamin-c-supplementation-can-prevent-postoperative-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
Rui Shi, Zhen-Han Li, Dan Chen, Qing-Chen Wu, Xiao-Li Zhou, Hong-Tao Tie
We undertook a systematic review and meta-analysis to evaluate the effect of vitamin C supplementation (vitamin C solely or adjunct to other therapy) on prevention of postoperative atrial fibrillation (POAF) in patients after cardiac surgery. PubMed, EMbase, Web of Science and Cochrane Library were systematically searched to identify randomized controlled trials (RCTs) assessing the effect of vitamin C supplementation in adult patients undergoing cardiac surgery, and the meta-analysis was performed with random-effects model...
March 30, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29602943/hemoptysis-after-cardiomems-implantation-case-report-and-review
#17
Aniket S Rali, Zubair Shah, Andrew J Sauer, Kamal Gupta
BACKGROUND The CardioMEMS heart failure system is a small sensor that is placed in a branch pulmonary artery for ambulatory monitoring of pulmonary artery pressures. CardioMEMS has been approved for use in the United States in patients with New York Heart Association (NYHA) class III heart failure and frequent hospitalizations. In this report we describe a patient who had hemoptysis after CardioMEMS implantation. Further, we discuss possible etiologies for the occurrence of hemoptysis and suggest strategies to minimize this risk...
March 31, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29602588/-transesophageal-echocardiography-in-perioperative-period-guiding-the-decision-making-during-hemodynamic-instability-due-to-atrial-fibrillation
#18
João Paulo Jordão Pontes, Aline Tonin Dos Santos, Marcello Fonseca Salgado Filho
BACKGROUND AND OBJECTIVE: Atrial fibrillation is the most common cardiac arrhythmia, which may occur during the perioperative period and lead to hemodynamic instability due to loss of atrial systolic function. During atrial fibrillation management, electrical cardioversion is one of the therapeutic options in the presence of hemodynamic instability; however, it exposes the patient to thromboembolic event risks. Transesophageal echocardiography is a diagnostic tool for thrombi in the left atrium and left atrial appendage with high sensitivity and specificity, allowing early and safe cardioversion...
March 27, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29590141/length-of-hospitalization-and-mortality-for-bleeding-during-treatment-with-warfarin-dabigatran-or-rivaroxaban
#19
Blake Charlton, Gboyega Adeboyeje, John J Barron, Deborah Grady, Jaekyu Shin, Rita F Redberg
BACKGROUND: Different outcomes among patients hospitalized for bleeding after starting anticoagulation could influence choice of anticoagulant. We compared length of hospitalization, proportion of Intensive Care Unit (ICU) admissions, ICU length of stay, and 30- and 90-day mortality for adults with atrial fibrillation hospitalized for bleeding after starting warfarin, dabigatran, or rivaroxaban. METHODS: An US commercial database of 38 million members from 1 November 2010 to 31 March 2014 was used to examine adults with atrial fibrillation hospitalized for bleeding after starting warfarin (2,446), dabigatran (442), or rivaroxaban (256)...
2018: PloS One
https://www.readbyqxmd.com/read/29577930/need-for-permanent-pacemaker-after-surgical-aortic-valve-replacement-reduces-long-term-survival
#20
J Hunter Mehaffey, Nathan S Haywood, Robert B Hawkins, John A Kern, Nicholas R Teman, Irving L Kron, Leora T Yarboro, Gorav Ailawadi
BACKGROUND: Permanent pacemaker (PPM) has been touted as an inconsequential complication following Transcatheter Aortic Valve Replacement (TAVR). As TAVR moves to lower risk patients, the long-term implications remain poorly understood; therefore we evaluated the long-term outcomes of pacemaker in Surgical Aortic Valve Replacement (SAVR) patients. METHODS: A total of 2,600 consecutive patients undergoing SAVR over the past 15 years were reviewed using an institutional Society of Thoracic Surgeons (STS) database and social security death records...
March 22, 2018: Annals of Thoracic Surgery
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