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Outstanding Clinical Review

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648 papers 500 to 1000 followers Topics related to cardiac anesthesia & critical care
https://www.readbyqxmd.com/read/29673380/a-standardized-approach-to-treat-complex-aortic-valve-endocarditis-a-case-series
#1
Anna Gomes, Jayant S Jainandunsing, Sander van Assen, Peter Paul van Geel, Bhanu Sinha, Sandro Gelsomino, Daniel M Johnson, Ehsan Natour
BACKGROUND: Surgical treatment of complicated aortic valve endocarditis often is challenging, even for experienced surgeons. We aim at demonstrating a standardized surgical approach by stentless bioprostheses for the treatment of aortic valve endocarditis complicated by paravalvular abscess formation. METHODS: Sixteen patients presenting with aortic valve endocarditis (4 native and 12 prosthetic valves) and paravalvular abscess formation at various localizations and to different extents were treated by a standardized approach using stentless bioprostheses...
April 19, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29674324/indications-for-the-performance-of-intracranial-endovascular-neurointerventional-procedures-a-scientific-statement-from-the-american-heart-association
#2
REVIEW
Clifford J Eskey, Philip M Meyers, Thanh N Nguyen, Sameer A Ansari, Mahesh Jayaraman, Cameron G McDougall, J Kevin DeMarco, William A Gray, David C Hess, Randall T Higashida, Dilip K Pandey, Constantino Peña, Hermann C Schumacher
Intracranial endovascular interventions provide effective and minimally invasive treatment of a broad spectrum of diseases. This area of expertise has continued to gain both wider application and greater depth as new and better techniques are developed and as landmark clinical studies are performed to guide their use. Some of the greatest advances since the last American Heart Association scientific statement on this topic have been made in the treatment of ischemic stroke from large intracranial vessel occlusion, with more effective devices and large randomized clinical trials showing striking therapeutic benefit...
April 19, 2018: Circulation
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#3
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29672125/submassive-pulmonary-embolism
#4
Parth M Rali, Gerard J Criner
Pulmonary Embolism (PE) presents a spectrum of hemodynamic consequences ranging from being asymptomatic to a life-threatening medical emergency. Management of sub massive and massive PE often involves clinicians from multiple specialties that can potentially delay the development of a unified treatment plan. Additionally, patients with submassive PE can deteriorate after their presentation and require escalation of care. Underlying comorbidities like chronic obstructive pulmonary disease (COPD), cancer, congestive heart failure and interstitial lung disease can impact the patient's hemodynamic ability to tolerate submassive PE...
April 19, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29661408/cerebrospinal-fluid-drain-related-complications-in-patients-undergoing-open-and-endovascular-repairs-of-thoracic-and-thoraco-abdominal-aortic-pathologies-a-systematic-review-and-meta-analysis
#5
REVIEW
L Q Rong, M K Kamel, M Rahouma, R S White, A D Lichtman, K O Pryor, L N Girardi, M Gaudino
BACKGROUND: Cerebrospinal-fluid (CSF) drainage is recommended by current guidelines for spinal protection during open and endovascular repairs of thoracic and thoraco-abdominal aortic aneurysms. In the published literature, great variability exists in the rate of CSF-related complications and morbidity. Herein, we perform a systematic review and meta-analysis on the incidence of CSF drainage-related complications, and compare the complication rates between open and endovascular repairs...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661409/anticoagulant-and-side-effects-of-protamine-in-cardiac-surgery-a-narrative-review
#6
REVIEW
C Boer, M I Meesters, D Veerhoek, A B A Vonk
Neutralisation of systemic anticoagulation with heparin in cardiac surgery with cardiopulmonary bypass requires protamine administration. If adequately dosed, protamine neutralises heparin and reduces the risk of postoperative bleeding. However, as its anticoagulant properties are particularly exerted in the absence of heparin, overdosing of protamine may contribute to bleeding and increased transfusion requirements. This narrative review describes the mechanisms underlying the anticoagulant properties and side-effects of protamine, and the impact of protamine dosing on the activated clotting time and point-of-care viscoelastic test results, and explains the distinct protamine dosing strategies in relation to haemostatic activation and postoperative bleeding...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29655828/venoarterial-extracorporeal-membrane-oxygenation-in-cardiogenic-shock
#7
REVIEW
Mary E Keebler, Elias V Haddad, Chun W Choi, Stuart McGrane, Sandip Zalawadiya, Kelly H Schlendorf, D Marshall Brinkley, Matthew R Danter, Mark Wigger, Jonathan N Menachem, Ashish Shah, JoAnn Lindenfeld
Venoarterial extracorporeal membrane oxygenation has emerged as a viable treatment for patients in cardiogenic shock with biventricular failure and pulmonary dysfunction. Advances in pump and oxygenator technology, cannulation strategies, patient selection and management, and durable mechanical circulatory support have contributed to expanded utilization of this technology. However, challenges remain that require investigation to improve outcomes.
April 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#8
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...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29613888/the-effect-of-inflow-cannula-angle-on-the-intraventricular-flow-field-of-the-left-ventricular-assist-device-assisted-heart-an-in-vitro-flow-visualization-study
#9
Karen May-Newman, Nikolas Marquez-Maya, Ricardo Montes, Saniya Salim
Previous studies have identified left ventricular assist device (LVAD) inflow cannula (IC) malposition as a significant risk for pump thrombosis. Thrombus development is a consequence of altered flow dynamics, which can produce areas of flow stasis or high shear that promote coagulation. The goal of this study was to measure the effect of IC orientation on the left ventricle (LV) flow field using a mock circulatory loop, and identify flow-based indices that are sensitive measures of cannula malposition. Experimental studies were with a customized silicone model of the dilated LV and the EVAHEART LVAS...
March 30, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29629926/neuroprognostication-postcardiac-arrest-translating-probabilities-to-individuals
#10
Clifton W Callaway
PURPOSE OF REVIEW: Predicting neurological recovery in patients who are comatose after cardiac arrest is an important activity during postarrest care, and this prediction can affect survival. As no early test or clinical finding perfectly predicts potential for recovery, guidelines recommend using data from multiple examinations or tests to estimate patient prognosis. RECENT FINDINGS: Studies reported accuracy of initial clinical examination, progression of clinical examination, early (<24 h) brain imaging, electroencephalography (EEG), evoked potentials, later (>24 h) brain imaging, blood markers of brain injury, and cerebral oximetry for predicting good or poor outcome...
April 6, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29622181/mitral-valve-regurgitation-in-the-contemporary-era-insights-into-diagnosis-management-and-future-directions
#11
REVIEW
Abdallah El Sabbagh, Yogesh N V Reddy, Rick A Nishimura
Mitral valve regurgitation (MR) is the most common valvular heart disease. Primary MR is a disease of the mitral valve apparatus, whereas secondary MR is a disease of the left ventricle. Diagnosing and managing MR is often challenging and requires a structured approach, integrating findings on history, physical examination, and imaging. Decisions regarding treatment depend on knowledge of the etiology, natural history, and outcome of interventions for these patients with mitral valve disease. The optimal timing of intervention requires a comprehensive 2-dimensional and Doppler echocardiogram in each patient to determine the cause of the mitral valve disease, the severity of the regurgitation, and the effect of the volume overload on the left ventricle, as well as determining if a durable valve repair can be performed...
April 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29614239/the-extracorporeal-life-support-organization-maastricht-treaty-for-nomenclature-in-extracorporeal-life-support-a-position-paper-of-the-extracorporeal-life-support-organization
#12
Steven A Conrad, L Mikael Broman, Fabio S Taccone, Roberto Lorusso, Maximilian V Malfertheiner, Federico Pappalardo, Matteo Di Nardo, Mirko Belliato, Lorenzo Grazioli, Ryan P Barbaro, D Michael McMullan, Vincent Pellegrino, Daniel Brodie, Melania M Bembea, Eddy Fan, Malaika Mendonca, Rodrigo Diaz, Robert H Bartlett
Extracorporeal life support (ECLS) was developed more than 50 years ago initially with venoarterial (VA) and subsequently venovenous (VV) configurations. As the technique of ECLS has significantly improved and newer skills developed, complexity in terminology and advances in cannula design led to some misunderstanding and inconsistency in definitions both in clinical practice and scientific research. This document is a consensus of multispecialty international representatives of the Extracorporeal Life Support Organization, including the North American, Latin American, European, South and West Asian, and Asian-Pacific chapters, imparting a global perspective on ECLS...
April 3, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29627355/contemporary-reviews-in-critical-care-medicine-atrial-fibrillation-in-the-intensive-care-unit
#13
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/29625862/intramural-hematoma
#14
REVIEW
Andrew Maslow, Michael K Atalay, Neel Sodha
No abstract text is available yet for this article.
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29608493/left-ventricular-distension-in-veno-arterial-extracorporeal-membrane-oxygenation-from-mechanics-to-therapies
#15
Keshava Rajagopal
Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is increasingly commonly used to treat acute cardiac or pulmonary failure because of a wide range of etiologies. However, although the despite progressively improving outcomes, the mortality associated with V-A ECMO, particularly when used to treat cardiac failure (its most common indication), continues to be high. Consistent with this, V-A ECMO is associated with numerous morbid complications. Left ventricular (LV) distension is a major complication of V-A ECMO, and is challenging both to treat and diagnose...
March 28, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29608496/antithrombotic-management-of-patients-with-prosthetic-heart-valves
#16
Abdallah Sanaani, Srikanth Yandrapalli, Joseph Michael Harburger
Valvular heart disease is a major public health issue. The prevalence of valvular heart disease is expected to increase due to an aging population. Valve dysfunction manifests as valve stenosis, regurgitation, or both, due to various etiologies. Valve repair and replacement are the main treatment options for severe valve dysfunction. Valve replacement is achieved by using either a mechanical or a bioprosthetic valve. Mechanical valves are more durable but require lifelong anticoagulation with associated complications...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29608499/diagnosis-treatment-and-management-of-orthotopic-liver-transplant-candidates-with-portopulmonary-hypertension
#17
Anna Koulava, Abdallah Sannani, Avi Levine, Chhaya Aggarwal Gupta, Sarina Khanal, William Frishman, Roxana Bodin, David C Wolf, William Aronow, Gregg M Lanier
Portopulmonary hypertension (POPH) is seen in 5-8% of orthotopic liver transplantation (OLT) candidates and has significant implications for clinical outcomes. POPH is characterized by vasoconstriction and remodeling of the pulmonary vasculature. It is exacerbated by the hyperdynamic circulation that is common in advanced liver disease. Screening all OLT candidates with transthoracic echocardiography to assess pulmonary pressures and right ventricular function is crucial, as clinical symptoms alone are not reliable...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29598870/cardiac-implantable-electronic-devices-in-patients-with-left-ventricular-assist-systems
#18
REVIEW
David D Berg, Muthiah Vaduganathan, Gaurav A Upadhyay, Jagmeet P Singh, Mandeep R Mehra, Garrick C Stewart
Recent progress and evolution in device engineering, surgical implantation practices, and periprocedural management have advanced the promise of durable support with left ventricular assist systems (LVAS) in patients with stage D heart failure. With greater uptake of LVAS globally, a growing population of LVAS recipients have pre-existing cardiac implantable electronic devices (CIEDs). Strategies for optimal clinical management of CIEDs in patients with durable LVAS are evolving, and clinicians will increasingly face complex decisions regarding implantation, programming, deactivation, and removal of CIEDs...
April 3, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29576105/perioperative-management-of-patients-with-congenital-or-acquired-disorders-of-the-qt-interval
#19
REVIEW
M O'Hare, Y Maldonado, J Munro, M J Ackerman, H Ramakrishna, D Sorajja
QT prolongation can be attributable to various causes that can be categorised as acquired or congenital. Arrhythmias related to QT prolongation can result in clinical presentations, such as syncope and sudden cardiac death. The perioperative period presents a number of issues that may affect a patient's risk of developing polymorphic ventricular tachycardia or torsades de pointes. Although most patients may have an unremarkable perioperative course, some may have complications; this review article aims to help clinicians avoid potential complications, and to help them address treatment for perioperative issues that may occur...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29576106/emergency-care-of-patients-receiving-non-vitamin-k-antagonist-oral-anticoagulants
#20
REVIEW
J W Eikelboom, S Kozek-Langenecker, A Exadaktylos, A Batorova, Z Boda, F Christory, I Gornik, G Kėkštas, A Kher, R Komadina, O Koval, G Mitic, T Novikova, E Pazvanska, S Ratobilska, J Sütt, A Winder, D Zateyshchikov
Non-vitamin K antagonist oral anticoagulants (NOACs), which inhibit thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, edoxaban) have been introduced in several clinical indications. Although NOACs have a favourable benefit-risk profile and can be used without routine laboratory monitoring, they are associated-as any anticoagulant-with a risk of bleeding. In addition, treatment may need to be interrupted in patients who need surgery or other procedures. The objective of this article, developed by a multidisciplinary panel of experts in thrombosis and haemostasis, is to provide an update on the management of NOAC-treated patients who experience a bleeding episode or require an urgent procedure...
April 2018: British Journal of Anaesthesia
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