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.

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.

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

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.  

Coronary Artery Bypass Surgery in a Patient with a Functional Single Lung

2005 ◽  
Vol 13 (4) ◽  
pp. 377-379 ◽  
Author(s):  
Levent Yazicioglu ◽  
Atilla Aral ◽  
Ozge Uymaz ◽  
Hakki Akalin
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Operative Mortality ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Postoperative Management ◽  
Open Heart ◽  
Mortality And Morbidity

Destructed lung and pneumonectomy are associated with anatomic and physiologic changes that may interfere with the conduct of subsequent open heart surgery. Here we report a case of an autopneumonectomized patient who required open heart surgery. The preoperative, intraoperative and postoperative management of this patient was unique. Open heart procedures on patients with a single lung can be performed with acceptable operative mortality and morbidity.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2019 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 23%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Hemoglobin Level Decrease after Open Heart Surgery in a Tertiary Hospital in Indonesia

2020 ◽  
pp. 149-152
Author(s):  
Anabella Nifulea ◽  
Reza Sudjud Widianto ◽  
Rama Nusjirwan
Keyword(s):  
Heart Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Tertiary Hospital ◽  
Hemoglobin Level ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Open Heart ◽  
Cabg Surgery ◽  
Female Patients

Background: Open heart surgery is usually performed by connecting the heart to a cardiopulmonary bypass (CPB) machine. The use of the CPB machine may decrease the hemoglobin level and a very low hemoglobin levelcould cause seriouscomplications.This study aimed to explore the decrease in hemoglobin level after open heart surgery. Methods: A cross-sectional retrospective descriptive study was conducted on medical records of patients underwent coronary artery bypass graft (CABG) surgery and heart valve surgery in a tertiary hospital in Indonesia in 2018. The total sampling method was deployed to all medical records of patients underwent CABG surgery (n=25) and patients underwent heart valve surgery (n=3). Results: The decrease in hemoglobin level among young-adult female patients after heart valve surgery was 6.8 g/dl. The average decrease in mid-adult male and female patients after CABG surgery were 6 g/dl and 5.8 g/dl, respectively, and, after the heart valve surgery, the levels were 8.5 g/dl and 5.4 g/dl, respectively. The average decrease in Hb level among late-adult male and female patients after CABG surgery was 6.1 g/dl and 5.4 g/dl, respectively. Conclusion: Hemoglobin level decreases after an open heart surgery. Therefore, observation on the hemoglobin level to prevent complications and to facilitate early treatment is necessary.

Sign in / Sign up

Export Citation Format

Share Document