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Cardiac Arrythmias
Published in Charles Theisler, Adjuvant Medical Care, 2023
Ascorbic Acid: Postoperative patients in whom AF develops have an increased incidence of strokes and perioperative myocardial infarction, are prone to development of congestive heart failure and respiratory failure, and thus are at an increased risk of mortality. The role of vitamin C was studied in 100 randomized patients undergoing coronary bypass surgery.11 Half received ascorbic acid and a ß-blocker preoperatively and postoperatively, and the other half received only a ß-blocker. The group that received both vitamin C and a ß-blocker had a 4% incidence of AF compared with 25% in the control group. Additional studies have reported similar findings. In a 2005 study on the role of vitamin C in the prevention of early recurrence of AF following cardioversion, AF recurred in 4.5% of patients pretreated with vitamin C, compared with 36.3% in the control group. The control group treated with vitamin C had a significant reduction in serum inflammatory indices, such as white blood cell count, fibrinogen level, and level of C-reactive protein. Taking vitamin C before and for a few days after heart surgery helps prevent irregular heartbeat after heart surgery.12
Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
One technologically dependent class of patient is the patient who has undergone open heart coronary artery bypass grafting, or CABG surgery. These patients, immediately postoperatively, are unable to sustain spontaneous respiration because of the various anesthetic, analgesic, and paralytic agents they receive during surgery which are still present within their systems postoperatively. Furthermore, in traditional open-heart surgery, the heart and lungs are usually stopped during the bypass grafting procedure. Hence, by procedure’s end, patients are not normally breathing spontaneously and are completely dependent upon life-sustaining mechanical ventilation to maintain respiratory function.
Mechanisms of action for estrogen in cardioprotection
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
With the progress in diagnostic and surgical techniques, more patients are now exposed to procedures, e.g. coronary bypasses, balloon angioplasty, coronary atherectomy, thrombolysis and elective cardioplegia (during open heart surgery), which increase the incidence and prevalence of the syndrome among men and women132.
Platelet-leukocyte aggregates – a predictor for acute kidney injury after cardiac surgery
Published in Renal Failure, 2021
Shenghan Yang, Xunbei Huang, Juan Liao, Qin Li, Si Chen, Chaonan Liu, Liqin Ling, Jing Zhou
Our cohort enrolled adult patients (18–65 years old) with rheumatic valve disease who underwent surgical intervention at West China Hospital, Sichuan University between November 1, 2011, and September 30, 2012. Patients with following conditions were excluded: (a) known organ dysfunction, including adult respiratory distress syndrome (ARDS), kidney failure or New York Heart Association (NYHA) class IV heart failure, (b) preoperative pulmonary diseases including chronic obstructive pulmonary disease, pneumonia, and pulmonary hypertension, (c) confirmed systemic inflammatory response syndrome (SIRS) . (d) history of any heart surgery , (e) required a second operation because of hemorrhage or other adverse event, and (f) patients who have been or are participating in other clinical studies. Detailed definitions of above diseases are provided in Supplemental Information 1.
Clinical outcomes for congenital heart disease patients presenting with infective endocarditis
Published in Expert Review of Cardiovascular Therapy, 2020
Not all congenital heart diseases carry on the same risk of IE [5,19–23]. Lesions with high-speed jets and Venturi effect represent the at-highest risk targets for IE. The major risk group includes cyanotic heart disease, past history of IE, and prostheses, tubes put in place during palliative or repair heart surgery. Other heart diseases such as left to right shunts or native valvular heart disease are classified as moderate risk, but the risk of bacterial infection on heart lesion defined as ‘minor’ (not significant hemodynamically, in an asymptomatic patient) is underestimated. The repair of heart disease (closure of a shunt, valve repair, etc.) often reduces the risk without completely nullify it, as shown by Morris et al, in a series of 3860 patients followed over 35 years after cardiac surgery [22]: the authors showed that episodes of IE are observed even in the very long term and the persistence of lesions, even minor (minimal shunt, valve leak, etc.), perpetuates a potential risk of IE. Only the absence of residual shunt and of associated valve damage can cancel the risk. The installation of prostheses, tubes, pacemaker, keeps the patient in a situation of major risk [5].
Expected social support and recovery of functional status after heart surgery
Published in Disability and Rehabilitation, 2020
Our conclusions are strengthened by the national scope of the HRS and the standardized prospective data collection of expected social support prior to heart surgery. Despite the fact that data collection for this study began approximately 20 years ago, we believe the national scope of the HRS means the results remain relevant today. To our knowledge, there have been no major nation-wide changes in relation to clinical practice for rehabilitation after heart surgery. Yet, our study is subject to certain limitations of the data and analysis. First, the HRS did not contain detailed information about the indication for surgery or surgical characteristics, such as operative complexity or perioperative complications. Second, the measure of expected social support was obtained only in a relatively well-functioning group of older adults who, at the time when this question was asked, did not receive help for ADL/IADL limitations. Third, measures of social support were specific to assistance with ADL/IADLs, but did not address overall closeness with friends and family. Lastly, the variable timing of heart surgery relative to the 2-year gap between interviews meant that some functional limitations resolving quickly after surgery could have been missed in our measure of short-term recovery.