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Venous-to-Arterial pCO2 Difference in High-risk Surgical Patients
Alteration of tissue perfusion is a main contributor to organ dysfunction in high-risk surgical patients. The difference between venous carbon dioxide and arterial carbon dioxide pressure (pCO2 gap) has been described as a parameter reflecting tissue hypoperfusion in critically ill patients who are insufficiently resuscitated.
Impact of Repositioning During Transcatheter Aortic Valve Replacement on Embolized Debris
Abstract BACKGROUND: Use of the dual-filter cerebral embolic protection (CEP) device has been linked to a lower stroke rate in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Captured debris is found in almost every filter. The impact of repositioning on number and area of captured debris has not been studied. METHODS: Consecutive patients (n…
Calculating Risk for Poor Outcomes After Transcatheter Aortic Valve Replacement
Abstract OBJECTIVE: To outline the tools available to help understand the risk of transcatheter aortic valve replacement (TAVR) and the gaps in knowledge regarding TAVR risk estimation. METHODS: Review of the literature. RESULTS: Two models developed and validated by the American College of Cardiology can be used to estimate the risk of short-term mortality, a 6-variable in-hospital…
The Influence of Carbon Dioxide Field Flooding in Mitral Valve Operations With Cardiopulmonary Bypass on S100ß Level in Blood Plasma in the Aging Brain
Abstract INTRODUCTION: The risk of air microembolism during cardiopulmonary bypass (CPB) is high and influences the postoperative outcome, especially in elderly patients. The use of carbon dioxide (CO2) atmosphere during cardiac surgery may reduce the risk of cerebral air microembolism. The aim of our study was to assess the influence of CO2 field flooding on microembolism-induced…
Emerging Indications for Extracorporeal Membrane Oxygenation in Adults with Respiratory Failure
Recent advances in technology have spurred the increasing use of extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure.Ultimately, with upcoming and future technological advances, there is the promise of true destination therapy, which could lead to a major paradigm shift in the management of respiratory failure.
Influence of Time Interval Between Coronary Angiography to Off-Pump Coronary Artery Bypass Surgery on Incidence of Cardiac Surgery Associated Acute Kidney Injury
The aim of this study was to assess influence of time interval between coronary angiography (CAG) to off-pump CABG (OPCABG) on incidence of cardiac surgery associated acute kidney injury (CSA-AKI).
Different Dose Regimes and Administration Methods of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis of Randomized Trials
The efficacy of tranexamic acid (TXA) to reduce perioperative blood loss and allogeneic blood transfusion in cardiacsurgeries has been proved in previous studies, but its adverse effects especially seizure has always been a problem of concern.
The Pharmacological Protection of Renal Function in Patients Undergoing Cardiac Surgery
Abstract OBJECTIVES: To compare the effects of different routes and timings of administration of dopamine and mannitol used to alleviate the adverse effects of prolonged cardiopulmonary bypass (CPB) on renal functions in coronary artery surgery. METHODS: Group I (n: 25 patients): Mannitol 1 g/kg was added into the priming solution for CPB. Group II (n: 25 patients): IV dopamine was…
Evaluation and Reconditioning of Donor Organs for Transplantation Through Ex Vivo Lung Perfusion
In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lungperfusion, with evaluation of oxygenation capacity.
Transcatheter Mitral Valve Replacement: An Alternate Treatment Methodology for Patients at High Surgical Risk
Transcatheter mitral valve repair and replacement (TMVR) is a recent technology that can benefit MVR patients as an alternative, minimally invasive, and safer solution than conventional open-heart surgical approaches.
Dual Inflow Without Circulatory Arrest for Hemiarch Replacement
Abstract BACKGROUND: Open distal graft to proximal aortic arch anastomosis is central to a hemiarch replacement. Even if the ischemic tolerance time of several organs during circulatory arrest (CA) at normothermia is much longer than that of the brain, very little is known about the safety and clinical efficacy of moderate hypothermia for organ protection during…
Conscious Sedation Versus General Anesthesia in Transcatheter Aortic Valve Replacement: A Cost and Outcome Analysis
The use of conscious sedation (CS) as compared with general anesthesia (GA) has shown better clinical outcomes for TAVR patients.
Association Between Body Mass Index and Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement (TAVR) with Edwards SAPIEN™ 3 TAVR Valves: A Single-Center Experience
We compared standard body mass index (BMI)classes with the odds of requiring a permanent pacemaker (PPM) implantation in patients undergoing Transcatheter aortic valve replacement (TAVR) with Edwards SAPIEN™ 3 valves (ESV3) (Edwards Lifesciences, Irvine, CA, USA).
Cold Agglutinins in a Patient Undergoing Normothermic Cardiac Operation With Warm Cardioplegia
Abstract Cold agglutinins are autoantibodies that agglutinate red blood cells at low temperatures, leading to haemagglutination and haemolysis. They are generally of no clinical significance. However, when people with cold agglutinins undergo cardiac operation with hypothermia and coldcardioplegia, they can experience complications. Thus, different perioperative management is required for such patients. We describe a 74-year-old man with cold agglutinins incidentally detected on the preoperative…
Cold Agglutinin-Induced Hemolytic Anemia as the Primary Presentation in SLE – A Case Report
Abstract Cold agglutinin-induced hemolytic anemia as the primary presentation in systemic lupus erythematosus (SLE) is extremely rare. Only few cases have been reported in literature so far. Here, we report a 17-year-old girl who presented with features of hemolytic anemia and later diagnosed as a case of SLE.
Tranexamic Acid Versus ɛ-Aminocaproic Acid: Efficacy and Safety in Pediatric Cardiac Surgery
OBJECTIVE: Tranexamic acid (TXA) and ɛ-aminocaproic acid (EACA) are used for antifibrinolytic therapy in cardiac surgery, although data directly comparing their blood sparing effect and their side effects, especially in paediatric cardiac surgical patients, are still missing. METHODS: We analysed perioperative data of 234 paediatric patients weighing less than 20 kg undergoing cardiac surgery. In a 5-month period,…
Investigation and Evaluation of Potential Aerosol Release by Maquet/Getinge Heater-Cooler Units Used during Cardiac Surgery
Heater-Cooler units (HCUs) supply tempered water through blood heat exchangers and through warming/cooling blankets to control the body temperature of heart surgery patients.
Comparative Study Between Different Modes of Ventilation During Cardiopulmonary Bypass and its Effect on Postoperative Pulmonary Dysfunction
BACKGROUND: Postoperative pulmonary dysfunction is a prevalent complication after cardiac surgery; it has many contributing considerations due to either the surgery itself, anomalies to gas exchange or maybe as a result of alterations in lung mechanics. The aim of this study was to compare pressure-controlled ventilation versus volume-controlled ventilation in the presence of no ventilation…
Minimally Invasive Biventricular Mechanical Circulatory Support With Impella Pumps as a Bridge to Heart Transplantation
Abstract Cardiogenic shock from biventricular failure that requires acute mechanical circulatory support carries high 30 day mortality. Acute mechanical circulatory support can serve as bridge to orthotopic heart transplant (OHT) in selected patients. We report a patient with biventricular failure secondary to rapidly progressive cardiac sarcoidosis refractory to medical management who was bridged to OHT…
Impella Versus IABP in Acute Myocardial Infarction Complicated by Cardiogenic Shock.
OBJECTIVE: We investigated the benefit of Impella, a modern percutaneous mechanical support (pMCS) device, versus former standard intra-aortic balloon pump (IABP) in acute myocardial infarction complicated by cardiogenic shock (AMICS). METHODS: This single-centre, retrospective study included patients with AMICS receiving pMCS with either Impella or IABP. Disease severity at baseline was assessed with the IABP-SHOCK II score. The…
Single-Dose Cardioplegia Protects Myocardium as Well as Traditional Repetitive Dosing: A Noninferiority Randomized Study
The present prospective noninferiority randomized trial was designed to demonstrate the safety and efficacy of a single dose of Custodiol histidine-tryptophan-ketoglutarate compared with repetitive cold-blood cardioplegia.
Cost-Effectiveness of Left Atrial Appendage Closure for Stroke Reduction in Atrial Fibrillation: Analysis of Pooled, 5-Year, Long-Term Data
Recent publications reached conflicting conclusions about the cost-effectiveness of left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, Marlborough, MA) for stroke risk reduction in nonvalvular atrial fibrillation (AF).
A Systematic Review and Meta-Analysis of Bivalirudin Application in Peripheral Endovascular Procedures
The direct thrombin inhibitor bivalirudin (BIV) was shown to be superior to unfractionated heparin (UFH) in percutaneous coronary interventions for reducing procedural blood loss. The aim of this study was to compare outcome profiles of BIV and UFH in peripheral endovascular procedures (PEPs) by synthesizing the currently available data.
Thromboelastography and Thromboelastometry in Assessment of Fibrinogen Deficiency and Prediction for Transfusion Requirement: A Descriptive Review
Both Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) have been increasingly used to diagnose fibrinogen deficiency and guide fibrinogen transfusion in trauma and surgical bleeding patients.
