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  • Levin Bengtsen posted an update 3 days, 9 hours ago

    The questionnaire carried out showed that anaesthesia and postoperative care after TAVR are underestimated.

    The preliminary results regarding anaesthetic management in TAVR procedures demonstrate that monitored sedation is safe, provided that contraindications are observed.

    The preliminary results regarding anaesthetic management in TAVR procedures demonstrate that monitored sedation is safe, provided that contraindications are observed.

    Constrictive pericarditis (CP) usually presents as a result of chronic fibrous pericardial thickening and calcification of the pericardium which causes reduced cardiac output. Despite the lack of prospective studies comparing the different therapeutic strategies, surgical pericardiectomy is a valuable treatment under most circumstances.

    We analyzed our records to highlight the predictors of morbidity and mortality of pericardiectomy and also short-term surgical outcome of the same procedure in a single center.

    We carried out a comprehensive retrospective analysis of the records of patients who underwent surgery for CP at our institute between 2013 and 2018. 30 patients underwent isolated pericardiectomy. All patients underwent median sternotomy and total pericardiectomy without the use of cardiopulmonary bypass. Pre-operative, intra-operative and post-operative characteristics were noted.

    Fifteen patients had a history of pulmonary tuberculosis. The majority of the patients presented with NYHA grade III or IV. 60% of the patients were male. The preoperative mean central venous pressure was 24 ±9 mm Hg and decreased to 9 ±5 mm Hg after surgery. The 30-day mortality was 6.66% (2/30). Morbidity was mainly due to low-cardiac output syndrome (

    = 4). A total of 26 patients had significant improvement in their NYHA status.

    Although pericardiectomy for CP remains associated with some operative mortality, the short-term outcome is favorable, and surgical treatment is able to improve the functional class in the majority of survivors.

    Although pericardiectomy for CP remains associated with some operative mortality, the short-term outcome is favorable, and surgical treatment is able to improve the functional class in the majority of survivors.

    Veno-venous extracorporeal membrane oxygenation (ECMO) support has been used for respiratory insufficiency. Its role in blood oxygenation has been well documented. However, the effects on myocardial electrophysiology have not been studied in detail.

    To reveal the acute effects of extracorporeal support on new electrocardiography (ECG) parameters in patients with preserved left ventricular functions.

    This retrospective study was conducted in three separate clinics. Sixteen consecutive patients under veno-venous ECMO for respiratory insufficiency who soon could be successfully weaned were analyzed. Immediately before and 2 hours after initiation of ECMO, ECG was performed. P wave, QT, QTc and T wave peak to end were measured and calculated from obtained surface 12-lead ECG.

    There were statistically significant differences immediately before and 2 hours after initiation of ECMO treatment in the Tp-e interval and Tp-e/QTc ratio, the maximum QTc, minimum QTc, and QTc dispersion values, and P wave dispersion (

    < 0.0001 for each). All ECG parameters were significantly decreased with ECMO support.

    All atrial and ventricular repolarization parameters were decreased in patients with VV-ECMO support. Despite the limited role of ECMO in intractable arrhythmias, the findings of the study revealed that ECMO therapy for respiratory insufficiency may improve atrial ventricular depolarization and repolarization. Therefore, simple 12-lead surface ECG with new ECG parameters may be evaluated for better outcomes.

    All atrial and ventricular repolarization parameters were decreased in patients with VV-ECMO support. Despite the limited role of ECMO in intractable arrhythmias, the findings of the study revealed that ECMO therapy for respiratory insufficiency may improve atrial ventricular depolarization and repolarization. Therefore, simple 12-lead surface ECG with new ECG parameters may be evaluated for better outcomes.

    It is unclear whether it is possible to determine the training load on the basis of the 6-minute walk test (6-MWT) in patients after cardiac surgery with low tolerance of physical exercise.

    Use of the 6-MWT to determine an individual initial training load in walking training on a treadmill in the early phase of cardiac rehabilitation in men after coronary artery bypass graft (CABG) surgery.

    Twenty-two men aged 54 to 74 years, up to 3 months after CABG surgery participated in walking training on a treadmill (12-15 sessions). Patients underwent the initial and final treadmill exercise stress test (TEST) and the 6-MWT. Based on 6-MWT results, the initial training load was prescribed. Before the 6-MWT and 3 minutes after its completion, lactate concentration was determined.

    The 6-MWT distance increased from 420 ±80 m to 519 ±61 m (

    < 0.001), and the energy expenditure from 4.4 ±1.4 MET to 6.3 ±1.3 MET (

    < 0.001). There was a positive correlation between 6-MWT distance and energy expenditure in the TEST before rehabilitation (

    = 0.60,

    = 0.005), and after rehabilitation (

    = 0.75,

    < 0.001). A negative correlation was found between the baseline 6-MWT distance and distance increment in the final 6-MWT (

    = -0.66,

    = 0.002). The 6-MWT did not induce hyperlactatemia.

    The 6-MWT can be used in exercise intensity prescription, especially for determining the individual initial training load, load progression, as well as its correction during follow-up tests.

    The 6-MWT can be used in exercise intensity prescription, especially for determining the individual initial training load, load progression, as well as its correction during follow-up tests.

    The aim of the study was to present our experience and evaluate the valve-related factors and the incidence of prosthetic valve endocarditis.

    This is a retrospective study. Between 2010 and 2018, 36 patients were re-operated on due to prosthetic valve endocarditis The valve-related factors (type, size and position of the prosthetic valve) were analysed.

    Thirty-six patients had prosthetic valve endocarditis. The overall hospital mortality was 16.67%. Early vs. late onset prosthetic valve endocarditis mortality was 23.08% vs. 13.04% respectively. learn more The type, size or position of the prosthesis was not associated with prosthetic valve endocarditis. There was a statistically significant difference between occurrence of prosthetic infection between mitral repair and replacement both in mechanical and biological valve groups. The most common infective agent in the early onset group was Staphylococcus aureus, whereas in the late onset group it was Enterococcus faecalis. Out of 13 patients with early prosthetic valve endocarditis, 11 had infection in the perioperative period around primary operation.

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