scholarly journals 255 Tricuspid regurgitation in the community by routine echocardiography

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Denis Leonardi ◽  
Valentina Siviero ◽  
Martina Setti ◽  
Caterina Maffeis ◽  
Diego Fanti ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Epidemiological Studies ◽  
Routine Practice ◽  
Clinical Settings ◽  
Impact On Survival ◽  
High Event ◽  
Survival Risk

Abstract Aims Tricuspid Regurgitation (TR) is quite frequent in the community and often overlooked in routine clinical practice. This study aims to convey the TR rate of diagnosis and impact on survival in a geographically defined population of an Italian referral centre, considering five different clinical contexts. Methods The study included consecutive outpatients with comprehensive echocardiography and complete clinical evaluation over 7 years of practice. Outpatients with TR greater than moderate were included, and the different clinical contexts evaluated: patients with concomitant significant mitral regurgitation (MR-TR), heart failure (HF-TR), previous open-heart surgery (postop-TR), pulmonary hypertension (PHTN-TR) and isolated TR (isolated-TR). Results Among all consecutive echocardiograms performed in routine practice (N=6797) in a geographically defined community, moderate or severe TR was found in 4.8% (N = 327; mean age 76±10, 56% female). Median follow-up was 6.1 [2.2–8.9] years. TR severity was an independent determinant of survival: risk ratio for mortality of severe TR vs. moderate was 1.72 [95% CI 1.06–2.77; P = 0.03] univariate and 1.76 [95% CI 1.02–3.01; P = 0.04] after adjusted for age, sex, MR, PHTN and EF. Only 2.8% of patients underwent tricuspid valve surgery during follow-up. Outpatients with MR-TR or HF-TR held the worst prognosis (Figure). As compared to isolated-TR, the mortality risk was 2.67 [95% CI 1.05–6.78; P = 0.04] for HF-TR and 2.04 [95% CI 1.00–4.14; P = 0.05] for MR-TR. Risk ratios for mortality vs. postop-TR were 3.66 [95% CI 1.19–11.26; P= 0.02] for HF-TR and 2.79 [95% CI 1.08–7.21; P = 0.03] for MR-TR. There was no interaction between the TR clinical context and the survival impact of TR (P=0.09). Conclusions Significant TR is frequent in our community, comparable to key epidemiological studies. TR severity independently impacts survival in all clinical settings, and it is associated with an absolute high event-rate when present with concomitant MR or HF. These results give importance to early diagnosis with grading to be performed through accurate echocardiography and renew the interest in new and safe, less invasive percutaneous intervention to improve patients' survival.

scholarly journals Neuropsychomotor development before and after open-heart surgery in infants

2009 ◽  
Vol 67 (2b) ◽  
pp. 457-462 ◽  
Author(s):  
Taís Sica da Rocha ◽  
Ana Guardiola ◽  
Jefferson Pedro Piva ◽  
Cláudia Pires Ricachinevski ◽  
Aldemir Nogueira
Keyword(s):  
Heart Surgery ◽  
Intensive Care Unit Discharge ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Neurodevelopmental Outcomes ◽  
Early Improvement ◽  
Before And After ◽  
Neurological Exam ◽  
Brazilian Studies

There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 ± 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.

scholarly journals Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Mohanty ◽  
C Trivedi ◽  
D G Della Rocca ◽  
C Gianni ◽  
B MacDonald ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ischemic Cardiomyopathy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Long Term Outcome ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Abstract Introduction We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. Method Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar <0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations. Results A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%). At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p<0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02). Conclusion In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

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

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.

scholarly journals Early results of a real-world series with two transapical transcatheter mitral valve replacement devices

2020 ◽  
Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Functional Improvement ◽  
Study Cohort ◽  
Early Results ◽  
Transcatheter Mitral Valve Replacement

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract

Synchronous Open Heart Surgery and Laparoscopic Cholecystectomy: An Observational Case Study with 28 Patients

2017 ◽  
Vol 83 (3) ◽  
pp. 314-321
Author(s):  
Mustafa Bilge Erdogan ◽  
Mehmet Kaplan ◽  
Hakki Kazaz ◽  
Bulent Salman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Acalculous Cholecystitis ◽  
Tricuspid Valve Repair ◽  
Inhospital Mortality ◽  
Open Heart ◽  
Severe Problem

Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital. Among these, 28 (1%) patients underwent concomitant LC in the same session by the same experienced surgeon. The mean age of the patients was 61.4 ± 9.1 years, and the proportion of males was 71.4 per cent. Acalculous cholecystitis was found in 42.9 per cent of the patients. Patients stayed in the intensive care unit for 3.1 ± 1.4 days and were discharged from the hospital after 16.5 ± 6.3 days. Postoperative 2-year follow-up was completed in all patients with a mean follow-up period of 3.4 ± 2.0 years. The overall complication rate was 28.6 per cent. LC-related complications were seen in four patients. No inhospital mortality was observed. Only one patient who underwent mitral valve replacement and tricuspid valve repair died in the second year after the operation due to congestive heart failure. Three patients died due to noncardiac reasons in the follow-up period. By increasing the experiences of surgeons in laparoscopic surgery in critically ill patients, LC can be safely performed concurrently in patients scheduled for OHS.

Follow-up of Australian Aboriginal Patients Following Open-Heart Surgery in Western Australia

2004 ◽  
Vol 13 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Nand K Kejriwal ◽  
J.T.H Tan ◽  
A Vasudevan ◽  
M Ong ◽  
M.A.J Newman ◽  
...  
Keyword(s):  
Western Australia ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Australian Aboriginal

scholarly journals Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Stroke ◽  
1986 ◽  
Vol 17 (3) ◽  
pp. 410-416 ◽  
Author(s):  
K A Sotaniemi ◽  
H Mononen ◽  
T E Hokkanen
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Follow Up Study

scholarly journals Primary Cardiac Sarcoma Remission after Surgery: 5-Years Follow-up: Case Report

2018 ◽  
Vol 21 (5) ◽  
pp. E401-E403 ◽  
Author(s):  
Melike Elif Teker ◽  
Önder Teskin
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Radical Resection ◽  
Patient Specific ◽  
Anterior Leaflet ◽  
Full Remission ◽  
Primary Cardiac Sarcoma

Background: Primary cardiac sarcoma is a rare and atypical clinical entity. We present a patient with long-term remission after primary cardiac sarcoma resection. Case Report: A 42-year-old previously healthy female presented to the emergency department after an effort-induced 30-minute episode of chest pain and extreme shortness of breath. Physical examination upon admission was remarkable for a pulse of 99/minute; blood pressure was 101/73 mmHg. Transthoracic echocardiography showed a mass measuring 5.5 × 5.6 cm extending from the left septum to the mitral valve anterior leaflet. A multilobulated broad-based 5.5 × 5.6 × 4 cm3 mass invading a large portion of the left septum to the mitral valve anterior leaflet was completely excised in the open heart surgery. Chemotherapy regimen (paclitaxel 175 mg/m2/day on day 1, every 21 days) was started after operation. Full remission was provided. Metastasis and recurrence have not been observed for 5 years of follow-up by PET. We observed during 5 years and used a PET. And the finally we did not see metastasis at the 5 years of follow-up. Conclusions: We strongly recommend that a patient-specific multidisciplinary approach involving radical resection, chemotherapy, and radiation therapy in these cases results in patient survival and a significant improvement in quality of life. We also think that it is necessary to perform MRI to exclude other illnesses that are considered to be a myxoma.

scholarly journals Effect of Home-Based Cardiac Rehabilitation Program on Exercise Capacity in Open Heart Surgery Patients at Naresuan University Hospital

2017 ◽  
Vol 35 (4) ◽  
pp. 285
Author(s):  
Phavinee Paorod ◽  
Weerapong Chidnok ◽  
Jarun Sayasathid
Keyword(s):  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Rehabilitation Program ◽  
University Hospital ◽  
Open Heart ◽  
Cardiac Rehabilitation Program ◽  
Home Based

Objective: To investigate the effects of home-based cardiac rehabilitation program on exercise capacity using the six-minute walk test (6-MWT) in open heart surgery patients, Naresuan University Hospital.Material and Method: In a quasi-experimental study design, seventy patients who were diagnosed with heart diseases and received open heart surgery at Cardiac Center, Naresuan University Hospital were enrolled and collected data from October 2015 - September 2016 (n=70). The patients completed 8-12 weeks home-based cardiac rehabilitation program. The patients were performed the 6-MWT before hospital discharge, the first and second follow up time point. Data were expressed as average mean and chi-square test were used to determine the relationships among outcome parameters.Results: There was a significant within-group in 6-MWT distance after completed home-based cardiac rehabilitation program (377.0±69.0 meters) compared to before hospital discharge (209.0±62.0 meters) and the first follow up time point (4-8 weeks) (306.0±88.0 meters) (p-value<0.050).Conclusion: The 8-12 weeks home-based cardiac rehabilitation program exhibited significant positive effects on exercise capacity in open heart surgery patients, Naresuan University Hospital.

Safety of neonatal sternal wound reconstruction after open heart surgery

2020 ◽  
Vol 13 (12) ◽  
pp. e237573
Author(s):  
Venus Barlas ◽  
Barkat Ali ◽  
Anil Shetty
Keyword(s):  
Wound Repair ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Muscle Flap ◽  
Standard Of Care ◽  
Open Heart ◽  
Muscle Flaps ◽  
Congenital Cardiac Anomalies ◽  
Long Term Follow Up

An open sternal wound is a dreaded complication after open heart surgery for neonatal congenital cardiac anomalies. Vascularised muscle flap reconstruction of sternal wound defects, to prevent life-threatening mediastinal infections, is the standard of care in adults and children. However, there is paucity of published literature regarding the safety of this technique in neonates. We describe a successful operative technique for complex reconstruction of an open heart sternal defect on a neonatal male patient. On 6 months postoperative follow-up, we identified an issue with sternal instability. Patient underwent a subsequent operation for reinforcement of the sternal wound repair with Vicryl mesh. The authors report safety of using three separate vascularised muscle flaps in a single neonatal operation. Long-term follow-up of the sternal wound reconstruction is warranted to determine need for secondary procedures.

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