Relevant bibliographies by topics / Heart – Surgery – Complications

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  2. Dissertations / Theses
  3. Books
  4. Book chapters
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Academic literature on the topic 'Heart – Surgery – Complications'

Author: Grafiati
Published: 4 June 2021
Last updated: 2 February 2022

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Journal articles on the topic "Heart – Surgery – Complications"

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Khan, Jamal H., April M. Lambert, Joseph H. Habib, Mike Broce, Mary S. Emmett, and Elaine A. Davis. "Abdominal Complications After Heart Surgery." Annals of Thoracic Surgery 82, no. 5 (November 2006): 1796–801. http://dx.doi.org/10.1016/j.athoracsur.2006.05.093.

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Healy, Fiona, Brian D. Hanna, and Raezelle Zinman. "Pulmonary Complications After Congenital Heart Surgery." Current Respiratory Medicine Reviews 7, no. 2 (April 1, 2011): 78–86. http://dx.doi.org/10.2174/157339811794927879.

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KURT, Muhammed, Jens LITMATHE, Ansgar ROEHRBORN, Peter FEINDT, Udo BOEKEN, and Emmeran GAMS. "Abdominal complications following open-heart surgery." Acta Cardiologica 61, no. 3 (June 1, 2006): 301–6. http://dx.doi.org/10.2143/ac.61.3.2014832.

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Leahy, Noreen M. "Neurologic complications of open heart surgery." Journal of Cardiovascular Nursing 7, no. 2 (January 1993): 41–42. http://dx.doi.org/10.1097/00005082-199301000-00006.

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Alfieri, Anthony, and Morris N. Kotler. "Noncardiac complications of open-heart surgery." American Heart Journal 119, no. 1 (January 1990): 149–58. http://dx.doi.org/10.1016/s0002-8703(05)80095-x.

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Haddy, Steven, Maged Mikhail, Durai Thangathurai, and Christina Warneck. "Complications in patients having heart surgery." Seminars in Anesthesia, Perioperative Medicine and Pain 15, no. 3 (September 1996): 256–72. http://dx.doi.org/10.1016/s0277-0326(96)80016-x.

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Gilman, Sid. "Neurological complications of open heart surgery." Annals of Neurology 28, no. 4 (October 1990): 475–76. http://dx.doi.org/10.1002/ana.410280402.

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Sever, Kenan, Cihan Ozbek, Burce Goktas, Serap Bas, Murat Ugurlucan, and Denyan Mansuroglu. "Gastrointestinal Complications After Open Heart Surgery." Angiology 65, no. 5 (April 9, 2013): 425–29. http://dx.doi.org/10.1177/0003319713482357.

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Walsh, Shaun K., Michael A. Gardner, E. Gregory Stanfford, Mark F. O'Brien, and John F. Graff. "Gastrointestinal complications of open heart surgery." Asia Pacific Journal of Thoracic & Cardiovascular Surgery 3, no. 1 (July 1994): 49. http://dx.doi.org/10.1016/1324-2881(94)90084-1.

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Groves, P. "VALVE DISEASE: Surgery of valve disease: late results and late complications." Heart 86, no. 6 (December 1, 2001): 715–21. http://dx.doi.org/10.1136/heart.86.6.715.

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Dissertations / Theses on the topic "Heart – Surgery – Complications"

1

Gold, Sasha Dione, and n/a. "Cognitive functioning of patients who develop delirium after cardiac surgery." University of Otago. Department of Psychology, 2006. http://adt.otago.ac.nz./public/adt-NZDU20070205.120554.

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In the present study the cognitive outcomes of cardiac surgery were examined in patients who did or did not develop delirium early post-operatively. The study expanded on previous research by investigating: (1) the relationship between delirium and functioning on specific cognitive domains; (2) the relationship between delirium and cognitive functioning after taking into account pre-existing cognitive impairment; and (3) the cognitive profile of delirium. The study employed a non-equivalent pre-test post-test design. Participants were 80 candidates for coronary artery graft replacement and/or heart valve repair or replacement operations who were 60 years of age or over. Participants underwent a neuropsychological assessment pre-operatively, daily assessments between post-operative days 2-5 for identification of delirium, and a follow-up neuropsychological assessment 12 weeks post-operation. Twenty-one participants met DSM-IV diagnostic criteria for delirium early post-operation. Participants who experienced delirium performed worse than participants who did not on one global cognitive measure and one specific cognitive domain at follow-up. However, this was likely due to the contribution of other factors such as age, years of schooling, pre-operative performance, and neurological events post-operation. There was no difference in the proportion of participants who did or did not develop delirium who met specified criteria for cognitive decline from pre-operation to follow-up. Significantly more participants who developed delirium, relative to those who did not, met criteria for pre-existing cognitive impairment. After taking into account pre-existing impairment and other potentially contributing variables, delirium was a significant predictor of performance on an attentional task at follow-up. There were no significant differences between the cognitive profiles of participants who did or did not develop delirium, at pre-operation or at follow-up. At both time points the profiles of these groups resembled the profile of a group of patients with vascular dementia. In conclusion, although participants who experienced delirium performed worse on certain cognitive domains, this appeared to be due to factors other than delirium. However, after taking pre-existing cognitive impairment, and other relevant variables into account, delirium adversely affected attentional performance. Delirium was associated with a vascular dementia profile, but this profile was not specific to delirium. Study findings have both theoretical and clinical implications. Consistent with the theoretical literature, the findings support impaired brain reserve as a risk factor for delirium, and the hypotheses that a combination of impaired brain reserve and events associated with delirium are responsible for subsequent cognitive performance. However, in the case of attention, events associated with delirium appear to be responsible for poorer performance, possibly due to the persistence of impaired attention, which is an essential feature of the delirium episode. A further theoretical implication is that individuals who experience delirium may be particularly vulnerable to developing vascular dementia, however, there needs to be further investigation of this risk in a non-cardiac surgery population. Clinically, study findings highlight the need to investigate possible cognitive impairment in individuals with cardiovascular disease, and in persons who experience delirium. When indicated, appropriate monitoring and/or treatment strategies should be employed to reduce the impact of cognitive deterioration.
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Hellgren, Laila. "Heart Valve Surgery : Preoperative Assessment and Clinical Outcome." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5929.

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Dunckley, Maria. "Barriers to recovery after coronary artery bypass grafting surgery." Thesis, Coventry University, 2007. http://curve.coventry.ac.uk/open/items/cb90ef80-269b-6eb1-2986-bb2c61227bb3/1.

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Introduction: Coronary artery bypass grafting surgery is an effective treatment for coronary heart disease for many patients; however, evidence suggests that there are some patients who do not report a good post-operative recovery. Although several studies have begun investigating possible reasons for these observations, little is known about the impact of CABG on quality of life and there still remains a lack of information that can help clinicians identify those people more likely to experience poorer recovery so that interventions can be targeted appropriately. Aims: The overall aim was to investigate barriers to and facilitators of recovery after CABG. Method: Phase 1 was a retrospective qualitative study involving semi-structured interviews with eleven patients who had undergone CABG and with ten health professionals experienced in caring for these patients. Data were analysed using thematic analysis. Phase 2 was a prospective study comprising two components, questionnaire and interview. The questionnaire included measures of quality of life, perceived recovery, demographic and psychosocial variables and was administered prior to surgery and at six and twelve months post-surgery. A sample of ten people who completed questionnaires were interviewed at the same time points and data analysed using framework analysis. Results: Interview data described the patient experience of undergoing CABG and identified components of a good recovery from the patient perspective. Patient and health professional participants identified numerous barriers and facilitators to recovery at three key time points - prior to surgery, during the hospital inpatient stay and post-CABG - and noted the complex inter-relationships between them, thus emphasising the need for a holistic approach to investigating recovery. Questionnaire data described the pattern of psychosocial functioning, quality of life and perceived recovery across the surgical pathway and identified depression and self-efficacy as the main predictors of post-CABG quality of life and perceived recovery. Using interview and questionnaire data a model of recovery is proposed. Conclusions: Findings from this research have identified a complex inter-related network of barriers and facilitators to recovery, suggested the possible mechanisms by which they impact on post-CABG outcome and identified recommendations for clinical practice.
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Linden, Matthew D. "The haemostatic defect of cardiopulmonary bypass." University of Western Australia. School of Surgery and Pathology, 2003. http://theses.library.uwa.edu.au/adt-WU2006.0009.

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[Truncated abstract] Cardiac surgery involving cardiopulmonary bypass is a complex procedure that results in significant changes to blood coagulation, fibrinolytic biochemistry, platelet number and function, and the vasculature. These are due to pharmacological agents which are administered, haemodilution and contact of the blood with artificial surfaces. Consequently there are significant risks of thrombosis and haemorrhage associated with this procedure. The research presented in this thesis utilises in vitro, in vivo, and a novel ex vivo model to investigate the nature of the haemostatic defect induced by cardiopulmonary bypass. The components studied include the drugs heparin, protamine sulphate, and aprotinin, different types of bypass circuitry (including heparin bonded circuits) and procedures such as acute normovolaemic haemodilution. Patient variables, such as Factor V Leiden, are also studied. Each of these components is assessed for the effects on a number of laboratory measures of haemostasis including activated partial thromboplastin time, prothrombin time, activated protein C ratio, antithrombin concentration, heparin concentration, thrombin-antithrombin complex formation, prothrombin fragment 1+2 formation, markers of platelet surface activation and secretion, activated clotting time, haemoglobin concentration and coagulation factor assays.
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Vánky, Farkas. "Surgery for aortic stenosis : with special reference to myocardial metabolism, postoperative heart failure and long-term outcome /." Linköping : Linköpings universitet, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7471.

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Jayaram, Raja. "Effects of peri-operative statin treatment on atrial electrical properties, post-operative atrial fibrillation and in-hospital clinical outcomes in patients undergoing elective cardiac surgery." Thesis, University of Oxford, 2014. https://ora.ox.ac.uk/objects/uuid:224a03c7-30f5-456b-a996-0679591ea6a8.

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Surgical myocardial revascularization remains the standard of care for patients with multi-vessel coronary artery disease. A growing body of evidence indicates that systemic inflammation and myocardial oxidative stress are associated with the development of postoperative atrial fibrillation (POAF) and low cardiac output syndrome in patients undergoing cardiac surgery. Statins have been shown to exert rapid anti-inflammatory and antioxidant effects by inhibiting myocardial NOX2 oxidases and by increasing the bioavailability of nitric oxide (NO). However, whether these so-called pleiotropic effects of statins result in improved patient outcomes remains to be established. To provide further insights into the mechanisms of action and impact on clinical outcomes of peri-operative statin treatment in patients undergoing cardiac surgery, I studied the molecular mechanisms underlying the myocardial nitroso-redox balance in samples of the right atrial appendages (RAA) obtained before (PRE) and after cardiopulmonary bypass (CPB) and reperfusion (POST) and setup two double-blind randomised placebo-controlled trials: 1) STARR (Statin Treatment on Atrial Refractoriness and Reperfusion injury), which tested the effect of Atorvastatin (80 mg once daily for up to 6 days before surgery and 5 days after) on the atrial effective refractory period (AERP, over 4 post-operative days) and superoxide production in paired PRE- and POST- RAA samples from 60 patients 2) STICS (Statin Treatment In Cardiac Surgery), which assessed the effects of peri-operative treatment with Rosuvastatin (20mg od) on POAF (assessed by continuous holter ECG monitoring for 5 days postoperatively) and myocardial injury (assessed by serial troponin I measurements) in 1922 patients undergoing elective cardiac surgery. I observed that atrial superoxide production increased significantly after reperfusion due to increased mitochondrial and NOX2 oxidase activity and to uncoupling of NOS activity. NOS activity in RAA samples decreased significantly after reperfusion (by 60%), but this reduction was not prevented by BH4 supplementation (10 μM) or NOX2 inhibition. Instead, I identified increased endothelial NOS S-glutathionylation as the main mechanism responsible for NOS uncoupling after reperfusion. In STARR, atorvastatin prevented increase in RAA superoxide production, maintained the functionally coupled status of NOS and NO bioavailability after reperfusion but had no measurable effect on postoperative AERP. In STICS, treatment with rosuvastatin significantly reduced LDL-C concentration by 48 hours after surgery but had no effect on the incidence of POAF (203 (21%) of the Rosuvastatinallocated patients vs. 197 (20%) of the placebo-allocated patients) or on perioperative myocardial damage (P = 0.80). Pre-defined subgroup analyses (age, sex, prior statin use, baseline troponin concentration, duration of randomized treatment before surgery, type of cardiac surgery, and postoperative use of anti-inflammatory drugs) did not identify any category of patient who benefited from perioperative rosuvastatin treatment. Nor were there beneficial effects on any of the other in-hospital clinical outcomes that were assessed. In conclusion, cardiac surgery on CPB is associated with myocardial nitroso redox imbalance that is reversed by perioperative intensive therapy with statins. However, these effects have no beneficial effects on common in-hospital complications after elective cardiac surgery. Although the benefits of long-term statin therapy in patients requiring myocardial revascularization are well established, the work presented in this thesis does not support routine use of perioperative intensive therapy with statins for the prevention of postoperative complications in patients undergoing elective cardiac surgery.
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Abad, Vázquez Cipriano Carlos. "Contribución al estudio de la función pulmonar en pacientes intervenidos de cirugía cardíaca extracorpórea : biopsia pulmonar y lavado broncoalveolar." Doctoral thesis, Universitat de Barcelona, 1988. http://hdl.handle.net/10803/405391.

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En la presente tesis se hace una introducción histórica, clasificación y se relatan las complicaciones de la circulación extracorpórea. Seguidamente se hace una revisión bibliografica y se justifica la realización de la tesis. Para el estudio se toman 31 enfermos que se intervienen de cirugia cardiaca extracorpórea y se les realiza un protocolo clínico de estudio que incluye la realización de una biopsia pulmonar (microscopia óptica y electrónica) y lavado bronco alveolar; antes y después de la circulación extracorpórea. Como resultados y conclusiones se obtiene: 1) Mejoría clínica tras la cirugía; 2) Pocas alteraciones en la tensión arterial, gasometría, radiología torácica y presiones de llenado; 3) Cambios tras la extracorpórea en la biopsia pulmonar y estudio a microscopio óptico con secuestro de polimorfonocleades en el capilar pulmonar y presencia de células de descamación; 4) Cambios en el estudio a microscopio electronico con secuestro de polimorfonocleares en el capilar pulmonar, presencia de neumocitos II y alteración en las celulas endoteliales con presencia de abundantes vesiculas de micropicnocitosis. En el lavado broncoalveolar realizado tras la extracorpórea se registran cambios importantes con mayor número de células (P(0.05) y mayor cantidad de neutrófilos en el segundo o lavado postcirculación extracorporea; 5) Se demuestra que la circulación extracorpórea produce alteraciónes estructurales en el pulmón (biopsia pulmonar y lavado broncoalveolar). Finalmente, se realiza una extensa revisión bibliográfica.
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Hernández, Enríquez Marco. "Transcatheter Aortic Valve Implantation: Moving Forward to Minimize Vascular and Bleeding Complications = Implante Transcatéter de Válvula Aórtica: Avanzando hacia la Reducción de Complicaciones Vasculares y Hemorrágicas." Doctoral thesis, Universitat de Barcelona, 2020. http://hdl.handle.net/10803/669896.

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INTRODUCTION: TAVI has settled as the standard of care of AS for inoperable, high-risk, and selected intermediate-risk patients undergoing aortic valve replacement. Vascular and bleeding complications are related to worst outcomes. HYPOTHESES: a. The reduction and early recognition of vascular and bleeding complications might improve clinical outcomes in patients treated with TAVI. b. A full percutaneous transfemoral approach for TAVI is related to a lower rate of major bleedings in comparison to the surgical cut-down approach. c. The development of post-TAVI thrombocytopenia has a prognosis value in short-term clinical outcomes. d. The kinetics of drop platelet count (DPC) after TAVI are different according to the type of valve implanted. MATERIALS AND METHODS: Sub-project 1: “Comparison of complications between percutaneous puncture or surgical cut-down for transfemoral access in TAVI” Data from the Spanish TAVI Registry were analyzed. Patients undergoing transfemoral TAVI in 41 Spanish centers from January 2010 to July 2015 were included. Subjects were divided into percutaneous puncture (PG) and cut-down group (CG). A propensity-matched comparison was performed to avoid selection bias. Vascular and bleeding complications were evaluated at 30-days and mid-term follow-up. Sub-project 2: “Study of Thrombocytopenia after TAVI” a. Patients from 2 Spanish centers between 2012 to 2016 were included. Subjects with severe baseline thrombocytopenia (<100x109/L) and peri-procedural death were excluded. Laboratory analyses were performed. Two groups were created according the DPC: ≤30% or >30%. Clinical, procedural characteristics and outcomes were collected retrospectively. b. Patients treated with transfemoral TAVI in a French high-volume center from 2008 to 2016 were included. Exclusion criteria were non-transfemoral approach, severe baseline thrombocytopenia and peri-procedural death. The study protocol was like the previous study. RESULTS: Sub-project 1 A total of 2,465 transfemoral TAVI patients were included. The PG had 1,833 patients (74,3%) and the CG had 632 patients (25,6%). Propensity matching score resulted in 615 pairs. Vascular complications at 30-days were significantly higher in the PG (RR 2,66; IC95% [1,85-3,64], p = <0,001) mainly driven to minor vascular complications. In contrast, the bleeding complications were higher in the CG (RR 0,45; IC95% [0,26-0,78], p = 0,003). At a mean follow-up of 323 days, the rates remained similar. Higher rates of vascular complications in the PG: 15% vs. 5,1% (HR 2,23; IC95% [1,6-3,11]; p = <0,001) and higher rates of major bleedings in the CG: 3,4% vs. 1,6% (HR 0,57; IC95% [0,35-0,95], p = 0,03). Sub-project 2 a) The analyzed population included 195 patients: 100 (52,2%) treated with self-expanding valves (SEV) and 95 (48,8%) with balloon-expandable valves (BEV). The mean percentage of DPC was 31,9±15,3%. The DPC was significantly higher in the BEV population in comparison to SEV (36,3±15,1% vs 27,7±14,4, p<0,001). After multivariate analysis, the use of BEV was independently associated to a DPC>30% (67,4% vs. 36,0%; OR 3,4; 95% CI, 1,42-8,16). AT 30-days, the DPC>30% was associated to a higher rate of major and life-threatening bleedings, vascular complications, sepsis, and death. At 1-year there were no differences in mortality. (6,35% vs. 10,0%; HR 1,54; 95% CI, 0,56-4,25). b) A total of 609 were included. The mean DPC was 32,5±13,9%. The DPC was higher in the BEV group (33.9±14.2 vs 30.7±13.4%, p=0.006), and the nadir was reached significantly later in comparison with the SEV group. (3,0±1,3 vs 2,5±1,1 days, p<0,001). After the multivariate analysis, the factors related to a DPC>30% were the use of BEV, known coronary disease and preserved left ventricle ejection fraction. At 30-days the DPC>30% was associated to a higher rate of major and life-threatening bleedings (6,8 vs 2,1%, p=0.009) and death (3,5 vs 0,8%, p=0.036). At 1-year there were no differences in mortality CONCLUSIONS: 1. The reduction and early recognition of vascular and bleeding complications is associated to an improvement in clinical outcomes in patients treated with TAVI. 2. The completely percutaneous approach of transfemoral TAVI yielded lower rate of major bleedings and higher rate of minor vascular complications in comparison to the surgical cut-down and closure. 3. A post-procedural DPC>30% is related with worse clinical outcomes at 30-days after TAVI. 4. The use of balloon-expandable valves seems to be associated with a higher risk of drop on platelet counts after TAVI.
El Implante Transcatéter de Válvula Aórtica (TAVI) se ha consolidado como el tratamiento de elección en pacientes inoperables, de alto y seleccionados con intermedio riesgo quirúrgico. Las complicaciones vasculares y hemorrágicas están asociadas a peores resultados clínicos y a mayor estancia intrahospitalaria. Subproyecto 1: “Comparación entre las complicaciones de la punción percutánea y disección quirúrgica en el Implante Transfemoral de Válvula Aórtica” Análisis retrospectivo del Registro Nacional TAVI. Se incluyeron pacientes tratados con TAVI transfemoral en 41 centros españoles desde enero 2010 hasta julio 2015. Se evaluaron la complicaciones vasculares y hemorrágicas a los 30 días y a medio término. Asimismo, se evaluó la frecuencia de ictus, daño renal agudo, infarto del miocardio y muerte. Para reducir el sesgo de selección se realizó un “score de propensión”. Subproyecto 2: “Estudio de la Trombocitopenia después del Implante Transcatéter de Válvula Aórtica” a) Se incluyeron pacientes tratados con TAVI en 2 centros españoles entre enero 2012 y diciembre 2016. Se excluyeron pacientes con plaquetopenia severa basal (<100x109/L) y con muerte peri-procedimiento. Se realizaron analíticas seriadas durante el ingreso. El seguimiento clínico se realizó a los 30 días, 3 meses y 1 año posterior al procedimiento. Se recogieron las características basales, del procedimiento y los eventos clínicos en una base de datos. Se crearon 2 grupos de acuerdo con el porcentaje de caída de plaquetas: ≤30% y >30%. b) Se incluyeron pacientes tratados con TAVI transfemoral en un centro francés de alto volumen de TAVI, entre enero 2008 y diciembre 2016. Se excluyeron los pacientes con acceso no transfemoral, con plaquetopenia severa pre-procedimiento y con muerte peri-procedimiento. El protocolo del estudio fue similar al del estudio previo. La disminución y el reconocimiento temprano de complicaciones vasculares y hemorrágicas permite mejores resultados clínicos en pacientes tratados con TAVI. El abordaje completamente percutáneo de la TAVI se asoció a una tasa menor de sangrados mayores y a una mayor tasa de complicaciones vasculares menores en comparación con el abordaje quirúrgico. La caída en el porcentaje de plaquetas >30% se relaciona con peores resultados clínicos a los 30 días post-TAVI. El uso de las prótesis balón-expandibles parece asociarse a un mayor riesgo de disminución de plaquetas.
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Neto, José Garcia. "O ROTEM tem a habilidade de prever sangramento em cirurgia cardíaca valvar?" Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5156/tde-31072017-134032/.

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Introdução: Considerando que uma melhor vigilância do estado hemostático dos doentes antes, durante e após o ato cirúrgico pode ter impacto significativo na sua evolução, e sabendo que os testes clássicos da coagulação têm limitações para avaliar a hemóstase na globalidade, e presumindo-se que o ROTEM seja um teste que permite efetuar esta avaliação da coagulação, fizemos hipótese de que este método seria uma ferramenta que teria a habilidade de prever sangramento em cirurgia cardíaca valvar. Objetivos: 1) Verificar se o ROTEM (Tromboelastometria Rotacional) ao analisar o estado da coagulação sanguínea de pacientes submetidos à cirurgia cardíaca valvar tem a capacidade de prever maior risco de sangramento com suas consequentes complicações; 2) Correlacionar comorbidades e história clinica pré-existentes à cirurgia cardíaca valvar com o nível de sangramento apresentado. Métodos: Foram incluídos 100 pacientes consecutivos submetidos à cirurgia cardíaca valvar com circulação extracorpórea (CEC) nos seguintes procedimentos: cirurgia cardíaca valvar em uma ou mais valvas, incluindo reoperações e cirurgias combinadas, realizadas no Instituto do Coração (INCOR) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Estudo prospectivo que buscou avaliar a eficácia do uso da tromboelastometria rotacional na previsão de sangramento em cirurgia cardíaca valvar. Após a indução anestésica foram coletados: Tromboelastometria, coagulograma, fibrinogênio, dímero D e contagem de plaquetas; com a finalidade de verificar potencial risco de sangramento neste paciente. Correspondente ao tempo - 0 (T0). Estes mesmos exames foram recoletados na admissão na Unidade de Terapia Intensiva Cirúrgica (UTIC), onde o paciente foi recebido após o procedimento cirúrgico cardíaco valvar. Correspondente ao tempo - 1 (T1). Optou-se pela coleta de T1 na UTI, pois a CEC já terá sido descontinuada e a heparina revertida com a administração da protamina. Resultados: Os pacientes fora subdivididos em quartis de acordo com o sangramento, configurando um total (n) de 100 pacientes com uma média de sangramento (débitos dos drenos) de 492,95 mL, apresentando um desvio padrão de 388,14 mL e 2260 mL. Não foi encontrada nenhuma variável estatisticamente significante entre os grupos, comparando-se exames laboratoriais pré-operatórios, tempo de CEC, tempo de pinçamento e uso de drogas vaso ativas. Porém, ocorreu diferença significativa (p = 0,015) nos níveis transfusionais de hemocomponentes entre os quartis. Ocorreu uma relação significante (p =0,014) entre o nível adequado de calcemia e tendência a menor sangramento nos grupos estudados. Os resultados do ROTEM - INTEM, ROTEM - EXTEM e ROTEM - FIBTEM não demonstraram diferença estatística significante entre os grupos estudados. Considerando-se os desfechos, baixo débito, choque cardiogênico, arritmia, AVC, insuficiência renal aguda, óbito e reoperação, apenas a reoperação apresentou resultados com diferença significante entre os grupos (p =0,024). Conclusões: 1- O ROTEM não demonstrou a capacidade de prever sangramento em cirurgia cardíaca valvar. 2 - Não houve correlação do sangramento apresentado com as comorbidades pré-existentes
INTRODUCTION: Considering that better monitoring of the haemostatic status of patients before, during and after the surgical procedure can have a significant impact on their evolution, and knowing that classical coagulation tests have limitations in assessing hemostasis overall, and assuming that ROTEM is a test that allows to perform this evaluation, we hypothesized that this method would be a tool that would have the ability to predict bleeding in valve heart surgery. OBJECTIVES: 1) To verify if the ROTEM (Rotational Thromboelastometry) when analyzing the blood coagulation status of patients submitted to valve heart surgery has the capacity to predict a greater risk of bleeding with its consequent complications; 2) To correlate pre-existing comorbidities and clinical history with valve heart surgery with the level of bleeding presented. METHODS: We included 100 consecutive patients submitted to cardiac valve surgery with cardiopulmonary bypass (CPB) in the following procedures: valvular heart surgery in one or more valves, including reoperations and combined surgeries performed at the Heart Institute of the University of São Paulo. It is a prospective study aimed at evaluating the efficacy of rotational thromboelastometry in the prediction of bleeding in valve heart surgery. After the anesthetic induction were collected: thromboelastometry, coagulogram, fibrinogen, D-dimer and platelet count, with the purpose of verifying potential risk of bleeding in this patient. These samples were defined as time - 0 (T0). These same exams were collected on admission to the Intensive Care Unit. These samples were defined as time - 1(T1 We chose to collect T1 in the ICU, because at this moment it is expected that the total reversal of anticoagulation has already occurred .. RESULTS: Patients were subdivided into quartiles according to bleeding, with a total of 100 patients with a mean bleed (drainage rates) of 492.95 mL. No statistically significant variables were found between the groups, comparing preoperative laboratory tests, CPB time, clamping time and use of vasoactive drugs. However, there was a significant difference (p = 0.015) in transfusion levels of blood components between the quartiles. There Abstract was a significant relationship (p = 0.014) between the adequate level of calcemia and tendency to less bleeding in the groups studied. The results of ROTEM - INTEM, ROTEM - EXTEM and ROTEM - FIBTEM did not show a statistically significant difference between the groups studied. Considering the outcomes, low rate, cardiogenic shock, arrhythmia, stroke, acute renal failure, death and reoperation, only reoperation presented results with significant difference between the groups (p = 0.024). CONCLUSIONS: 1 - ROTEM did not demonstrate the ability to predict bleeding in valvular heart surgery. 2 - There was no correlation of bleeding presented with pre-existing comorbidities
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Heriot, Jody L. "Implementation of a Beta Blocker Protocol." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/415.

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Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction. Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and intermediate-risk cardiac patients undergoing non-cardiac surgery in a medium-sized private hospital in suburban South Florida. There are barriers to the implementation of the published guidelines for beta blocker administration, including lack of awareness of the best current practice and a lack of a formal beta blocker protocol at the institutional level. Methods: A simple and inexpensive beta blocker protocol was implemented and evaluated by various means. Beta blocker administration practices were examined and documented prior to and after protocol implementation. Beta blocker usage was examined prior to and after protocol implementation Findings/Implications: It was hypothesized that increased anesthesia provider awareness would lead to increased administration of perioperative beta blockers to high-risk and intermediate-risk cardiac patients undergoing non-cardiac procedures. Although there was a knowledge increase related to the new beta blocker protocol, no change in practice was observed.
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Books on the topic "Heart – Surgery – Complications"

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Pathological correlation after cardiac surgery. Oxford [England]: Butterworth-Heinemann, 1991.

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Lee, Myles Edwin. Near misses in cardiac surgery. Boston: Butterworth-Heinemann, 1992.

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Mohr, Rephael. Management of bleeding after open heart surgery. New York: Chapman & Hall, 1997.

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Scott, Mitchell R., and Miller D. Craig, eds. Manual of postoperative management in adult cardiac surgery. Baltimore, MD, U.S.A: Williams & Wilkins, 1988.

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Utah Postgraduate Course in Anesthesiology (32nd 1987 Salt Lake City, Utah). Anesthesia, the heart, and the vascular system. Dordrecht: M. Nijhoff, 1987.

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Dr, Martin Bruce, ed. Cardiac anaesthesia. Oxford: Oxford University Press, 2010.

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Freeman, Roger. Infection in cardiothoracic intensive care. London: Edward Arnold, 1987.

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Barnette, Martha. The Bill Schroeder story. New York: Morrow, 1987.

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Cardiovascular anesthesia. New York: Springer-Verlag, 1985.

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Lemmer, John H. Handbook of patient care in cardiac surgery. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010.

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Book chapters on the topic "Heart – Surgery – Complications"

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Shanmuganathan, Mayooran, and Owais Dar. "Complications of Heart Transplantation." In Cardiac Surgery, 665–70. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-24174-2_73.

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Vanini, Benedetta, C. Placenti, and A. M. D’Armini. "Major Psychiatric Complications of Cardiac Surgery." In Brain and Heart Dynamics, 1–12. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-319-90305-7_28-1.

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Vanini, Benedetta, Claudio Placenti, and Andrea M. D’Armini. "Major Psychiatric Complications of Cardiac Surgery." In Brain and Heart Dynamics, 387–98. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-28008-6_28.

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Sadeghian, Hakimeh, and Zahra Savand-Roomi. "Malfunction and Other Complications After Heart Valve Surgery." In 3D Echocardiography of Structural Heart Disease, 327–68. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-54039-9_6.

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Furlan, A. J., and S. C. Jones. "Central Nervous System Complications Related to Open Heart Surgery." In Clinical Medicine and the Nervous System, 287–304. London: Springer London, 1987. http://dx.doi.org/10.1007/978-1-4471-3129-8_15.

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Overby, Philip. "Neurologic Complications and Neuromonitoring in Pediatric Congenital Heart Disease." In Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care, 3299–307. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-4619-3_173.

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Carlson, Barbara C. "The Relationship of Preoperative Anxiety and Postoperative Complications in Patients Having Open Heart Surgery." In Impact of Cardiac Surgery on the Quality of Life, 425–31. Boston, MA: Springer US, 1990. http://dx.doi.org/10.1007/978-1-4613-0647-4_51.

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Demaria, Roland G., and Mohammed Al Yamani. "The History of Surgery for Ischemic Heart Disease and Mechanical Complications of Myocardial Infarction After the Advent of CPB." In Dawn and Evolution of Cardiac Procedures, 265–71. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2400-7_27.

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Maier, Ch, and W. Knippenberg. "Effects of preoperative digitalisation on postoperative left heart performance and incidence of complications following hip surgery. First results of a prospective study." In Cardiac Glycosides 1785–1985, 487–92. Heidelberg: Steinkopff, 1986. http://dx.doi.org/10.1007/978-3-662-11292-2_64.

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Botta, M., M. Lemma, C. Santoli, C. Luongo, B. Sparacia, E. Bergmann, A. Barthelemy, et al. "New Frontiers: Hyperbaric Oxygen Therapy (HBO) in Open Heart Surgery’s Complications." In Handbook on Hyperbaric Medicine, 765–847. Milano: Springer Milan, 1996. http://dx.doi.org/10.1007/978-88-470-2198-3_28.

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Conference papers on the topic "Heart – Surgery – Complications"

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Böttger, C., P. Akhyari, A. Mehdiani, A. Albert, R. Westenfeld, B. Sowinski, D. Saeed, A. Lichtenberg, and U. Boeken. "LVAD Complications Causing High-Urgent Status on Waiting List: Impact on Outcome after Heart Transplantation." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679027.

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Eltigani Ali Mustafa, Ammar, Cornelia Sonia Carr, Shady Mohammed, Mohd Nasir Mohd Mughal, and Abdulaziz Alkhulaifi. "Guidelines For The Use Of Negative Pressure Incision Management To Reduce Wound Complications Following Heart Surgery." In Qatar Foundation Annual Research Conference Proceedings. Hamad bin Khalifa University Press (HBKU Press), 2014. http://dx.doi.org/10.5339/qfarc.2014.hbpp0169.

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Liu, Kunlun, and Victor H. Barocas. "The Dynamic Simulation of Flow Through a Tissue Engineered Bileaflet Heart Valve." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-193075.

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Approximately 250,000 patients diagnosed with valvular heart disease undergo valve repair/replacement surgery annually worldwide [1, 2]. Despite being over 50 years old, heart valve replacement technology, with the choice of mechanical or bioprosthetic, remains imperfect. The 10-year mortality rate after replacement is 30–55%, with reoperation rates of 2–4% per year because of mechanical failure, bleeding and thromboembolic complications, and calcification. It is therefore imperative that design and analysis tools be developed for the biosolid and biofluid mechanics of potential replacement valves.
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Taskin, M. Ertan, Tao Zhang, Bartley P. Griffith, and Zhongjun J. Wu. "Design Optimization of a Wearable Artificial Pump-Lung Device With Computational Modeling." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19399.

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The heart-lung machine has been commonly used to replace or supplement the functions of both the heart and lung in the open heart surgery and extracorporeal membrane oxygenation (ECMO). Although ECMO devices are efficient on respiratory support, this traditional system consists of multiple components and is bulky. Furthermore, ECMO devices are associated with clinical complications as well as the necessity of being confined to the bed. To eliminate these, we aimed to design and develop a wearable artificial pump lung (APL) device.
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Yang, Weiguang, Jeffrey A. Feinstein, V. Mohan Reddy, and Alison L. Marsden. "Optimization of an Idealized Y-Graft for the Fontan Procedure Using CFD and a Derivative-Free Optimization Algorithm." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206492.

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The Fontan procedure is a surgery performed to treat patients with single ventricle congenital heart defects. The Fontan is the final of three surgical stages. The first stage consists of aortic reconstruction, in a Norwood procedure or variant thereof. In the second stage, the Bidirectional Glenn procedure, the superior vena cava (SVC) is disconnected from the heart and redirected into the pulmonary arteries (PAs). In the third and final stage, the inferior vena cava (IVC) is connected to PAs via a straight Gore-Tex tube, forming a T-shaped junction. Although early survival rates following the Fontan procedure can exceed 90%, significant morbidity remains after surgery including venous hemodynamic abnormalities, diminished exercise capacity, thromboembolic complications, protein-losing enteropathy, heart transplant etc. [1].
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Kanamori, Y., I. Yada, I. Yuasa, M. Kusagawa, and K. Deguchi. "PHYSIOLOGICAL ROLE OF THE ENHANCED FIBRINOLYTIC ACTIVITY DURING CARDIOPULMONARY BYPASS IN OPEN HEART SURGERY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644658.

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Fibrinolytic activity is reportedly increased during cardiopulmonary bypass( CPB ), and this increase has been considered to be related to the bleeding complications in open heart surgery. The purpose of this study was to clarify the nature of the fibrinolytic activity duringCPB. Twenty patients with valve replacement or aortocoronary bypass surgery were examined. The following parameters were determined: fibrinogen, plasminogen, fibrinopeptide A( FPA ), fibrinopeptide B β 15-42 ( FPB β15-42 ), and tissue-type plasminogen activator ( t-PA ). For further characterization of the fibrinolytic activity, the fibrin plate method was used. Intrinsic fibrinolytic activity was determined by the assay of the fibrinolytic activity of the kaolin activatedeuglobulin. Extrinsic fibrinolyticactivity was estimated by the assayof Cl-inactivator resistant fibrinolytic activity as well as t-PA. Fibrinogen and plasminogen did not decrease except at the beginning of CPB. FPA was increased significantly during CPB. FPB3 15-42 was also increased to four times the preoperative value at 2 hrs of CPB. The intrinsic fibrinolytic system was activatedonly a short time after the startof CPB. The Cl-inactivator resistant fibrinolytic activity was activated gradually during CPB, reached a maximum level 1 hr after the start of CPB, and returned to the preoperative level within 1 hr after the end of CPB. The changes on t-PA paralleled the course of the Cl-inactivator resistant fibrinolytic activity, indicating that enhanced fibrinolytic activity during CPB is predominantly of extrinsic origin caused by t-PA. We conclude that thrombin activity continues during CPB despite the use of heparin, and thatthe enhanced fibrinolytic activity during CPB is essential because t-PA activates plasminogen predominantly at the sites where fibrin is formed, resulting in the dissolution of the microthrombi formed during CPB.
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Yang, Weiguang, Jeffrey A. Feinstein, Irene E. Vignon-Clementel, Shawn C. Shadden, and Alison L. Marsden. "Customization of the Fontan Y-Graft: Are Unequal Branches Necessary for Optimal Hepatic Flow Distribution?" In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53752.

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Due to surgical complexity and clinical complications, single ventricle defects are among the most severe and challenging congenital heart diseases to treat. Patients usually undergo a three-staged surgery. The first stage consists of shunt insertion and aortic reconstruction in a Norwood procedure. In the second stage, the Bidirectional Glenn procedure, the superior vena cava (SVC) is disconnected from the heart and redirected into the pulmonary arteries (PA’s). In the third and final stage, the Fontan procedure, the inferior vena cava (IVC) is connected to the PA’s via a straight Gore-Tex tube, forming a T-shaped junction with or without offset.
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Claiborne, Thomas E., Michalis Xenos, Jawaad Sheriff, Dinesh Peter, Yared Alemu, Yasushi Kato, Leonard Pinchuk, Shmuel Einav, Jolyon Jesty, and Danny Bluestein. "Development and Optimization of a Novel Polymeric Prosthetic Heart Valve Using the Device Thrombogenicity Emulation (DTE) Methodology." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80186.

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Calcific aortic valve disease (CAVD) is the most common and life threatening form of valvular heart disease, characterized by stenosis and regurgitation, which is currently treated at the symptomatic end-stages via open-heart surgical replacement of the diseased valve with typically either a xenograft tissue valve or mechanical heart valve. These options offer the clinician a choice between structural valve deterioration and anticoagulant therapy respectively, effectively replacing one disease with another [1]. Polymeric heart valves (PHV) offer the promise of reducing or eliminating these complications [2] and may be efficacious for patients who cannot tolerate cardiothoracic surgery by using instead transcatheter valve implantation (TAVI) [3], where there is evidence that tissue valves are damaged during implantation [4], and in pulsatile circulatory support devices such as the SynCardia Total Artificial Heart. But development of PHVs has been slow due to the lack of sufficiently durable and biocompatible formulations.
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Pellet, Mathieu, Pierre Melchior, Youssef Abdelmoumen, and Alain Oustaloup. "Fractional Thermal Model of the Lungs Using Havriliak-Negami Function." In ASME 2011 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2011. http://dx.doi.org/10.1115/detc2011-48095.

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This paper is about fractional system identification of a thermal model of the lungs. Usually, during open-heart surgery, an extracorporeal circulation (ECC) is carried out on the patient. In order to plug the artificial heart/lung machine on the blood stream, the lungs are disconnected from the circulatory system. This may results in postoperative respiratory complications. A method to protect the lungs has been developed by surgeon and anesthetist. It is called: bronchial hypothermia. The aim is to cool the organ in order to slow down its deterioration. Unfortunately the thermal properties of the lungs are not well-known yet. Mathematical models are useful and needed in order to improve the knowledge of these organs. As proved by several previous works, fractional models are especially appropriate to model thermal systems (model compacity, accuracy) and the dynamic of fractal systems. Thus, fractional models of the lungs have been determined using time domain system identification with the Havriliak-Negami function. A comparison with integer order models was also carried out. The aim of this paper is to present the results of this study.
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Bosi, Giorgia M., Claudio Capelli, Robin Chung, Michael Mullen, Andrew M. Taylor, and Silvia Schievano. "Patient-Specific Computational Simulations of Transcatheter Aortic Valve Implantation (TAVI)." In ASME 2013 Conference on Frontiers in Medical Devices: Applications of Computer Modeling and Simulation. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/fmd2013-16154.

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In the past decade, Transcatheter Aortic Valve Replacement (TAVI) has been shown to be a feasible, less invasive option to open heart surgery for aortic valve replacement; however, TAVI is indicated only in patients with severe, symptomatic, aortic stenosis and who are considered at high or prohibitive risk for conventional surgery [1]. To date, two different TAVI devices are available on the market — the balloon-expandable Edwards-Sapien® Valve (Edwards Lifesciences, CA, USA) and the self-expandable CoreValve ReValving System® (Medtronic, MN, USA) — with many other devices currently under development and clinical trials. The procedural success rate has been >90% in all studies [1], but vascular complications, electrical conduction abnormalities and paravalvular leak — 65–89% of cases, the majority being trivial to mild, with 0 to 26% moderate and 0 to 10% severe — still remain major safety concerns. In particular, a negative influence of moderate to severe paravalvular leak on survival rates has recently been demonstrated [2].
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Reports on the topic "Heart – Surgery – Complications"

1

Heart surgery in young children: routine monitoring of complications can help assess the quality of care. National Institute for Health Research, March 2021. http://dx.doi.org/10.3310/alert_45520.

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