Acupuncture Anesthesia for Open Heart Surgery: A Report of 800 Cases

1979 ◽  
Vol 07 (01) ◽  
pp. 77-90 ◽  
Author(s):  
I. Hollinger ◽  
J.A. Richter ◽  
W. Pongratz ◽  
M. Baum
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Valvular Disease ◽  
Anesthetic Techniques ◽  
Open Heart ◽  
Pharmacological Agents ◽  
Neuromuscular Relaxant ◽  
Metabolic Load ◽  
Acupuncture Anesthesia

This article reports the utilization of acupuncture in combination with chemical anesthesia and neuromuscular relaxant for patients with cardiac surgery, including valvular disease and by-pass. In 800 patients studied using this type of combination of anesthetic techniques, it was found that this procedure can be successful for cardica surgery and that it allows light planes of anesthesia with less interference to circulatory regulation. There is a certain advantage of using acupuncture anesthesia when compared with chemical anesthesia, as the pharmacological agents are not used and hence post no metabolic load for the patients. From the 800 patients studied, it seems justifiable to recommend this anesthetic procedure for cardiac surgery.

scholarly journals Pre-operative and peri operative predictors of acute renal failure after cardiac surgery

2019 ◽  
Vol 6 (3) ◽  
pp. 756
Author(s):  
Praveen Dhaulta ◽  
Vikas Panwar
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Ejection Fraction ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Variable ◽  
Open Heart ◽  
Multiple Variables

Background: Acute kidney injury (AKI) is one of the most serious complications during the postoperative period of cardiac surgery. Multiple variables predict the ARF after cardiac surgery. Objective of this study was to evaluate the significance of pre and peri-operative variables which may help in predicting the chances of developing ARF after cardiac surgery.Methods: This study was an observational, prospective study conducted among patients who were scheduled to undergo open heart surgery under cardiopulmonary bypass.Results: In total, 50 patients who underwent open-heart surgery, ARF was seen in 5 patients, with the incidence rate of 10%. Acute renal failure was present in one patient with ejection fraction <35, 2 patients had ejection fraction between 35 to 50 and 2 patients with ejection fraction >50. It was seen in 4 patients with 1-2 hrs of cardiopulmonary bypass and in 1 patient with >2 hrs of cardiopulmonary bypass. ARF was also seen in 4 patients with hematocrit between 22-26% and in 1 patient with >26%.Conclusions: The study provided a clinical variable score that can predict ARF after open-heart surgery. The score enhances the accuracy of prediction by accounting for the effect of all major risk factors of ARF.

scholarly journals The Impact of Perioperative Viscoelastic Test Application on Blood Product Usage and Outcome in Cardiac Surgery; Regional Cardiac Surgery Center Experience

2021 ◽  
Author(s):  
Murat Aksun ◽  
Saliha Aksun ◽  
Mehmet Ali Çoşar ◽  
Elif Neziroğlu ◽  
Senem Girgin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Experience ◽  
Heart Surgery ◽  
Blood Product ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart ◽  
Blood Products ◽  
Product Use ◽  
The Impact

Objective: Thromboelastography (TEG) is a diagnostic modality that gives information about coagulation. Despite all blood-preserving precautions in open heart surgery there are blood losses and the use of blood and blood products becomes inevitable. TEG is mostly not available in every center and habits, trends and clinical experience in blood use create the possibility of causing unnecessary use of blood and blood products. In this study, it was aimed to determine the effect of the use of thromboelastography on the use of blood and blood products in cardiac surgery. Methods: Two hundred patients between 18-70 years old who underwent open heart surgery were included in the study. After the cardiopulmonary bypass (CPB), the cases were confirmed to have an Activated Clotting Time (ACT) value in the range of 120-150 sec after protamine administration. In 100 patients in the TEG group, the coagulation status was evaluated with TEG and it was decided how to apply blood and blood product use. Blood and blood product use was applied to 100 patients in the control group based on clinical experience and foresight. The total amount of blood and blood product used, fluid balance, need for inotropics, mechanical ventilator time, complications, duration of intensive care and discharge times were recorded. Results: Use of Fresh Frozen Plasma (FFP) at the after CPB in the TEG group was statistically significantly lower than that of the control group FFP (p<0.05). Postoperative FFP and postoperative platelet use in the study group were statistically significantly lower than in the postoperative FFP and postoperative platelet values of the control group (p <0.05). Conclusion: The use of thromboelastography is a very useful monitoring in terms of reducing FFP use after CPB and reducing FFP and platelet usage in the postoperative period. In this way, the unnecessary use of blood and blood products can be prevented.

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 Subclavian Vein Catheterisation for Cardiac Surgery in Children

1980 ◽  
Vol 8 (1) ◽  
pp. 81-83 ◽  
Author(s):  
John L. Poole
Keyword(s):  
Cardiac Surgery ◽  
Central Venous Pressure ◽  
Success Rate ◽  
Subclavian Vein ◽  
Heart Surgery ◽  
Venous Pressure ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Central Venous ◽  
Infusion Line

Infraclavicular subclavian vein catheterisation is a useful means of measuring central venous pressure and establishing a central infusion line in children undergoing open heart surgery. In 48 children ranging in age from 15 months to 13 years, there was a high success rate and no morbidity.

Intraoperative Hemofiltration in Adults: Prevention of Hypercirculatory Syndrome?

2005 ◽  
Vol 13 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Theodor Tirilomis ◽  
Martin Friedrich ◽  
Horia Sîrbu ◽  
Ivan Aleksic ◽  
Thomas Busch
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Cohort Study ◽  
Heart Surgery ◽  
Statistical Significance ◽  
Open Heart Surgery ◽  
Group Versus ◽  
Coronary Bypass ◽  
Open Heart ◽  
Perioperative Mortality

Hypercirculatory syndrome (HCS) after cardiac surgery may be a sequela of extracorporeal circulation due to hemodilution and release of inflammatory mediators. The aim of this study was to investigate the influence of intraoperative hemofiltration (HF) on the incidence of HCS. A prospective cohort study of 80 patients scheduled for elective coronary bypass was performed. The patients were randomized to two groups: in the conventional (CONV) group 40 patients were treated conventionally and in the HF group 40 patients underwent intraoperative HF. There was no perioperative mortality. The incidence of HCS was comparable in both groups (32% in CONV group versus 40% in HF group; n.s.). Mean cardiac output was higher and systemic vascular resistance lower in CONV group patients than in HF group patients, however these differences did not reach statistical significance. According to this data intraoperative HF does not prevent postoperative HCS induced by cardiopulmonary bypass. Further studies are required to identify the etiology of HCS, and to prevent it occurring after open-heart surgery.

scholarly journals Prevalence of co-morbidities among adult patients presented for open heart surgery and the implication on convalescence period

2017 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Hayel Al Adwan ◽  
Ashraf Fadel ◽  
Yanal F. Al Naser ◽  
Abdallah Al Qaysi ◽  
Rami Qsous ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Anesthetic Management ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Adult Patients ◽  
Open Heart ◽  
Previous Myocardial Infarction ◽  
Icu Discharge

Background: Improvements in perioperative medical care, anesthetic management, surgical and myocardial protection techniques made cardiac surgery feasible in the high risk surgical patients. The aim of the study was to determine the prevalence of comorbidities in adult patients undergoing open heart surgery and to evaluate their implications on recovery profile.Methods: This randomized retrospective observational study of 100 adult patients presented for heart surgery for different pathologies took place at Queen Alia heart Institute in the period of time between February 2013 and June 2014. Patients' data was collected in forms, tabulated and retrospectively analyzed. Patients' demographics, co-morbidities and type of surgery were recorded. Risk stratification models (ASA-American Society of Anesthesiology and EUROSCORE 2- European system for cardiac operative risk evaluation) were used. Time of extubation, ICU discharge and hospital discharge was recorded with each patient.Results: Age of patients ranged from 18 to 77 years (mean±SD: 58±12). 83% of patients were male and 17% were female. 80 patients were presented for CABG and 20 patients for heart valve(s) surgery. BMI (body mass index, mean±SD) was 28.9±4.6 kg/m². The prevalence of smoking was 56% (6 times higher among males (64%), in comparison to females (12%). Hypertension was prevalent in 72% of patients; diabetes was present in 53%, respiratory disease in 30%, previous myocardial infarction in 23%, 37% of patients had left ventricular impairment, renal impairment in 6%, renal failure in 2% and previous stroke in 2%. EUROSCORE values ranged between 0.5 to 5.3 % (mean 1.4%). ASA grades ranged from 2 to 4 (85% of patients were grade 3). 5% of surgeries were emergent. Average operative time was 248±47 minutes (mean±SD). 30% of patients needed inotropic support and 6% needed intra-aortic balloon. Mean time in the intensive care was 43.2±28.8 hours (mean±SD).Conclusions: There is a high prevalence of co-morbidities in patients presented for cardiac surgery. Most common associated diseases were hypertension, obesity, smoking, previous myocardial infarction and diabetes; which are all well known risk factors of ischemic heart disease. Preoperative risk scoring is of paramount importance.

scholarly journals Impact of some intraoperative factors on wound infection in cardiac surgery

2021 ◽  
Vol 20 (1) ◽  
pp. 36-43
Author(s):  
A. V. Stepin
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Wound Infection ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Wound Infections ◽  
Open Heart ◽  
Postoperative Wound ◽  
Sternal Infection ◽  
Mammary Arteries

Relevanc. Surgical Site Infection (SSI) after open heart surgery is a significant problem in clinical, social, and economic aspect which causes the need to identification of the preferred procedures for successful prevention of the SSI.Objectives. To determine risk of the SSI in cardiac surgery depending on complexity of intervention, using of cardiopulmonary bypass (CBP) and use of both internal mammary arteries (IMA).Methods. Prospective observations study from 2010 to 2019 in cardiac surgery department of the Ural Institute of Cardiology, where in total 4993 open heart surgery procedures were consecutively performed. All SSI cases were recorded up to 90 days after surgery. The analysis was performed to identify risk of cardiopulmonary bypass (CPB), bilateral IMA grafting and combined procedures on the risk of the postoperative wound infection.Results. During the investigation period, total 220 cases of the SSI (4,5%) have been registered of the 4993 patients undergoing open heart surgery. It included 42 cases of deep sternal infection (0,9%) and 178 cases of superficial infection (3,6%). The main pathogen identified was Staphylococcus epidermidis (56,4%). During the hospital period, 151 cases (66,5%) of SSI have been detected, with the median time to detection of the complication 6 days. The relative mortality risk in deep sternal infection group was 4,4 times higher than in the group without SSI (HR 4,6, 95 % CI 1,5-13,9, p=0,003624). CABG increases the relative risk of SSI in compare with non-CABG procedures (OR 3,086169; 95%CI 1,281 – 7,437), while the complexity of the operation (combined versus isolated interventions) does not significantly increase the risk (OR 0.972283; 95% CI: 0.696 - 1.359). The incidence of SSI in the group of in situ BIMA grafting was 8.8%, significantly increasing the likelihood of the SSI in compare to those with SIMA (OR 2.167983, 95% CI 1.463 - 3.212; p =0,000057). CBP significantly increases the risk of postoperative wound infections (OR 1.523890, 95% CI 1.149 - 2.022, p = 0.001742).Conclusions. Refusal of cardiopulmonary bypass, simultaneous procedures and bilateral coronary artery bypass does not allow completely to avoid postoperative wound infections. Nevertheless, the technical features of the preparations and use of grafts, including skeletonization, prevention of coagulation and the preference for sequential composite CABG, can reduce the risk associated with the type of the open heart surgery.

scholarly journals Incidence of Permanent Pacemaker Implantation after Cardiac Surgery: A Single Centre Experience

2019 ◽  
Vol 73 (4) ◽  
pp. 364-367
Author(s):  
Mārtiņš Kalējs ◽  
Edgars Prozorovskis ◽  
Kaspars Kupics ◽  
Ivars Brečs ◽  
Uldis Strazdiņš ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Aortic Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Pacemaker Implantation ◽  
Intervention Group ◽  
Permanent Pacemaker ◽  
Open Heart ◽  
Single Centre ◽  
Permanent Pacemaker Implantation

Abstract Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4–8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its influence on intrahospital outcomes. This was a single-centre retrospective study. We reviewed all patients who underwent either open heart surgery or transcatheter aortic valve implantation (TAVI) between the years 2015 and 2017. Included were all patients with PPI postoperatively before discharge. We compared the patient demographics, and perioperative state, incidence of PPI and intrahospital stay among groups. After cardiac surgery a total of 135 (4.2%) patients received a PPI. The PPI incidence was highest in the tricuspid valve intervention group — 8.8% followed by aortic valve replacement (AVR) patients with 3.3%. After TAVI incidence of PPI was 4.0% after Sapien valve and 8% after CoreValve implantations, respectively. Incidence of PPI after TAVI with the Sapien valve was not significantly higher when compared to conventional AVR, but it was significantly higher after TAVI with CoreValve. Regardless of the initial procedure a need for PPI significantly increased the total length of hospital stay.

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