Academic literature on the topic 'Cardiovascular system Surgery Patients Japan'
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Journal articles on the topic "Cardiovascular system Surgery Patients Japan"
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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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Ohtsu, Hiroshi, Akihiko Shimomura, Sakiko Miyazaki, Naohiro Yonemoto, Shinichiro Ueda, Chikako Shimizu, and Kazuhiro Sase. "Cardiotoxicity of adjuvant chemotherapy with trastuzumab: a Japanese claim-based data analysis." Open Heart 9, no. 2 (August 2022): e002053. http://dx.doi.org/10.1136/openhrt-2022-002053.
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ObjectiveAdjuvant chemotherapy with trastuzumab improves the postoperative life expectancy of women with early-stage breast cancer. Although trastuzumab is reportedly cardiotoxic, quantification based on real-world evidence is lacking. Therefore, in this study, we aimed to analyse trastuzumab cardiotoxicity using a nationwide claim-based database.MethodsIn this retrospective study, we used data from a nationwide claims database (Japan Medical Data Center, Tokyo, Japan) under the universal healthcare system. Women with breast cancer who underwent initial surgery were included. Patients with recurrent or advanced-stage breast cancer, with a history of heart failure, receiving neoadjuvant chemotherapy or a preoperative history of less than 6 months were excluded. Propensity score (PS) was calculated using logistic regression based on age, cardiovascular risk factors, radiotherapy and concomitant anthracyclines (AC).ResultsWe identified 12 060 eligible patients (mean age 50.8±8.56 years) between January 2010 and December 2019. After 1:2 PS matching (trastuzumab users, TZ, n=1005; non-users, NT, n=2010), Cox proportional hazards model analysis showed that the rate of heart failure development within 18 months postoperative was significantly higher in the TZ group than in the NT group (adjusted HR 2.28, 95% CI 1.38 to 3.77). Baseline cardiac evaluation in the combined AC/TZ cases was 27.2% preoperative, 66.0% pre-AC and 86.6% pre-TZ, respectively.ConclusionTrastuzumab cardiotoxicity remained relevant in the claim-based analysis adjusted for AC effects. Further collaborative studies in cardio-oncology with real-world data are warranted to improve the rate of baseline cardiovascular risk assessment in patients with cancer scheduled for cardiotoxic cancer treatment.
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Yamamoto, Taira, Daisuke Endo, Hironobu Yamaoka, Akie Shimada, Satoshi Matsushita, and Atsushi Amano. "Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting." Heart Surgery Forum 24, no. 3 (June 11, 2021): E530—E533. http://dx.doi.org/10.1532/hsf.3535.
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Background: Aortic valve reoperation increases the risk of mortality and morbidity. The 2017 European Society of Cardiology guidelines for managing valvular heart disease with a previous heart surgery and intact bypass grafts consider patients with high surgical risk to be injury-prone during sternotomy. In high-risk patients with prior coronary artery bypass grafting, several authors have reported the noninferiority or superiority of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement; however, in Japan, TAVR cannot be performed for patients on hemodialysis. In this study, we report a case of successful implantation of the new rapid-deployment bioprosthesis in a 65-year-old Japanese man on dialysis with prior coronary artery bypass grafting. Methods: The rapid-deployment aortic valve system has demonstrated excellent hemodynamic performance, durability, and safety. However, implantation requires specific training and the analysis of preoperative 3D computed tomographic imaging. The cineangiography revealed patency of all grafts, and the saphenous vein graft (SVG) had overlapped the planned aortotomy position. By avoiding the anastomotic part of the SVG, we could perform rapid-deployment aortic valve replacement efficiently even if the aortic incision was repositioned, and the incision was smaller than planned. Results: We used the 23-mm Intuity valve without an additional stitch, and the cardiopulmonary bypass and aortic cross-clamp times were only 52 and 39 minutes, respectively. Conclusion: This novel valve may be beneficial in complex combinational procedures for hemodialysis patients with prior coronary artery bypass grafting.
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Ochiai, Ryota, Arata Murakami, Tomohiko Toyoda, Keiko Kazuma, and Koichiro Niwa. "Opinions of Physicians Regarding Problems and Tasks Involved in the Medical Care System for Patients with Adult Congenital Heart Disease in Japan." Congenital Heart Disease 6, no. 4 (July 2011): 359–65. http://dx.doi.org/10.1111/j.1747-0803.2011.00548.x.
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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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Miyairi, Takeshi, Hiroaki Miyata, Tsuyoshi Taketani, Daigo Sawaki, Tohru Suzuki, Yasunobu Hirata, Hideyuki Shimizu, Noboru Motomura, and Shinichi Takamoto. "Risk Model of Cardiovascular Surgery in 845 Marfan Patients Using the Japan Adult Cardiovascular Surgery Database." International Heart Journal 54, no. 6 (2013): 401–4. http://dx.doi.org/10.1536/ihj.54.401.
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Kurazumi, Hiroshi, Masaya Takahashi, and Shigeru Ikenaga. "Outcomes of cardiovascular surgery for chronic dialysis patients in current Japan." Asian Cardiovascular and Thoracic Annals 27, no. 6 (June 19, 2019): 464–70. http://dx.doi.org/10.1177/0218492319859147.
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Background The number of dialysis patients in Japan is rising, with an increasing number requiring cardiovascular surgery. Methods We investigated the short- and long-term outcomes in 70 dialysis patients among a total of 1124 who underwent cardiovascular surgery in our hospital between 2004 and 2016. We investigated outcomes following open surgery and identified factors that affected the prognosis. We also compared the long-term survival rate with the survival rate of the Japanese dialysis population. Results The long-term survival rate was 70.6%, 51.1%, and 19.2% after 3, 5, and 10 years, respectively. The causes of long-term death were heart disease in 8 patients, cerebrovascular disease in 7, cachexia in 3, infection in 2, and other causes in 3. The freedom from cardiac death was 88.7%, 77.9%, and 54.9% after 3, 5, and 10 years, respectively. Multivariate analysis using Cox’s proportional hazard model showed that a history of atherosclerosis obliterans (hazard ratio 5.4, p = 0.05) and mediastinitis (hazard ratio 10.2, p = 0.03) were risk factors for death in long-term follow-up, and a history of atherosclerosis obliterans was an independent risk factor for cardiac death in long-term follow-up (hazard ratio 5.3, p = 0.01). Five-year survival of the study subjects was comparable to that of the Japanese dialysis population. Conclusions The prognosis for dialysis patients after open surgery was equivalent to that of Japanese dialysis patients in general. A high proportion of late postoperative deaths were due to heart disease. Patients with atherosclerosis obliterans had a poor prognosis.
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Abe, Tomonobu, Hiraku Kumamaru, Kiyoharu Nakano, Noboru Motomura, Hiroaki Miyata, and Shinichi Takamoto. "Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Japan Cardiovascular Surgery Database. 3. Valvular heart surgery." Asian Cardiovascular and Thoracic Annals 29, no. 4 (January 10, 2021): 300–309. http://dx.doi.org/10.1177/0218492320981459.
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Objectives We aimed to present data regarding the current status and trends of valvular heart surgeries in Japan from the Japan Cardiovascular Surgery Database for the 2017–2018. Methods We extracted data on cardiac valve surgeries performed in 2017 and 2018 from the Japan Cardiovascular Surgery Database. We determined the trend in the number of aortic valve replacement procedures from 2013 to 2018. The operative mortality rates were calculated for representative valve procedures stratified by age group. Data regarding minimally invasive procedures and transcatheter aortic valve replacement in the Japan Cardiovascular Surgery Database are also presented. Results In conjunction with the dramatic increase in the number of transcatheter aortic valve replacements in 2017 and 2018, surgical aortic valve replacement also increased from 26,054 to 28,202. The operative mortality rate in first-time valve procedures was 1.8% in isolated aortic valve replacement, 0.9% in isolated mitral valve repair, and 8.2% and 4.6% in mitral valve replacement with biological prostheses and with mechanical prostheses, respectively. Regarding minimally invasive procedures, 30.8% of first-time isolated mitral valve plasty procedures were performed by a right thoracotomy. Although patients who underwent surgery by a right thoracotomy had better clinical outcomes, it was also apparent that patients who underwent surgery by a right thoracotomy had lower operative risk profiles. The overall mortality rates after transcatheter aortic valve replacement and surgical aortic valve replacement were 1.5% and 1.8%, respectively. Conclusion We have reported benchmark data on heart valve surgery in 2017 and 2018 from the Japan Cardiovascular Surgery Database.
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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.
Dissertations / Theses on the topic "Cardiovascular system Surgery Patients Japan"
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Cheng, Pak-ho, and 鄭柏濠. "P wave characteristics and QRS duration in patients after Fontan-type procedures." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B43781627.
Full textBooks on the topic "Cardiovascular system Surgery Patients Japan"
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Cardiovascular anesthesia. New York: Springer-Verlag, 1985.
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Akihiko, Matsumoto, DeBakey Michael E. 1908-, and Kondo J, eds. Advances in cardiovascular surgery: Proceedings of the 8th Congress of Michael E. DeBakey International Surgical Society, 11-15 September, 1990, Yokohama, Japan. Amsterdam: Excerpta Medica, 1991.
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Borggrefe, Martin. Catheter ablation of ventricular tachycardia in patients with structural heart disease. Armonk, N.Y: Futura Pub. Co., 2000.
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Hodge, Tanya. Fast Facts for the Cardiac Surgery Nurse, Second Edition: Caring for Cardiac Surgery Patients in a Nutshell. Springer Publishing Company, Incorporated, 2015.
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M, Taylor K., ed. Cardiac Surgery and the Brain. E. Arnold, 1993.
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Paul, Richard, and Susanna Price. Imaging the cardiovascular system in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0143.
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Cardiac imaging in the critically ill can be challenging. Interpretation requires a broad knowledge of cardiovascular pathophysiology, the range of available investigations, and their sensitivity and specificity in diagnosing individual conditions. Applying first principles and interpreting findings in the clinical context are mandatory. Useful non-invasive investigations include simple chest X-ray, thoracic ultrasound, and computed tomography (CT) to detect pulmonary and extrapulmonary pathology, whilst CT coronary angiography can evaluate stent and graft patency, and identify extramural plaques, undiagnosed with conventional angiography. Invasive left heart cardiac catheterization may be indicated in patients with cardiovascular instability and particularly in patients where cardiac surgery has involved manipulation of the coronary arteries, whilst right heart catheterization remains the gold standard for haemodynamic assessment of pulmonary hypertension. Echocardiography has many applications in the ICU, ranging from haemodynamic monitoring to aiding diagnosis of complex pathology and rapid diagnosis in cardiac arrest. Other investigation modalities less frequently used in the critical care population are also discussed within this chapter.
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Kilkelly, Shannon. Coagulation System. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0090.
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Despite the development of entirely new classes of anticoagulant medication, vitamin K antagonists like warfarin continue to be commonly prescribed for a wide range of cardiovascular diagnoses. Conversely, the advent of low molecular weight heparin has greatly simplified the use of the drug to the point that patients can dose themselves at home with no need for any type of monitoring. Given the widespread use of these medications, it is not surprising that an increasing number of patients requiring urgent or emergent surgery will present with a medically induced coagulopathy. Managing this coagulopathy requires assessment of the urgency of the operation, the patient’s volume status, and the need for reanticoagulation following surgical intervention.
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Schirmer, Uwe, and Andreas Koster. Anaesthesia for cardiac surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0056.
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Cardiac anaesthesia continues to develop as a specialized discipline within the wide field of clinical anaesthesia. A comprehensive knowledge of cardiovascular physiology and its improved monitoring with modern invasive and non-invasive devices is the basis for the pharmacological treatment of complex cardiovascular disorders. Excellent skills in intraoperative transoesophageal echocardiography have become essential. Rapid developments in cardiopulmonary bypass techniques and surgical devices have resulted in the speedy introduction of new surgical techniques which anaesthesia has to embrace. The developments in the field of (left) ventricular assist devices are expansive. By changing the paradigm of the indication of implantation from ‘bridging to heart transplantation’ to ‘destination therapy’, particularly in the large group of elderly patients with end-stage heart failure, these complex operations are no longer restricted to the small group of heart centres performing heart transplantation. This chapter provides a comprehensive review of modern cardiac anaesthesia in the contemporary world of quickly evolving cardiac surgery. The basics of anaesthesia management for the ‘cardiac’ patient are described and principles of extracorporeal circulation as well as diagnostic and treatment strategies of disturbances of the haemostatic system are highlighted. Pharmacological strategies to treat left- and right-heart failure and strategies for temporary mechanical support are outlined. Further areas of focus are the anaesthetic implications of modern less or minimally invasive procedures such as off-pump coronary artery bypass grafting and minimally invasive valve implantation/surgery and anaesthesia for implantation of ventricular assist devices and heart transplantation.
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Toner, Andrew, Mark Hamilton, and Maurizio Cecconi. Post-surgery, post-anaesthesia complications. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0047.
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Postoperative complications are common in high-risk surgical populations and are associated with poor short-term and long-term outcomes. Morbidity can be identified using prospective assessment of pathological criteria, or deviations from the ideal postoperative course requiring clinical intervention. While infections are the most prevalent complication type, morbidity affecting the heart, lungs, kidneys, or brain carry the worst prognosis. Specific pathophysiological processes drive morbidity in each organ system. In addition, dysfunction of the cardiovascular and immune systems can lead to multiorgan impairment, and have been the focus of many clinical trials. Perioperative strategies backed by the strongest evidence base include smoking cessation, surgical safety checklists, perioperative warming, pre-emptive antibiotics, venous thromboembolism prophylaxis, enhanced recovery protocols, and early critical care rescue when complications arise. Isolated attempts to optimize cardiovascular function or attenuate inflammatory responses have not been consistently successful in improving outcomes. As the proportion of surgical patients meeting high-risk criteria rises, reducing the incidence of postoperative complications has become a priority in many developed healthcare systems. To meet this need, improved implementation of proven strategies should be combined with routine and rigorous surgical outcome reporting. In addition, advances in pathophysiological understanding may lead to novel interventions offering multisystem protection in the surgical period.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0076.
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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
Book chapters on the topic "Cardiovascular system Surgery Patients Japan"
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I. Lutfarakhmanov, Ildar, Peter I. Mironov, Ildar R. Galeev, and Valentin N. Pavlov. "Cardiovascular Changes during Robot-Assisted Pelvic Surgery." In Blood - Updates on Hemodynamics and Thalassemia. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.99544.
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The application of robotic assistance in pelvic surgery has become popular across multiple specialties during the past decades, facilitating minimally invasive surgery. The most remarkable challenges regarding these procedures are the carbon dioxide pneumoperitoneum and steep Trendelenburg position. The combination of two factors affects the patient additionally or synergistically and have important physiological effects on cardiovascular system. All those changes are usually well tolerated in patients with normal cardiac function, but it can be different in elderly patients or even in patients with underlying heart conditions. In order to provide the proper management of patients undergone the robotic surgery, we aim to thoroughly understand these effects and overview the risks and possible related cardiovascular complications. Further, a short introduction on dangerous areas of robot-assisted pelvic surgery will be briefly reviewed.
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Hall, Andrew P., and Melanie J. Davies. "Diabetes management in surgery." In Oxford Textbook of Endocrinology and Diabetes, 1905–8. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199235292.003.1495.
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Diabetes mellitus is a common condition in the general population, and particularly so among hospital inpatients. Complications associated with diabetes mellitus further increase its incidence in surgical patients, particularly those requiring vascular, renal, or ophthalmic procedures. Patients with diabetes have a higher rate of morbidity and mortality associated with surgery. This includes cardiovascular and renal complications, infection, and impaired wound healing. The process of surgery, a controlled form of trauma, provokes a metabolic response due to the release of cytokines and stress-associated hormones. These agents promote a catabolic state that includes increased insulin resistance. The resulting hyperglycaemia leads to overflow of substrates in the mitochondria and the generation of excess free oxygen radicals, which can be toxic to the cell. It should, therefore, be possible to reduce these effects by avoiding or attenuating the stress response and/or counteracting its metabolic effects. The stress response is proportional to the degree of tissue trauma. Insulin administration and normoglycaemia have been shown to reverse catabolic changes and improve wound healing and skin grafting, and also to reduce the incidence of infective complications. Additionally, the stress response may be, in part, attenuated by the choice of anaesthetic technique. Neuraxial (spinal and epidural local anaesthetic) analgesia can reduce sympathetic nervous system tone and adrenal output. Additionally, much ophthalmic surgery is now performed with local anaesthesia techniques. Such approaches avoid the more prolonged starvation and cardiorespiratory risks associated with general anaesthesia.
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Ikura, Megumi, Kazuki Nakagita, Takaya Uno, Hiromi Takenaka, Sachi Matsuda, Miho Yoshii, Rikako Nagata, et al. "Role of the Transplant Pharmacist." In Heart Transplantation [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102372.
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At the National Cerebral and Cardiovascular Center, Japan, pharmacists have been involved in drug treatment management and patient care as members of multidisciplinary heart transplant teams that include surgeons, physicians, recipient transplant coordinators, and nurses during the waiting period for heart transplantation (HTx), HTx surgery, and post-HTx. During the waiting period, pharmacists play an important role in adjusting the use of antibiotics, anticoagulants, and antiarrhythmics by patients receiving a ventricular assist device (VAD). During HTx surgery and post-HTx, pharmacists advise physicians regarding the individualized medication protocol for immunosuppression and infection prevention to be used for each patient based on the patient’s pre-HTx characteristics as well as gene polymorphisms. They thus contribute to reducing the burden on the physician through the sharing of tasks. Throughout all three phases of HTx, pharmacists repeatedly provide medication and adherence education to the patients and caregivers. It is hoped that an academic society-led training protocol as well as transplant pharmacists will be established in Japan and other developed countries, and that these specialized transplant pharmacists would then provide individualized pharmacotherapy for the use of various antibiotics, anticoagulants, and immunosuppressive agents that have a narrow range of treatment in VAD and HTx patients.
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Balik, Martin. "Perioperative cardiac care of the high-risk non-cardiac patient." In The ESC Textbook of Intensive and Acute Cardiovascular Care, edited by Marco Tubaro, Pascal Vranckx, Eric Bonnefoy-Cudraz, Susanna Price, and Christiaan Vrints, 990–1008. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849346.003.0075.
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Non-cardiac surgery conveys a cardiac risk related to the status of the patient's cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Memis Bilgin, Yavuz. "Clinical Effects and Possible Mechanisms of Transfusion-Related Immunomodulation." In Blood Donation and Transfusion [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.107228.
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Allogeneic blood components are commonly transfused in trauma, surgery, and intensive care units and are related with adverse effects, such as postoperative infections, multi-organ failure, and mortality. The adverse effects of blood transfusions on the immune system are called as transfusion-related immunomodulation (TRIM). Many clinical trials are conducted to show the clinical effects of TRIM. They found in different clinical settings controversial results. There are many possible mechanisms of TRIM. Although until now, the exact mechanisms are not elucidated resulting in a challenge to unravel this complex interaction between immunomodulation and clinical events leading to morbidity and mortality. It has been postulated that allogeneic leukocytes are associated with the clinical adverse effects of TRIM that predominantly is observed in high-risk patients as cardiovascular surgery. Allogeneic leukocytes could activate inflammation cascade leading to adverse events in high-risk patients. Also other blood components as red cells, plasma, and platelets can play a role in the development of inflammatory complications after blood transfusions. In this review, we will discuss the clinical effects and the possible mechanisms of TRIM in relation with allogeneic leukocytes and mediators derived from allogeneic blood transfusions.
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Al-Suhaymi, Zainab. "Congenital Heart Disease and Surgical Outcome in Down Syndrome." In Genetics and Etiology of Down Syndrome [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.97134.
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The prevalence of congenital heart disease has accounted for nearly one-third of all significant congenital anomalies worldwide. The first report about an association between cardiac anomalies and Down Syndrome was in (1876). Ten years after discovering of Down Syndrome and the credit of association between congenital cardiac anomalies and mongolism was suggested in (1894) by Garrod. There many studies performed to identify a correlation between genotype and phenotype in Down Syndrome, little is known about cardiovascular phenotype in Down Syndrome. Congenital heart disease is considered one of the highest causes of mortality and morbidity in Down Syndrome compared to patients with the same lesion of non-down. There is a big debate about surgical management and considered them as risk factors of surgery with precaution and recent technology, Down Syndrome considered as a normal patient in prognosis. This chapter aimed to shed the light on congenital heart disease in Down Syndrome and current knowledge in specific mutations associated with them and how the effect of innovative technology and management to treat them end at the same outcome and sometimes better based on recent research and Scoring System.
Conference papers on the topic "Cardiovascular system Surgery Patients Japan"
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Poppv, S., A. Philapitsch, H. Murday, J. Fenyes, and P. G. Kirchhoff. "CONTINUOUS PERIOPERATIVE ADMINISTRATION OF Cl-ESTERASE-INHIBITOR CONCENTRATE AND APROTININ IN CARDIOVASCULAR SURGERY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644328.
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The results obtained in our randomised study in 3 groups of patients performed in 1982/83 suggested the administration of protease inhibitors to be effective in counteracting the activation of the kallikrein, coagulation and fibrinolytic systems during extracorporeal circulation (ECC) thus lowering the rate of postoperative bleeding complications. Since Cl-esterase-inhibitor (Cl-INH) proved to be the main inhibitor of the kallikrein (KK) system and aprotinin that of plasmin further studies to investigate the efficacy of a combined treatment and to develop an improved dosage regimen were initiated in 1985.Pilot:1: 3 patients/aprotinin; pilot 2: 3 patients/Cl-INH Concentrate; pilot 3: 5 patients/Cl-INH Concentrate + aprotinin. Test parameters included: protein/Biuret; Cl-INH/rocket immune electrophoresis and chromogenic substrate method; kaolin induced kallikrein generation; plasminogen activation using streptokinase; plasmin inhibiton capacity; coagulation factors I, II, V, VII, VIII, and X; reptilase clotting time, thrombin time; platelets and the thrombelastogram.15 blood samples were taken at regular intervals over approx. 16 hours before, during and after surgery, as well as on the first and second postoperative day.Dosage in pilot 1 and 2 was 500 × 103 KIU aprotinin and 1500 PU Cl-INH, respectively, followed by the continous i.v. infusion of 125 × 103 KIU aprotinin/h and 125 PU CI-INH/h, respectively over approx. 16 hours. This regimen still appeared inadequate to prevent the activation of the KK and fibrinolytic system. In pilot 3 therefore, the continous infusion of both concentrates was increased by 100 % (250 × 103 KIU aprotinin/h + 250 PU Cl-INH/h), while the bolus-injection remained the same as in pilot 1 and 2. Using this optimised combined regimen parameters of the kallikrein, coagulation and fibrinolytic system remained almost unchanged compared to values obtained prior to ECC.
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Burks, William Garret, Paola Jaramillo, and Alexander Leonessa. "Development of Electromagnetic Stimulation System to Aid Patients Suffering From Vocal Fold Paralysis." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14562.
Full textAbstract:
Vocal fold paralysis affects approximately 7.5 million Americans. Paralysis can be caused by numerous conditions, including head, neck or surgical trauma, endotracheal intubation, neurological conditions, cancer, tumors, just to mention a few. Currently, vocal fold paralysis treatment involves surgery and voice therapy. The vocal folds are composed of a three part material stretched along the larynx, which enables frequency change. Intrinsic laryngeal muscles coordinate the motion of vocal folds during respiration, vocalization, and aid in airway protection. Sensory information is carried by the Superior Laryngeal Nerve (SLN) and the Recurrent Laryngeal Nerve (RLN). Injury to the RLN results in paralysis of all laryngeal muscles excluding the cricothyroid muscle [1]. Although optimal larynx reinnervation has been extensively researched and implemented to improve voice paralysis [2], voice electrotherapy offers an alternative to effectively stimulate the larynx muscles for voice production, breathing and airway protection. One of the main causes of voice disorders is neurological in nature and causes abnormal vocal fold vibration. Of particular importance to this research is paralysis due to RLN injury, which causes acute temporary paralysis [3]. Currently, invasive electrical stimulus is used to activate muscle function; however, abnormal activation of muscle patterns causes muscles to function out of synchronization resulting in low vocal output [4]. For this reason, our work focuses on the development of an effective electromagnetic stimulation system to aid patients with unilateral vocal fold paralysis by stimulating the RLN and in turn reinnervating the adequate laryngeal muscles involved in the vocal fold motion for the purposes of sound vocalization, respiration, and airway protection. So far, a proof of principle has been developed and evaluated to assess the system’s feasibility. The preliminary experiments have been conducted using BioMetal Fibers (BMF) (Toki Corporation, Japan), which are fiber-like solid state actuators designed to contract and extend similar to muscles. BMF contracts when stimulated through a current generated in this case through an electromagnetic field.
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Crhová, Marie, Iva Hrnčiříková, Radka Střeštíková, Klára Šoltés-Mertová, Martin Komzák, Kateřina Kapounková, and Anna Ondračková. "Effect of a 3-month Exercise Intervention on Physical Performance, Body Composition, Depression and Autonomic Nervous System in Breast Cancer Survivors: A Pilot Study." In 12th International Conference on Kinanthropology. Brno: Masaryk University Press, 2020. http://dx.doi.org/10.5817/cz.muni.p210-9631-2020-50.
Full textAbstract:
Purpose: Breast cancer patients are at increased risk of developing comorbidities such as lymphedema, sarcopenia, osteoporosis and cardiovascular disease after breast cancer treatment. These complications contribute to a decrease in quality of life, cardiorespiratory fitness and muscle strength. Regular and long-term physical activity is an effective non-pharmacological strategy that can improve physical, psychological and social outcomes. The aim of our research was to evaluate the effect of various modes of an exercise intervention on physical performance, body composition, depression and autonomic nervous system in breast cancer survivors. Methods: 16 women after surgery with hormonal treatment enter the research. Thirteen of them completed the controlled, quasi-experimental study (54 ± 9 yrs, 164cm ± 6cm, 72 ± 12kg) and were divided into 3 groups according to their place of living: trained under supervision (n=5) (SUPERV), trained at home without supervision by videos (n=7) (HOME) and with no prescribed physical activity (n=4) (CON). Exercise intervention lasted 3 months and comprised of 60 min training units 3 × week (aerobic with resistant exercise in a 2 : 1 mode combined with regular weekly yoga and breathing exercises). The exercise intensity was set individually at 65–75% of HRR based on spiroergometry and was continuously controlled by heart rate monitors. The same principles applied to the HOME group, which, in addition to heart rate monitors, recorded frequency, length, HRmax, HRavg, and Borg scale of intensity perception. VO2max, BMI, fat mass, depression level (Beck’s depression inventory) and the power of the autonomic nervous system (total power and sympatho-vagal balance) were analyzed. For data evaluation we used descriptive statistics and Cohens d effect size. Results: 3 women dropped out of research because of medical reason. In all groups VO2max values increased. The largest increase in VO2max values was in SUPERV group by 36%, in HOME group by 20% and in CON group by 2%. Body weight decreased for groups SUPERV (˗1.2 kg) and CON (-0.1kg), for HOME group there was an increase (+0.2 kg). Body mass index decreased for SUPERV group (-0.4), for HOME and CON it increased (both +0.1). Total power decreased in SUPERV (-0.6) and HOME group (-0.2), in CON has not changed. The same results were achieved by the sympatho-vagal balance, only the CON group increased. Values from Beck’s depression inventory decreased for all groups, most for CON group. Conclusion: A 3-months of supervised and controlled exercise had a significant effect on physical fitness and body composition in comparison with non-supervised home-based physical intervention. Our results indicate that it is strongly advisable to apply a supervised exercise program to induce positive physiological changes in breast cancer survivors as part of aftercare.