scholarly journals Cardiac surgery for patients with schizophrenia: clinical experience of six patients

Surgery Today ◽  
2021 ◽  
Author(s):  
Mutsuo Tanaka ◽  
Minoru Okamoto ◽  
Kensho Yamashita
Keyword(s):  
Cardiac Surgery ◽  
Causes Of Death ◽  
Perioperative Management ◽  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Cardiovascular Complications ◽  
Bypass Grafting ◽  
Careful Monitoring ◽  
The Mean ◽  
Observation Period

Abstract Purpose The incidence of schizophrenia in Japan is 0.7%, which is similar to the worldwide incidence. The mortality rate of patients with schizophrenia is reported to be higher than that of the general population, and cardiovascular disease is high among the causes of death. Hence, strategies for cardiovascular surgery for patients with schizophrenia are necessary. Methods We studied six patients with schizophrenia (five males, one female) who underwent cardiac surgery in our hospital between April 2008 and December 2019. Result The mean age was 63.6 years. The surgical procedures were coronary artery bypass grafting (CABG) (n = 4), CABG concomitant with valve procedures (n = 1), and resection of myxoma (n = 1). There were no major cardiovascular complications and no other fatal complications. The mean observation period was 1510.6 ± 1430.1 (140–4068) days, the mean post-operative hospital stay was 17.8 ± 3.5 (13–22) days, and there was no mortality within 30 days after surgery. During the observation period, one patient died. The survival rate was 83.3% at 1, 3, and 5 years. Conclusion Cardiac surgery for patients with schizophrenia is possible with careful monitoring of indications and perioperative management.

scholarly journals Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery

2014 ◽  
Vol 35 (2) ◽  
pp. 67-72 ◽  
Author(s):  
Laura Fonseca ◽  
Fernando Nataniel Vieira ◽  
Karina De Oliveira Azzolin
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Medical Records ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Factors Associated ◽  
Continuous Sedation ◽  
The Mean

Our objective was to identify factors associated with the duration of mechanical ventilation (MV) postoperative to cardiac surgery and assess the association between duration of endotracheal intubation, length of stay in the Intensive Care Unit (ICU) and hospital. Longitudinal, retrospective study of medical records of 116 adults undergoing cardiac surgery from March 2012 to May 2013. The mean age was 57±14 years, predominantly male and coronary artery bypass grafting surgery (52.6%). The MV time was 15.25(7.66 to 23.68) hours. Associated with longer MV was the age (r=0.5,p<0.001), comorbidities (r=0.344,p<0.001), cardiopulmonary bypass time (r=0.244,p=0.008), duration of continuous sedation (r=0.607,p<0.001), sedative doses (r=0.4, p<0.001), time of vasoconstrictors and vasodilators (r=0.711, p< 0.001, r=0.368, p<0.001), drainage of the 1st time (r=0.201, p<0.031), presence of drains (r=0.445, p<0.001), postoperative complications (r=0.524, p< 0.001) and hospital stay. Our data confirms that both preoperative, transoperative and postoperative variables prolong the VM and therefore the hospital stay.

Pregnancy-Related Cardiovascular Complications: Case Presentation and Review of Literature

2016 ◽  
Vol 19 (5) ◽  
pp. E248-E254 ◽  
Author(s):  
Hasan Baki Altinsoy ◽  
Ozkan Alatas ◽  
Salih Colak ◽  
Hakan Atalay ◽  
Omer Faruk Dogan
Keyword(s):  
Cardiac Surgery ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Median Time ◽  
Artery Bypass ◽  
Prosthetic Heart Valve ◽  
Cardiovascular Complications ◽  
Time To Diagnosis ◽  
Valve Thrombosis ◽  
Placental Blood

Background: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. Methods: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period. We used levosimendan as a potent inodilator in all patients to increase feto-placental blood flow and fetal heart rhythm.Results: Median time to diagnosis was 23.8 h (range 11.7-120 h) and median time from diagnosis to arrival in the operating theater was 9.8 h (range 7.4-19.8 h). One patient with prosthetic heart valve thrombosis underwent concomitant cesarean section prior to cardiac surgery. In a young pregnant woman who had spontaneous dissection of the left anterior descending artery, on-pump beating heart coronary artery bypass grafting was performed without cross clamping. Two and three months after surgery, cesarean sections were performed without any complication in two pregnant women.Conclusion: Because unusual cardiovascular complications are the main cause of maternal and/or fetus death during pregnancy, prompt and exact diagnosis is very important. Life-saving surgical strategy with the help of appropriate teams are necessary to optimize outcome for both mother and baby.

scholarly journals Postoperative Delirium in Patients with Chronic Obstructive Pulmonary Disease after Coronary Artery Bypass Grafting

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 342
Author(s):  
Aleksandra Szylińska ◽  
Iwona Rotter ◽  
Mariusz Listewnik ◽  
Kacper Lechowicz ◽  
Mirosław Brykczyński ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiac Surgery ◽  
Pulmonary Disease ◽  
Postoperative Delirium ◽  
Artery Bypass ◽  
Chronic Obstructive ◽  
Bypass Grafting ◽  
Obstructive Pulmonary Disease ◽  
Probability Of Survival ◽  
Copd Patients

Background and Objectives: The incidence of postoperative delirium (POD) in patients with chronic obstructive pulmonary disease (COPD) is unclear. It seems that postoperative respiratory problems that may occur in COPD patients, including prolonged mechanical ventilation or respiratory-tract infections, may contribute to the development of delirium. The aim of the study was to identify a relationship between COPD and the occurrence of delirium after cardiac surgery and the impact of these combined disorders on postoperative mortality. Materials and Methods: We performed an analysis of data collected from 4151 patients undergoing isolated coronary artery bypass grafting (CABG) in a tertiary cardiac-surgery center between 2012 and 2018. We included patients with a clinical diagnosis of COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The primary endpoint was postoperative delirium; Confusion Assessment Method in the Intensive Care Unit (CAM-ICU) was used for delirium assessment. Results: Final analysis included 283 patients with COPD, out of which 65 (22.97%) were diagnosed with POD. Delirious COPD patients had longer intubation time (p = 0.007), more often required reintubation (p = 0.019), had significantly higher levels of C-reactive protein (CRP) three days after surgery (p = 0.009) and were more often diagnosed with pneumonia (p < 0.001). The CRP rise on day three correlated positively with the occurrence of postoperative pneumonia (r = 0.335, p = 0.005). The probability of survival after CABG was significantly lower in COPD patients with delirium (p < 0.001). Conclusions: The results of this study confirmed the relationship between chronic obstructive pulmonary disease and the incidence of delirium after cardiac surgery. The probability of survival in COPD patients undergoing CABG who developed postoperative delirium was significantly decreased.

scholarly journals Inferior outcomes following cardiac surgery in patients with a functioning renal allograft

2020 ◽  
Author(s):  
Ibrahim T Fazmin ◽  
Muhammad U Rafiq ◽  
Samer Nashef ◽  
Jason M Ali
Keyword(s):  
Cardiac Surgery ◽  
Renal Transplantation ◽  
Renal Allograft ◽  
Artery Bypass ◽  
Perioperative Period ◽  
Outcome Data ◽  
Term Survival ◽  
Logistic Euroscore ◽  
Prolonged Length ◽  
The Mean

Abstract OBJECTIVES Renal transplantation is an effective treatment for end-stage renal failure. The aim of this study was to evaluate outcomes for these patients undergoing cardiac surgery. METHODS A retrospective analysis identified patients with a functioning renal allograft at the time of surgery. A 2:1 propensity matching was performed. Patients were matched on: age, sex, left ventricle function, body mass index, preoperative creatinine, operation priority, operation category and logistic EuroSCORE. RESULTS Thirty-eight patients undergoing surgery with a functioning renal allograft were identified. The mean age was 62.4 years and 66% were male. A total of 44.7% underwent coronary artery bypass grafting and 26.3% underwent a single valve procedure. The mean logistic EuroSCORE was 10.65. The control population of 76 patients was well matched. Patients undergoing surgery following renal transplantation had a prolonged length of intensive care unit (3.19 vs 1.02 days, P &lt; 0.001) and hospital stay (10.3 vs 7.17 days, P = 0.05). There was a higher in-hospital mortality (15.8% vs 1.3%, P = 0.0027). Longer-term survival on Kaplan–Meier analysis was also inferior (P &lt; 0.001). One-year survival was 78.9% vs 96.1% and 5-year survival was 63.2% vs 90.8%. A further subpopulation of 11 patients with a failed renal allograft was identified and excluded from the main analysis; we report demographic and outcome data for them. CONCLUSIONS Patients with a functioning renal allograft are at higher risk of perioperative mortality and inferior long-term survival following cardiac surgery. Patients in this population should be appropriately informed at the time of consent and should be managed cautiously in the perioperative period with the aim of reducing morbidity and mortality.

scholarly journals Use of Quality of Life in Cardiovascular Surgery in Coronary Artery Bypass Grafting: Validation, Reproducibility, and Quality of Life in One Year of Follow-Up

2019 ◽  
Vol 108 (3) ◽  
pp. 764-769 ◽  
Author(s):  
Marina Macedo Kuenzer Bond ◽  
Jenny Lourdes Rivas de Oliveira ◽  
Pedro Silvio Farsky ◽  
Vivian Lerner Amato ◽  
Arturo Adrian Jara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
One Year

The oxygen debt during routine cardiac surgery: illusion or reality?

Perfusion ◽  
2002 ◽  
Vol 17 (3) ◽  
pp. 167-173 ◽  
Author(s):  
Y M Ganushchak ◽  
J G Maessen ◽  
D S de Jong
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Uptake ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Lactate Concentration ◽  
Oxygen Debt ◽  
Plasma Lactate ◽  
Mean Values ◽  
Lactate And Pyruvate ◽  
The Mean

Background: Patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CPB) are often thought to have tissue hypoxia and intraoperative oxygen debt accumulation despite the lack of sufficient data to support this assumption. Methods and results: Oxygen uptake and related parameters, including the plasma lactate and pyruvate concentrations, were studied during the peri-operative period in a group of 15 consecutive patients who underwent coronary artery bypass graft surgery. The actual oxygen uptake (VO2) and delivery (DO2) were compared with the individual expected (computed) oxygen transport values. The mean values of DO2 and VO2were in the range of the expected values. Our results demonstrate a leading role for body temperature in perioperative changes of oxygen consumption rate ( r2 = 0.65, p< 0.001). Plasma lactate and pyruvate did not exceed the physiological range in any patient. However, with initiation of CPB, the lactate to pyruvate (LA/PVA) ratio increased (from 9.87± 2.43 at T1 to 12.08± 1.51 at T2, p< 0.05). The mean value of the LA/PVA ratio was elevated during surgery. Later, upon lowering of the plasma lactate concentration in the postoperative period, the LA/PVA ratio decreased to normal values. Without any other evidence of hypoxia, this increase in the LA/PVA ratio could be explained by washout of lactate from previously hypoperfused tissues and intraoperative decrease of lactate clearance. Conclusion: Systemic oxygenation was not impaired during CPB, or during 18 h after surgery in the studied group of patients.

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