Journal articles: 'Cardiovascular system Surgery Complications Japan'

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Nakamura, Shinichi, Taku Rokutanda, Hirofumi Kurokawa, and Yoshirou Onoue. "Endovascular Treatment of Long Superficial Femoral Artery–Chronic Total Occlusions Using the Gogo Catheter With IVUS Via a Popliteal Puncture Method Is Effective, Safe, and Useful." Vascular and Endovascular Surgery 54, no. 3 (January 3, 2020): 225–32. http://dx.doi.org/10.1177/1538574419896735.

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Objectives: We aimed to investigate the usefulness of inserting a 6Fr sheath guided by duplex ultrasonography via a popliteal artery puncture. We also aimed to demonstrate endoluminal tracking using a retrograde approach using the Gogo catheter with intravascular ultrasound (IVUS). Background: The bidirectional approach is useful for increasing the success rate of the procedure for long superficial femoral artery–chronic total occlusions (SFA-CTOs). However, this procedure becomes somewhat complicated. Since the proximal blood vessel diameter is clearly larger than the distal end of the CTO and the body surface duplex guide can also be used in the proximal part, it is easier to introduce a retrograde guidewire (GW) into the proximal end. Methods: We performed endovascular treatment for long SFA-CTOs with a Gogo catheter + IVUS guide in 31 consecutive cases (male 20/female 11; mean age, 75.6 ± 7.6) from May 2017 to November 2018. We advanced the IVUS until the true lumen could be confirmed and advanced the Gogo catheter toward the IVUS for reinforcement. We attempted to approach the long CTO by repeating this procedure. We named this procedure the GIP method (GIP: Gogo catheter with IVUS via a popliteal puncture). Hemostasis of the popliteal artery was achieved using a commercially available compression hemostatic kit (Tometa-kun, XEMEX, Japan). Results: Successful revascularization was achieved in all cases (in 2 cases, a femoral artery puncture was added, and a bidirectional approach was used, and in 1 case, a CROSSER system was used). On average, the fluoroscopy time was 42.2 ± 30.4 minutes, radiation dose 93.7 ± 78.7 mGy, and amount of contrast medium used 15.0 ± 9.6 mL. The procedure time was defined as from the start of the popliteal artery puncture to the time the GW passed through the CTO lesion, including the posture transformation time from prone to the supine position. The procedure time was 42.1 ± 40.2 minutes. There were no major adverse events or other major complications, such as a distal embolism, rupture of the CTO lesion, arteriovenous fistula, or major hematoma requiring a transfusion or surgical treatment. Only 2 small hematomas occurred at the popliteal artery puncture site. The patients were treated conservatively and were discharged as usual. Conclusions: Endovascular treatment of long SFA-CTOs via the popliteal approach was effective and safe. Using the GIP method to address long SFA-CTOs is recommended.

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Murkin, John M. "Neurologic Complications in Noncardiac Surgery." Seminars in Cardiothoracic and Vascular Anesthesia 10, no. 2 (June 2006): 125–27. http://dx.doi.org/10.1177/10892532062889881.

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In this article, the incidence of nervous system injuries associated with noncardiac surgery is reviewed briefly. In general, these can be divided into injuries that are clinically apparent (eg, stroke or peripheral nerve damage), which may generally be detectable on clinical examination, and more subtle forms of brain injury (eg, personality changes and postoperative cognitive dysfunction), injuries that are primarily detected by neuropsychological testing.

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Kobayashi, Junjiro. "Discrepancy of Future Cardiovascular Surgery and Current Board Certification System in Japan." Japanese Journal of Cardiovascular Surgery 45, no. 4 (2016): m4—m4_2. http://dx.doi.org/10.4326/jjcvs.45.m4.

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Fujita, Tomoyuki, Hiroyuki Yamamoto, Junjiro Kobayashi, Satsuki Fukushima, Hiroaki Miyata, Kizuku Yamashita, and Noboru Motomura. "Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database." General Thoracic and Cardiovascular Surgery 68, no. 12 (June 25, 2020): 1439–46. http://dx.doi.org/10.1007/s11748-020-01418-y.

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Abstract Background Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry. Methods We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Risk factors for operative mortality and severe complications following mitral valve surgery were analyzed. Results The 30-day and hospital mortality rates were 20% and 26%, respectively. Chronic hemodialysis, abrupt rupture after AMI, resuscitation before surgery, and preoperative venoarterial extracorporeal membrane oxygenation were associated with mortality. Mitral valve replacement was chosen mainly (90%) for surgical correction of mitral regurgitation in these patients. There was no significant difference in short-term outcomes between mitral valve replacement versus mitral valve repair, despite non-matched characteristics in background between the treatment groups. Concomitant coronary artery bypass grafting had no impact on short-term outcomes. Conclusions Information derived from the nationwide database of patients with AMI-associated PMR show that PMR is a rare condition in the modern era. However, PMR is a severe disease with a mortality rate as high as 26%. The severity of the condition is associated with the risk for poor outcomes.

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Watanabe, Go. "Successful Intracardiac Robotic Surgery Initial Results from Japan." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 5, no. 1 (January 2010): 48–50. http://dx.doi.org/10.1097/imi.0b013e3181c46db6.

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Objective The purpose of this study is to report our 2-year experience of performing endoscopic intracardiac procedures using the da Vinci Surgical System. Our teams at Kanazawa University and Tokyo Medical University groups began using the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA) in 2005. This series represents the first Japanese application of robotic technology for totally endoscopic open-heart surgery. Methods From January 2008 to February 2009, 10 patients (mean age: 46.8 ± 16.3 years, 70% women) underwent endoscopic atrial septal defect closure and resection of the left atrial myxoma using the da Vinci Surgical System and peripheral cardiopulmonary bypass technique. Of the 10 patients, nine were classified as New York Heart Association class II and 1 patient exhibited atrial arrhythmias. In addition, two patients required mitral valve plasty (n = 2) and tricuspid annuloplasty (n = 1). Results Mean da Vinci Surgical System working time was 140.7 ± 57.4 minutes. Mean cardiopulmonary bypass and aortic cross clamp times were 103.1 ± 37.1 and 30.0 ± 16.9 minutes, respectively. There were no conversions to sternotomy or small thoracotomy. There were no hospital deaths. Mean intensive care unit and hospital stays were 1 day and 3.1 ± 0.3 days, respectively. All patients appreciated the cosmetic result and fast recovery. Conclusions Closed-chest atrial septal defect closure and myxoma resection performed using robotic techniques achieved excellent results and rapid postoperative recovery and provided an attractive cosmetic advantage over median sternotomy.

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Kovacevic-Kostic, Natasa, Radmila Karan, Mile Vranes, Dejan Markovic, Milos Velinovic, and Zivan Maksimovic. "Preoperative preparation of vascular patients undergoing nonvascular surgery." Acta chirurgica Iugoslavica 58, no. 2 (2011): 55–61. http://dx.doi.org/10.2298/aci1102055k.

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Patients with vascular diseases mainly caused by atherosclerosis, that are undergoing nonvascular surgery, often have co-existing conditions which affect their cardiovascular system. Cardiovascular complications are among the most common perioperative complications including respiratory complications and infections. These include coronary disease, hypertension, heart insufficiency, pulmonary hypertension, and renovascular hypertension, among others. Preoperative preparation must include the use of ?blocker therapy, antihypertensive, antithrombotic and antilipogenic therapy. Electrocardiogram (ECG) and trans-thoracic echocardiography are the minimum preoperative diagnostic evaluations that should be performed, because complications may arise even in patients without prior cardiovascular symptomatology. Venous diseases are the most common contemporary diseases affecting people of all age groups and races. Invasive-diagnostic-therapeutic procedures may cause lesions of venous endothelium, hence perioperative prevention of deep vein thrombosis (DVT) with the use of heparin or low-molecular -weight heparin (LMWH) should be undertaken.

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Takai, Koji, Masaru Sawazaki, Shiro Tomari, Koji Yamana, and Yutaka Ogawa. "Development of a new data entry system suitable for the Japan Adult Cardiovascular Surgery Database." General Thoracic and Cardiovascular Surgery 57, no. 4 (April 2009): 192–96. http://dx.doi.org/10.1007/s11748-008-0363-3.

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Stoliński, Jarosław, Robert Musiał, Dariusz Plicner, and Janusz Andres. "Respiratory System Function in Patients after Minimally Invasive Aortic Valve Replacement Surgery." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, no. 2 (March 2017): 127–36. http://dx.doi.org/10.1097/imi.0000000000000349.

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Objective The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. Methods Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. Results Complications of the respiratory system occurred in 16.8% of AVR and 11.0% of RT-AVR patients ( P = 0.067). The rate of pleural effusions, thoracenteses, pneumonias, or phrenic nerve dysfunctions was not significantly different between groups. Perioperative mortality was 1.9% in AVR and 1.0% in RT-AVR ( P = 0.417). Mechanical ventilation time after surgery was 9.7 ± 5.9 hours for AVR and 7.2 ±3.2 hours for RT-AVR patients ( P < 0.001). Stroke (odds ratio [OR] = 13.4, P = 0.008), increased postoperative blood loss (OR = 9.6, P <0.001), and chronic obstructive pulmonary disease (OR = 7.7, P < 0.001) were risk factors of prolonged mechanical lung ventilation. A week after surgery, the results of most pulmonary function tests were lower in the AVR than in the RT-AVR group ( P < 0.001 was seen for forced expiratory volume in the first second, vital capacity, total lung capacity, maximum inspiratory pressure and maximum expiratory pressure, P = 0.377 was seen for residual volume). Conclusions Right anterior aortic valve replacement minithoracotomy surgery with single-lung ventilation did not result in increased rate of respiratory system complications. Spirometry examinations revealed that pulmonary functional status was more impaired after AVR in comparison with RT-AVR surgery.

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Aydin, Ebuzer, Mehmet Senel Bademci, Cemal Kocaaslan, Emine Seyma Denli Yalvac, and Ahmet Oztekin. "Complications of iliofemoral deep venous thrombosis treatment with AngioJet pharmacomechanical thrombectomy system." Journal of Vascular Surgery: Venous and Lymphatic Disorders 8, no. 3 (May 2020): 496. http://dx.doi.org/10.1016/j.jvsv.2019.11.017.

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Egglin, Thomas K. P., Paul V. O'Moore, Alvan R. Feinstein, and Arthur C. Waltman. "Complications of peripheral arteriography:A new system to identify patients at increased risk." Journal of Vascular Surgery 22, no. 6 (December 1995): 787–94. http://dx.doi.org/10.1016/s0741-5214(95)70070-6.

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Kashiwazaki, Daina, Naoki Akioka, Naoya Kuwayama, Kiyohiro Houkin, Marcus Czabanka, Peter Vajkoczy, and Satoshi Kuroda. "Berlin Grading System Can Stratify the Onset and Predict Perioperative Complications in Adult Moyamoya Disease." Neurosurgery 81, no. 6 (June 10, 2017): 986–91. http://dx.doi.org/10.1093/neuros/nyx140.

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Abstract BACKGROUND The grading system for moyamoya disease is not established. OBJECTIVE To assess the usefulness of a recently proposed grading system for stratifying the clinical severity and predicting postoperative morbidity in adult moyamoya disease. METHODS We investigated 176 hemispheres from 89 adult patients who were diagnosed with moyamoya disease in Japan. Their data were analyzed using the Berlin grading system with minor modifications. After summarizing the numerical values for digital subtraction angiography (1-3 points), magnetic resonance imaging (0-1 points), and single-photon emission computed tomography (0-2 points), 3 grades of moyamoya disease were defined: mild (grade I) = 1 to 2 points, moderate (grade II) = 3 to 4 points, and severe (grade III) = 5 to 6 points. In total, 82 of 161 hemispheres underwent superficial temporal artery to middle cerebral artery anastomosis and indirect synangiosis. Postoperative neurological morbidity was included within 30 d after surgery. RESULTS Preoperative examinations categorized 87 hemispheres as grade I, 39 as grade II, and 50 as grade III. There was a significant correlation between the Berlin grading system and clinical severity (P < .001). Perioperative complications occurred in 12 of 82 (14.6%) hemispheres, including transient ischemic attack in 3 hemispheres, ischemic stroke in 4 hemispheres, symptomatic hyperperfusion in 4 hemispheres, and intracerebral hemorrhage in 1 hemisphere. The Berlin grading system was related to their occurrence (P < .001). CONCLUSION The Berlin grading system facilitates the stratification of clinical severity and predicting postoperative neurological morbidity in adult moyamoya disease, thereby suggesting its general usage in clinical practice.

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Furlan, Julio C., and Michael G. Fehlings. "Cardiovascular complications after acute spinal cord injury: pathophysiology, diagnosis, and management." Neurosurgical Focus 25, no. 5 (November 2008): E13. http://dx.doi.org/10.3171/foc.2008.25.11.e13.

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Cardiovascular complications in the acute stage following traumatic spinal cord injury (SCI) require prompt medical attention to avoid neurological compromise, morbidity, and death. In this review, the authors summarize the neural regulation of the cardiovascular system as well as the pathophysiology, diagnosis, and management of major cardiovascular complications that can occur following acute (up to 30 days) traumatic SCI. Hypotension (both supine and orthostatic), autonomic dysreflexia, and cardiac arrhythmias (including persistent bradycardia) are attributed to the loss of supraspinal control of the sympathetic nervous system that commonly occurs in patients with severe spinal cord lesions at T-6 or higher. Current evidence-based guidelines recommend: 1) monitoring of cardiac and hemodynamic parameters in the acute phase of SCI; 2) maintenance of a minimum mean arterial blood pressure of 85 mm Hg during the hyperacute phase (1 week after SCI); 3) timely detection and appropriate treatment of neurogenic shock and cardiac arrhythmias; and 4) immediate and adequate treatment of episodes of acute autonomic dysreflexia. In addition to these forms of cardiovascular dysfunction, individuals with acute SCIs are at high risk for deep venous thrombosis (DVT) and pulmonary embolism due to loss of mobility and, potentially, altered fibrinolytic activity, abnormal platelet function, and impaired circadian variations of hemostatic and fibrinolytic parameters. Current evidence supports a recommendation for thromboprophylaxis using mechanical methods and anticoagulants during the acute stage up to 3 months following SCI, depending on the severity and level of injury. Low-molecular-weight heparin is the first choice for anticoagulant prophylaxis in patients with acute SCI. Although there is insufficient evidence to recommend (or refute) the use of screening tests for DVT in asymptomatic adults with acute SCI, this strategy may detect asymptomatic DVT in at least 9.4% of individuals who undergo thromboprophylaxis using lowmolecular- weight heparin. Indications and treatment of DVT and acute pulmonary embolism are well established and are summarized in this review. Recognition of cardiovascular complications after acute SCI is essential to minimize adverse outcomes and to optimize recovery.

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Dzhioeva, O. N., and O. M. Drapkina. "Postoperative atrial fibrillation as a risk factor for cardiovascular complications in non-cardiac surgery." Cardiovascular Therapy and Prevention 19, no. 4 (September 5, 2020): 2540. http://dx.doi.org/10.15829/1728-8800-2020-2540.

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Reducing mortality due to cardiovascular complications (CVC) after non-cardiac surgery is one of the priority tasks of modern healthcare. According to the literature data, it is the CVC that are leading cause of perioperative mortality in non-cardiac surgery. Atrial fibrillation (AF) is a common complication after surgery. It is believed that in most cases the AF is potentiated by a combination of factors. It is intraoperative triggers, such as deliberate hypotension, anemia, injury, and pain, that can directly contribute to development of arrhythmia. However, heart rate monitoring after non-cardiac surgery is performed in only a small number of patients, so in most cases, arrhythmias remain unreported. The Revised Cardiac Risk Index (RCRI) and theAmericanCollegeof Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator are the current tools for assessing perioperative cardiovascular risk. Postoperative AF is not included in any CVC risk stratification system. The presented review systematizes the data that postoperative AF is closely associated with perioperative complications and in some cases it may be the only marker of these complications. It has been shown that AF detection is of great clinical importance in both high-risk patients and, especially, in patients with a low risk of potential complications in non-cardiac surgery.

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Matsuda, Yuhei, Masaaki Karino, Tatsuo Okui, and Takahiro Kanno. "Complications of Poly-l-Lactic Acid and Polyglycolic Acid (PLLA/PGA) Osteosynthesis Systems for Maxillofacial Surgery: A Retrospective Clinical Investigation." Polymers 13, no. 6 (March 14, 2021): 889. http://dx.doi.org/10.3390/polym13060889.

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Two second-generation PLLA/PGA bioresorbable osteosynthetic plate systems for oral and maxillofacial surgery are available in Japan. The two systems have different PLLA-PGA component ratios (RapidSorb®, 85:15; Lactosorb®, 82:18) and plate and screw shapes. We conducted a retrospective study to compare our clinical evaluation and examine the incidence of postoperative complications between the two plate systems. A retrospective survey was conducted in 148 patients (midfacial fracture/trauma (68.2%) and dentofacial deformity patients (31.8%); males (54.7%); median age, 37.5 years) treated using maxillofacial osteosynthetic plate systems. The complications included plate exposure (7.4%), infection, (2.7%), and plate breakage (0.7%). Multivariate logistic regression analysis showed a significant correlation between sex (female), plate system (Lactosorb®), number of plates, and pyriform aperture and periorbital sites of plate placement (p < 0.05). Additionally, the propensity score-adjusted model showed a significant correlation between Lactosorb® and postoperative complications (odds ratio 1.007 (95% confidence interval, 1.001–1.055), p < 0.01). However, the two plate systems showed a low incidence rate of complications, and the plate integration and survivability were similar using 2.0-mm or 1.5-mm resorbable plate regardless of the plate system. Our findings suggest that female sex and a greater number of plates are risk factors for postoperative complications, whereas pyriform aperture and periorbital plate placements reduce the risk.

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Yoshikawa, Reiko, and Jun Katada. "Effects of active smoking on postoperative outcomes in hospitalised patients undergoing elective surgery: a retrospective analysis of an administrative claims database in Japan." BMJ Open 9, no. 10 (October 2019): e029913. http://dx.doi.org/10.1136/bmjopen-2019-029913.

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ObjectivesThe purpose of this study was to investigate the effects of smoking on prognosis after elective surgeries. Incidence of 30-day postoperative complications was compared between propensity score-matched ‘ever-smoker’ and ‘never-smoker’ cohorts. Thirty-day mortality and medical costs during the hospital stay were also compared.Design and settingA large-scale retrospective study using deidentified administrative claims data obtained from 372 acute care hospitals across Japan using the Diagnosis Procedure Combination system (ie, a flat-fee payment system).ParticipantsInpatients who were hospitalised to undergo elective surgery.Primary and secondary outcome measuresThe primary endpoint of this study was incidence of 30-day postoperative complications. Secondary endpoints were 30-day mortality and total medical costs during hospitalisation. Comparison between ever-smokers and never-smokers was conducted using matched cohorts created by 1:1 propensity score matching.ResultsUsing 561 598 eligible patients, matched ever-smoker and never-smoker cohorts (n=1 55 593 each) were created. Ever-smokers were defined as patients with Brinkman Index ≥1. The percentage of patients who were male was 76.7%, and mean ages for ever-smokers and never-smokers were 65.1±13.8 years old and 66.4±15.3 years old, respectively. The Brinkman Index of the ever-smoker cohort was 677.6±553.4. Smoking was significantly associated with higher risk of 30-day postoperative complications compared with not smoking (OR 1.15, 95% CI 1.13 to 1.17, p<0.001). Similarly, smoking was significantly associated with postoperative 30-day mortality, with OR of 1.22 (95% CI 1.08 to 1.39, p=0.002).ConclusionsOur results suggest that smoking could be associated with risk of poor postoperative outcomes. In particular, a history of smoking may increase the risk of 30-day postoperative complications as well as that of 30-day mortality. The results suggest that smoking might have a harmful effect on postoperative outcomes irrespective of types of surgery.

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Motoyama, Satoru, Hiroyuki Yamamoto, Hiroaki Miyata, Masahiko Yano, Takushi Yasuda, Masaichi Ohira, Yoshiaki Kajiyama, et al. "Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan." Esophagus 17, no. 1 (October 3, 2019): 41–49. http://dx.doi.org/10.1007/s10388-019-00694-9.

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Abstract Background In 2009, the Japan Esophageal Society (JES) established a system for certification of qualified surgeons as “Board Certified Esophageal Surgeons” (BCESs) or institutes as “Authorized Institutes for Board Certified Esophageal Surgeons” (AIBCESs). We examined the short-term outcomes after esophagectomy, taking into consideration the certifications statuses of the institutes and surgeons. Methods This study investigated patients who underwent esophagectomy for thoracic esophageal cancer and who were registered in the Japanese National Clinical Database (NCD) between 2015 and 2017. Using hierarchical multivariable logistic regression analysis adjusted for patient-level risk factors, we determined whether the institute’s or surgeon’s certification status had greater influence on surgery-related mortality or postoperative complications. Results Enrolled were 16,752 patients operated on at 854 institutes by 1879 surgeons. There were significant differences in the backgrounds and incidences of postoperative complications and surgery-related mortality rates between the 11,162 patients treated at AIBCESs and the 5590 treated at Non–AIBCESs (surgery-related mortality rates: 1.6% vs 2.8%). There were also differences between the 6854 patients operated on by a BCES and the 9898 treated by a Non-BCES (1.7% vs 2.2%). Hierarchical logistic regression analysis revealed that surgery-related mortality was significantly lower among patients treated at AIBCESs. The institute’s certification had greater influence on short-term surgical outcomes than the operating surgeon’s certification. Conclusions The certification system for surgeons and institutes established by the JES appears to be appropriate, as indicated by the improved surgery-related mortality rate. It also appears that the JES certification system contributes to a more appropriate medical delivery system for thoracic esophageal cancer in Japan.

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Hirokawa, Masayuki, Katsushi Oda, Akira Yamamoto, Hideaki Nishimori, Atsushi Hata, Takashi Fukutomi, Kunihiko Hirose, and Shiro Sasaguri. "Endoscopic Vein Surgery in Lower Extremities with VasoView System." Asian Cardiovascular and Thoracic Annals 8, no. 2 (June 2000): 146–49. http://dx.doi.org/10.1177/021849230000800213.

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The VasoView system was used for endoscopic saphenous vein harvesting in 10 coronary artery bypass patients and for endoscopic subfascial division of perforating veins in 8 patients with varicose veins. In both procedures, the surface of the saphenous vein and the subfascial plane were dissected using the VasoView dissection cannula. An operative tunnel was subsequently created by inflating and deflating the balloon and maintained by carbon dioxide insufflation. The branches of the saphenous vein and the perforating veins were divided with bipolar scissors under endoscopic vision. In endoscopic saphenous vein harvesting, the mean graft length was 31.5 ± 7.5 cm and the mean number of skin incisions was 3 ± 1.2. In endoscopic subfascial division of perforating veins, 3.4 ± 1.7 veins were divided. The VasoView system is attributed with a decrease in complications after vein surgery in the lower extremities.

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Cho, Haruhiko, Takaki Yoshikawa, Mari Saito Oba, Naoki Hirabayashi, Junya Shirai, Toru Aoyama, Tsutomu Hayashi, et al. "Matched pair analysis to examine the effects of a planned preoperative exercise program in early gastric cancer patients with metabolic syndrome to reduce operative risk: The Adjuvant Exercise for General Elective Surgery (AEGES) study group." Journal of Clinical Oncology 32, no. 3_suppl (January 20, 2014): 166. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.166.

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166 Background: Since obesity is a risk factor during surgery, the effects of a preoperative exercise program to reduce the incidence of peri- and postoperative complications in patients with a high BMI (> 25) and metabolic syndrome were investigated. An assessment of the effects of prospectively planned preoperative exercise was performed in a prospective matching study comparing an exercise testing group and a usual preoperative preparation group who underwent gastrectomy for gastric cancer in Japan. Methods: Stage I gastric cancer patients with metabolic syndrome diagnosed according to the criteria of the Japanese Ministry of Health, Labour and Welfare were enrolled in a surgery after preoperative exercise group. The control group was selected from a database using an individual matching approach for surgery, sex, weight, BMI, volume of visceral fat and institution. The primary end point was the frequency of postoperative complications (cardiovascular events, pneumonia, surgery-related abdominal complications, etc.). Results: A total of 72 patients (54 in the surgery alone group, 18 in the preoperative exercise group) were analyzed. The median operative time and amount of bleeding were 208 min and 130 ml in the surgery alone group and 248 min and 105 ml in the exercise group, respectively. Postoperative complications occurred in one case (5.5%) in the exercise group and 22 (40.7%) cases in the surgery alone group. Conclusions: Preoperative exercise is safe, and its benefits in reducing postoperative complications are promising and therefore warrant further investigation.

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Maeda, Koji, Takao Ohki, Yuji Kanaoka, Kota Shukuzawa, Takeshi Baba, and Masamichi Momose. "A Novel Shaggy Aorta Scoring System to Predict Embolic Complications Following Thoracic Endovascular Aneurysm Repair." European Journal of Vascular and Endovascular Surgery 60, no. 1 (July 2020): 57–66. http://dx.doi.org/10.1016/j.ejvs.2019.11.031.

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Kuntz, Salomé, Anne Lejay, Nabil Chakfe, Céline Deslarzes, Alexandre Than Vinh Nguyen, Alban Longchamp, Rosalinda D’amico, Jean-Marc Corpataux, and Sébastien Deglise. "Long-term evaluation of the EVAS system and management of the surgical complications." Annals of Vascular Surgery 84 (August 2022): 101. http://dx.doi.org/10.1016/j.avsg.2022.06.085.

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Obitsu, Y., S. Ishimaru, and H. Shigematsu. "The Education System to Master Endovascular Aortic Repair in Japan – The Japanese Committee for Stentgraft Management." European Journal of Vascular and Endovascular Surgery 39 (March 2010): S5—S9. http://dx.doi.org/10.1016/j.ejvs.2009.12.024.

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Riles, Thomas S. "Results, complications, and follow-up of 415 bypass operations for occlusive disease of the carotid system." Journal of Vascular Surgery 3, no. 6 (June 1986): 942–43. http://dx.doi.org/10.1016/0741-5214(86)90444-1.

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Perrault, Louis P., Michel Pellerin, Michel Carrier, Raymond Cartier, Denis Bouchard, Philippe Demers, and Edward M. Boyle. "The PleuraFlow Active Chest Tube Clearance System: Initial Clinical Experience in Adult Cardiac Surgery." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 7, no. 5 (September 2012): 354–58. http://dx.doi.org/10.1097/imi.0b013e31827e2b4d.

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Objective To address the clinical consequences related to chest tube clogging, a novel chest drainage apparatus, the PleuraFlow Active Tube Clearance System (Clear Catheter Systems, Bend, OR), was developed. The aim of this world's first clinical experience study was to follow clinicians using the PleuraFlow system to assess usability issues and potential areas of improvement in the heart surgery setting. Methods A user preference study was conducted to assess how specified users (surgeons, nurses, and intensive care physicians) used the PleuraFlow system to achieve specified goals in an efficient manner. Data were collected from patient charts and by a questionnaire that they had filled. Results All the surgeons (n = 7) noted that the device was not any more difficult to insert than a conventional chest tube and was easy to assemble and use. There were no reports of malfunction or complications related to the installation or use of the system. A majority, 77% (24/31), of nurses felt that the device was more time efficient than stripping, milking, or tapping the chest tubes to keep them open. A majority (16/19, 84%) of the PleuraFlow chest tubes and guide tubes were removed together in one piece within 1 day of surgery (on postoperative day 1). Conclusions Overall, the physicians and nurses rated the PleuraFlow system positively for its ability to be incorporated into the postoperative workflow of managing the drainage of patients after heart surgery. This device may be useful to allow caregivers to be certain that chest tubes are functioning in the early hours after surgery, when active bleeding is resolving and when complications from undrained blood can ensue.

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Ikeda, Shuhei, Kazuo Washida, Tomotaka Tanaka, Erika Kitajima, Tetsuya Chiba, Kazuki Fukuma, Takeshi Yoshimoto, Satoshi Saito, Yorito Hattori, and Masafumi Ihara. "A Nationwide Multi-Center Questionnaire Survey on the Real-World State and Issues Regarding Post-Stroke Complications in Japan." Journal of Stroke and Cerebrovascular Diseases 30, no. 4 (April 2021): 105656. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105656.

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Yakubtsevich, R. E., and K. O. Kratkou. "THE INFLUENCE OF CLINICAL AND LABORATORY FACTORS ON THE DEVELOPMENT OF HEMODYNAMIC COMPLICATIONS DURING ANESTHESIA IN CARDIAC SURGERY." Journal of the Grodno State Medical University 19, no. 4 (September 12, 2021): 367–75. http://dx.doi.org/10.25298/2221-8785-2021-19-3-367-375.

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Background. Currently, cardioanesthesiology is one of the most actively developing areas of modern medicine. Thanks to new methods of treatment, the contingent of patients for whom it became possible to undergo cardiac surgery has significantly expanded. The main problems that lead to hemodynamic complications are endothelial dysfunction and cellular hypoxia. Purpose. To present data on the influence of clinical and laboratory factors of endothelial dysfunction and cellular hypoxia on the development of hemodynamic complications during anesthesia in cardiac surgery. Material and methods. The review and analysis of literature data from 49 sources is presented. Results. The laboratory markers of endothelial dysfunction leading to the development of major hemodynamic complications in cardiovascular diseases are MPC-1, CRP, NO, TNF-α, IL-6, homocysteine. Conclusion. The data obtained indicate a significant effect of cell markers (MPC-1, CRP, NO, TNF-A, IL-6, homocysteine) as well as clinical and laboratory factors of endothelial dysfunction not only on the development of major diseases of the cardiovascular system, but also on their complications. An early study of these markers can improve anesthesia during cardiac surgery as well as reduce complications in the postoperative period.

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Ueda, Haruki, Hideyuki Arima, Tokumi Kanemura, Masao Koda, Mitsuru Yagi, Koji Yamada, Kazumasa Ueyama, Yukihiro Matsuyama, and Hiroshi Taneichi. "The Development of a Nationwide, Multicenter Electronic Database for Spinal Instrumentation Surgery in Japan: Japanese Spinal Instrumentation Society Database (JSIS-DB)." Healthcare 10, no. 1 (December 31, 2021): 78. http://dx.doi.org/10.3390/healthcare10010078.

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(1) Background: Despite the number of complicated and expensive spine surgery procedures maintained by the national health insurance system in Japan, until now there has been no large-scale multicenter clinical database for this field to understand and improve healthcare expenditure and treatment outcomes. The purpose of this report is to announce the establishment and methodology of a nationwide registry system for spinal instrumentation surgeries by the Japanese Spinal Instrumentation Society (JSIS), and to report the progress over the first 1.5 years of this database’s operation. (2) Methods: The JSIS recently produced an online database with an electronic server. The collected information included patient background, surgery information, and early complications of primary and revision cases. Analysis included data from February 2018, when registration began, to August 2019. (3) Results: As of August 2019, 73 facilities have completed the required paperwork to start, and 55 facilities have registered cases. Of the total 5456 registered cases, 4852 were valid and 2511 were completed. (4) Conclusions: JSIS-DB, the nationwide web-based registry system for spinal instrumentation surgery in Japan, was launched for the purpose of research, healthcare policy regulation, and improved patient care, and its methodology and progress in the first 1.5 years are reported in this study.

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Childress, Beverly B., Scott A. Berceli, Peter R. Nelson, W. Anthony Lee, and C. Keith Ozaki. "Impact of an Absorbent Silver-Eluting Dressing System on Lower Extremity Revascularization Wound Complications." Annals of Vascular Surgery 21, no. 5 (September 2007): 598–602. http://dx.doi.org/10.1016/j.avsg.2007.03.024.

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Bondariev, R. V., L. Yу Markulan, V. M. Ivantsok, O. O. Bondarieva, and M. M. Levon. "NATURE OF POST-SURGERY COMPLICATIONS AFTER CHOLECYSTECTOMY OF DESTRUCTIVE CHOLECYSTITIS IN PATIENTS OF AN OLDER AGE GROUP WITH A ISCHEMIC HEART DISEASE." Kharkiv Surgical School, no. 4 (October 12, 2020): 15–19. http://dx.doi.org/10.37699/2308-7005.4.2020.03.

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Аbstract. The significance of the problem of acute cholecystitis in the elderly and senile is due to a high increase in the incidence, the presence of marked concomitant diseases. There is no literature data on a comparative analysis of early post-surgery complications of acute destructive cholecystitis in elderly and senile patients with concomitant coronary heart disease after traditional cholecystectomy and laparoscopic cholecystectomy. The Aim of the study is a comparative analysis of the nature of early post-surgery complications after traditional cholecystectomy and laparoscopic cholecystectomy of acute destructive cholecystitis in the elderly and senile with concomitant coronary heart disease. Materials and methods of research. A comparative analysis of early post-surgery complications was performed in 392 patients aged 60 and over with concomitant coronary heart disease who underwent surgical treatment for acute destructive cholecystitis. Depending on the method of surgical treatment, patients were divided into two groups: the І group (n = 178) — surgical treatment was carried out in the amount of traditional cholecystectomy, sanitation of the abdominal cavity with saline and decasan solution; the ІІ group (n = 214) — surgical treatment included laparoscopic cholecystectomy, sanitation of the abdominal cavity with saline and «decasan» solution, extraction of the gallbladder in a rubber sterile container through a subxiphoid wound, which, after removal of the gallbladder, was sanitized with «decasan» solution. Research results. Complications from the cardiovascular system in the 1st group were noted in 2.8 % of patients, pneumonia — 1.1 %, from the abdominal cavity — 8.5 %, wounds — 25.8 %, postoperative intestinal paresis — 19, 1 %, mortality — 1.1 %. In the 2nd group, complications from the cardiovascular system — 0.5 %, from the abdominal cavity — 4.7 %, wounds — 4.2 %, postoperative intestinal paresis — 8.4 %, mortality — 0.5 %. Complications related to bile leakage, the development of biloma or biliary peritonitis in the groups did not differ. Conclusions. The use of laparoscopic cholecystectomy in acute destructive cholecystitis in elderly people with concomitant coronary heart disease has reduced the number of postoperative complications from the cardiovascular system compared with traditional cholecystectomy from 2.8 % to 0.5 %, from the abdominal cavity — from 8.5 to 4.7 %, from the side of the wound — from 25.8 to 4.2 %, reduce mortality from 1.1 to 0.5 %.

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Falk, Volkmar, Davy C. H. Cheng, Janet Martin, Anno Diegeler, Thierry A. Folliguet, L. Wiley Nifong, Patrick Perier, Ehud Raanani, J. Michael Smith, and Joerg Seeburger. "Minimally Invasive versus Open Mitral Valve Surgery a Consensus Statement of the International Society of Minimally Invasive Coronary Surgery (ISMICS) 2010." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 6, no. 2 (March 2011): 66–76. http://dx.doi.org/10.1097/imi.0b013e318216be5c.

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Objective The purpose of this consensus conference was to deliberate the evidence regarding whether minimally invasive mitral valve surgery via thoracotomy improves clinical and resource outcomes compared with conventional open mitral valve surgery via median sternotomy in adults who require surgical intervention for mitral valve disease. Methods Before the consensus conference, the consensus panel reviewed the best available evidence up to March 2010, whereby systematic reviews, randomized trials, and nonrandomized trials were considered in descending order of validity and importance. The accompanying meta-analysis article in this issue of the Journal provides the systematic review of the evidence. Based on this systematic review, evidence-based statements were created for pre-specified clinical questions, and consensus processes were used to derive recommendations. The American Heart Association/American College of Cardiology system was used to label the level of evidence and class of each recommendation. Results and Conclusions Considering the underlying level of evidence, and notwithstanding the limitations of the evidence base (retrospective studies with important differences in baseline patient characteristics, which may produce bias in results of the evidence syntheses), the consensus panel provided the following evidence-based statements and overall recommendation: In patients with mitral valve disease, minimally invasive surgery may be an alternative to conventional mitral valve surgery (Class IIb), given that there was comparable short-term and long-term mortality (level B), comparable in-hospital morbidity (renal, pulmonary, cardiac complications, pain perception, and readmissions) (level B), reduced sternal complications, transfusions, postoperative atrial fibrillation, duration of ventilation, and intensive care unit and hospital length of stay (level B). However, this should be considered against the increased risk of stroke (2.1% vs 1.2%) (level B), aortic dissection (0.2% vs 0%) (level B), phrenic nerve palsy (3% vs 0%) (level B), groin infections/complications (2% vs 0%) (level B), and, prolonged cross-clamp time, cardiopulmonary bypass time, and procedure time (level B). The available evidence consists almost entirely of observational studies and must not be considered definitive until future adequately controlled randomized trials further address the risk of stroke, aortic complications, phrenic nerve complications, pain, long-term survival, need for reintervention, quality of life, and cost-effectiveness.

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Kashchenko, Yurii V., Dmytro P. Sakevych, Stamatella-Ahapi S. Arvanitaki, and Serhii A. Rudenko. "Complications and Mortality after CABG Surgery in Patients with Reduced Ejection Fraction." Ukrainian Journal of Cardiovascular Surgery 30, no. 3 (September 26, 2022): 9–14. http://dx.doi.org/10.30702/ujcvs/22.30(03)/ks034-0914.

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Coronary artery bypass grafting (CABG) is a complex, high-tech surgical intervention. Its success depends not only on the skill and experience of the surgeon but equally on the coherence of work and professionalism of all services involved in the operation. Severe left ventricular (LV) dysfunction after heart surgery is one of the main causes of cardiogenic shock, which is characterized by a local transient reduction of myocardial contractility (“stunned” myocardium) and/or significant cell damage caused by ischemia. In this state, systemic metabolic disorders often occur: increased concentration of free fatty acids, lactic acidosis, hypoxemia, and increased catecholamine content. General approaches to determining the risk of CABG surgery have not been definitively established. In addition, the data concerning the choice of optimal tactics in patients with a reduced ejection fraction (EF) are still limited. Relatively high early operative mortality in patients with reduced left ventricular EF requires further serious study. The aim. To determine the dominant complications and causes of fatal cases in patients with reduced LV contractility after CABG surgery. Materials and methods. The study included 210 patients with EF of 35% or less, who underwent CABG at the National Amosov Institute of Cardiovascular Surgery in the period from 01/01/2015 to 12/31/2021. Among them were 190 men (90.5%) and 20 women (9.5%). The age of the patients ranged from 29 to 83 years (61.1±8.9). Most patients underwent revascularization of three or more arteries. Results and discussion. In the group of patients with EF 35-30% in the postoperative period, acute heart failure (HF) occurred in 5 (3.8%) cases, respiratory failure (RF) was observed in 3 (2.3%) cases, renal failure in 3 (2.3%) cases, central nervous system (CNS) complications in 5 (3.8%). At the same time, along with the decrease in EF, the frequency of postoperative complications increased. In patients with EF below 24%, the frequency of postoperative complications increased significantly: acute HF was noted in 3 (15%) cases, RF in 5 (25%) cases, renal failure in 2 (10%) cases, CNS complications were noted in 0 (0%) cases. The duration of artificial lung ventilation increased significantly to 24.9±27.7 hours, the length of stay in the intensive care unit increased to 12.8±8 days, and the total length of stay of the patient in the hospital to 20.2±11.7 days. Conclusion. Based on the data we received, we concluded that: in patients with reduced LV myocardial contractility, such complications as HF, RF and renal failure, CNS complications most often occur; in addition, their frequency is higher than that in patients with preserved EF and increases with its decrease; one of the most frequent and life-threatening complications in this group of patients was acute HF; the use of intra-aortic balloon pump allows to avoid or improve treatment of HF and, at the same time, to increase survival in patients with reduced LV contractility.

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Scavée, V., S. Theys, and J.-C. Schoevaerdts. "Surgery of varicose veins with transilluminated powered mini-phlebectomy: clinical experience." Phlebology: The Journal of Venous Disease 18, no. 2 (June 1, 2003): 97–99. http://dx.doi.org/10.1258/026835503321895415.

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The authors report their experience with a new surgical technique, the transilluminated powered mini-phlebectomy (Trivex' System, Smith & Nephew Inc, Andover, USA), to remove primary varicose veins. There were 70 patients, 50 women and 20 men, with a mean age of 52 ± 9 years. The average operating time was 56 ± 8 min (range 30–75 min). The mean number of incisions was five (range 2–8). The postoperative pain, cosmetic scores and all complications were evaluated prospectively.

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Morgado, Plínio Ferreira, and Márcio Abrahão. "Angled telescopic surgery, an approach for laryngeal diagnosis and surgery without suspension." Sao Paulo Medical Journal 117, no. 5 (September 2, 1999): 224–26. http://dx.doi.org/10.1590/s1516-31801999000500008.

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CONTEXT: Many methods have been used successfully for the diagnosis and treatment of laryngeal diseases. Microscopic and, recently, telescopic surgery represent the state of the art in endoscopic laryngeal surgery but drawbacks are possible during their application. To keep the suspension apparatus adequately positioned, excessive force is sometimes placed on the upper teeth and tongue with the laryngoscope tube causing damage. Complications in relation to the pharynx, larynx and cardiovascular system have also been reported. OBJECTIVE: In order to reduce complications resulting from the manipulation or stimulation of the upper aerodigestive tract and from torque forces on the upper teeth. We present a method of larynx surgery in which laryngeal suspension is not required. DESIGN: Technical report. TECHNIQUES: We have devised a fiber-optic telescope with its 40mm distal portion deviated 60 degrees from the direction of the proximal portion. This angle was taken by measuring patients immediately before standard microlaryngeal surgery was performed. The surgical instruments have the same angle as the telescope, in order to work on the larynx. This technique provides an image that is not limited by the distal aperture of the laryngoscope and has an advantage in that magnification and illumination may be provided by changing the distance of the lesion from the tip of the instrument. we have operated on four patients with laryngeal diseases and have had no complications as a result of this approach. We feel that this technique gives us the freedom to view the lesions better and helps to minimize the drawbacks caused by laryngeal suspension.

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Vinh, Vu Huu, Huynh Quang Khanh, Nguyen Hoang Binh, and Nguyen Van Khoi. "Pectus excavatum repair using bridge fixation system." Asian Cardiovascular and Thoracic Annals 27, no. 5 (April 19, 2019): 374–80. http://dx.doi.org/10.1177/0218492319846733.

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Background The stability of the pectus bar is an important determinant of the success of pectus excavatum repair surgery. In practice, several different types of fixation method are in use for stabilizing pectus bars. The aim of this study was to compare the performance of the bridge fixation system with previous fixation systems for stabilizing pectus bars. Methods We performed a retrospective review of 1760 pectus excavatum repair cases conducted in the Thoracic Department of Choray Hospital and its satellite hospitals, between 2007 and 2017. We compared the results of 560 patients who had the bridge fixation system with the previous 1200 patients who had other fixation techniques. Results The bridge fixation system with 2 bars in 560 patients gave better results in terms of bar stabilization, operative time, and postoperative complications, compared to the previous 1200 patients who had other stabilization techniques. The average skin-to-skin surgery time using the bridge fixation system was 55 min. Of the 560 cases, only one patient showed trivial one bar dislocation, and one had a postoperative complication (pneumothorax). Conclusions We found the bridge fixation system to be superior not only in terms of stabilizing the bars but also for minimizing the time of surgery and postoperative complications, compared to other fixation systems. The bridge fixation system with 2 bars showed excellent results. Use of 3 bars is not necessary. One bar was used in the other fixation techniques and the results were found to be inferior compared to those using 2 bars.

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Szefner, J. "Control and Treatment of Hemostasis in Cardiovascular Surgery." International Journal of Artificial Organs 18, no. 10 (October 1995): 633–48. http://dx.doi.org/10.1177/039139889501801016.

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The hemostasis protocol applied at the Cardiovascular Surgery Dept. of La Pitié Hospital has greatly reduced thromboembolic accidents and excessive bleeding, with consequent benefits for patients as well as cost reduction. Protocol also has been adopted for patients implanted with a circulatory assist device or a TAH. This paper presents our criteria on supervision and treatment of coagulation with such patients, who reflect all the acquired pathology in clinical hemostasis. From 04/86 to 07/94, 82 patients underwent TAH as a bridge to transplantation. Mean age: 38. Overall duration of mechanical support: 1930 days (mean: 23), of which 137 and 603 for 2 patients. Average duration of CPB: 150 min. Systematic approach to complex TAH-blood interaction and pre-operative multiple organ dysfunction used to control bleeding and/or thromboembolism after CPB. In addition to routine tests, specific regular testing was carried out at least once a day for platelet functions, for thrombin formation and its regulatory pathways, and for the fibrinolytic system. Patients were treated with small doses of Heparin, large doses of Dypyridamole, small doses of Aspirin, modulated doses of Aprotinin, Ticlopidine, Pentoxifylline, FFP, as well as Fibrinogen and AT III concentrates. Dosage was adapted to patient's clinical profile as well as to test interpretation criteria to provide personalized treatment. DIC, widely present in its different phases, was thus diagnosed and treated. All DIC bleeding was controlled, making it possible to detect other causes of post-operatory bleeding and use blood derivates rationally. There were no thromboembolic complications and no iatrogenic bleeding. TAH explantation shows no evidence of macroscopic clots in high risk sites, confirmed by microscopic analysis.

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Yu, Yang, Shanshan Xu, Bing Yan, Xiaodong Tang, Honggang Zhang, Caifei Pan, and Shengmei Zhu. "Incidence and Associations of Acute Kidney Injury after General Thoracic Surgery: A System Review and Meta-Analysis." Journal of Clinical Medicine 12, no. 1 (December 21, 2022): 37. http://dx.doi.org/10.3390/jcm12010037.

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(1) Background: Acute kidney injury (AKI) is related to adverse outcomes in critical illness and cardiovascular surgery. In this study, a systematic literature review and meta-analysis was carried out to evaluate the incidence and associations of AKI as a postoperative complication of thoracic (including lung resection and esophageal) surgical procedures. (2) Methods: Adopting a systematic strategy, the electronic reference databases (PubMed, EMBASE, and Cochrane Library) were searched for articles researching postoperative renal outcomes that were diagnosed using RIFLE, AKIN or KDIGO consensus criteria in the context of a thoracic operation. A random-effects model was applied to estimate the incidence of AKI and, where reported, the pooled relative risk of mortality and non-renal complications after AKI. The meta-analysis is registered in PROSPERO under the number CRD42021274166. (3) Results: In total, 20 studies with information gathered from 34,826 patients after thoracic surgery were covered. Comprehensively, the incidence of AKI was estimated to be 8.8% (95% CI: 6.7–10.8%). A significant difference was found in the mortality of patients with and without AKI (RR = 2.93, 95% CI: 1.79–4.79, p < 0.001). Additionally, in patients experiencing AKI, cardiovascular and respiratory complications were more common (p = 0.01 and p < 0.001, respectively). (4) Conclusions: AKI is a common complication associated with adverse outcomes following general thoracic surgery. An important issue in perioperative care, AKI should be considered as a highly significant prognostic indicator and an attractive target for potential therapeutic interventions, especially in high-risk populations.

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Koga, Masatoshi, Toshiyuki Uehara, Nobuyuki Yasui, Yasuhiro Hasegawa, Kazuyuki Nagatsuka, Yasushi Okada, and Kazuo Minematsu. "Factors Influencing Cooperation Among Healthcare Providers in a Community-Based Stroke Care System in Japan." Journal of Stroke and Cerebrovascular Diseases 20, no. 5 (September 2011): 413–23. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2010.02.012.

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Vendramin, Igor, Daniela Piani, Andrea Lechiancole, Sandro Sponga, Massimo Sponza, Michela Puppato, Uberto Bortolotti, and Ugolino Livi. "Late complications of the Djumbodis system in patients with type A acute aortic dissection." Interactive CardioVascular and Thoracic Surgery 31, no. 5 (October 2, 2020): 704–7. http://dx.doi.org/10.1093/icvts/ivaa178.

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Abstract The Djumbodis system is a metallic stent designed to prevent false lumen dilatation after repair of acute aortic dissection. Although the exact number of Djumbodis stents inserted worldwide could not be ascertained from a review of the literature, available data indicate 9 specific device-related complications from 4 patient series and 3 case reports: stent deformity or fracture (4), progressive enlargement of the distal false lumen (3) and distal pseudoaneurysm (1); a further patient with pseudoaneurysm of the distal suture line is added from personal observation. The present review confirms the inability of the Djumbodis stent to provide reduction and/or elimination of the false lumen after repair of type A dissection, highlighting peculiar device-related complications. Current survivors with a Djumbodis stent should undergo close follow-up to prevent possible catastrophic events due to device failure.

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Willems, Ruben, Philip Tack, Katrien François, and Lieven Annemans. "Direct Medical Costs of Pediatric Congenital Heart Disease Surgery in a Belgian University Hospital." World Journal for Pediatric and Congenital Heart Surgery 10, no. 1 (January 2019): 28–36. http://dx.doi.org/10.1177/2150135118808747.

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Objectives: The recent trend to optimize the efficiency of health-care systems requires objective clinical and economic data. European data on the cost of surgical procedures to repair or palliate congenital heart disease in pediatric patients are lacking. Methods: A single-center study was conducted. Bootstrap analysis of variance and bootstrap independent t test assessed the excess direct medical costs associated with minor and major complications in nine surgical procedure types, from a health-care payer perspective. Generalized linear models with log-link function and inverse Gaussian family were used to determine associated covariates with the total hospitalization cost. Descriptive statistics show the repartition between out-of-pocket expenditures and reimbursed costs. Results: Four hundred thirty-seven patients were included. Mean hospitalization costs ranged from €11,106 (atrial septal defect repair) to €33,865 (Norwood operation). Operations with major complications yielded excess costs compared to operations with no complications, ranging from €7,105 (+65.2%) for a truncus arteriosus repair to €27,438 (+251.7%) for a tetralogy of Fallot repair. Differences in costs were limited between operations with minor versus no complications. Age at procedure, intensive care unit stay, procedure risk category, reintervention, and postoperative mechanical circulatory support were associated with higher total hospitalization costs. Out-of-pocket expenditures represented 6% of total hospitalization costs. Conclusion: Operations with major complications yield excess costs, compared to operations with minor or no complications. Cost data and attribution are important to improve clinical practice in a cost-effective manner. The health-care system benefits from strategies and technological advancements that have an impact on modifiable cost-affecting parameters.

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Ho, Jacky Y. K., Joyce W. Y. Chan, Simon C. Y. Chow, Peter S. Y. Yu, Micky W. T. Kwok, Gary S. H. Cheung, and Randolph H. L. Wong. "Application of Cerebral Protection System in Open Mitral Replacement with Extensive Calcified Left Atrial Thrombus." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 15, no. 1 (December 26, 2019): 85–87. http://dx.doi.org/10.1177/1556984519892242.

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Neurological complications remain a major burden in cardiac surgery, despite various intraoperative measures attempting to reduce its occurrence. Advancement of percutaneous approach in valve replacement has brought focus to the use of cerebral protection system (CPS). We reported a novel application of percutaneous CPS in open heart surgery for a patient with an extensive calcified left atrial thrombus to reduce risk of embolic stroke. Although, there is no evidence to advocate routine use of CPS in all open cardiac surgical patients, we believe it is a technically feasible and probably safe approach for neurological protection in high-risk patients.

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Kitamura, Hideki, Hitoshi Okabayashi, Michiya Hanyu, Jota Nakano, Satoshi Kono, Takuya Nomoto, Atsushi Nagasawa, Hisashi Sakaguchi, Hiroyuki Johno, and Takehiko Matsuo. "Early Results and Problems with St. Jude Medical Symmetry Bypass System in Japan." Asian Cardiovascular and Thoracic Annals 12, no. 3 (September 2004): 236–38. http://dx.doi.org/10.1177/021849230401200312.

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Tanaka, Nobuhiro, Ryuichi Waseda, Daisuke Saito, Masahiro Ohsima, Isao Matsumoto, and Hirofumi Takemura. "A novel fluorescent lung-marking technique using the photodynamic diagnosis endoscope system and vitamin B2." Interactive CardioVascular and Thoracic Surgery 31, no. 6 (September 17, 2020): 853–59. http://dx.doi.org/10.1093/icvts/ivaa193.

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Abstract OBJECTIVES For small pulmonary nodules that are unidentifiable by palpation or in endoscopic surgeries wherein palpation is not feasible, visualizing their location is necessary when performing pulmonary sublobar resection procedures, such as wedge resection or segmentectomy. We invented a new transbronchial lung-marking technique using the photodynamic diagnosis endoscope system and vitamin B2 and examined its feasibility and safety via porcine studies. METHODS We established the marking procedure in pigs and examined the marking clarity and size, fluorescence intensity and duration and possible complications. In another study, sublobar resection for virtual target lesions was performed in pigs based on the fluorescent markings. The procedure duration, marking visibility, surgical margin from the lesions and technique-related complications were assessed. RESULTS All 36 markings in 6 pigs were identifiable and were widely distributed over the right lung. The median diameter and fluorescence intensity at 60 min after marking were 6.0 (5.5–6.7) mm and 137.5 (122–168), respectively. All 18 markings for the 6 virtual target lesions (3 markings for each target) were clearly identified, and all target lesions were found in the resected specimens. The median duration per marking was 244 (194–255) seconds. The shortest median surgical margin from a target lesion was 11.5 (9.3–13.5) mm. No procedure-related complications were observed. CONCLUSIONS This novel transbronchial fluorescent lung-marking technique was useful and safe in sublobar resections for small non-palpable pulmonary lesions.

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Murphy, Douglas, J. Michael Smith, Leland Siwek, David A. Langford, John R. Robinson, Branden Reynolds, Usha Seshadri-Kreaden, and Amy M. Engel. "Multicenter Mitral Valve Study: A Lateral Approach Using the da Vinci Surgical System." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 2, no. 2 (March 2007): 56–61. http://dx.doi.org/10.1097/imi.0b013e31803c9b2a.

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Objective The purpose of this study was to demonstrate the feasibility of simple to complex endoscopic robotic mitral valve repair, using a lateral approach. Methods Data were retrospectively collected on 201 patients undergoing a lateral “ports only” endoscopic robotic mitral valve repair at three institutions. Techniques of aortic occlusion included the endoaortic balloon or a transthoracic clamp. The efficacy of the repair was measured intraoperatively by transesophageal echocardiogram. Results Two hundred one patients with a mean age of 55.2 ± 14.2 were intended to undergo elective robotic mitral valve surgery. One hundred eighty-six (92.5%) were scheduled for a repair procedure and 15 (7.5%) were scheduled for replacement. The repair was accomplished in 179 of 186 (96.2%) of patients. Eight patients (4.3%) required a conversion to sternotomy incision. Seven converted patients received a mitral valve repair and one received a replacement mitral valve. Mitral valve pathology included 10% isolated anterior leaflet involvement, 43% isolated posterior leaflet involvement, and 6% bileaflet pathology, and the remaining patients had dilated annulus, chordal rupture, or elongation. One hundred seventy-nine patients (96.2%) had regurgitation grade of 0 to 1 after repair. Two patients (1%) died. Other adverse events included reoperation for valve-related complications, 2 of 201 (1%); reoperation for cardiac-related complications, 3 of 201 (1.5%); and new onset of atrial fibrillation, 35 of 201 (17.4%). Conclusions A lateral endoscopic robotic approach to mitral valve repair is safe, feasible, and can be performed consistently with acceptable postoperative results. Further follow-up is required to determine the long-term efficacy of this approach to robotic mitral valve repair.

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Perinpanayagam, Madurra, Signe H. Larsen, Kristian Emmertsen, Marianne B. Møller, and Vibeke E. Hjortdal. "Nineteen Years of Adult Congenital Heart Surgery in a Single Center." World Journal for Pediatric and Congenital Heart Surgery 8, no. 2 (March 2017): 182–88. http://dx.doi.org/10.1177/2150135116682454.

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Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

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El Habbal, Magdi H., and Martin J. Elliott. "European approach to cardiopulmonary bypass in neonates." Cardiology in the Young 3, no. 4 (October 1993): 347–52. http://dx.doi.org/10.1017/s1047951100001773.

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The advent of cardiopulmonary bypass in 1953, and its subsequent continuous refinements, have securely established the specialty of cardiovascular surgery. In conjunction with the improved methods of myocardial preservation, this has allowed the safe repair of acquired and complex congenital cardiac defects. During the years, the many variables of the systems used for cardiopulmonary bypass have been altered to the point that most operations are now reproducible with, relatively, low morbidity and mortality. Although in its present form the system is quite reasonable for most routine surgery, it is far from perfect. There remains, therefore, a quest for alterations to improve the system as an ongoing process. Certain complications of open-heart surgery persist and many new and unique approaches to the concept of organ protection and the treatment of these complications must be developed and refined.

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Murkin, John M. "Central Nervous System Complications in Cardiac Surgery: Retrograde Cerebral Perfusion, Pressure, Pulsatility, Temperature, and pH Management During Cardiopulmonary Bypass." Seminars in Cardiothoracic and Vascular Anesthesia 4, no. 2 (July 2000): 65–69. http://dx.doi.org/10.1053/vc.2000.6490.

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Currently, clinical management strategies during cardio pulmonary bypass (CPB) are undergoing profound changes. Renewed interest in normothermic versus hypothermic perfusion during CPB has resulted in appar ently contradictory results regarding patient outcomes. Much effort has been devoted to defining physiological responses of the brain to various alterations during CPB (eg, pH strategy, normothermia versus hypothermia, pulsatile or nonpulsatile perfusion, use of arterial line filtration, circulatory arrest, retrograde cerebral perfu sion). In addition, prospective studies are examining the impact of diverse strategies on neuropsychological and neurological outcomes after CPB, to define optimal management techniques.

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Ebigbo, A., G. Tziatzios, S. K. Gölder, A. Probst, and H. Messmann. "Double-endoscope assisted endoscopic submucosal dissection for treating tumors in rectum and distal colon by expert endoscopists: a feasibility study." Techniques in Coloproctology 24, no. 12 (August 19, 2020): 1293–99. http://dx.doi.org/10.1007/s10151-020-02308-4.

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Abstract Background Colorectal endoscopic submucosal dissection (ESD) is an effective but challenging procedure. To facilitate ESD, several methods that apply traction are available; however, the optimal one remains to be established. The aim of this study was to evaluate the feasibility and safety of the double-endoscope assisted ESD (DEA-ESD) by improving traction to treat complex colorectal lesions. Methods Naïve or previously treated lesions in the rectum and sigmoid colon were included. A grasping forceps advanced through a small-caliber endoscope (GIF-XP190N, Olympus Medical Systems, Tokyo, Japan, 5.4 mm outer diameter) was used to apply traction to the mucosal flap. Lesions were deemed complex when they exceeded a total of nine points on the SMSA scoring system (size, morphology, site, and access) and recurrent when they were previously treated with endoscopic mucosal resection (EMR). Outcome measures included procedural success, total procedure time, complications, and recurrence rate at 3-month follow-up. Results Nine patients (mean age 62.3 ± 14.5 years) were included; five had rectal and four had tumors in the sigmoid colon. The median SMSA score was 14 (SMSA Level IV—complex polyp), while three patients were pre-treated with EMR. DEA-ESD was technically feasible in all cases. En bloc resection and R0 resection rates were 100%, respectively, with a mean procedure time of 128.4 ± 54.1 min. No immediate or delayed complications occurred. Conclusions DEA-ESD is a feasible and safe method for treating complex or recurrent tumors in the rectum and distal colon.

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Dorros, Gerald. "Complications Associated with Extracranial Carotid Artery Interventions." Journal of Endovascular Therapy 3, no. 2 (May 1996): 166–70. http://dx.doi.org/10.1177/152660289600300208.

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Efforts to ameliorate the tremendous personal and financial ramifications of stroke in this country have focused on the recently validated stroke reduction potential of carotid endarterectomy. During the years in which numerous randomized trials compiled their evidence in favor of surgical treatment, the evolution of minimally invasive therapeutic alternatives to surgery spread to encompass nearly every vascular bed in the body. Only the fragile cerebrovascular system remains as the final challenge for interventionists. Any revascularization alternative to carotid endarterectomy should achieve the same initial and long-term outcomes as the surgical gold standard, with comparable morbidity and mortality. After years of cautious, circumspect application, carotid angioplasty is now a contender for this role. Assisted by the newer stent technology, minimally invasive carotid interventions are entering clinical trials. While it is premature to discuss the stroke reduction potential of these catheter-based techniques, it is imperative that we recognize and prepare to treat the myriad, sometimes catastrophic, complications of these therapeutic approaches to carotid obliterative disease.

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Mshar, S. V., and V. Yanushko. "THE ROLE OF X-RAY ENDOVASCULAR SURGERY IN THE TREATMENT OF OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITY ARTERIES IN ELDERLY AND SENILE PATIENTS." Emergency Cardiology and Cardiovascular Risks 4, no. 2 (2020): 1069–73. http://dx.doi.org/10.51922/2616-633x.2020.4.2.1069.

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Obliterating atherosclerosis ranks third in the system of cardiovascular disease. With age the incidence of peripheral artery disease increases and makes 3-5% in general population. The most difficult group of patients with peripheral artery disease (PAD) or obliterating atherosclerosis is elderly patients. Currently there is a tendency to increase the life expectancy and aging of the Belarusian population. Elderly and senile patients with obliterating atherosclerosis (PAD) are characterized by a multi-level lesion and damage to the distal parts of the arterial bed, an increase in the number of comorbidities, a high risk of cardiovascular death, and seeking medical help often at the stage of critical lower limb ischemia. Patients at high risk of cardiovascular complications with intermittent lameness are subject to conservative treatment. When developing a clinic for critical lower limb ischemia, due to the low effectiveness of conservative methods of treatment, it is worth considering revascularization of the lower limb arteries. Open surgical methods of treatment are associated with a high risk of complications and mortality. X-ray endovascular methods of treatment of patients of the older age group are characterized by a lower risk of complications, lower injury rate. The use of low-injury x-ray endovascular and hybrid methods of treatment in elderly and senile patients can improve the results of treatment (reduce the frequency of amputations, reduce the risk of complications, improve the quality of life).

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Waldherr, Kickuth, Ludwig, Do, and Triller. "Superselective embolization of deep femoral artery branch pseudoaneurysm with a coaxial microcatheter system." Vasa 35, no. 1 (February 1, 2006): 45–49. http://dx.doi.org/10.1024/0301-1526.35.1.45.

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This report describes the use of transluminal coil embolization to treat pseudoaneurysm of deep femoral artery branch in two patients. The pseudoaneurysms had developed after coronary angiography in one patient and after hip replacement in the other. Immediate control angiography after embolization procedures demonstrated complete closure of the pseudoaneurysms. During follow-up of 19 and 3 months, respectively, there was no recurrent bleeding. The aim of this case report is to show the advances in endovascular microcatheter technology, and embolic materials, that made percutaneous transluminal embolization of arterial pseudoaneurysms safe and efficient. In addition, it keeps the medical personnel aware of vascular injuries at the access site related to endovascular procedures as well as vascular complications of total hip arthroplasty. It calls their attention to the possibility of endovascular treatment as an alternative to surgery.

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Miceli, Antonio. "Vascular Complications and Low Delivery System Profile: The Role of Surgical Aortic Valve Replacement." Seminars in Thoracic and Cardiovascular Surgery 30, no. 2 (2018): 150–51. http://dx.doi.org/10.1053/j.semtcvs.2018.04.004.

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Journal articles on the topic 'Cardiovascular system Surgery Complications Japan'

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