open heart
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2022 ◽  
Vol 271 ◽  
pp. 106-116
Maj Stenmark ◽  
Edin Omerbašić ◽  
Måns Magnusson ◽  
Viktor Andersson ◽  
Martin Abrahamsson ◽  

2022 ◽  
Vol 30 (1) ◽  
Malene S. Enevoldsen ◽  
Per Hostrup Nielsen ◽  
J. Michael Hasenkam

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.

2022 ◽  
Vol Publish Ahead of Print ◽  
Elisa Mikus ◽  
Simone Calvi ◽  
Alberto Albertini ◽  
Alberto Tripodi ◽  
Fabio Zucchetta ◽  

Symmetry ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 81
Bogdan Mocan ◽  
Claudiu Schonstein ◽  
Calin Neamtu ◽  
Mircea Murar ◽  
Mircea Fulea ◽  

Following cardiac surgery, patients experience difficulties with the rehabilitation process, often finding it difficult, and therefore lack the motivation for rehabilitation activities. As the number of people aged 65 and over will rise by 207 percent globally by 2050, the need for cardiac rehabilitation will significantly increase, as this is the main population to experience heart problems. To address this challenge, this paper proposes a new robotic exoskeleton concept with 12 DoFs (6 DoFs on each arm), with a symmetrical structure for the upper limbs, to be used in the early rehabilitation of cardiac patients after open-heart surgery. The electromechanical design (geometric, kinematic, and dynamic model), the control architecture, and the VR-based operating module of the robotic exoskeleton are presented. To solve the problem of the high degree of complexity regarding the CardioVR-ReTone kinematic and dynamic model, the iterative algorithm, kinetic energy, and generalized forces were used. The results serve as a complete model of the exoskeleton, from a kinematic and dynamic point of view as well as to the selection of the electric motors, control system, and VR motivation model. The validation of the concept was achieved by evaluating the exoskeleton structure from an ergonomic point of view, emphasizing the movements that will be part of the cardiac rehabilitation.

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Sarah Nicole Fernández ◽  
Blanca Toledo ◽  
Jesús Cebrián ◽  
Ramón Pérez-Caballero ◽  
Jesús López-Herce ◽  

Continuous incisional lidocaine infusion has been proposed as an adjunctive therapy in the management of postoperative pain in adult patients. The aim of this study was to determine the efficacy and safety of a continuous subcutaneous lidocaine infusion in pediatric patients following open heart surgery. All patients receiving a subcutaneous lidocaine infusion in median sternotomy incisions after open heart surgery during 2 consecutive years were included in the study. A historical cohort of patients was used as a control group. Demographic variables (age, size, and surgical procedure), variables related to sedation and analgesia (COMFORT and analgesia scales, drug doses, and duration), and complications were registered. 106 patients in the lidocaine infusion group and 79 patients in the control group were included. Incisional analgesia was effective for the treatment of pain as it reduced the dose and duration of intravenous fentanyl (odds ratio (OR) 6.26, confidence interval (CI) 95%: 2.48-15.97, p = 0.001 ; OR 4.30, CI 95%: 2.09-8.84, p = 0.001 , respectively). The reduction in fentanyl use was more important in children over two years of age. Adverse effects were seen in three children (2.8%): they all had decreased level of consciousness, and one of them presented seizures as well. Two of these three patients had lidocaine levels over 2 mcg/ml. A continuous lidocaine incisional infusion is effective for the treatment of pain after open heart surgery. This procedure reduced intravenous analgesic drug requirements in pediatric patients undergoing a median sternotomy incision. Although the incidence of secondary effects is low, monitoring of neurologic status and lidocaine blood levels are recommended in all patients.

Cureus ◽  
2022 ◽  
Darlene R Deters ◽  
John Hunninghake ◽  
Judy Ruiz ◽  
Deborah J Marquez ◽  
Deborah J Ramirez ◽  

2022 ◽  
Vol 16 (1) ◽  
pp. 17
JunHyun Kim ◽  
MinHee Heo ◽  
JiYeon Kim ◽  
BeomIl Park ◽  
SangIl Lee ◽  

Vu Thi Thuc Phuong ◽  
Bui Duc Tam ◽  
Tran Cong Thanh

Pain after cardiac surgery is always an obsession of patients and a top concern of anesthesiologists. Experimental subjects challenged by acute pain and patients in chronic pain experience impairments in attention control, working memory, mental flexibility, problem solving, and information processing speed. The two most commonly used analgesia methods are patient-controlled analgesia (PCA) and erector spinea plane block (ESP). Our study aimed to compare the analgesic effect of ESP with PCA in patients after cardiac surgery using extracorporeal circulation and evaluate the disavantages of these two pain relief techniques. Subject and methods: This study was a randomized controlled intervention study of adult patients who underwent open-heart surgery patients with extracorporeal circulation from May 2020 to September 2021 in the Department of Anesthesiology and Intensive Care Unit - Hanoi Heart Hospital. Results: Two hundred and four (204) consecutive patients were collected, included 108 patients in the ESP group and 96 patients in the PCA group. The mean intraoperative fentanyl amount in the ESP group (0.57±0.50 mg) was lower than in the PCA group (1.00±0.00 mg) (p<0.05). The average VAS score when the patient was lying still and taking deep breaths at the time of assessment in both groups was below 3 (corresponding to low pain level) (p>0.05). The mean morphin consumption 24 hours after surgery was significantly lower in the ESP group (0,23±0,12 mg) than in the PCA group (17,92±3,32 mg) (p<0.05). The mean time after surgery in the ESP group (3.80±1.02 hours) and the PCA group (5.21±1.10 hours) had a clear difference between p<0.05. The mean time of extubation in the ESP group (8.06±1.60 hours) was statistically significantly lower than in the PCA group (8.83±1.43 hours) (p<0.05). The rate of nausea in the ESP group (20.98%) was lower than in the PCA group (58.33%) (p<0.05). Conclusion: Both methods had good analgesic effect with an average VAS score ≤ 3. The ESP group had a lower mean postoperative morphine consumption, a higher patient satisfaction level, and a lower rate of nausea, vomiting, and slow breathing statistically significant less than the PCA group.

Mehmet Erdem Toker ◽  
Cüneyt Arkan ◽  
Ahmet Erdal Taşçi ◽  
Erdal Polat ◽  
Üzeyi̇r Yilmaz ◽  

Objectives: Active cancer and heart disease, which share similar environmental and biological characteristics, can occur concomitantly. Open heart surgery may be required for these patients when indicated. The aim of this study is to demonstrate the early and long-term results and discuss the intervention strategy in patients with different types of active malignancies, who underwent open heart surgery. Patients and Methods: Between January 2012 and May 2020, open heart surgery was performed on 10 patients with active malignancies. The mean age was 65.5 (52–77), and 4 of the patients were female. 2 patients were operated emergently due to advanced pleural effusion. AVR+CABG, CABG, CABG+left upper lobectomy and AVR+MVR were performed in 4 patients with lung cancer; AVR+CABG were performed in 1 patient with colon cancer; CABG was performed in 4 patients each with one of the following conditions: lymphoma, breast cancer, essential thrombocytosis, meningioma); and mass resection operation from the left atrium and left ventricle was performed in one patient with osteosarcoma. Results: 8 patients were discharged and 2 patients died in the early postoperative period. Postoperative left hemiparesis developed in 1 patient. 6-month, 1-year and 5-year survival rates were 79%, 37.5% and 25%, respectively. Conclusion: Open heart surgery can be successfully performed with acceptable mortality and morbidity rates on the high-risk patient group with active cancer. We believe that, where percutaneous coronary intervention and/or TAVI are not considered or deemed appropriate, surgical intervention should be performed with careful patient selection in patients with multi-vessel coronary artery disease, coronary artery stenosis +aortic stenosis, and in cases requiring double valve replacement.

2021 ◽  
pp. 41-44
L. G. Kudryavtseva ◽  
P. V. Lazarkov ◽  
V. I. Sergevnin

Purpose of the study. Comparative assessment of the incidence of nosocomial purulent-septic infections (PSI) in children after open and closed heart surgery for congenital defects.Materials and methods. 503 medical records of children after cardiac surgery were studied. GSI was identified according to epidemiological standard case definitions.Results. It turned out that the incidence rate of PSI in children after open heart surgery is an order of magnitude higher than after minimally invasive endovascular interventions. Hospital-acquired pneumonia most often occurs in children after operations.Conclusion. The increased incidence of PSI after open heart surgery, as compared to endovascular surgery, is due to a longer surgical intervention and the subsequent longer stay of patients in the intensive care unit, where such an epidemiologically significant procedure as artificial lung ventilation is performed.

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