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Li XH, Zhang SY, Xiao F. Clinical outcomes after coronary artery bypass grafting in patients with dialysis-dependent end-stage renal disease and an analysis of the related influencing factors. Heart Vessels 2023:10.1007/s00380-023-02261-w. [PMID: 36941459 DOI: 10.1007/s00380-023-02261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
Perioperative and short/mid-term survival rates of dialysis-dependent patients with end-stage renal disease (ESRD), who undergo coronary artery bypass grafting (CABG), and the factors influencing mortality are not well evaluated In China. We retrospectively analyzed the perioperative and postoperative 1-, 3-, and 5-year survival rates of 53 dialysis-dependent ESRD patients who underwent CABG, and compared the factors related to perioperative mortality and all-cause mortality during the postoperative follow-up. Survival rates were expressed as Kaplan-Meier survival curves, and factors influencing the follow-up survival rates were analyzed using the log rank (Mantel-Cox) test. There were eight perioperative deaths, resulting in 15.1% mortality. Intraoperative intra-aortic balloon pump use (P = 0.01), advanced age (P = 0.0027), and high EuroSCORE II score (P = 0.047) were associated with increased perioperative mortality. Forty-five discharged patients were followed from 2 months to 10 years (median, 4.2 years) postoperatively. There were 19 all-cause deaths, including 10 cardiac deaths (10/19, 52.6%). Comparisons between groups indicated that the presence of peripheral artery disease (PAD) increased mortality during follow-up (P = 0.025); 1-, 3-, and 5-year survival rates were 93.3, 79.5, and 66.8%, respectively. The results of the long-rank analysis indicated that the presence of PAD was a risk factor for postoperative survival (log rank χ2 = 4.543; P = 0.033). Dialysis-dependent patients with ESRD had high perioperative mortality and unsatisfactory short- and medium-term survival after CABG. PAD was a risk factor affecting patients' postoperative survival. Multidisciplinary teamwork is needed to enhance postoperative management and reduce complications, to improve postoperative survival in these patients.
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Affiliation(s)
- Xi-Hui Li
- Department of Cardiovascular Surgery, Peking University First Hospital, Beijing, 100034, China.
| | - Si-Yu Zhang
- Department of Cardiovascular Surgery, Peking University First Hospital, Beijing, 100034, China
| | - Feng Xiao
- Department of Cardiovascular Surgery, Peking University First Hospital, Beijing, 100034, China
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Schoonen A, van Klei WA, van Wolfswinkel L, van Loon K. Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study. Front Cardiovasc Med 2022; 9:926957. [PMID: 36247457 PMCID: PMC9558721 DOI: 10.3389/fcvm.2022.926957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesLow cardiac output syndrome (LCOS) is a serious complication after cardiac surgery. Despite scientific interest in LCOS, there is no uniform definition used in current research and clinicians cannot properly compare different study findings. We aimed to collect the LCOS definitions used in literature and subsequently applied the definitions obtained to existing data to estimate their effect on the intraoperative LCOS incidences in adults, children and infants.DesignThis is a literature review, followed by a retrospective cohort study.SettingThis is a single-institutional study from a university hospital in the Netherlands.ParticipantsPatients from all ages undergoing cardiac surgery with cardiopulmonary bypass between June 2011 and August 2018.InterventionsWe obtained different definitions of LCOS used in the literature and applied these to data obtained from an anesthesia information management system to estimate intraoperative incidences of LCOS. We compared intraoperative incidences of LCOS in different populations based on age (infants, children and adults).Measurements and main resultsThe literature search identified 262 LCOS definitions, that were applied to intraoperative data from 7,366 patients. Using the 10 most frequently published LCOS definitions, the obtained incidence estimates ranged from 0.4 to 82% in infants, from 0.6 to 56% in children and from 1.5 to 91% in adults.ConclusionThere is an important variety in definitions used to describe LCOS. When applied to data obtained from clinical care, these different definitions resulted in large distribution of intraoperative LCOS incidence rates. We therefore advocate for standardization of the LCOS definition to improve clinical understanding and enable adequate comparison of outcomes and treatment effects both in daily care and in research.
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Affiliation(s)
- Anna Schoonen
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands
- *Correspondence: Anna Schoonen
| | - Wilton A. van Klei
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Anesthesia and Pain Management Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, Toronto General Hospital, Toronto, ON, Canada
| | - Leo van Wolfswinkel
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kim van Loon
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands
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Shibasaki I, Fukuda T, Ogawa H, Tsuchiya G, Takei Y, Seki M, Kato T, Kanazawa Y, Saito S, Kuwata T, Yamada Y, Haruyama Y, Fukuda H. Mid-term results of surgical aortic valve replacement with bioprostheses in hemodialysis patients. IJC HEART & VASCULATURE 2022; 40:101030. [PMID: 35434259 PMCID: PMC9011164 DOI: 10.1016/j.ijcha.2022.101030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022]
Abstract
HD patients underwent SAVR-BP for AS (hospital mortality, 8.8%; 5-year mortality, 42.1%). Preoperative risk factors for 5-year mortality: age, hyperlipidemia, LVDd, LVDs, and Japan SCORE. Postoperative risk factors for 5-year mortality: length of ICU stay, and albumin level at discharge.
Background Limited studies have assessed the factors affecting prognosis in hemodialysis (HD) patients who undergo surgical aortic valve replacement with a bioprostheses (SAVR-BP). This study aimed to evaluate the outcomes of HD patients who had undergone SAVR-BP for aortic stenosis (AS) and identify the risk factors for mortality. Methods This retrospective study included 57 HD patients who had undergone SAVR-BP for AS between July 2009 and December 2020. Multivariate logistic regression was used to predict factors associated with mid-term outcomes and death or survival. Kaplan − Meier curves were also generated for mid-term survival. Results The in-hospital mortality rate was 8.8%, and the 5-year mortality rate was 42.1%. The independent predictors of 5-year mortality were preoperative age (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.175–2.083, p = 0.002), hyperlipidemia (HR, 0.02; 95% CI, 0.002–0.297, p = 0.004), left ventricular diastolic diameter (HR, 1.74; 95% CI, 1.142–2.649, p = 0.010), left ventricular systolic diameter (HR, 0.61; 95% CI, 0.392–0.939, p = 0.025), and Japan SCORE (HR, 1.28; 95% CI, 1.052–1.563, p = 0.014). The postoperative predictors included intensive care unit stay (HR, 1.11; 95% CI, 1.035–1.194, p = 0.004) and albumin level (HR, 0.38; 95% CI, 0.196–0.725, p = 0.003). Conclusions The 5-year prognosis of HD patients undergoing SAVR may be improved by early diagnosis (before the occurrence of LV hypertrophy/enlargement) and nutritional management with oral intake to alleviate postoperative hypoalbuminemia. Registration number of clinical studies: UMIN000047410.
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Blumenfeld O, Dichtiar R, Sharoni E, Leviner DB. Outcomes of cardiac surgery in patients with end-stage renal disease: Insights from the Israel national registries. J Card Surg 2022; 37:760-768. [PMID: 35112395 DOI: 10.1111/jocs.16254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/17/2021] [Accepted: 11/02/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND End-stage renal disease (ESRD) has been shown to be associated with increased mortality in patients undergoing cardiac surgery. We aimed to compare the short- and mid-term mortality after cardiac surgery of patients with dialysis-dependent ESRD (DD-ESRD) to patients with normal renal function (NRF), using national registries: the ESRD registry, the adult cardiac surgery registry (ACSR), and the National Mortality Registry. METHODS The study population comprised 8207 adult patients who underwent either isolated coronary artery bypass grafting (CABG), isolated aortic valve replacement (AVR), isolated mitral valve replacement (MVR), or CABG + valve-related procedure, between January 2017 and April 2019. Data were retrospectively extracted and reported to the ACSR by the department of medical records of each medical center. RESULTS One hundred and four DD-ESRD patients (mean age 63.2 ± 8.8 years, 83.7% males) were compared with 8103 NRF patients (mean age 64.9 ± 9.8 years, 77.6% males). Median follow-up for the total cohort was of 32.0 months (IQR; 25.0, 40.0). In DD-ESRD compared to NRF patients, 30-day mortality was higher (14.4% vs. 2.3%, respectively, p = 0.0001) and 4-year survival was significantly lower (44% ± 0.06 vs. 91% ± 0.04, respectively, p = 0.0001). Fifty-three percent of DD-ESRD 30-day mortality was caused by sepsis. Risk factors associated with reduced midterm survival included: DD-ESRD patients (HR = 4.7, 95% CI; 1.2-18.2), MVR procedure (HR = 1.5, 95% CI; 1.04-2.1) and combined CABG + valve-related procedure (HR = 1.6, 95% CI; 1.2-2.04). CONCLUSIONS Preoperative DD-ESRD was associated with a significant increase in 30-day and mid-term mortality after cardiac surgery. The highest mortality rate was observed in valvular and combined procedures.
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Affiliation(s)
- Orit Blumenfeld
- Israel Center for Disease Control, Ministry of Health, Jerusalem, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Ministry of Health, Jerusalem, Israel
| | - Erez Sharoni
- Cardiac surgery department, Carmel Medical center, Haifa, Israel
| | - Dror B Leviner
- Cardiac surgery department, Carmel Medical center, Haifa, Israel
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Sekino M, Okada K, Funaoka H, Sato S, Ichinomiya T, Higashijima U, Matsumoto S, Yoshitomi O, Eishi K, Hara T. Association between Enterocyte Injury and Mortality in Patients on Hemodialysis Who Underwent Cardiac Surgery: An Exploratory Study. J Surg Res 2020; 255:420-427. [DOI: 10.1016/j.jss.2020.05.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 12/26/2022]
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Aljohani S, Alqahtani F, Almustafa A, Boobes K, Modi S, Alkhouli M. Trends and Outcomes of Aortic Valve Replacement in Patients With End-Stage Renal Disease on Hemodialysis. Am J Cardiol 2017; 120:1626-1632. [PMID: 28882333 DOI: 10.1016/j.amjcard.2017.07.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/30/2017] [Accepted: 07/10/2017] [Indexed: 11/29/2022]
Abstract
Hemodialysis (HD) patients with aortic stenosis are less likely to undergo aortic valve replacement (AVR) due to their excess perioperative mortality. We aimed to evaluate contemporary utilization and outcomes of combined and isolated AVR in HD patients. The Nationwide Inpatient Sample was used to identify 142,046 patients who underwent AVR in 2005 to 2014, of whom 2,264 (1.6%) were on HD. Crude and adjusted in-hospital outcomes and costs were assessed in unmatched and propensity-matched cohorts of HD and non-HD patients, respectively. The utilization of AVR in HD patients increased significantly (p = 0.047), with a significant decrease in mortality (p = 0.013). Compared with patients not on HD, crude in-hospital mortality in HD patients was twice higher (11.8% vs 6.2%, p <0.0001). HD patients had more blood transfusion and a trend toward more strokes. Lengths of stay and hospital charges, and rates of nonhome discharges were also higher in the HD group. In the propensity-matched cohorts of HD versus non-HD patients, in-hospital mortality rates after AVR remained twofold higher in the HD group (8.1% vs 3.9%, p <0.001). Rates of blood transfusion, cardiac tamponade, length of stay, hospital charges, and nonhome discharges were also higher in HD patients. In conclusion, AVR utilization in HD patients increased and its associated mortality decreased over the last decade. However, AVR mortality in HD patients remained twofold higher compared with non-HD patients. Also, AVR in HD patients was associated with higher cost, longer hospitalizations, and more frequent nonhome discharges.
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Affiliation(s)
- Sami Aljohani
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Fahad Alqahtani
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Ahmad Almustafa
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Khaled Boobes
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sujal Modi
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia
| | - Mohamad Alkhouli
- Department of Medicine, Division of Cardiovascular Diseases, West Virginia University Heart & Vascular Institute, Morgantown, West Virginia.
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Condado JF, Maini A, Leshnower B, Thourani V, Forcillo J, Devireddy C, Mavromatis K, Sarin EL, Stewart J, Guyton R, Simone A, Keegan P, Lerakis S, Block PC, Babaliaros V. End-stage renal disease and severe aortic stenosis: Does valve replacement improve one-year outcomes? Catheter Cardiovasc Interv 2017; 89:1109-1115. [DOI: 10.1002/ccd.26875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 10/08/2016] [Accepted: 11/06/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Jose F. Condado
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Aneel Maini
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Bradley Leshnower
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - Vinod Thourani
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - Jessica Forcillo
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - Chandan Devireddy
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Kreton Mavromatis
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Eric L. Sarin
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - James Stewart
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Robert Guyton
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - Amy Simone
- Divisions of Cardiothoracic Surgery; Emory University School of Medicine; Atlanta Georgia
| | - Patricia Keegan
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Stamatios Lerakis
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Peter C. Block
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
| | - Vasilis Babaliaros
- Structural Heart and Valve Center; Divisions of Cardiology, Emory University School of Medicine; Atlanta Georgia
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Nasr R, Chilimuri S. Preoperative Evaluation in Patients With End-Stage Renal Disease and Chronic Kidney Disease. Health Serv Insights 2017; 10:1178632917713020. [PMID: 35185335 PMCID: PMC8848094 DOI: 10.1177/1178632917713020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 05/11/2017] [Indexed: 11/17/2022] Open
Abstract
Optimal preoperative management of dialysis patients remains challenging. Patients with end-stage renal disease (ESRD) have higher mortality in the perioperative setting compared with non-ESRD patients. However, it is well established that dialysis should be done on the day before surgery. Additional dialysis session prior to surgery does not improve outcomes. All dialysis patients should undergo blood work to check electrolytes and especially serum potassium prior to any surgery. Some medications, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics, should be stopped prior to surgery to minimize hemodynamic changes during surgery. The dialysis access should be carefully examined for any signs of infection. The arteriovenous fistula or graft should be evaluated for patency. Glycemic control in diabetic ESRD and chronic kidney disease patients is very important, and clinicians should be aware of the risk of bleeding and the appropriate analgesics that can be used in dialysis patients in the perioperative setting. In conclusion, preoperative evaluation in patients with ESRD should be a multidisciplinary approach.
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Affiliation(s)
- Rabih Nasr
- Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA
| | - Sridhar Chilimuri
- Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA
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Cappabianca G, Ferrarese S, Musazzi A, Terrieri F, Corazzari C, Matteucci M, Beghi C. Predictive factors of long-term survival in the octogenarian undergoing surgical aortic valve replacement: 12-year single-centre follow-up. Heart Vessels 2016; 31:1798-1805. [PMID: 26843194 DOI: 10.1007/s00380-016-0804-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/22/2016] [Indexed: 11/27/2022]
Abstract
The improvement of life expectancy created more surgical candidates with severe symptomatic aortic stenosis and age >80. Therefore, the main objective of this observational, retrospective single-centre study is to compare the long-term survival of octogenarians that have undergone surgical aortic valve replacement (AVR) to the survival of the general population of the same age and to establish whether any perioperative characteristics can anticipate a poor long-term result, limiting the prognostic advantage of the procedure at this age. From 2000 to 2014, 264 octogenarians underwent AVR at our institution. Perioperative data were retrieved from our institutional database and patients were followed up by telephonic interviews. The follow-up ranged between 2 months and 14.9 years (mean 4.1 ± 3.1 years) and the completeness was 99.2 %. Logistic multivariate analysis and Cox regression were respectively applied to identify the risk factors of in-hospital mortality and follow-up survival. Our patient population ages ranged between 80 and 88 years. Isolated AVR (I-AVR) was performed in 136 patients (51.5 %) whereas combined AVR (C-AVR) in 128 patients (48.5 %). Elective procedures were 93.1 %. Logistic EuroSCORE was 15.4 ± 10.6. In-hospital mortality was 4.5 %. Predictive factors of in-hospital mortality were the non-elective priority of the procedure (OR 5.7, CI 1.28-25.7, p = 0.02), cardiopulmonary bypass time (OR 1.02, CI 1.01-1.03, p = 0.004) and age (OR 1.36, CI 1.01-1.84, p = 0.04). Follow-up survival at 1, 4, 8 and 12 years was 93.4 % ± 1.6 %, 72.1 % ± 3.3 %, 39.1 % ± 4.8 % and 20.1 % ± 5.7 %, respectively. The long-term survival of these patients was not statistically different from the survival of an age/gender-matched general population living in the same geographic region (p = 0.52). Predictive factors of poor long-term survival were diabetes mellitus (HR 1.55, CI 1.01-2.46, p = 0.05), preoperative creatinine >200 μmol/L (HR 2.07, CI 1.21-3.53, p = 0.007) and preoperative atrial fibrillation (HR 1.79, CI 1.14-2.80, p = 0.01). In our experience, AVR can be safely performed in octogenarians. After a successful operation, the survival of these patients returns similar to the general population. Nevertheless, the preoperative presence of major comorbidities such as diabetes mellitus, renal dysfunction and atrial fibrillation significantly impact on long-term results.
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Affiliation(s)
- Giangiuseppe Cappabianca
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
| | - Sandro Ferrarese
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
| | - Andrea Musazzi
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
| | - Francesco Terrieri
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
| | - Claudio Corazzari
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
| | - Matteo Matteucci
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
| | - Cesare Beghi
- Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Viale Borri 57, 21100, Varese, Italy
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Heart valve surgery in hemodialysis-dependent patients: nutrition status impact on surgical outcome. J Artif Organs 2016; 19:134-40. [DOI: 10.1007/s10047-015-0883-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 12/26/2015] [Indexed: 10/22/2022]
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Zuo M, Gao J, Zhang X, Cui Y, Fan Z, Ding M. Capillary electrophoresis with electrochemiluminescence detection for the simultaneous determination of cisatracurium besylate and its degradation products in pharmaceutical preparations. J Sep Sci 2015; 38:2332-9. [DOI: 10.1002/jssc.201500092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/03/2015] [Accepted: 04/03/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Ming Zuo
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
| | - Jieying Gao
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
| | - Xiaoqing Zhang
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
| | - Yue Cui
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
| | - Zimian Fan
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
| | - Min Ding
- Key Laboratory of Clinical Laboratory Diagnostics, Ministry of Education; College of Laboratory Medihaocine, Chongqing Medical University; Chongqing China
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Klváček A, Šantavý P, Zuščich O, Konečný J, Hájek R, Lonský V. Five-year experience with cardiac surgery procedures in dialysis-dependent patients. COR ET VASA 2015. [DOI: 10.1016/j.crvasa.2015.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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AlWaqfi N, Khader Y, Ibrahim K. Coronary artery bypass: predictors of 30-day operative mortality in Jordanians. Asian Cardiovasc Thorac Ann 2012; 20:245-51. [PMID: 22718710 DOI: 10.1177/0218492311434647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To determine the risk factors and rate of 30-day operative mortality among Jordanian patients undergoing isolated coronary artery bypass surgery, we reviewed the records (January, 2005 to July, 2009) of 1,046 consecutive patients. Demographic and perioperative data were analyzed by univariate and multivariate analysis. The 30-day operative mortality rate was 5.9%. Significant independent predictors of death were age>65 years, female sex, heart failure, ejection fraction≤35%, prolonged inotropic support, mechanical ventilation>12 h, postoperative pneumonia, and postoperative stroke. The 30-day operative mortality rate was comparable to that reported in other countries.
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Affiliation(s)
- Nizar AlWaqfi
- Princess Muna Heart Center, Department of General Surgery, Jordan University of Science and Technology and King Abdullah University Hospital, Irbid, Jordan.
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Abstract
We describe a simple technique for left ventricular aneurysm without ventriculotomy. After confirming there is no thrombus in the left ventricular aneurysm, the aneurysm is pushed into the left ventricle and fixed with horizontal mattress sutures and running vertical sutures. This technique has quite low risk of bleeding.
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