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Cirurgia cardiaca

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107 papers 25 to 100 followers
By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
https://www.readbyqxmd.com/read/28365080/the-cocos-trial-caloric-control-in-cardiac-surgery-patients-promotes-survival-an-interventional-trial-with-retrospective-control
#1
Elisabeth De Waele, Ducnam Nguyen, Karlien De Bondt, Mark La Meir, Marc Diltoer, Patrick M Honoré, Herbert Spapen, Joeri J Pen
BACKGROUND & AIMS: Malnutrition is widespread among cardiac surgery patients and is independently related to an adverse postoperative evolution or outcome. We aimed to assess whether nutrition therapy (NT) could alter caloric deficit, morbidity, and mortality in patients scheduled for non-emergency coronary artery bypass graft (CABG) or aortic valve surgery. METHODS: 351 patients undergoing either elective CABG or aortic valve surgery were studied. Patients receiving NT were enrolled from January 2013 until December 2014...
March 18, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28364394/transcatheter-mitral-valve-interventions-current-therapies-and-future-directions
#2
REVIEW
Ramon A Partida, Sammy Elmariah
Transcatheter interventions for the treatment of aortic valve stenosis have become commonplace since the advent of transcatheter aortic valve implantation. However, transcatheter mitral valve therapies have lagged in development due to the complexity of mitral valve anatomy. Transcatheter edge-to-edge leaflet repair using the MitraClip device provides an option for the treatment of severe primary mitral valve regurgitation in high or prohibitive surgical risk patients, and multiple novel approaches are evolving to replace or repair the mitral valve...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28286090/surgical-revascularisation-in-the-early-phase-of-st-segment-elevation-myocardial-infarction-haemodynamic-status-is-more-important-than-the-timing-of-the-operation
#3
Vilem Rohn, Tomas Grus, Jan Belohlavek, Jan Horak
BACKGROUND: Surgical revascularisation in patients with acute myocardial infarction with ST-Segment Elevation (STEMI) is usually considered as a second choice when direct angioplasty/stent fails. However, improvements in surgical technique and postoperative care may justify coronary artery bypass grafting (CABG) in STEMI. METHODS: This was a retrospective analysis of prospectively gathered data of 135 patients with acute STEMI, treated with CABG in our department from February 2008 to December 2012...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28203408/determinants-of-prolonged-intensive-care-unit-stay-in-patients-after-cardiac-surgery-a-prospective-observational-study
#4
Theodore Kapadohos, Epameinondas Angelopoulos, Ioannis Vasileiadis, Serafeim Nanas, Anastasia Kotanidou, Andreas Karabinis, Katerina Marathias, Christina Routsi
BACKGROUND: Prolonged intensive care unit (ICU) stay of patients after cardiac surgery has a major impact on overall cost and resource utilization. The aim of this study was to identify perioperative factors which prolong stay in ICU. METHODS: All adult patients from a single, specialized cardiac center who were admitted to the ICU after cardiac surgery during a 2-month period were included. Demographic and clinical characteristics, comorbidities, preoperative use of drugs, intraoperative variables, and postoperative course were recorded...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#5
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
BACKGROUND: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. METHODS: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28131427/previous-percutaneous-coronary-intervention-does-not-increase-adverse-events-after-coronary-artery-bypass%C3%A2-surgery
#6
Chikara Ueki, Hiroaki Miyata, Noboru Motomura, Genichi Sakaguchi, Takehide Akimoto, Shinichi Takamoto
BACKGROUND: Adverse effects of previous percutaneous coronary intervention (PCI) on clinical outcomes after coronary artery bypass grafting (CABG) are unclear. This study aimed to evaluate the effect of previous PCI on early outcomes after subsequent CABG by using data from the Japanese national database. METHODS: This study analyzed data from 48,051 consecutive patients that were retrieved from the Japan Adult Cardiovascular Surgery Database. These patients underwent primary, isolated, elective CABG between January 2008 and December 2013...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28135709/acute-kidney-injury-and-in-hospital-mortality-after-coronary-artery-bypass-graft-versus-percutaneous-coronary-intervention-a-nationwide-study
#7
Wen Shen, Rodrigo Aguilar, Alex R Montero, Stephen J Fernandez, Allen J Taylor, Christopher S Wilcox, Michael S Lipkowitz, Jason G Umans
BACKGROUND: Post-procedural acute kidney injury (AKI) is associated with significantly increased short- and long-term mortalities, and renal loss. Few studies have compared the incidence of post-procedural AKI and in-hospital mortality between 2 major modalities of revascularization - coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) - and results have been inconsistent. METHODS: We generated a propensity score-matched cohort that includes a total of 286,670 hospitalizations with multi-vessel coronary disease undergoing CABG or PCI (2004-2012) from the National Inpatient Sample database...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28109574/revascularization-strategies-and-outcomes-in-elderly-patients-with-multivessel-coronary-disease
#8
J Trevor Posenau, Daniel M Wojdyla, Linda K Shaw, Karen P Alexander, E Magnus Ohman, Manesh R Patel, Peter K Smith, Sunil V Rao
BACKGROUND: Balancing risks and benefits of revascularization in elderly patients with multivessel coronary artery disease (CAD) is challenging. The appropriate revascularization strategy for elderly patients with multivessel CAD is unclear. METHODS: We used the Duke Databank for Cardiovascular Disease to identify patients aged 75 years or more who had multivessel disease and treatment with percutaneous coronary intervention or coronary artery bypass graft surgery (CABG) within 30 days of the index catheterization between October 1, 2003, and June 30, 2013...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/12947371/angiographically-silent-left-main-disease-detected-by-intravascular-ultrasound-a-marker-for-future-adverse-cardiac-events
#9
Mark J Ricciardi, Sheridan Meyers, Kelly Choi, John L Pang, Lynne Goodreau, Charles J Davidson
BACKGROUND: Concomitant moderate obstructive left main (LM) disease is associated with future cardiac events and poor prognosis in patients undergoing percutaneous intervention (PCI). Whether prognosis is similarly effected by LM disease not detected by angiography, but evident on intravascular ultrasound (IVUS) imaging, is not known. The purpose of this study was to evaluate the long-term prognosis of patients with angiographically insignificant LM coronary artery disease undergoing PCI...
September 2003: American Heart Journal
https://www.readbyqxmd.com/read/23892449/bypass-to-the-left-coronary-artery-system-may-accelerate-left-main-coronary-artery-negative-remodeling-and-calcification
#10
Yunpeng Shang, Gary S Mintz, Jun Pu, Jun Guo, Nobuaki Kobayashi, Theresa Franklin-Bond, Martin B Leon, Jeffrey W Moses, Akiko Maehara, Takehisa Shimizu, Tadayuki Yakushiji
AIMS: This study aimed to use intravascular ultrasound (IVUS) data to reveal the mechanism of lesion progression in the native coronary circulation proximal to bypass grafts after coronary artery bypass grafting (CABG). METHODS AND RESULTS: We reviewed IVUS images in 86 patients with an angiographically significant left main coronary artery (LMCA) stenosis. Overall, 41 patients underwent CABG more than 6 months (mean 8.2 ± 6.1 years) previously and had at least one patent graft to the left coronary artery system...
November 2013: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28099219/a-review-of-the-clinical-utility-of-intravascular-ultrasound-and-optical-coherence-tomography-in-the-assessment-and-treatment-of-coronary-artery-disease
#11
REVIEW
Stephen Daniel Matthews, William H Frishman
Coronary artery disease remains one of the leading causes of morbidity and mortality in the United States. As a medical society, we continue to search for ways to better treat coronary artery disease and prevent acute coronary syndrome (ACS). As it stands, only statins and antiplatelet agents have been proven to significantly reduce the occurrence of ACS. A histopathological understanding of the pathogenesis of ACS has provided insight into the importance of plaque morphology. Therefore, it has been proposed that increasing the ability to detect true vulnerable, "at-risk" lesions, would foster the use of percutaneous coronary intervention as a means for the prevention of ACS...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28065908/ticagrelor-but-not-clopidogrel-active-metabolite-displays-antithrombotic-properties-in-the-left-atrial-endocardium
#12
Martin F Reiner, Alexander Breitenstein, Erik W Holy, Martina Glanzmann, Heidi Amstalden, Simon F Stämpfli, Nicole R Bonetti, Volkmar Falk, Stephan Keller, Gianluigi Savarese, Stefano Benussi, Francesco Maisano, Thomas F Lüscher, Jürg H Beer, Jan Steffel, Giovanni G Camici
Aims: Oral anticoagulation is considered standard therapy for stroke prevention in atrial fibrillation (AF). Endocardial activation triggers expression of pro-thrombotic mediators including tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1), and contributes to thrombus formation in the left atrial appendage (LAA) of AF patients. Recently, pleiotropic effects of specific P2Y12 receptor antagonists were demonstrated; however, whether these drugs possess antithrombotic effects on LAA endocardial cells currently remains unknown...
March 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/27570160/optimal-timing-from-myocardial-infarction-to-coronary-artery-bypass-grafting-on-hospital-mortality
#13
MULTICENTER STUDY
Elizabeth L Nichols, Jock N McCullough, Cathy S Ross, Robert S Kramer, Benjamin M Westbrook, John D Klemperer, Bruce J Leavitt, Jeremiah R Brown, Elaine Olmstead, Felix Hernandez, Gerald L Sardella, Carmine Frumiento, David Malenka, Anthony DiScipio
BACKGROUND: Whether delaying coronary artery bypass grafting (CABG) after myocardial infarction (MI) is associated with better outcomes or is an unnecessary use of health care resources is unclear. This study investigated the relationship between MI-to-CABG timing on in-hospital death. METHODS: From the Northern New England Cardiovascular Disease Study Group (NNE) Cardiac Surgery Registry we identified 3,060 isolated CABG patients with prior MI from 2008 to 2014...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#14
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
February 28, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27594874/predictors-of-new-onset-atrial-fibrillation-in-elderly-patients-with-coronary-artery-disease-after-coronary-artery-bypass-graft
#15
Rubanenko O Anatoĺevna, Fatenkov O Veniaminovich, Khokhlunov S Mikhaylovich
OBJECTIVE: To identify the factors associated with the development of postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) in elderly patients with coronary artery disease (CAD). METHODS: A total of 81 patients with CAD who underwent CABG were enrolled in the study. Patients were divided into two groups: Group 1, without postoperative atrial fibrillation (59 patients, 74.6% men, mean age 65.8 ± 4.0 years); Group 2, with early new-onset atrial fibrillation after CABG (22 patients, 90...
July 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27498373/renoprotection-by-remote-ischemic-conditioning-during-elective-coronary-revascularization-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
Chenghui Zhou, Yunseok Jeon, Patrick Meybohm, Alexander Zarbock, Paul Jeffrey Young, Lihuan Li, Derek J Hausenloy
BACKGROUND: Remote ischemic conditioning (RIC) has been recognized an emerging non-invasive approach for preventing acute kidney injury (AKI) in patients undergoing either elective coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). On the other hand, accumulating evidence has indicated the involving role of pre-CABG contrast usage for coronary angiography in post-surgery AKI risk. Along with the shortening time delay of CABG after coronary angiography, and the prevalent hybrid coronary revascularization (HCR), the AKI prevention by RIC has faced challenges following coronary revascuralization...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27460359/prompt-impact-of-first-prospective-statin-mega-trials-on-postoperative-lipid-management-of-cabg-patients-a-20-year-follow-up-in-a-single-hospital
#17
A Palomäki, V Hällberg, M Ala-Korpela, P T Kovanen, K Malminiemi
BACKGROUND: The long-term success of coronary artery bypass grafting (CABG) depends on secondary prevention. Vast evidence provided by the results of cholesterol mega-trials over two decades has shown that effective reduction of LDL cholesterol improves the prognosis of patients with coronary heart disease. However, the implementation of these results into the clinical practice has turned out to be challenging. We analysed how the information derived from clinical statin trials and international recommendations affected the local treatment practices of dyslipidaemia of CABG patients during a 20-year time period...
July 26, 2016: Lipids in Health and Disease
https://www.readbyqxmd.com/read/27479778/comparative-effectiveness-of-coronary-artery-bypass-grafting-cabg-surgery-and-percutaneous-coronary-intervention-pci-in-elderly-patients-with-diabetes
#18
Ruchit Shah, Yi Yang, John P Bentley, Benjamin F Banahan
OBJECTIVE: To compare the relative effectiveness of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) among elderly patients with diabetes regarding acute myocardial infarction (AMI), stroke, repeat revascularization, and all-cause mortality. METHODS: A retrospective cohort study was conducted using the 2006-2008 5% national sample of Medicare claims data. Elderly (≥65 years) beneficiaries with at least two claims of diabetes separated by ≥30 days and who had at least one inpatient claim for multi-vessel CABG or PCI between 1 July 2006 and 30 June 2008 were identified...
November 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27326237/choice-of-prosthetic-heart-valve-in-a-developing-country
#19
Shiv Kumar Choudhary, Sachin Talwar, Balram Airan
Mechanical prostheses and stented xenografts (bioprosthesis) are most commonly used substitutes for aortic and mitral valve replacement. The mechanical valves have the advantage of durability but are accompanied with the risk of thromboembolism, problems of long-term anticoagulation, and associated risk of bleeding. In contrast, bioprosthetic valves do not require long-term anticoagulation, but carry the risk of structural valve degeneration and re-operation. A mechanical valve is favoured in young patients (<40 years) if reliable anticoagulation is ensured...
2016: Heart Asia
https://www.readbyqxmd.com/read/27275298/incidence-and-impact-of-patient-prosthesis-mismatch-in-isolated-aortic-valve-surgery
#20
Selman Dumani, Ermal Likaj, Andi Kacani, Laureta Dibra, Elizana Petrela, Vera Beca, Ali Refatllari
AIM: The mains topics of this work are the incidence of patient-prosthesis mismatch and the influence in the early results of isolated aortic valve surgery. METHODS: In 193 patients isolated aortic valve surgery was performed. The study population was divided in three subgroups: 20 patients with severe, 131 patients with moderate and 42 patients without patient-prosthesis mismatch. The indexed effective orifice area was used to define the subgroups. Operative mortality and perioperative complications were considered the indicators of the early results of aortic valve surgery...
December 15, 2015: Open Access Macedonian Journal of Medical Sciences
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