scholarly journals Predictors of Post-Operative Acute Kidney Injury in relation with N-Terminal Pro-B-Type Natriuretic Peptide Level among Patients Undergoing Mitral Valve Replacement

2021 ◽  
Vol 8 (2) ◽  
pp. 85-89
Author(s):  
Md Tanvir Hossain ◽  
Asraful Hoque ◽  
Tasmin Rubayath ◽  
Romena Rahman ◽  
Abu Shadat Mohammad Saem Khan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Natriuretic Peptide ◽  
Mitral Valve Replacement ◽  
Kidney Injury ◽  
Natriuretic Peptide Level ◽  
Peptide Level ◽  
Operative Variable

Background: The N-terminal Pro-B-type natriuretic peptide (NT-proBNP) level can be utilized as post-operative prediction models suring cardiac surgery. Objective: The objective was to find out the predictors of post-operative acute kidney injury in relation with N-Terminal Pro-B-Type natriuretic peptide level among mitral valve replacement patients. Methodology: This cross-sectional study was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2018 to December 2019. Patients with the age of more than or equal to 18 years with both sexes who were underwent mitral valve replacement were selected as study population. Patients were divided into two groups based on pre-operative NT-proBNP level. Post-operatively patients were observed on the basis of post-operative serum creatinine. Results: A total number of 100 patients were recruited for this study of which 50 cases were in group A and the rest of 50 cases were in the group B. Elevated NT-proBNP was the most powerful and independent pre-operative variable in predicting post-operative AKI development (OR 0.999, 95% CI 0.998-1.00) Conclusion: In conclusion elevated NT-proBNP is the most powerful and independent pre-operative variable in predicting post-operative acute kidney injury. Journal of Current and Advance Medical Research, July 2021;8(2):85-89

scholarly journals Perioperative Cerebral Ischaemia in Cardiac Surgery and BIS

2005 ◽  
Vol 33 (4) ◽  
pp. 514-517 ◽  
Author(s):  
J. Villacorta ◽  
F. Kerbaul ◽  
F. Collart ◽  
C. Guidon ◽  
M. Bonnet ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Ct Scan ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Bispectral Index ◽  
Cerebral Ischaemia ◽  
Air Embolism ◽  
Aortic Cross Clamp ◽  
Bispectral Index Monitoring

A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.

scholarly journals Cardiac surgery in patients with heparin induced thombocytopenia (HIT II)

2009 ◽  
Vol 56 (1) ◽  
pp. 47-52
Author(s):  
M.D. Jovic ◽  
D.G. Nezic ◽  
B.M. Calija ◽  
D.S. Nenadic ◽  
A.M. Knezevic ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Anticoagulant Therapy ◽  
Anticoagulation Therapy ◽  
Thrombin Inhibitors ◽  
Postoperative Treatment ◽  
Per Oral

Heparin-induced thrombocytopenia (HIT) might be lifethreatening in patients undergoing open heart surgery, due to thromboembolic events, thrombocytopenia and bleeding. If cardiac surgery with cardiopulmonary bypass (CPB) is necessary, anticoagulation therapy will be based on usage of danaparoid or direct thrombin inhibitors. Female patient was switched from per oral anticoagulant therapy to low molecular heparin therapy preparing for reredo mitral valve replacement due to endocarditis and artificial valve thrombosis. In next 10 days, thrombocytopenia was obvious (Tr 302 000 mm3 to 11 000 mm3) , and diagnoses of HIT were done. Anticoagulant therapy was continued with danaparoid, 750 IU/12 h sc. During the surgery, reredo mitral valve replacement and aortocoronary bypass on anterior descending coronary artery, blood salvage technique with rhirudin( intravenous bolus 0,4 mg/kg, in CPB prajming solution 0,4mg/kg and continuous infusion during CPB 0,15 mg/kg/h ) during cardiopulmonary bypass was used. Active coagulation time and +++ were monitored, without any sign of micro thrombosis in circuit. Postoperatively, per oral anticoagulation therapy was initiated with prolonged postoperative treatment due to basic disease, endocarditis. Patient was discharged from hospital on 21-st postoperative day without any complication.

scholarly journals A Meta-Analysis of Randomized and Observational Studies: Aspirin Protects from Cardiac Surgery-Associated Acute Kidney Injury

2019 ◽  
Vol 22 (4) ◽  
pp. E301-E307
Author(s):  
Huijiao Liu ◽  
Jianwei Li ◽  
Miaolian Chen ◽  
Ting Yang ◽  
Zongfa Ruan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
Antiplatelet Therapy ◽  
Valve Replacement ◽  
Observational Studies ◽  
Kidney Injury ◽  
Controlled Trials ◽  
Randomized Controlled

Background: Antiplatelet therapy is critical in the management of coronary artery diseases. For patients undergoing cardiac surgeries, including coronary artery bypass graft (CABG) and valve replacement, controversy remains in preoperative antiplatelet therapy concerning risk of bleeding. For safety concern, aspirin is recommended to be withdrawn 5 to 10 days before a cardiac surgery. Recent studies, however, indicate that preoperative aspirin may have a protective effect on cardiac surgery-associated acute kidney injury (CSA-AKI). Objective: To estimate the efficacy of preoperative aspirin in preventing CSA-AKI. Methods and results: Eligible studies included randomized controlled trials (RCTs) and observational studies (OSs) of patients, who had undergone CABG, valve replacement, or combined surgery. These studies compared preoperative aspirin with placebo/no aspirin and reported the least incidence of CSA-AKI. One RCT and five OSs met the inclusion criteria. Data retrieved suggested that aspirin prescribed within five days before cardiac surgery decreased post-operative renal failure [odds ratio (OR), 0.67; 95% confidence interval (CI), 0.50-0.89; P < 0.01] and 30-day mortality (OR, 0.64; 95% CI, 0.53-0.77; P < 0.01). One RCT and three OSs suggested aspirin protected from major adverse cardiocerebral events (MACE) (OR, 0.88; 95% CI, 0.76-1.01; P = 0.07). One RCT and two OSs suggested aspirin did not increase risk of re-exploration for bleeding (OR, 1.01; 95% CI, 0.76-1.34; P = 0.95). Conclusion: Preoperative low-dose aspirin decreases post-operative CSA-AKI, mortality, and MACE without increasing the risk of re-exploration. But most of the studies are observational. They lack a uniformed standard on prescription of aspirin and outcomes measurement. No stratification analysis is performed concerning different types of surgical procedures and comorbidities. More randomized controlled trials are necessary to confirm the efficacy and safety of preoperative aspirin prescription.

Prevention of acute kidney injury

2018 ◽  
Author(s):  
Norbert Lameire
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Growth Factor ◽  
Atrial Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Potential Role ◽  
Kidney Injury ◽  
Pharmacological Interventions ◽  
Selection Of

This chapter summarizes the pharmacological interventions that can be used in the prevention of acute kidney injury (AKI). These following interventions are discussed: the use and selection of vasopressors; the administration of loop diuretics and mannitol; vasodilating drugs including dopamine, atrial natriuretic peptide, nesiritide, fenoldopam, and adenosine antagonists. The role of N-acetylcysteine in the prevention of contrast-induced AKI and cardiac surgery is discussed. The chapter concludes with a summary of the potential role of insulin-like growth factor and erythropoietin in the prevention of AKI.

scholarly journals Massive Left Atrial Thrombus in Two Patients with Heparin-Induced Thrombocytopenia Type II after Cardiac Surgery

TH Open ◽  
2018 ◽  
Vol 02 (03) ◽  
pp. e334-e337 ◽  
Author(s):  
Yuriy Mandryk ◽  
Markus Czesla ◽  
Christian Mogilansky ◽  
Kristina Stefkova ◽  
Aloys Drees ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Surgical Patients ◽  
Type Ii ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Heparin Induced Thrombocytopenia

AbstractHeparin-induced thrombocytopenia type II (HIT type II) can have devastating consequences in cardiac surgical patients. We report two cases of massive left atrial thrombus after mitral valve replacement and endocardial cryoablation in patients with HIT type II.

scholarly journals Management of a Case of Aortic Valve Replacement with Left Ventricle Clot Removal Developing Acute Kidney Injury in Postoperative Period

2020 ◽  
Author(s):  
Naresh Kumar Aggarwal ◽  
Sushanta Bhoi
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Postoperative Period ◽  
Severe Aortic Stenosis ◽  
Kidney Injury ◽  
Clot Removal

AbstractCardiac surgery associated-acute kidney injury (AKI) is a common and a serious complication of cardiac surgery requiring cardiopulmonary bypass and it is the second most common cause of AKI in intensive care unit. Recently, two consensus conferences have suggested new diagnostic criteria to define AKI and risk score to better identify patients who will develop AKI after cardiac surgery. In fact, prompt recognition of high-risk patients could allow a more aggressive management at a reversible stage of an incoming ARF. In this case report, we have discussed a case of 21-year-old patient with bicuspid aortic valve with severe aortic stenosis with ejection fraction 15% and left ventricle (LV) clot undergoing surgery for aortic valve replacement with LV clot removal. In the postoperative period, he developed AKI that was managed successfully by early intervention by slow low efficiency dialysis and diafiltration and hemodialysis and patient discharged successfully from hospital.

Sign in / Sign up

Export Citation Format

Share Document