scholarly journals Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review

2022 ◽  
Vol 30 (1) ◽  
Author(s):  
Malene S. Enevoldsen ◽  
Per Hostrup Nielsen ◽  
J. Michael Hasenkam
Keyword(s):  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Valve Surgery ◽  
Open Heart ◽  
Temporary Pacing ◽  
Number Of Patients ◽  
Temporary Pacemaker ◽  
Pacemaker Electrodes ◽  
Significant Factors

Abstract Background To assess the achieved risk and benefits of inserting temporary epicardial pacemaker electrodes after open-heart surgery for potential treatment of postoperative cardiac arrhythmias, and to investigate the extent of its use in clinical practice. Main text A systematic search was conducted in PubMed and repeated in Embase and Scopus using the PRISMA guidelines. The search identified 905 studies and resulted in 12 included studies, where the type of surgery, study design, total number of included patients, number of patients having temporary pacemaker electrodes inserted, number of patients requiring temporary pacing, primary reason for pacing, significant factors predicting temporary pacing, registered complications and study conclusion were assessed. Eight papers concluded that routine insertion of temporary pacemaker electrodes in all postoperative patients is unnecessary. One paper concluded that they should always be inserted, while three papers concluded that pacing is useful in the postoperative period, but did not recommend a frequency of which they should be inserted. Conclusions The literature suggests that the subgroup of younger otherwise healthy patients without preoperative arrhythmia having isolated coronary artery bypass grafting surgery or single valve surgery should not routinely have temporary pacemaker electrodes inserted.

Development and Evaluation of Preoperative Teaching Materials for CABG/Valve Surgery Patients

2019 ◽  
Vol 12 (1) ◽  
pp. 73-92
Author(s):  
Patricia A. McLaughlin
Keyword(s):  
Heart Surgery ◽  
Assessment Tool ◽  
Perioperative Complications ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Valve Surgery ◽  
Open Heart ◽  
Patient Anxiety ◽  
Teaching Materials ◽  
Improvement Project

BackgroundPatients often experience anxiety and feel overwhelmed by the prospect of undergoing open-heart surgery. Randomized controlled trials have found preoperative education materials and counseling to reduce levels of patient anxiety, depression, and perioperative complications following coronary artery bypass grafting (CABG)/valve surgery.ObjectiveThe purposes of this performance improvement project were to develop preoperative teaching materials for cardiac surgery inpatients and evaluate their usability.MethodsExisting CABG/valve teaching materials were evaluated. A new booklet was developed through an iterative process. An expert panel reviewed the final draft using the patient education materials assessment tool for printable materials (PEMAT-P). Patients were surveyed for usability and usefulness.ResultsExpert reviewer results for using the PEMAT-P tool for understandability and actionability were 99% and 100%. Of 62 teaching booklets and patient preparedness questionnaires distributed, N = 11 (17.7%) were returned. Nearly all respondents (90.9%) agreed or strongly agreed for questions related to how well the booklet prepared them for surgery. Likewise, 90.9% of respondents agreed or strongly agreed with statements about design and content of the booklet. The hospital consumer assessment of healthcare providers and systems performance reports from October 1, 2016 to December 31, 2016 showed improvement for discharge information (96.2% from 92.2%), symptom to look for (100% from 94.9%), and care transitions (66.2% from 54.3%).ConclusionsThe development and implementation of evidence-based preoperative teaching materials help patients and families prepare for open-heart surgery and self-care after discharge.Implications for NursingNurses' utilization of preoperative teaching materials improves patient satisfaction, preparedness, and usefulness.

Robotic mitral valve surgery: how soon will we be moving away from open heart surgery?

2012 ◽  
Vol 8 (6) ◽  
pp. 797-799
Author(s):  
Saina Attaran ◽  
Jon Anderson ◽  
Prakash Punjabi
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Open Heart

scholarly journals Preoperative oral hygiene recommendation before open-heart surgery: patients’ adherence and reduction of infections: a quality improvement study

2019 ◽  
Vol 8 (2) ◽  
pp. e000512
Author(s):  
Preben Ulrich Pedersen ◽  
Anita Tracey ◽  
Jesper Eske Sindby ◽  
Merete Bjerrum
Keyword(s):  
Oral Hygiene ◽  
Heart Surgery ◽  
Medical Information ◽  
Open Heart Surgery ◽  
Intervention Group ◽  
Open Heart ◽  
Efficient Treatment ◽  
Intention To Treat ◽  
Number Of Patients ◽  
Cost Efficient

AimTo implement recommendations for oral hygiene before elective open-heart surgery in a thoracic surgery ward and to evaluate whether the number of patients who needed to be treated with antibiotics postoperatively was reduced.BackgroundHealthcare systems are challenged to implement initiatives that reduce the development of nosocomial infections, to offer patients a safe and cost-efficient treatment and to reduce the use of antibiotics. Previous interventions have focused on staff behaviour in reducing postoperative infections. In this study, patients were recommended to carry out oral hygiene as recommended in a clinical guideline.MethodsA quasiexperimental design with a control and an intervention group was used. Information on adherence to the recommendation was collected at admission. All medical information and prescriptions of antibiotics were obtained from patients’ medical records. Data were reported as intention to treat.ResultsAltogether 972 patients (506 controls and 466 interventions) were included in the study. Of the intervention patients, 405 (86.9%, 95% CI 83.3 to 89.8) reported that they had adhered to the oral hygiene recommendation. 64 (12.6%) control patients and 36 (7.7%) in the intervention group (p=0.015) were treated with antibiotics postoperatively.ConclusionsIt was feasible to involve patients in a programme for oral hygiene and thereby reduce the number of patients needing antibiotics after open-heart surgery and this might contribute to reducing costs.

Intraoperative Low-volume Acute Normovolemic Hemodilution in Adult Open-heart Surgery

2002 ◽  
Vol 97 (2) ◽  
pp. 367-373 ◽  
Author(s):  
Valter Casati ◽  
Giovanni Speziali ◽  
Cesare D'Alessandro ◽  
Clara Cianchi ◽  
Maria Antonietta Grasso ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Postoperative Bleeding ◽  
Open Heart Surgery ◽  
Valve Surgery ◽  
Control Group ◽  
Open Heart ◽  
Acute Normovolemic Hemodilution ◽  
Normovolemic Hemodilution ◽  
Low Volume

Background Recently, various studies have questioned the efficacy of intraoperative acute normovolemic hemodilution (ANH) in reducing bleeding and the need for allogeneic transfusions in cardiac surgery. The aim of the present study was to reevaluate the effects of a low-volume ANH in elective, adult open-heart surgery. Methods Two hundred four consecutive adult patients undergoing cardiac surgery were prospectively randomized in a nonblinded manner into two groups: ANH group (103 patients), where 5-8 ml/kg of blood was withdrawn before systemic heparinization and replaced with colloid solutions, and a control group, where no hemodilution was performed (101 patients). Procedures included single and multiple valve surgery, aortic root surgery, coronary surgery combined with valve surgery, or partial left ventriculectomy. The purpose of the study was to evaluate the efficacy of ANH in reducing the need for allogeneic blood components. Routine hematochemical evaluations, perioperative blood loss, major complications, and outcomes were also recorded. Results No differences were found between the groups regarding demographics, baseline hematochemical data, and operative characteristics. There was no difference in the amount of transfusions of packed red cells, fresh frozen plasma, platelet concentrates, total number of patients transfused (control group, 36% vs. ANH group, 34.3%; P = 0.88), and amount of postoperative bleeding (control group, 412 ml [313-552 ml] vs. ANH group, 374 ml [255-704 ml]) (median [25th-75th percentiles]); P = 0.94. Further, perioperative complications, postoperative hematochemical data, and outcomes were not different. Conclusions In patients undergoing elective open-heart surgery, low-volume ANH showed lack of efficacy in reducing the need for allogeneic transfusions and postoperative bleeding.

Use of warm priming solution in open heart surgery: its effects on hemodynamics and acute inflammation

Perfusion ◽  
2008 ◽  
Vol 23 (2) ◽  
pp. 89-94 ◽  
Author(s):  
M Buyukates ◽  
S Acikgoz ◽  
O Kandemir ◽  
E Aktunc ◽  
E Ceylan ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Organ Damage ◽  
Significant Rise ◽  
Open Heart ◽  
Hemodynamic Parameters ◽  
Ephedrine Hydrochloride ◽  
Factor Α

Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20°C and 36°C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15th and 60th minutes of aortic cross-clamping and the 24th hour following surgery. Serum pre-albumin, α-1 antitrypsin, and tumor necrosis factor-α levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.

scholarly journals Micra Transcatheter Pacing System Implant under Direct Visualization During Minimally Invasive Tricuspid Valve Surgery

2020 ◽  
Vol 3 (11) ◽  
pp. 01-04
Author(s):  
Mohamad Sinno
Keyword(s):  
Tricuspid Valve ◽  
Coronary Artery Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Cardiac Pacing ◽  
Valve Surgery ◽  
Direct Visualization ◽  
Tricuspid Valve Surgery ◽  
Atrioventricular Nodal Conduction

Atrioventricular nodal conduction abnormalities are common after open heart surgery and more so during or after valve surgery. The incidence of atrioventricular (AV) block after tricuspid valve (TV) surgery is higher than what is observed following coronary artery bypass surgery or left sided valve interventions due to the proximity of the TV annulus to the AV node and hence requirements for cardiac pacing are high. However, the mechanical interference between pacing leads and TV leaflet mobility and coaptation can result in regurgitation rendering such an approach counterintuitive. We report a case of Micra Transcatheter pacing system (TPS) implant under direct visualization at the time of tricuspid valve surgery performed via a right mini-thoracotomy approach.

scholarly journals Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial

2019 ◽  
Author(s):  
Fatemeh Hosseini Kasnavieh ◽  
Hassan Rezaeipandari ◽  
Mehdi Hadadzadeh ◽  
Mahmood Vakili ◽  
Fatemeh Hosseini Biouki
Keyword(s):  
Clinical Trial ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart

Introduction: Delirium has been considered as the most common cognitive disorder after major surgery. Melatonin therapy is effective in reducing the incidence of delirium after open heart surgery with pain relief mechanism and adjustment of the sleep cycle and the absence of specific side effects. This study was conducted to determine the effectiveness of melatonin on prevention of delirium after coronary artery bypass surgery.   Methods: The double blind randomized controlled clinical trial  recruited 140 patients, equally decided, who underwent  coronary artery bypass surgery in Afshar Hospital, Yazd city, 2016. All participants of the two groups were evaluated for the presence of delirium  on the day of surgery and three days after by the Confusion Assessment Method for ICU (CUM-ICU). Respectively, The intervention and control group received 3 mg melatonin and 3 mg placebo orally before and after the operation. Data were analyzed by Chi-square, T-test, paired t-test and Cochran tests.   Results: The incidence of delirium in the melatonin and the control group was 35.7% and 5.7% on the day of operation, 68.6% and 31.4% three days after the operation, respectively. The results showed that there was a significant difference in the frequency of cognitive test of CAM-ICU on day of surgery and three days after surgery between the two groups (p <0.001).   Conclusion: Despite the efficacy of melatonin therapy in reducing delirium, further studies on the effects of other effective drugs on the treatment of delirium, such as antipsychotics and receptor blockers, should be considered.  

Temporary pacing

ESC CardioMed ◽  
2018 ◽  
pp. 1978-1980
Author(s):  
Alexander Bauer
Keyword(s):  
Critical Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Non Invasive ◽  
Temporary Pacing ◽  
Life Saving ◽  
Transcutaneous Pacing ◽  
The Right

Temporary pacing was first introduced in 1952 by Zoll and co-workers. This life-saving technique is used in a variety of critical care settings. It can be achieved by leads placed in the right ventricle or atrium, or both, via the femoral, jugular, or subclavian vein. Epicardial insertion of pacing leads is frequently used during open heart surgery. A non-invasive option is transcutaneous pacing through adhesive electrode pads. This chapter discusses indications, technique, implantation, complications, and follow-up of temporary pacemakers.

Sign in / Sign up

Export Citation Format

Share Document