Neonatal Brain Protection in Cardiac Surgery and the Role of Intraoperative Neuromonitoring

Aim: The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).Materials and Methods: We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.Results: The 2 groups were not significantly different with respect to demographic and operative data (P > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (P < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (P < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (P = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.Conclusion: Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.

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OC79 THE ROLE OF PROCALCITONIN, C-REACTIVE PROTEIN AND WHITE BLOOD CELLS IN THE DIFFERENTIAL DIAGNOSIS BETWEEN SEPSIS AND SIRS IN CARDIAC SURGERY PATIENTS

Journal of Cardiovascular Medicine ◽

10.2459/01.jcm.0000549931.77196.23 ◽

2018 ◽

Vol 19 ◽

pp. e32

Author(s):

D. Brugnetti ◽

K. Reeve ◽

U. Held ◽

H. Löblein ◽

D. Odavic ◽

...

Keyword(s):

Differential Diagnosis ◽

Cardiac Surgery ◽

Blood Cells ◽

White Blood Cells ◽

C Reactive Protein ◽

Reactive Protein

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11 / Role of peroperative haemodynamic parameters in the development of postoperative delirium after cardiac surgery

10.26226/morressier.5aeb0ac907b0d6001a79a70a ◽

2018 ◽

Author(s):

Roel Croonen

Keyword(s):

Cardiac Surgery ◽

Postoperative Delirium ◽

Haemodynamic Parameters

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Faculty Opinions recommendation of Role of intraoperative and postoperative blood glucose concentrations in predicting outcomes after cardiac surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3347958.3036057 ◽

2010 ◽

Author(s):

Paul Barash

Keyword(s):

Cardiac Surgery ◽

Blood Glucose ◽

Blood Glucose Concentrations

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Faculty of 1000 evaluation for The role of different anesthetic techniques in altering the stress response during cardiac surgery in children: a prospective, double-blinded, and randomized study.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718007742.793479149 ◽

2013 ◽

Author(s):

Gregor Theilmeier ◽

Hans-Jörg Gillmann ◽

Jan Larmann

Keyword(s):

Cardiac Surgery ◽

Stress Response ◽

Randomized Study ◽

Anesthetic Techniques ◽

Double Blinded

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The role of cardiac surgery in transvenous lead extraction (TLE) – experience from high volume center and 3207 procedures

European Heart Journal ◽

10.1093/ehjci/ehaa946.0836 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Tulecki ◽

M Czajkowski ◽

S Targonska ◽

K Tomkow ◽

D Nowosielecka ◽

...

Keyword(s):

Cardiac Surgery ◽

Tricuspid Valve ◽

Surgical Intervention ◽

Clinical Success ◽

Left Ventricular ◽

Lead Extraction ◽

Icd Leads ◽

Ventricular Lead ◽

Cardiac Surgeon

Abstract Background The guidelines suggest close co-operation between TLE operating team and cardiac surgery and its key role in the management of life-threatening complications remains unquestionable. But the role of cardiac surgeon seems to be much more extended. Purpose We have analysed the role of cardiac surgery in treatment of patients undergoing TLE procedures. Methods Using standard non-powered mechanical systems we have extracted ingrown PM/ICD leads from 3207 pts (38,7% female, average age 65,7-y) during the last 14 years. Non-infectious TLE indications were in 66,4% of patients. 46% had PM DDD system, 19% PM SSI, 22% ICD, 9% CRT, 4% other systems. In 12% of patients abandoned leads were found. 8% of patients had one lead, 54% - two, 15% - three and 4% - 4–6 leads in the heart. An average dwell time of all leads was 91,5 mth. The lead entry side was left in 96% of patients, right in 3% and both – 4%. Results Procedural success 96,1%, clinical success - 97,8%, procedure-related death 0,2%. Major complications appeared in 1,9% (cardiac tamponade 1,2%, haemothorax 0,2%, tricuspid valve damage 0,3%, stroke, pulmonary embolism <1%). Conclusions Rescue cardiac surgery (for severe haemorrhagic complications) is still the most frequent reason of surgical intervention (1,1%). The second area of co-operation includes supplementary cardiac surgery after (incomplete) TLE (0,8%). The third one is connected with reconstruction or replacement of tricuspid valve, which can be affected by ingrown lead or damaged during TLE procedure (0,5%). Implantation of the complete epicardial system during any surgical intervention (rescue or delayed) should be considered as a supplementation of the operation (0,65%). Some of patients after TLE need implantation of epicardial leads for permanent epicardial pacing (0,6%) and some only left ventricular lead to rebuild permanent cardiac resynchronisation (0,5%). The single experience of large TLE centre indicates the necessity of close co-operation with cardiac surgeon, whose role seems to be more comprehensive than a surgical stand-by itself. Table 1 Funding Acknowledgement Type of funding source: None

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COVID-19 related mortality in post-operative cardiac surgical patients

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01487-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Azhar Hussain ◽

Amina Khalil ◽

Priyanka Kolvekar ◽

Prity Gupta ◽

Shyamsunder Kolvekar

Keyword(s):

Cardiac Surgery ◽

Long Term Outcomes ◽

Case Presentation ◽

Elective Cardiac Surgery ◽

The United Kingdom ◽

Global Pandemic ◽

Cardiac Operations ◽

Related Mortality

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

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