scholarly journals Report of the Second Bi-monthly Virtual Meeting of the Iranian Society of Cardiac Surgeons: Investigation of Three Interesting Cases

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Yaser Toloueitabar ◽  
Mohammad Reza Mirzaaghayan ◽  
Amir Nasser Jadbabaei ◽  
Sanaz Asadian
Keyword(s):  
Cardiac Surgery ◽  
Regular Meeting ◽  
Virtual Meeting ◽  
Cardiac Surgeons

: The Iranian society of cardiac surgeons (ISCS) has been holding a regular meeting every two months since 2005. This is the report of one of the mentioned meetings in which three interesting cardiac surgery cases were presented and discussed.

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

Air Embolism on Cardiopulmonary Bypass

2019 ◽  
pp. 160-165
Author(s):  
Aaron Hudson ◽  
Ryan Hood
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Cardiopulmonary Bypass ◽  
Sudden Death ◽  
Air Embolism ◽  
Cardiac Surgical Procedures ◽  
Daily Basis ◽  
Team Members ◽  
Cardiac Surgeons ◽  
Almost All

The danger associated with air embolism in cardiac surgery has been well established for over 125 years. In the first volume of Annals of Surgery, published in 1885, long preceding the era of cardiac surgery and the use of extracorporeal circulatory techniques, Dr. Nicholas Senn alluded to the ensuing calamity caused by air embolism: “I intend on this occasion to call your attention to one of the most dreaded and, I may add, one of the most uncontrollable causes of sudden death—I allude to air-embolism.”1,2 Since the advent of modern cardiac surgery, much attention has been focused on the prevention of air embolism by cardiac surgeons, anesthesiologists, and perfusionists alike. Indeed, all three team members are critically responsible for the safe conduct of thousands of cardiac surgical procedures occurring on a daily basis worldwide. While the morbidity and mortality of massive air embolism is exceedingly high, most believe that with appropriate training and unwavering vigilance during clinical practice, almost all massive air emboli can be prevented.3

Pediatric cardiac surgery in Indonesia

1998 ◽  
Vol 8 (4) ◽  
pp. 437-439 ◽  
Author(s):  
Toshihide Asou ◽  
Jusuf Rachmat
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Outcome ◽  
Congenital Heart ◽  
Pediatric Cardiac Surgery ◽  
Cardiac Surgeons ◽  
Cardiac Center ◽  
Doctors And Nurses ◽  
At Home

AbstractPediatric cardiac surgery in Indonesia first developed thanks to the cooperation of various cardiac centers abroad. The establishment of the ‘Harapan Kita’ National Cardiac Center in 1985 was one of the most important initial steps. Thereafter, the discipline advanced remarkably in terms of the number of the operations performed and the variety of the diseases treated and, as a result, the surgical outcome also improved. Numerous problems remain to be solved. Only 1% of the children with congenital heart disease are today properly treated in Indonesia. Some of the underlying problems responsible for this situation include a shortage of pediatric cardiac professionals, the lack of the information and education on the part of the patients, and a shortage of funding, both privately and publicly. It would thus be welcome for pediatric cardiac surgeons, cardiologists and nurses in Indonesia to learn about congenital heart disease from doctors and nurses in advanced countries in order to improve the outlook at home.

scholarly journals Stuck Between a Rock and a Hard Place: The Clinical Conundrum of Managing Cardiac Surgical Patients During the SARS-CoV-2 Pandemic

2021 ◽  
Author(s):  
Nitish Dhingra ◽  
Subodh Verma ◽  
Terrence Yau ◽  
Bobby Yanagawa ◽  
Makoto Hibino
Keyword(s):  
Cardiac Surgery ◽  
Patient Outcomes ◽  
Policy Development ◽  
Surgical Patients ◽  
Clear Understanding ◽  
Italian Population ◽  
Surgery Outcomes ◽  
Cardiac Surgeons ◽  
Cardiac Surgery Outcomes ◽  
Hard Place

Deferring non-emergent cardiac surgery became the strategy of choice for several international healthcare systems afflicted by high case burdens of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) in order to both conserve valuable healthcare resources and protect patients from possible exposure. Missing from the available dataset to help guide policy development has been a clear understanding of the extent to which COVID-19 infection modulates cardiac surgery outcomes. In their investigation, Bonalumi and colleagues uncovered an inpatient COVID-19 positivity rate of almost 10 times higher than that of the general Italian population, as well as a mortality rate over 20 times higher amongst cardiac surgery patients with perioperative COVID-19 infection compared to those COVID-negative. While the summation of available evidence points to the serious consideration cardiac surgeons must give to delaying surgeries during the COVID-19 pandemic, recognition must be given to the risks that postponing cardiac surgery may have on patient outcomes. Emerging data is beginning to demonstrate the efficacy of vaccination in preventing postoperative COVID-19 infection and morbidity.

scholarly journals Impact of Advances in Invasive Cardiology on Cardiac Surgery

2009 ◽  
Vol 3 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Ahmed A Alsaddique
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Catheterization ◽  
Early Years ◽  
Catheterization Laboratory ◽  
Coronary Artery Revascularization ◽  
Cardiac Catheterization Laboratory ◽  
Invasive Cardiology ◽  
Number Of Patients ◽  
The Future ◽  
Cardiac Surgeons

Background: There is a noticeable decline in the number of patients who undergo coronary artery revascularization procedures. The change is definite as it is reported by many centers around the world. This trend is of great concern to cardiac surgeons because of its impact on their practice, its adverse effect on training and the degree of uncertainty it throws into future of the specialty. Methods: The data of the cardiac catheterization laboratory at the King Fahad Cardiac Center in the period between 1986 and 2006 was examined looking at the changing pattern of management of patients who undergo cardiac catheterization. Results: In the early years, angioplasty was attempted in around 10% of patients leaving the rest for surgical consideration or medical therapy. Currently only 15% of patients who undergo selective coronary angiography are referred for surgery. The majority are offered angioplasty and stenting. The trend is towards more catheter-based interventions and less towards surgery. Conclusions: Our findings are in agreement with the general consensus about the specialty. Cardiac surgeons should perhaps consider acquiring new skills which may be outside the operating room. Adding catheter based intervention particularly in valves to cardiac surgery training would be a bonus for the future surgeons that will give them the necessary edge to meet the new challenges. It is incumbent on the leaders in the field to establish a clear strategy for the future. Mini-Abstract: Impact of advances in invasive cardiology on cardiac surgery, based on actual analysis of the pattern of referrals to surgery of over two decades.

Core Concepts in Cardiac Surgery

2018 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Relevant Literature ◽  
Controversial Issues ◽  
Surgical Trainees ◽  
Core Concepts ◽  
Lung Failure ◽  
Cardiac Surgeon ◽  
The Individual ◽  
Cardiac Surgeons

This textbook provides the reader with up-to-date concepts in cardiac surgery encompassing many of its subdisciplines, including coronary artery surgery and conduit choice, valvular heart surgery, minimally invasive approaches, and surgery for heart and lung failure. It includes concise reviews of the relevant literature in addition to important technical details. The individual chapters are written by internationally renowned experts in their respective fields, providing the practicing cardiac surgeon with current updates in the specialty, and also covering controversial issues that would have a direct impact in everyday practice. This textbook is an invaluable resource for senior cardiac surgical trainees and practicing cardiac surgeons.

Heart and Mitochondria: Pathophysiology and Implications for Cardiac Surgeons

2017 ◽  
Vol 66 (01) ◽  
pp. 011-019 ◽  
Author(s):  
Michael Schwarzer ◽  
Susanne Rohrbach ◽  
Bernd Niemann
Keyword(s):  
Cardiac Surgery ◽  
Ischemia Reperfusion ◽  
Systemic Circulation ◽  
Cardiac Damage ◽  
Protective Mechanisms ◽  
Ischemic Conditioning ◽  
Disease States ◽  
Similar Disease ◽  
Myocardial Ischemia Reperfusion ◽  
Cardiac Surgeons

Excluding the heart from systemic circulation during cardiac surgery renders the myocardium ischemic, resulting in cardiac damage. In addition, another hit to the myocardium will occur upon restoration of blood flow, in the reperfusion phase. Experimental data from animal models have revealed that loss of cardiac metabolic flexibility and mitochondrial dysfunctions contributes to contractile impairment in hypertrophied, failing, obese, and diabetic hearts. Such diseased hearts are prone to myocardial ischemia–reperfusion (I/R) injury. Although analyses in human cardiac samples are not as comprehensive as animal data, similar disease-associated metabolic and mitochondrial changes exist. Considering increasing age and comorbidities in patients nowadays, it is not surprising that I/R injuries remain a major cause of morbidity and mortality after cardiac surgery. Mitochondria have emerged as critical targets but also key regulators of myocardial I/R injury, and the extent of mitochondrial damage is a major determinant of myocardial I/R injury. Although cardioprotective mechanisms are diverse, many come together and involve steps at the point of mitochondria. We will, therefore, provide a description of mitochondrial alterations observed in various cardiac disease states and discuss the current experimental knowledge of the role of mitochondria in I/R and of potential protective mechanisms against myocardial I/R injury involving mitochondria. Within this review, we will focus on the protection against I/R injury conferred by caloric restriction (CR) and by ischemic conditioning. Further research is needed to establish whether strategies targeting mitochondria, which have been proposed from preclinical studies, could be translated into cardioprotective therapies against I/R injury in patients.

Do We Need Basic Research in Cardiac Surgery?

2016 ◽  
Vol 66 (01) ◽  
pp. 002-006 ◽  
Author(s):  
Christian Schlensak ◽  
David Schibilsky ◽  
Gloria Faerber ◽  
Torsten Doenst
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Basic Science ◽  
Basic Research ◽  
Daily Practice ◽  
Western Blots ◽  
Daily Work ◽  
Chain Reactions ◽  
Polymerase Chain Reactions ◽  
Cardiac Surgeons

Thinking about the daily practice of cardiac surgery, genetically altered mouse models, polymerase chain reactions, western blots, and other laboratory tools are the last that comes to mind. It is, therefore, not surprising that the pursuit of such basic science activities by practicing surgeons and those in training is often limited. However, there is an innate connection between these two seemingly different disciplines. To address and visualize this connection, we propose the following three hypotheses. First, cardiac surgery would not be at its present level of expertise without fundamental contributions of basic science. Second, without practicing cardiac surgeons performing basic research and translating their results to clinical practice next to their daily work, our ability to care for cardiac surgery patients would be poorer. Third, basic science training for those aiming to become practicing cardiac surgeons improves their ability to properly care for their patients. Finally, we will discuss some potentially even unexpected implications for our currently changing daily clinical practice.

scholarly journals Multidisciplinary Surgery in Thoracic Wall Reconstruction for Sternal Osteomyelitis

2016 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Anil Gokce ◽  
Seyhan Babaroglu ◽  
Hasan Murat Ergani ◽  
Yucel Akkas
Keyword(s):  
Cardiac Surgery ◽  
Pectoral Muscle ◽  
Thoracic Wall ◽  
Large Defect ◽  
Muscle Flaps ◽  
Sternal Osteomyelitis ◽  
Thoracic Wall Reconstruction ◽  
Cardiac Surgeons ◽  
Extensive Deformation

Sternal osteomyelitis and dehiscence are a common problem with an incidence rate of 0.5% to 5.0% after major cardiac surgery. However, the management of separation of the sternum in the patient's thorax remains a challenge for cardiac surgeons and thoracic surgeons using the incision. After cardiac surgery, post-op sternal dehiscence and osteomyelitis was developed in the patient. The old steel wires were removed and the sternum was resected due to long-term infection and extensive deformation of the sternum. Pectoralis muscle flaps were partially mobilized and adducted. The large defect was closed using a large prolene patch. Proper sized transversal titanium plates were selected. Due to the sternum bone was severely destroyed by infection, longer transversal titanium plates were chosen to achieve thoracic stability. Healthy tissues were detected on the ribs. A total of 4 titanium plates were placed intermittently. The plates were fixed to the ribs with titanium locking screws. The pectoral muscle flaps adducted to the plates by the plastic surgery team. A total of 3 drains were placed, one in the mediastinum and two between the thoracic wall and muscle structures.

scholarly journals Reoperative Cardiac Surgery – Part II

2018 ◽  
Vol 21 (2) ◽  
pp. 124 ◽  
Author(s):  
Curtis G Tribble
Keyword(s):  
Cardiac Surgery ◽  
Surgical Case ◽  
Reoperative Cardiac Surgery ◽  
Cardiac Surgeons

The preparation for a reoperative cardiac surgical case was covered in Part I of this two part review [Tribble 2018]. Part II will cover primarily intraoperative strategies and techniques.  As noted in Part I, there has been surprisingly little written about the strategies and techniques of reoperative cardiac surgery. Thus, the goal of this two-part review is to collect and collate some of the lessons, abjurations, and tenets related to reoperative cardiac surgery that may be valuable to cardiac surgeons, especially those in training or early in their careers.Some time-honored admonitions that can apply to all complex operations, often enunciated by “old salts,” bear repeating:•  Everything matters. Nothing is neutral.•  Some say that a “life or death” decision is made, on average, every 10 seconds during cardiac surgery. •  If something can go wrong, presume that it will.•  If it seems absolutely impossible for something to go wrong, it will anyway, at least some of the time.•  When something does go wrong, it generally does so all at once.•  If what you are doing is working, keep on doing it. If it ain’t working, do something else.

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