scholarly journals S100B in cardiac surgery brain monitoring: friend or foe?

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lapergola ◽  
Alessandro Graziosi ◽  
Ebe D’Adamo ◽  
Patrizia Brindisino ◽  
Mariangela Ferrari ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Pediatric Patients ◽  
Early Stage ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Standard Of Care ◽  
Perioperative Period ◽  
Morbidity Rate ◽  
The Cost

Abstract Recent advances in perioperative management of adult and pediatric patients requiring open heart surgery (OHS) and cardiopulmonary bypass (CPB) for cardiac and/or congenital heart diseases repair allowed a significant reduction in the mortality rate. Conversely morbidity rate pattern has a flat trend. Perioperative period is crucial since OHS and CPB are widely accepted as a deliberate hypoxic-ischemic reperfusion damage representing the cost to pay at a time when standard of care monitoring procedures can be silent or unavailable. In this respect, the measurement of neuro-biomarkers (NB), able to detect at early stage perioperative brain damage could be especially useful. In the last decade, among a series of NB, S100B protein has been investigated. After the first promising results, supporting the usefulness of the protein as predictor of short/long term adverse neurological outcome, the protein has been progressively abandoned due to a series of limitations. In the present review we offer an up-dated overview of the main S100B pros and cons in the peri-operative monitoring of adult and pediatric patients.

scholarly journals HEART TRANSPLANTATION IN PATIENTS WITH PREVIOUS OPEN HEART SURGERY

2016 ◽  
Vol 18 (3) ◽  
pp. 116-127
Author(s):  
R. Sh. Saitgareev ◽  
V. N. Poptsov ◽  
V. M. Zakharevich ◽  
A. R. Zakiryanov
Keyword(s):  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Perioperative Period ◽  
Clinical Situation ◽  
The Other ◽  
Circulatory Support ◽  
Open Heart

Heart Transplantation (HTx) to date remains the most effective and radical method of treatment of patients with end-stage heart failure. The defi cit of donor hearts is forcing to resort increasingly to the use of different longterm mechanical circulatory support systems, including as a «bridge» to the follow-up HTx. According to the ISHLT Registry the number of recipients underwent cardiopulmonary bypass surgery increased from 40% in the period from 2004 to 2008 to 49.6% for the period from 2009 to 2015. HTx performed in repeated patients, on the one hand, involves considerable technical diffi culties and high risks; on the other hand, there is often no alternative medical intervention to HTx, and if not dictated by absolute contradictions the denial of the surgery is equivalent to 100% mortality. This review summarizes the results of a number of published studies aimed at understanding the immediate and late results of HTx in patients, previously underwent open heart surgery. The effect of resternotomy during HTx and that of the specifi c features associated with its implementation in recipients previously operated on open heart, and its effects on the immediate and long-term survival were considered in this review. Results of studies analyzing the risk factors for perioperative complications in repeated recipients were also demonstrated. Separately, HTx risks after implantation of prolonged mechanical circulatory support systems were examined. The literature does not allow to clearly defi ning the impact factor of earlier performed open heart surgery on the course of perioperative period and on the prognosis of survival in recipients who underwent HTx. On the other hand, subject to the regular fl ow of HTx and the perioperative period the risks in this clinical situation are justifi ed as a long-term prognosis of recipients previously conducted open heart surgery and are comparable to those of patients who underwent primary HTx. Studies cited in the review may have important clinical applications, because they outline the range of problems and possible solutions in the performance of the HTx in recipients previously operated on open heart. This knowledge can facilitate the decision making process with regard to the opportunities and risks of the implementation of HTx. Given the uniqueness of each of the recipient and the donor, it is required to make a personalized approach to the question of the possible risks and to the preventive measures to reduce those risks in any given clinical situation. 

Open Heart Surgery in Patients with Chronic Renal Failure

1995 ◽  
Vol 3 (3-4) ◽  
pp. 112-116
Author(s):  
Mediha Boran ◽  
M Kamil Göl ◽  
Erol Şener ◽  
Oğuz Taşdemir ◽  
Kemal Bayazit
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Myocardial Revascularization ◽  
Open Heart ◽  
Valvular Heart Diseases

Coronary and valvular heart diseases are the main causes of mortality and morbidity among the long-term survivors of chronic renal failure. Despite the additional risk factors, open heart surgical procedures have recently been attempted with high rates of success in some patients with chronic renal failure. Forty-three patients with chronic renal failure that have undergone open heart surgery are included in this study. Ten of the patients were female and the mean age was 53.1 ± 11.2 (26 to 71). Twenty-five patients underwent aortocoronary bypass operations and 18 others underwent heart valve replacements. In this group of patients, 38 (88.3%) were in the compensated retention stage of chronic renal failure and 5 (11.7%) were in the end stage. The decompensated chronic renal failure patients were on regular hemodialysis and continued to receive hemodialysis in the preoperative and postoperative period. Sixteen patients of the compensated chronic renal failure group needed hemodialysis postoperatively. Early mortality rate was 7.8% (n = 3). Mean stay in the intensive care unit after the operation was 3.0 ± 3.3 days (2 to 22 days). In the long-term follow-up 3 patients underwent successful renal transplantations within 9 to 18 months after the cardiac operations. Two of these patients had valve replacements and 1 had concomitant valve replacement and coronary artery bypass grafting prior to renal transplantation. We conclude that coronary angiography, catheterization, myocardial revascularization, and valve replacements can be safely performed and should be considered if indicated in chronic renal failure patients.

Short and Long-term Results of Open Heart Surgery in Aortic Valve Disease

1998 ◽  
Vol 28 (9) ◽  
pp. 1509 ◽  
Author(s):  
Hyun-Sook Kim ◽  
Jae-Kwan Song ◽  
Jae-Hwan Lee ◽  
Young-Hak Kim ◽  
Min-Kyu Kim ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Valve Disease ◽  
Long Term Results ◽  
Open Heart ◽  
Short And Long Term

scholarly journals Treatment of cyanotic heart diseases in children

2004 ◽  
Vol 132 (suppl. 1) ◽  
pp. 9-13
Author(s):  
Ida Jovanovic ◽  
Vojislav Parezanovic ◽  
Slobodan Ilic ◽  
Djordje Hercog ◽  
Milan Vucicevic ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mortality Rate ◽  
Surgical Procedures ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Arterial Switch Operation ◽  
Open Heart Surgery ◽  
Age Groups ◽  
Mortality Rates ◽  
Cyanotic Heart Disease

Cyanotic heart diseases are relatively rare, but they are severe and heterogeneous congenital heart diseases, which require complex surgery. Development of different advanced surgical procedures, such as arterial switch operation (ASO), Fontan and its modifications, Norwood etc. operations, as well as better perioperative care significantly improved survival rate and quality of life of these children. The study group included 308 children treated for cyanotic heart disease in Yugoslavia, in the period January 2000 to July 2004. Some of them (239, 77.6%) were treated at the University Children?s Hospital in Belgrade, and others (69, 22.4%) in different institutions abroad. The age of the operated patients varied between 1 day and 19 years (median 12 months). The patients (pts) were divided into four groups, according to the disease and type of the operation. In the whole group of 308 patients treated due to cyanotic heart disease, there were 232 (75.3%) cases with open heart surgery and 76 (24.7%) with closed procedures. The mortality rate was significantly different between disease/operation groups, and age groups. Average mortality rates differed from 11.8% for palliative procedures to 12.5% for complete corrections. Mortality rate and achieved surgical results in treatment of chil?dren with cyanotic heart diseases were significantly worse than those published by leading cardiac surgery centers in the world. However, there is a clear tendency in introducing new surgical procedures, lowering the age at which the operation is done and decreasing the mortality rates.

scholarly journals Case report: Diagnosis and emergency surgery on a young patient with extensive aortic dissection without any risk factors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoud Shafiee ◽  
Mohsen Shafiee ◽  
Noorollah Tahery ◽  
Omid Azadbakht ◽  
Zeinab Nassari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Rare Condition ◽  
Underlying Disease ◽  
Case Presentation ◽  
History Of

Abstract Background Type A aortic dissection is a very dangerous, fatal, and emergency condition for surgery. Acute aortic dissection is a rare condition, such that many patients will not survive without reconstructive surgery. Case presentation We present a case 24-year-old male who came with symptoms of shortness of breath and cough. The patient underwent ECG, chest radiology, and ultrasound, where the patient was found to have right pleural effusion while his ECG was normal. In the history taken from the patient, he had no underlying disease, no history of heart diseases in his family. For a better diagnosis, ETT and aortic CT angiography was performed on the patient which confirmed the evidence of dissection. Immediately after the diagnosis, necessary arrangements were made for open heart surgery and the patient was prepared for surgery. The patient was admitted in the cardiac surgery ICU for 5 days and his medication was carefully administered. After the conditions were stabilized, the patient was transferred to the post-cardiac surgery ICU ward. The patient was discharged from the hospital one week after the surgery and returned to the office as an OPD one week after his discharge. Conclusion Various risk factors can play a role in creating aortic dissection. Therefore, it is necessary to pay attention to patients’ history for achieving a quick and definitive diagnosis. Therefore, to control the complications of placing the cannula as well as the duration of the surgery, it is very important to reduce the duration of pumping on the patient and to be very careful during the cannula placement.

scholarly journals Open heart surgery in Nigerian children the need for international and regional collaboration: the Balyesa and Enugu experience

2021 ◽  
Vol 6 (2) ◽  
pp. 044-047
Author(s):  
FA Ujunwa ◽  
AS Ujuanbi ◽  
JM Chinawa ◽  
D Alagoa ◽  
B Onwubere
Keyword(s):  
Success Rate ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Open Heart Surgery ◽  
Case Fatality ◽  
Open Heart ◽  
Cardiac Intervention ◽  
Regional Collaboration

Background: Children with congenital heart diseases (CHD) often require palliative or definitive surgical heart interventions to restore cardiopulmonary function. Lack of early cardiac intervention contributes to large numbers of potentially preventable deaths and sufferings among children with such conditions. Objectives: The aim of this study is to highlight our experience and the importance of international and regional collaboration in open heart surgery among children with CHD and capacity building of home cardiac teams in Bayelsa and Enugu States. Materials and Methods: In November 2016, a memorandum of understanding (MOU) was signed between the managements of FMC, Yenagoa, Bayelsa State, UNTH, Enugu and an Italian-based NGO- Pobic Open Heart International for collaboration in the area of free open-heart surgery for children with CHDs and training of home cardiac teams from both institutions either in Nigeria or in Italy. Patients for the program were recruited from Bayelsa and Enugu States with referrals from all over the country with combined screening and selection done in UNTH. Selected patients were operated on and funded free of charge by the Italian NGO. Hands-on training of the home cardiac teams and cardiac intervention was done twice yearly in Nigeria. Result: From inception of the program in November, 2016 to May, 2019 a total of 47 children (21 Males, 26 Females; Age range 6 months to 14 yrs) with various types of congenital heart defects have benefitted from the program with 41 surgeries done in UNTH & 6 in Italy (complex pathologies) at no cost to the recipients. Also, home cardiac teams from UNTH and FMC, Yenagoa have gained from on-site capacity training & retraining from the Italian cardiac team both in Nigeria & in Italy. The Success rate was 95.7% (44) and Case Fatality rate was 4.3% (2). Conclusion: There is a great efficacy in early cardiac intervention. This is with respect to a high success rate and minimal Case Fatality seen in this study. This was achieved through Regional and international collaboration.

P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A E Moreyra ◽  
Y Yang ◽  
S Zinonos ◽  
N M Cosgrove ◽  
J Cabrera ◽  
...  
Keyword(s):  
Constrictive Pericarditis ◽  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Robert Wood Johnson Foundation ◽  
Open Heart ◽  
Significant Difference ◽  
Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

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