The effect of daily administration of IL-18 on cardiac structure and function

Perfusion ◽  
2008 ◽  
Vol 23 (4) ◽  
pp. 237-242 ◽  
Author(s):  
A Platis ◽  
Q Yu ◽  
D Moore ◽  
EV Khojeini ◽  
P Tsau ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Interstitial Fibrosis ◽  
Open Heart Surgery ◽  
Fold Increase ◽  
Posterior Wall ◽  
Left Ventricular Diastolic Dysfunction ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Neurological Dysfunction ◽  
Open Heart

Recently, the cytokine Interleukin-18 (IL-18) has been shown to be increased as a result of cardiac surgery. Elevated IL-18 has been associated with neurological dysfunction, systemic inflammatory response syndrome (SIRS), and multiple organ dysfunction syndrome (MODS) post open-heart surgery. The intent of the study contained herein was to determine the effect of IL-18 administration on cardiac function and structure. Eight C57BL/6 female mice were treated daily with 0.5μg/mouse of recombinant IL-18 for 7 days. Long axis echocardiography (ECHO) measurements of the anatomical and hemodynamic function of the heart for all mice were studied 24h after the last dose. The left ventricular wet weights increased from 84 ± 1 to 93 ± 3 mg when comparing the placebo (n = 8) with the IL-18 groups, respectively ( p = 0.01). With ECHO analysis, IL-18 significantly increased left ventricular (LV) mass, the left atrium dimensions (LA), and the left ventricular posterior wall thickness (LVPW) over the 8-day time period ( p < 0.01). There was a 5-fold increase in interstitial cardiac collagen content and a 30% increase in myocyte size in the IL-18 compared with the control groups ( p < 0.01). Administration of IL-18 appears to induce interstitial fibrosis and myocyte hypertrophy, resulting in increased ventricular stiffness. Thus, increased IL-18 during and post open-heart surgical procedures may induce left ventricular diastolic dysfunction and affect post-operative outcomes.

Cytochemical Analysis of Left Ventricular Biopsies in Open-Heart Surgery: A Pilot Study

1973 ◽  
Vol 148 (3) ◽  
pp. 255-264 ◽  
Author(s):  
M.V. Braimbridge ◽  
Sally A.R. Darracott ◽  
Lucille Bitensky ◽  
J. Chayen
Keyword(s):  
Pilot Study ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Open Heart ◽  
Cytochemical Analysis

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.

Misplacement of Left Ventricular Vent as a Cause of Cardioplegia Failure During Routine Open-Heart Surgery

2014 ◽  
Vol 5 (1) ◽  
pp. 133-134 ◽  
Author(s):  
Sachin Talwar ◽  
Palleti Rajashekhar ◽  
Aandrei Jivendra Jha ◽  
Balram Airan
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Open Heart

Pericardial effusion following cardiac surgery. A single-center experience

2017 ◽  
Vol 26 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Hien Sinh Nguyen ◽  
Hung Doan-Thai Nguyen ◽  
Thang Duc Vu
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Pericardial Effusion ◽  
Logistic Regression Analysis ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Open Heart ◽  
Z Score

Background Pericardial effusion is still a common postoperative complication after open heart surgery with cardiopulmonary bypass. Pericardial effusion significantly prolongs the hospital stay and associated costs as well as affecting overall outcomes after open heart surgery in Hanoi Heart Hospital, a tertiary hospital in Vietnam with an annual volume of 1000 patients. This study aimed to investigate the clinical presentation, incidence, and risk factors of postoperative pericardial effusion, which may ensure better prevention of pericardial effusion and improvement in surgical outcomes after open heart surgery. Methods A cross-sectional study was performed on 1127 patients undergoing open heart surgery from January 2015 to December 2015. Results Thirty-six (3.19%) patients developed pericardial effusion. Of these, 16 (44.4%) had cardiac tamponade. Pericardial effusion occurred after valve procedures in 77.8% of cases. Pericardial effusion was detected after discharge in 47.2% of cases at a mean time of 18.1 ± 13.7 days. Univariate logistic regression analysis showed that age > 25 years, body surface area ≥ 1.28 m2, preoperative liver dysfunction, New York Heart Association class III/IV, left ventricular end-diastolic diameter z score ≥ 0.55, and postoperative anticoagulant use were associated with postoperative pericardial effusion. Multivariate logistic regression analysis showed that left ventricular end-diastolic diameter z score ≥ 0.55 was an independent risk factor for postoperative pericardial effusion. Conclusions Routine postoperative echocardiography is necessary to detect postoperative pericardial effusion. Increased left ventricular end-diastolic dimension is an independent predictor of postoperative pericardial effusion.

Acute renal failure following open heart surgery: risk factors and prognosis

Perfusion ◽  
2005 ◽  
Vol 20 (6) ◽  
pp. 317-322 ◽  
Author(s):  
Ilknur Bahar ◽  
Ahmet Akgul ◽  
Mehmet Ali Ozatik ◽  
Kerem M Vural ◽  
Ali E Demirbag ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
High Morbidity ◽  
Open Heart ◽  
Preoperative Serum

Background: Acute renal failure (ARF) development after cardiac surgery carries high mortality and morbidity. Methods: Out of 14 437 consecutive patients undergoing open-heart surgery between January 1991 and May 2001, 168 (1.16%) developed postoperative ARF mandating hemodialysis. Possible perioperative risk factors, and the prognosis of this dreadful, often fatal complication were investigated. Results: The mortality rate in this group was 79.7% (134 patients). The risk factors associated with postoperative ARF were advanced age (p-0.000), diabetes mellitus (p-0.000), hypertension (p-0.000), high preoperative serum creatinine levels (p-0.004), impaired left ventricular function (p-0.002), urgent operation (p-0.000) or reoperation (p-0.007), prolonged cardiopulmonary bypass (CPB) (p-0.000) and aortic cross-clamp (ACC) (p-0.000) periods, level of hypothermia (p-0.000), concomitant procedures (p-0.000), low cardiac output state (p-0.000), re-exploration for bleeding or pericardial tamponade (p-0.000), and deep sternal or systemic infection (p-0.000). Of those who could be discharged from hospital, renal functions were restored in 21 patients (12.5%); however, eight patients (4.7%) became hemodialysis dependent. The mean follow-up period was 5.79/3.2 years (range: 4 months to 13 years; a total of 195 patient-years), and 10-year survival was 58.69/10.2% in the discharged patients. Conclusions: ARF development after cardiac surgery often results in high morbidity and mortality. Recognizing risk factors permits the timely institution of proper treatment, which is the key to reducing untoward outcomes.

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