scholarly journals The case of an 81‐year‐old man with left toes paralysis after cardiac procedure

Author(s):  
Keng Lam ◽  
Manya Khrlobyan ◽  
Navdeep Sangha
Keyword(s):  
2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Alberto Corticelli ◽  
Maura Grimaldi ◽  
Maurizio Marasini ◽  
Francesco Croci ◽  
Valeria Trifiletti ◽  
...  

AbstractWe report a case of two consecutive pregnancies in a patient where a Fontan connection, a cardiac procedure used since 1971 to provide palliation for patients that cannot support a biventricular circulation was used. Here we analyze the anesthesiological and obstetrical aspects particularly regarding some cardiovascular problems that occurred during the pregnancy and delivery.


Author(s):  
Benyamin Rahmani ◽  
Hossein Ghanbari ◽  
Spyridon Tzamtzis ◽  
Gaetano Burriesci ◽  
Alexander M. Seifalian

Aortic valve replacement (AVR) is the second most common cardiac procedure after coronary artery bypass grafting, accounting for more than 200,000 transplantations annually worldwide [1]. Currently available mechanical and bioprosthetic heart valve replacements are not ideal as they are associated with relevant complications. The tri-leaflet polymeric heart valves (PHVs) have been widely investigated as possible alternative to these substitutes. However, the clinical application of PHVs has been limited by their suboptimal design and poor durability of available polymeric materials. This study presents a new concept of surgical aortic valve using a novel nanocomposite polymer.


2021 ◽  
Vol 10 (21) ◽  
pp. 5080
Author(s):  
Elda Dzilic ◽  
Thomas Guenther ◽  
Amel Bouziani ◽  
Bernhard Voss ◽  
Stephanie Voss ◽  
...  

Background: Tricuspid valve (TV) repair is the recommended treatment for severe functional tricuspid regurgitation (fTR) in patients undergoing left-sided surgery. For this purpose, a wide range of annuloplasty devices differing in form and flexibility are available. This study reports the results using a three-dimensional annuloplasty ring (Medtronic, Contour 3D Ring) for TV repair and analysis of risk factors. Methods: A cohort of 468 patients who underwent TV repair (TVr) with a concomitant cardiac procedure from December 2010 to January 2017 was retrospectively analyzed. Results: At follow-up, 96.1% of patients had no/trivial or mild TR. The 30-day mortality was 4.7%; it significantly differed between electively performed operations (2.7%) and urgent/emergent operations (11.7%). Risk factors for recurrent moderate and severe TR were LVEF < 50%, TAPSE < 16 mm, and moderate mitral valve (MV) regurgitation at follow-up. Preoperatively reduced renal function lead to a higher 30-day and overall mortality. Reoperation of the TV was required in six patients (1.6%). Risk factors for TV related reoperations were preoperative TV annulus over 50 mm and an implanted permanent pacemaker. Conclusions: TVr with the Contour 3D annuloplasty ring shows low TR recurrence and reoperation rates. Risk-factor analysis for the recurrence of TR revealed the importance of left- and right-ventricular function.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
oleg otlivanchik ◽  
Jenny Lu ◽  
Natalie Cheng ◽  
Daniel L Labovitz ◽  
charles esenwa ◽  
...  

Introduction: Up to 15% of all strokes occur in patients who are already hospitalized for other conditions. A validated clinical tool to help rapidly discriminate between mimics and stroke among inpatients could greatly improve acute stroke care. Recently, the 2CAN score was developed and validated at a single Midwest academic medical center to identify inpatient strokes; a score of ≥2 was highly sensitive and specific for stroke. We sought to externally validate the 2CAN score at our institution. Methods: We conducted a retrospective cohort study of consecutive inpatient stroke codes at a single Northeast academic medical center from 7/1/2018 to 11/1/2019. Pre-specified variables, including patient demographics, vascular risk factors, and clinical features (neurological examination, vital signs, laboratory values, and final diagnoses), were abstracted from the electronic medical record. We determined the sensitivity, specificity, positive and negative predictive value of a 2CAN score ≥2 for stroke (ischemic stroke, hemorrhagic stroke, or TIA) in our cohort. The 2CAN score consists of clinical deficit score (0-3 points), recent cardiac procedure (1 point), atrial fibrillation (1 point), and code called within 24 hours of admission (1 point). We used multivariate logistic regression to identify additional determinants of stroke. Results: We identified 111 inpatient stroke codes on 110 patients, mean age 67 ± 1 year, 46.8% women, and 73.8% Black or Hispanic. Final diagnosis was stroke for 54 codes (48.6%) and mimic for 57 codes (51.3%), most commonly toxic-metabolic encephalopathy. 2CAN score ≥2 had 96.3% sensitivity, 45.6% specificity, 62.7% positive predictive value, and 92.3% negative predictive value for stroke. In a multivariable logistic regression model, only recent cardiac procedure (OR: 5.5; 95% CI: 1.1-27.5) and high clinical deficit score (OR: 3.9; 95% CI: 1.9-6.1) predicted stroke. Conclusion: The 2CAN score is externally valid and helps distinguish stroke from mimic in inpatients; having a score of <2 makes stroke very unlikely.


2015 ◽  
Vol 10 (S1) ◽  
Author(s):  
JB Grau ◽  
CE Kuschner ◽  
F Giovanni ◽  
E Tormey ◽  
S Wilson ◽  
...  

JAMA ◽  
1994 ◽  
Vol 272 (16) ◽  
pp. 1251-1252
Author(s):  
R. S. Zucker

Author(s):  
Jérémy Tricard ◽  
Daniel Milad ◽  
Anaëlle Chermat ◽  
Serge Simard ◽  
Yves Lacasse ◽  
...  

Abstract OBJECTIVES The association of unstable heart disease and resectable lung cancer is rare. The impacts of staged management, cardiac surgery with cardiopulmonary bypass (CPB) versus angioplasty, on long-term survival and cancer recurrence remain debated. We report our experience using staged management. METHODS From 1997 to 2016, 107 patients were treated at the Quebec Heart and Lung Institute: 72 underwent cardiac surgery with CPB (group 1), 35 were treated with angioplasty (group 2), followed by oncological pulmonary resection. RESULTS Two postoperative deaths (3%) and 1 ischaemic heart complication (1%) were reported in group 1. One death (3%) was reported in group 2. Two-year overall survival was 82% (59/72) in group 1 and 80% (28/35) in group 2; 5-year overall survival was 62% (33/53) in group 1 and 63% (19/30) in group 2. Two-year disease-free survival in group 1 was 79% (57/72) and 77% (27/35) in group 2; 5-year disease-free survival was 58% (31/53) in group 1 and 60% (18/30) in group 2. The independent risk factors for death after thoracic surgery were transfusions (P = 0.004) and grade ≥3 complications (P = 0.034). Independent risk factors for recurrence included the cancer stage (P &lt; 0.001) and, paradoxically, a shorter delay between cardiac and lung procedures (P = 0.031). CONCLUSIONS When a staged management remains feasible after cardiac procedure, oncological outcomes of patients with cardiopathy and lung cancer are satisfactory. CPB does not seem to be deleterious. The delay between procedures should intuitively be as small as possible but not at the expense of good recovery after the cardiac procedure.


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