“Blame it on the comorbidities” A 5-year follow-up of 53 chronic dialysis-dependent patients who underwent cardiac surgery

Abstract Background Following catheter ablation for atrial fibrillation (AF), CHADS2 and CHA2DS2-VASc have utility in predicting long-term outcomes. However, it is currently unknown if the same holds for patients undergoing surgical ablation. Purpose To determine whether CHADS2 and CHA2DS2-VASc predict long-term outcomes after surgical ablation in concomitance with other cardiac surgery. Methods In this prospective, follow-up study, we included patients who underwent biatrial ablation - or pulmonary vein isolation procedure concomitantly with other cardiac surgery between 2004 and 2018. CHADS2 and CHA2DS2-VASc scores were assessed prior to surgery and categorized in groups as 0–1, 2–4 or ≥5. Outcomes were death, AF, and AF-related death. Follow-up was ended in April 2019. Results A total of 587 patients with a mean age of 68.7±0.4 years were included. Both CHADS2 and CHA2DS2-VASc scores were predictors of survival p=0.005 and p<0.001, respectively (Figure). For CHADS2, mean survival times were 5.9±3.7 years for scores 0–1, 5.0±3.0 years for scores 2–4 and 4.3±2.6 years for scores ≥5. For CHA2DS2-VASc mean survival times were 7.3±4.0 years for scores 0–1, 5.6±2.9 years for scores 2–4 and 4.8±2.1 years for scores ≥5. The incidence of death was 20.1% for CHADS2 0–1, 24.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.186. The incidence of AF was 50.2% for CHADS2 0–1, 47.9% for CHADS2 2–4, and 76.5% for CHADS2 ≥5, p=0.073. The incidence of AF related death was 13.0% for CHADS2 0–1, 16.8% for CHADS2 2–4, and 35.3% for CHADS2 ≥5, p=0.031. The incidence of death was 16.8% for CHA2DS2-VASc 0–1, 26.2% for CHA2DS2-VASc 2–4, and 45.0% for CHA2DS2-VASc ≥5, p=0.001. The incidence of AF was 49.6% for CHA2DS2-VASc 0–1, 52.5% for CHA2DS2-VASc 2–4, and 72.5% for CHA2DS2-VASc ≥5, p=0.035. The incidence of AF related death was 12.2% for CHA2DS2-VASc 0–1, 16.0% for CHA2DS2-VASc 2–4, and 42.5% for CHA2DS2-VASc ≥5, p<0.001. Conclusion Both CHADS2 and CHA2DS2-VASc scores predict long-term outcomes after surgical ablation for AF. However, CHA2DS2-VASc was superior in predicting death, AF, and AF-related death. Survival curves Funding Acknowledgement Type of funding source: None

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Multiple pericardial hematomas: a case report and mini-review in multimodality imaging

BMC Medical Imaging ◽

10.1186/s12880-021-00617-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aninka Saboe ◽

Ferdy Sanjaya ◽

Raden Erwin Affandi Soeriadi ◽

Euis Maryani ◽

Nuraini Yasmin Kusumawardhani ◽

...

Keyword(s):

Cardiac Surgery ◽

Cardiac Imaging ◽

Single Photon ◽

Multimodality Imaging ◽

Photon Emission ◽

Vena Cava ◽

Intracardiac Thrombus ◽

Surgical Closure ◽

The Right

Abstract Background Pericardial hematoma is blood accumulation in the pericardial space. Although rare, it could arise in various conditions, such as after cardiac surgery. Clinical diagnosis of pericardial hematoma is implausible; thus, cardiac imaging plays a pivotal role in identifying this condition. We presented a case of multiple pericardial hematomas, which was found as an incidental finding in post-cardiac surgery evaluation. We highlighted the diagnostic challenge and the key features of multi-modality cardiac imaging in pericardial hematoma evaluation. Case presentation An asymptomatic, 35-years old male, who underwent surgical closure of secundum atrial septal defect (ASD) one month ago, came for routine transthoracic echocardiography evaluation. An intrapericardiac hematoma was visualized at the right ventricle (RV) 's free wall side. Another mass with an indistinct border was visualized near the right atrium (RA). This mass was suspected as pericardial hematoma differential diagnosed with intracardiac thrombus. Cardiac computed tomography (CT) scan showed both masses have an attenuation of 30–40 HU; however, the mass's border at the RA side was still not clearly delineated. Mild superior vena cava (SVC) compression and multiple mediastinal lymphadenopathies were also detected. These findings are not typical for pericardial hematomas nor intracardiac thrombus; hence another additional differential diagnosis of pericardial neoplasm was considered. We pursued further cardiac imaging modalities because the patient refused to undergo an open biopsy. Single-photon emission computer tomography (SPECT)/CT with Technetium-99 m (Tc-99 m) macro-aggregated albumin (MAA) and Sestamibi showed filling defect without increased radioactivity, thus exclude the intracardiac thrombus. Cardiac magnetic resonance imaging (MRI) reveals intrapericardial masses with low intensity of T1 signal and heterogeneously high intensity on T2 signal weighted imaged and no evidence of gadolinium enhancement, which concluded the diagnosis as subacute pericardial hematomas. During follow-up, the patient remains asymptomatic, and after six months, the pericardial hematomas were resolved. Conclusion Pericardial hematoma should be considered as a cause of pericardial masses after cardiac surgery. When imaging findings are atypical, further multi-modality cardiac imaging must be pursued to establish the diagnosis. Careful and meticulous follow-up should be considered for an asymptomatic patient with stable hemodynamic.

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27 Thirty Years Follow Up of the Naive T Cell Compartment After Neonatal Thymectomy Due to Cardiac Surgery

Pediatric Research ◽

10.1203/00006450-201011001-00027 ◽

2010 ◽

Vol 68 ◽

pp. 17-17

Author(s):

A W L Schadenberg ◽

R Van Gent ◽

R -J A Nievelstein ◽

F Haas ◽

J A M Borghans ◽

...

Keyword(s):

Cardiac Surgery ◽

T Cell ◽

Cell Compartment ◽

Neonatal Thymectomy ◽

Naïve T Cell ◽

Naive T Cell

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P01-302 - The effects of cardiac surgery on health - related quality of life, and emotional status outcomes: a follow-up study

European Psychiatry ◽

10.1016/s0924-9338(10)70510-1 ◽

2010 ◽

Vol 25 ◽

pp. 515 ◽

Cited By ~ 2

Author(s):

H.-B. Rothenhäusler ◽

A. Stepan

Keyword(s):

Quality Of Life ◽

Cardiac Surgery ◽

Health Related Quality ◽

Emotional Status ◽

Follow Up Study ◽

Related Quality ◽

Health Related

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Scimittar Syndrome; Right time to operate? and mid-term results.

Kosuyolu Heart Journal ◽

10.51645/khj.2021.m162 ◽

2021 ◽

Author(s):

Kenan Abdurrahman Kara ◽

Ergi̇n Arslanoğlu ◽

Fatih Tomrukçu ◽

Abdullah Arif Yılmaz ◽

Fatih Yiğit ◽

...

Keyword(s):

Cardiac Surgery ◽

Pulmonary Arterial Pressure ◽

Pulmonary Artery Hypertension ◽

Scimitar Syndrome ◽

Pulmonary Arterial ◽

The Right ◽

Vein Stenosis ◽

Mid Term Results

Objectives: Scimitar syndrome is a combination of rare congenital cardiopulmonary anomalies that can occur in 3% to 6% of patients with a partial abnormal venous connection. The presence of accompanying cardiac anomalies in these patients and in cases such as severe hypoplasia of the right lung or accompanying pulmonary artery hypertension necessitate early surgery in early infancy. Patients and Methods: 9 patients with scimitar syndrome operated on in our pediatric cardiac surgery clinic from 2012 to 2020 were retrospectively examined in our study. The ages of the patients ranged from 1 to 47 years, with a mean of 18.11±14.44. 1 patient died and mortality was 11.11%. Of the patients, 4 were male (44.44%) and 5 were female (55.56%). Patients' pulmonary arterial pressure ranged from 0.15 to 94 mmHg, with a mean of 39.22 ±22.49. Results: Close to 25% scimitar vein stenosis or scimitar vein drainage occlusion has been reported in the postoperative period, mostly in the newborn group in the literature. 2 patients had non-critical stenosis during the 3rd year follow-up despite the absence of stenosis orocclusion during the first 2 years of follow-up of 9 patients we followed. Their surgical follow-up is still ongoing since they are asymptomatic. Conclusion: As a result, the course of the disease depends on the follow-up of the patient, the timing of the surgery, and the quality of the anastomosis. The follow-up and treatment of these patients will be more accurate in advanced centers experienced in scimitar surgery.

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Electroencephalogram-Based Prognosis of Cardiac Surgery — A Long-Term Follow-Up Study

Impact of Cardiac Surgery on the Quality of Life ◽

10.1007/978-1-4613-0647-4_19 ◽

1990 ◽

pp. 145-151

Author(s):

Phiroze L. Hansotia ◽

Percy N. Karanjia ◽

Richard D. Sautter ◽

William O. Myers ◽

Jefferson F. Ray ◽

...

Keyword(s):

Cardiac Surgery ◽

Follow Up Study ◽

Long Term Follow Up

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Establishment of a New Platform for the Management of Patients After Cardiac Surgery: Descriptive Study (Preprint)

10.2196/preprints.13123 ◽

2018 ◽

Author(s):

Zhihui Zhu ◽

Haibo Zhang ◽

Yuehuan Li ◽

Xu Meng ◽

Yuqing Jiao ◽

...

Keyword(s):

Cardiac Surgery ◽

Clinical Data ◽

Academic Research ◽

Mobile Network ◽

Clinical Work ◽

Quality Data ◽

Radiographic Images ◽

Term Survival ◽

Echocardiographic Images

BACKGROUND Medical care for the Chinese population has been focused on first-line treatment, but with little follow-up on treated patients. As an important part of clinical work, follow-up evaluations are of great significance for the long-term survival of patients and for clinical and scientific research. However, the overall follow-up rate of discharged patients after surgery has been low for many years because of the limitations of certain follow-up methods and the presence of objective, practical problems. OBJECTIVE This study aimed to construct a new two-way interactive telemedicine follow-up platform to improve the collection of clinical data after cardiac surgery and provide reliable and high-quality follow-up services. METHODS Computer and network technologies were employed in the context of “Internet +” to develop follow-up databases and software compatible with a mobile network. Postoperative follow-up quality data including the follow-up rate and important postoperative indices were used as standards to evaluate the new follow-up management model after cardiac surgery. RESULTS This system has been officially operated for more than 5 years. A total of 5347 patients undergoing cardiac surgery have been enrolled, and the total follow-up rate was 90.22%. In addition, 6349 echocardiographic images, 4717 electrocardiographic images, and 3504 chest radiographic images have been uploaded during follow-up assessments. The international standardized ratio was 20,696 person-times. CONCLUSIONS This new management follow-up platform can be used to effectively collect clinical data, provide technical support for academic research, extend medical services, and provide more help to patients. It is of great significance for managing patients after cardiac surgery.

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AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov20157438-42 ◽

2015 ◽

Vol 7 (4) ◽

pp. 38-42 ◽

Cited By ~ 1

Author(s):

A V Sotnikov ◽

V M Melnikov ◽

R V Almadi ◽

G N Gorbunov

Keyword(s):

Cardiac Surgery ◽

Wound Infection ◽

Incidence Rate ◽

Control Group ◽

Study Group ◽

Intravenous Injections ◽

Deep Wound Infection ◽

Period 2 ◽

Deep Wound

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

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Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2014-3-39-42 ◽

2015 ◽

Vol 18 (3) ◽

pp. 39

Author(s):

Yu. I. Petrishchev ◽

A. L. Levit ◽

I. N. Leyderman

Keyword(s):

Cardiac Surgery ◽

Length Of Stay ◽

Plasma Levels ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Cardiac Surgeons ◽

The Given ◽

The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

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