Fetal Cardiac Intervention

Abstract Background Measuring change in health-related quality-of-life (HRQoL) is important to assess the impact of disease and/or treatment. Ecological momentary assessment (EMA) comprises the repeated assessment of momentary HRQoL in the natural environment and is particularly suited to capture daily experiences. Our objective was to study whether change in momentary measures or retrospective measures of HRQoL are more strongly associated with criterion measures of change in HRQoL. Twenty-six coronary artery disease patients completed momentary and retrospective HRQoL questionnaires before and after coronary revascularization. Momentary HRQoL was assessed with 14 items which were repeatedly presented 9 times a day for 7 consecutive days. Each momentary assessment period was followed by a retrospective HRQoL questionnaire that used the same items, albeit phrased in the past tense and employing a one-week time frame. Criterion measures of change comprised the New York Heart Association functioning classification system and the Subjective Significance Change Questionnaire. Regression analysis was used to determine the association of momentary and retrospective HRQoL change with the criterion measures of change. Results Change according to momentary HRQoL items was more strongly associated with criterion measures of change than change according to retrospective HRQoL items. Five of 14 momentary items were significantly associated with the criterion measures. One association was found for the retrospective items, however, in the unexpected direction. Conclusion Momentary HRQoL measures better captured change in HRQoL after cardiac intervention than retrospective HRQoL measures. EMA is a valuable expansion of the armamentarium of psychometrically sound HRQoL measures.

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Outcomes of primary percutaneous cardiac intervention for ST elevation myocardial infarction with a saphenous vein graft culprit

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.28662 ◽

2019 ◽

Vol 96 (1) ◽

Author(s):

Mark Kheifets ◽

Hana Vaknin‐Assa ◽

Gabriel Greenberg ◽

Abid Assali ◽

Ran Kornowski ◽

...

Keyword(s):

Myocardial Infarction ◽

Saphenous Vein ◽

Vein Graft ◽

Saphenous Vein Graft ◽

St Elevation Myocardial Infarction ◽

Cardiac Intervention ◽

Percutaneous Cardiac Intervention ◽

St Elevation

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Abstract TP115: Carotid Endarterectomy in Young and Middle Aged Patients

Stroke ◽

10.1161/str.47.suppl_1.tp115 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Isibor J Arhuidese ◽

Tammam Obeid ◽

Besma Nejim ◽

Kanhua Yin ◽

Sophie Wang ◽

...

Keyword(s):

Carotid Endarterectomy ◽

Physical Dependence ◽

Female Gender ◽

Patient Characteristics ◽

Adverse Outcomes ◽

Middle Aged ◽

Improvement Program ◽

Chi Square ◽

Aged Patients ◽

Cardiac Intervention

Introduction: The increasing prevalence and earlier onset of risk factors has resulted in an expanding population of younger patients undergoing carotid endarterectomy (CEA) in recent times. Outcomes after CEA are largely unreported in these patients. In this study, we evaluate 30-day postoperative outcomes after CEA in an exclusive cohort of young and middle aged patients. Methods: We studied all patients aged 64 years and younger, who underwent CEA in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from January 2005 to December, 2013. Univariate methods (Chi Square, ttest) were employed to compare patients’ characteristics. Multivariate regression adjusting for patient characteristics was used to identify predictors of adverse outcomes. Results: There were 15830 CEA’s performed in this cohort with a mean age of 58 (S.D:5.1) years. The majority of patients were male (59%), Caucasian (85%) and hypertensive (81%). Nearly half (46%) were symptomatic. Overall, 266 (1.7%) patients suffered stroke in the 30 day post-operative period, while mortality and myocardial infarction rates were 0.6% and 0.4% respectively. The significant predictors of stroke or death were female gender (OR: 1.49; 95%CI: 1.15-1.92; p=0.002), symptomatic status (OR: 1.69; 95%CI: 1.30-2.21; p<0.001), previous cardiac intervention (OR: 1.42; 95%CI: 1.04-1.93; p=0.026) and physical dependence (OR: 1.81; 95%CI: 1.16-2.82; p=0.01). The mean length of in-hospital stay was 3 (SD:5.6) days and complications within 30 days of surgery are shown in Table 1. Conclusions: Absolute stroke and mortality rates after CEA in young and middle aged patients are not different from those reported in the general population. Stroke and mortality are significantly higher in symptomatic, physically dependent patients and those with prior cardiac intervention. We recommend extra vigilance in the management of these patients in order to improve CEA outcomes.

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Open heart surgery in Nigerian children the need for international and regional collaboration: the Balyesa and Enugu experience

Journal of Cardiology and Cardiovascular Medicine ◽

10.29328/journal.jccm.1001117 ◽

2021 ◽

Vol 6 (2) ◽

pp. 044-047

Author(s):

FA Ujunwa ◽

AS Ujuanbi ◽

JM Chinawa ◽

D Alagoa ◽

B Onwubere

Keyword(s):

Success Rate ◽

Congenital Heart ◽

Heart Surgery ◽

Heart Diseases ◽

Heart Defects ◽

Open Heart Surgery ◽

Case Fatality ◽

Open Heart ◽

Cardiac Intervention ◽

Regional Collaboration

Background: Children with congenital heart diseases (CHD) often require palliative or definitive surgical heart interventions to restore cardiopulmonary function. Lack of early cardiac intervention contributes to large numbers of potentially preventable deaths and sufferings among children with such conditions. Objectives: The aim of this study is to highlight our experience and the importance of international and regional collaboration in open heart surgery among children with CHD and capacity building of home cardiac teams in Bayelsa and Enugu States. Materials and Methods: In November 2016, a memorandum of understanding (MOU) was signed between the managements of FMC, Yenagoa, Bayelsa State, UNTH, Enugu and an Italian-based NGO- Pobic Open Heart International for collaboration in the area of free open-heart surgery for children with CHDs and training of home cardiac teams from both institutions either in Nigeria or in Italy. Patients for the program were recruited from Bayelsa and Enugu States with referrals from all over the country with combined screening and selection done in UNTH. Selected patients were operated on and funded free of charge by the Italian NGO. Hands-on training of the home cardiac teams and cardiac intervention was done twice yearly in Nigeria. Result: From inception of the program in November, 2016 to May, 2019 a total of 47 children (21 Males, 26 Females; Age range 6 months to 14 yrs) with various types of congenital heart defects have benefitted from the program with 41 surgeries done in UNTH & 6 in Italy (complex pathologies) at no cost to the recipients. Also, home cardiac teams from UNTH and FMC, Yenagoa have gained from on-site capacity training & retraining from the Italian cardiac team both in Nigeria & in Italy. The Success rate was 95.7% (44) and Case Fatality rate was 4.3% (2). Conclusion: There is a great efficacy in early cardiac intervention. This is with respect to a high success rate and minimal Case Fatality seen in this study. This was achieved through Regional and international collaboration.

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