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    6208 results match your criteria Perioperative Cardiac Management

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    Cardiac surgery in a patient with implanted vagal nerve stimulator.
    Ann Card Anaesth 2018 Jan-Mar;21(1):57-59
    Medanta Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurugram, Haryana, India.
    The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. Read More

    Retrospective study of complete atrioventricular canal defects: Anesthetic and perioperative challenges.
    Ann Card Anaesth 2018 Jan-Mar;21(1):15-21
    Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Leipzig, Germany.
    Objective: The objective of this study was to highlight anesthetic and perioperative management and the outcomes of infants with complete atrioventricular (AV) canal defects.

    Design: This retrospective descriptive study included children who underwent staged and primary biventricular repair for complete AV canal defects from 1999 to 2013.

    Setting: A single-center study at a university affiliated heart center. Read More

    Periprocedural Anticoagulation for Catheter Ablation of Atrial Fibrillation: Practical Implications for Perioperative Management.
    J Cardiothorac Vasc Anesth 2017 Aug 11;31(4):1519-1526. Epub 2017 Jan 11.
    Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY; Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX; Department of Biomedical Engineering, University of Texas at Austin, Austin, TX; Department of Cardiology, University of Foggia, Foggia, Italy.

    Preoperative Thromboelastographic Profile of Patients with Congenital Heart Disease: Association of Hypercoagulability and Decreased Heparin Response.
    J Cardiothorac Vasc Anesth 2017 Dec 12. Epub 2017 Dec 12.
    Divison of Cardiac Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA. Electronic address:
    Objective: To describe the demographic and thromboelastographic characteristics of patients with congenital heart disease presenting with decreased heparin response before cardiac surgery.

    Design: Retrospective, observational study.

    Setting: Single institution, tertiary, academic, university hospital. Read More

    One-stage Approach for Hybrid Atrial Fibrillation Treatment.
    Arrhythm Electrophysiol Rev 2017 Dec;6(4):210-216
    Department of Cardiac Surgery, University Hospital Brussels,Free University of Brussels, Belgium.
    The one-stage approach for hybrid atrial fibrillation involves the simultaneous and close cooperation of different medical specialties. This review attempts to describe its challenging issues, exposing a plan to balance thrombotic risk and bleeding risk. It describes the combined surgical-electrophysiological procedure. Read More

    [Introduction and interpretation of guidelines on thromboprophylaxis in the perioperative period of urological surgery].
    Zhonghua Wai Ke Za Zhi 2018 Jan;56(1):18-23
    Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China.
    Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Read More

    Perioperative management of antiplatelet therapy in patients undergoing non-cardiac surgery following coronary stent placement: a systematic review.
    Syst Rev 2018 Jan 10;7(1). Epub 2018 Jan 10.
    Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
    Background: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation. Read More

    STEMI Due to Big Ostial Left Main Thrombus Extending Into Aorta: Challenging Situation With No Clear Guidelines.
    Cardiol Res 2017 Dec 22;8(6):331-335. Epub 2017 Dec 22.
    University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
    Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI). Read More

    Perioperative Anesthetic Management of a Case of Rare Ectopic Pheochromocytoma.
    World J Oncol 2017 Dec 28;8(6):191-195. Epub 2017 Dec 28.
    Central Laboratory, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
    We report an unusual case of pheochromacytoma and investigate the perioperative anesthetic management methods for giant abdominal aortic pheochromocytoma. We analyzed and summarized the recent clinical anesthetic management and experience in the hospital for a giant abdominal aortic pheochromocytoma, with the size of 20 × 14 × 5 cm. Under general anesthesia combined with TAPB, the resection of the giant abdominal aorta pheochromocytoma was successfully completed, and the patient was cured and discharged. Read More

    Surgical closure of patent ductus arteriosus in extremely low birth weight infants less than 750 grams.
    Kardiol Pol 2018 Jan 9. Epub 2018 Jan 9.
    Sana Heart Center Cottbus, Cottbus, Germany, Germany; Heart Diseases Center MEDINET, Nowa Sol, Poland, Poland.
    Background: Patent ductus arteriosus (PDA) occurs more frequently in premature infants. Depending on the degree of prematurity, these children often have other serious comorbidities that could significantly impact on surgical outcome.

    Aim: This study aimed to evaluate clinical results of the surgical ligation of PDA in extremely low body weight preterm infants with birth weight below 750 grams and to identify risk factors of mortality. Read More

    Management Of Antiplatelet Therapy In Patients Undergoing Elective Invasive Procedures Proposals From The French Working Group On Perioperative Hemostasis (Gihp) And The French Study Group On Thrombosis And Hemostasis (Gfht) In Collaboration With The French Society For Anesthesia And Intensive Care (Sfar).
    Anaesth Crit Care Pain Med 2018 Jan 5. Epub 2018 Jan 5.
    Sorbonne Universités_Univ Paris 06 (UPMC), ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Département de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France.
    The French Working Group on Perioperative Hemostasis (GIHP) and the French Study Group on Hemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anesthesia and Intensive Care (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure. Read More

    Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.
    Lancet 2018 Jan 3. Epub 2018 Jan 3.
    Intensive Care Medicine, Queen Mary University of London, London, UK.
    Background: There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.

    Methods: We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older undergoing any inpatient surgery in 25 countries in Africa (the African Surgical Outcomes Study). Read More

    Outcomes of Surgery for Severe Aortic Regurgitation with Systolic Left Ventricular Dysfunction.
    J Heart Valve Dis 2017 Jul;26(4):372-379
    Department of Cardiac Surgery, Fondazione Policlinico Universitario 'A. GemellI', Catholic University of Sacred Heart, Rome, Italy.
    Background: Management of patients with aortic regurgitation (AR) and severe impairment of left ventricular (LV) function characterized by an ejection fraction (EF) ≤35% is challenging. Conflicting results regarding perioperative and long-term survival of these patients have been reported. The study aim was to compare in-hospital outcomes and long-term survival of patients with AR and severe LV dysfunction versus moderate dysfunction (35% Read More

    TEG-Directed Transfusion in Complex Cardiac Surgery: Impact on Blood Product Usage.
    J Extra Corpor Technol 2017 Dec;49(4):283-290
    Department of Cardiothoracic Surgery, ProMedica Toledo Hospital, Toledo, Ohio; and.
    Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. Read More

    Multidisciplinary Perioperative Management of Pulmonary Arterial Hypertension in Patients Undergoing Noncardiac Surgery.
    South Med J 2018 Jan;111(1):64-73
    From the Department of Critical Care Medicine, and the Divisions of Pulmonary Medicine and Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida.
    Objectives: To describe the effect of implementing a contemporary perioperative pulmonary hypertension (PH)-targeted protocol in patients with pulmonary arterial hypertension (PAH) undergoing noncardiac surgery (NCS).

    Methods: The data of consecutive patients with PAH diagnosed by right heart catheterization who underwent NCS between January 1, 2006 and February 9, 2016 were reviewed. Patient demographics, etiology of PAH, clinical features, diagnostic data, utilization of PH-specific medications, and trend of perioperative complications rate were recorded during the study period. Read More

    Individualized surgical strategies for left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.
    Eur J Cardiothorac Surg 2017 Dec 26. Epub 2017 Dec 26.
    Institute of Cardiovascular Science, University College London, London, UK.
    Objectives: Surgical strategies to treat drug refractory left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy include septal myectomy (SM) and, less frequently, mitral valve (MV) repair or replacement. The primary aim of this study was to report the surgical technique and management outcomes in a consecutive group of patients with variable phenotypes of hypertrophic cardiomyopathy in a broad national specialist practice.

    Methods: A total of 203 consecutive patients, 132 men (mean age 48. Read More

    Novel Treatment Of A Degenerated Bioroot With The Use Of The Sutureless Valve Technique.
    Ann Thorac Surg 2017 Dec 27. Epub 2017 Dec 27.
    Department of Cardiac Surgery, Klinikum Oldenburg, Germany.
    We describe three patients with severe aortic regurgitation after aortic root replacement using the Medtronic Freestyle® bioprosthesis. In two cases, the indication was endocarditis. The third case showed rupture of the right coronary cusp. Read More

    Patterns of Kidney Injury in Pediatric Non-Kidney Solid Organ Transplant Recipients.
    Am J Transplant 2017 Dec 29. Epub 2017 Dec 29.
    Department of Medicine, University of Toronto, Toronto, Canada.
    The incidence of acute kidney injury (AKI) and its impact on chronic kidney disease (CKD) following pediatric non-kidney solid organ transplantation is unknown. We aimed to determine the incidence of AKI and CKD and examine their relationship among children who received a heart, lung, liver or multi-organ transplant at the Hospital for Sick Children between 2002 and 2011. AKI was assessed in the first year post-transplant. Read More

    Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management.
    J Vis Exp 2017 Nov 21(129). Epub 2017 Nov 21.
    Attune Medical; Department of Emergency Medicine, University of Texas, Southwestern Medical Center;
    Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. Read More

    Resuscitation of a Newborn with Right Hypoplastic Heart Syndrome: A Rare Confrontation for an Anesthesiologist.
    Anesth Essays Res 2017 Oct-Dec;11(4):1124-1125
    Department of Anaesthesia and Critical Care, Institute of Kidney Disease and Research Centre, Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
    According to newborn resuscitation guidelines, all referrals for neonates with suspected or confirmed duct-dependent congenital heart disease are to be discussed with pediatric cardiologist beforehand and are to be transferred immediately under their care for optimal management. However, in case of emergency, when there is not adequate time for preoperative consultations or a multidisciplinary approach, we should be able to manage these patients in the immediate perioperative period to decrease the likelihood of adverse outcome. We herewith describe a case where we as anesthesiologists successfully resuscitated a newborn with right hypoplastic heart in an emergency case of cesarean section till the baby was transferred to level III cardiac institution for further management. Read More

    Evaluation of Preoperative Flupirtine in Ambulatory Functional Endoscopic Sinus Surgery: A Prospective, Double-Blind, Randomized Controlled Trial.
    Anesth Essays Res 2017 Oct-Dec;11(4):902-908
    Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
    Background: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting.

    Materials And Methods: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia. Read More

    Anesthetic Management and Procedural Outcomes of Patients Undergoing Off-Pump Transapical Implantation of Artificial Chordae to Correct Mitral Regurgitation: Case Series of 76 Patients.
    Anesth Analg 2017 Dec 26. Epub 2017 Dec 26.
    Background: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure.

    Methods: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study. Read More

    An overview of surgical treatment modalities and emerging transcatheter interventions in the management of tricuspid valve regurgitation.
    Expert Rev Cardiovasc Ther 2018 Jan 15:1-15. Epub 2018 Jan 15.
    a Department of Cardiothoracic and Vascular Surgery , German Heart Center Berlin , Berlin , Germany.
    Introduction: Tricuspid valve regurgitation (TR) is frequently encountered and is most often functional (FTR) in nature. Surgical tricuspid valve (TV) treatment is well established in specialized centers. While transcatheter therapy for other valve disease is well established, interventional treatment of TV disease is still in its early stages. Read More

    Evaluating the role of clinical pharmacists in pre-procedural anticoagulation management.
    Hosp Pract (1995) 2017 Dec 28:1-6. Epub 2017 Dec 28.
    c Frankel Cardiovascular Center , Michigan Medicine , Ann Arbor , MI , USA.
    Objectives: While physicians are typically responsible for managing perioperative warfarin, clinic pharmacists may improve pre-procedural decision-making. We assessed the impact of pharmacist-driven care for chronic warfarin-treated patients undergoing outpatient right heart catheterization (RHC).

    Methods: 200 warfarin patients who underwent RHC between January 2012 and September 2015 were analyzed. Read More

    Modified Tricuspid Annular Plane Systolic Excursion Using Transesophageal Echocardiography and Its Utility to Predict Postoperative Course in Heart Transplantation and Left Ventricular Assist Device Implantation.
    J Cardiothorac Vasc Anesth 2017 Nov 21. Epub 2017 Nov 21.
    Department of Anesthesiology, Henry Ford Hospital, Detroit, MI.
    Objectives: Perioperative right ventricular (RV) function is important for determining the postoperative course in heart transplantation (HT) and left ventricular assist device (LVAD) implantation. The authors describe a modified tricuspid annular plane systolic excursion (m-TAPSE) using transesophageal echocardiography and assessed its clinical utility in HT and LVAD.

    Design: Retrospective medical record review. Read More

    Prolonged circulatory support with an Impella assist device in the management of cardiogenic shock associated with takotsubo syndrome, severe sepsis and acute respiratory distress syndrome.
    SAGE Open Med Case Rep 2017 14;5:2050313X17741013. Epub 2017 Dec 14.
    Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
    Severe sepsis has been known to trigger for takotsubo syndrome which is associated with profound physical or emotional stress. Severe sepsis is also associated with sepsis-induced cardiomyopathy, a reversible myocardial depression. We report a case in which a patient with takotsubo syndrome, cardiogenic shock, severe sepsis, and adult respiratory distress syndrome was managed with an Impella Cardiac Power circulatory support device for 108 h (4. Read More

    Evidence of intimal tear in type A intramural hematoma of the aorta: A case series.
    Int J Surg Case Rep 2017 Dec 12;42:179-181. Epub 2017 Dec 12.
    Unit of Cardiac Surgery, University of Palermo, Italy.
    Introduction: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease.

    Presentation Of Cases: We report two patients admitted to our institution with sudden onset thoracic pain. Read More

    Transfusion Requirements in Cardiac Surgery III (TRICS III): Study Design of a Randomized Controlled Trial.
    J Cardiothorac Vasc Anesth 2017 Nov 3. Epub 2017 Nov 3.
    Department of Anesthesia, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address:
    Objectives: To determine if a restrictive transfusion threshold is noninferior to a higher threshold as measured by a composite outcome of mortality and serious morbidity.

    Design: Transfusion Requirements in Cardiac Surgery (TRICS) III was a multicenter, international, open-label randomized controlled trial of two commonly used transfusion strategies in patients having cardiac surgery using a noninferiority trial design (ClinicalTrials.gov number, NCT02042898). Read More

    Open Cardiac Surgery without Blood and Blood Products Transplantation.
    Heart Surg Forum 2017 12 1;20(6):E239-E246. Epub 2017 Dec 1.
    Cardiovascular Surgery Clinic, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
    Background: Blood transfusions are the most common type of tissue and organ transplantation. Perioperative and postoperative transfusions may cause morbidity and mortality and transfusion should based on only hematocrit values but also on hemodynamic and clinical parameters of the patient, which cannot be ignored.

    Methods: A prospective study was conducted between January 2015 and October 2016 with adult patients undergoing elective open heart surgery. Read More

    The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm.
    J Vasc Surg 2018 Jan;67(1):2-77.e2
    Department of Surgery, University of Washington, Seattle, Wash.
    Background: Decision-making related to the care of patients with an abdominal aortic aneurysm (AAA) is complex. Aneurysms present with varying risks of rupture, and patient-specific factors influence anticipated life expectancy, operative risk, and need to intervene. Careful attention to the choice of operative strategy along with optimal treatment of medical comorbidities is critical to achieving excellent outcomes. Read More

    Reconstruction of Congenital Sternal Clefts: Surgical Experience and Literature Review.
    Plast Reconstr Surg Glob Open 2017 Nov 20;5(11):e1567. Epub 2017 Nov 20.
    Plastic and Reconstructive Surgery Section, Surgery Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
    Background: Sternal cleft is a rare anomaly with a reported incidence of 1:100,000 cases per live births. Surgical intervention represents a crucial factor altering the overall patient prognosis, since they are at high risk of impaired oxygenation, as well as multiple chest infections. Herein, we are reporting our experience of surgical management of such rare cases, alerting plastic surgeons to their possibly crucial role in the reconstructive team. Read More

    [Clinical application of electrical velocimetry in monitoring pediatric blood volume after cardiopulmonary bypass].
    Zhonghua Er Ke Za Zhi 2017 Dec;55(12):932-936
    Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
    Objective: To investigate the clinical applicability of electrical velocimetry (EV) in monitoring pediatric blood volume after cardiopulmonary bypass. Method: Between July 2016 and November 2016, 60 children with congenital heart disease were divided into EV group and traditional central venous pressure (CVP) group randomly. For EV group, the volume of fluid and vascular active medicine was adjusted according to the monitoring stroke volume variation (SVV) hemodynamic parameters. Read More

    Trends and Patterns of Corticosteroid Use During Coronary Artery Bypass Grafting Surgery in the United States.
    J Cardiovasc Pharmacol Ther 2017 Jan 1:1074248417743334. Epub 2017 Jan 1.
    1 Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
    Background: Several clinical trials have documented clinical benefits associated with prophylactic corticosteroid administration at the time of coronary artery bypass graft (CABG) surgery, including a reduction in the risk of atrial fibrillation and hospital length of stay. Despite the published data, the extent to which providers have adopted the perioperative use of corticosteroids remains unknown.

    Objectives: To assess temporal trends, between-hospital variation, and determinants of perioperative intravenous corticosteroid use during CABG surgery. Read More

    The physiologic basis for goal-directed hemodynamic and fluid therapy: the pivotal role of the venous circulation.
    Can J Anaesth 2017 Dec 18. Epub 2017 Dec 18.
    Department of Anesthesiology, Critical Care, and Pain Medicine, St. Elizabeth Medical Center, Brighton, MA, USA.
    Purpose: Understanding cardiovascular physiology should help clinicians to understand the purpose of fluid and drug management during the perioperative period. The purpose of this narrative review is to describe the pivotal role of the venous circulation in goal-directed hemodynamic and fluid therapy.

    Source: We selected relevant literature that examines the appropriateness of fluid therapy and pharmacologic interventions during the perioperative period. Read More

    Perioperative Management of Subarachnoid Hemorrhage in a Patient with Alagille Syndrome and Unrepaired Tetralogy of Fallot: Case Report.
    Front Surg 2017 4;4:72. Epub 2017 Dec 4.
    Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
    Alagille syndrome (ALGS) is a genetic disorder associated with multisystem dysfunction involving the hepatic, cardiovascular, and neurologic systems. Tetralogy of Fallot (TOF), a congenital cardiac anomaly, is commonly found in these patients. Patients with ALGS may also have an increased risk of cerebrovascular abnormalities and bleeding. Read More

    Intraoperative oxygen concentration and neurocognition after cardiac surgery: study protocol for a randomized controlled trial.
    Trials 2017 Dec 19;18(1):600. Epub 2017 Dec 19.
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
    Background: Postoperative cognitive dysfunction (POCD) is a common complication of cardiac surgery. Studies have identified potentially injurious roles for cardiopulmonary bypass (CPB) and subsequent reperfusion injury. Cognitive dysfunction has also been linked to the deleterious effects of hyperoxia following ischemia-reperfusion injuries in several disease states, but there has been surprisingly little study into the role of hyperoxia in reperfusion injury after CPB. Read More

    Renal risk stratification in left ventricular assist device therapy.
    Expert Rev Med Devices 2018 Jan 22;15(1):27-33. Epub 2017 Dec 22.
    a Division of Cardiology, Department of Medicine , Columbia University Medical Center , New York , NY , USA.
    Introduction: Left ventricular assist device (LVAD) therapy has greatly reduced mortality for patients with advanced heart failure (HF), both as a bridge to heart transplantation and as destination therapy. However, among other comorbidities, LVAD recipients face a risk of renal dysfunction, related to either the residual effects of HF or to LVAD support, which complicates the management of these patients and increases the risk of an adverse clinical outcome, including death. Areas covered: The authors summarize the current understanding of pre-LVAD predictors of post-LVAD renal dysfunction and need for renal replacement therapy (RRT), including emerging data about the risk conferred by proteinuria. Read More

    Three-vessel coronary artery aneurysmal disease complicated by multivessel thrombosis and cardiogenic shock: the saving role of intracoronary thrombolysis.
    BMJ Case Rep 2017 Dec 15;2017. Epub 2017 Dec 15.
    Department of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
    The benefit of intracoronary thrombolytics in ST-elevation myocardial infarction (STEMI) is not well established. Mainstays of STEMI management include intravenous thrombolytics, percutaneous coronary interventions and surgical revascularisation. However, in cases of STEMI secondary to coronary artery aneurysmal disease (CAAD), standard treatment options may not be suitable due to high thrombus burden, perioperative risk and factors unique to each patient. Read More

    Perioperative management of a patient with Coffin-Lowry syndrome complicated by severe obesity: A case report and literature review.
    Medicine (Baltimore) 2017 Dec;96(49):e9026
    aDepartment of Anesthesiology and Resuscitology, Ehime University Hospital, Shitsukawa, ToonbDepartment of Anesthesia and Perioperative Medicine, Ehime University Graduate School of MedicinecIntensive Care Unit, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan.
    Rationale: Coffin-Lowry syndrome (CLS) is a rare inherited disease with specific clinical features, such as mental retardation, facial dysmorphism, and cardiac abnormality. In particular, the characteristic facial features of CLS, including retrognathia and large tongue, are associated with difficult ventilation and/or intubation, which is a serious problem of anesthesia management. However, case reports on anesthesia management of CLS are very limited as there are only two published English reports till date. Read More

    Tracheal surgery in children: outcome of a 12-year survey.
    Interact Cardiovasc Thorac Surg 2017 Dec 12. Epub 2017 Dec 12.
    Pediatric Cardiac Surgery Unit, Heart Hospital, G. Monasterio Foundation, Massa, Italy.
    Objectives: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature.

    Methods: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Read More

    The Clinical Impact of Cardiology Consultation Prior to Major Vascular Surgery.
    Ann Surg 2018 Jan;267(1):189-195
    *Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI†Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, MI‡Section of Vascular Surgery, Department Surgery, Spectrum Health Center, Grand Rapids, MI§Section of Vascular Surgery, Department Surgery, Bronson Healthcare System, Kalamazoo, MI¶Section of Vascular Surgery, Department Surgery, Henry Ford Health System, Detroit, MI.
    Objective: To understand statewide variation in preoperative cardiology consultation prior to major vascular surgery and to determine whether consultation was associated with differences in perioperative myocardial infarction (poMI).

    Summary Background Data: Medical consultation prior to major vascular surgery is obtained to reduce perioperative risk. Despite perceived benefit of preoperative consultation, evidence is lacking specifically for major vascular surgery on the effect of preoperative cardiac consultation. Read More

    Spigelian hernia and pitfalls of postoperative anticoagulation.
    BMJ Case Rep 2017 Dec 13;2017. Epub 2017 Dec 13.
    Department of General Surgery, Kalgoorlie Regional Hospital, Kalgoorlie, Western Australia, Australia.
    Spigelian hernias are a rare lateral ventral abdominal hernia that carry a high risk of strangulation due to their smaller sizes, and require surgical intervention. In more complex cases involving an anticoagulated patient, perioperative management of anticoagulation must be monitored and reviewed to avoid potential pitfalls. We present an 81-year-old woman who presented with right groin pain, and was requiring warfarin anticoagulation due to her cardiac history. Read More

    Association of Atrial Fibrillation and Oral Anticoagulant Use With Perioperative Outcomes After Major Noncardiac Surgery.
    J Am Heart Assoc 2017 Dec 12;6(12). Epub 2017 Dec 12.
    Division of Cardiology, University of Toronto, Canada
    Background: We examined the association of atrial fibrillation (AF) and oral anticoagulant use with perioperative death and bleeding among patients undergoing major noncardiac surgery.

    Methods And Results: A population-based study of patients aged 66 years and older who underwent elective (n=87 257) or urgent (n=35 930) noncardiac surgery in Ontario, Canada (April 2012 to March 2015) was performed. Outcomes were compared between AF groups using inverse probability of treatment weighting using the propensity score. Read More

    The Utility of Simulation in the Management of Patients With Congenital Heart Disease: Past, Present, and Future.
    Semin Cardiothorac Vasc Anesth 2017 Dec 1:1089253217746243. Epub 2017 Dec 1.
    1 Icahn School of Medicine at Mt Sinai, New York, NY, USA.
    Significant advancements have been made in the diagnosis and management of congenital heart disease (CHD). As a result, a higher percentage of these patients are surviving to adulthood. Despite this improvement in management, these patients remain at higher risk of morbidity and mortality, particularly in the perioperative setting. Read More

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