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Total anomalous pulmonary venous connection with persistent left superior vena cava: A retrospective surgical series 完全性肺静脉异常连接伴持续性左上腔静脉:回顾性手术系列
Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.4103/jpcs.jpcs_42_22
Amit Mishra, Tarun Parmar, Herin Patel, Divyakant Parmar, Imelda Jain, Jigar Patel, Himani Pandya, Rajesh Sharma
Introduction: Total anomalous pulmonary venous connection (TAPVC) is a common cyanotic congenital heart disease seen in developing countries at tertiary referral centers. Association with persistent left superior vena cava (LSVC) without innominate vein (H-connection) is an extremely rare condition which makes the surgical correction extremely challenging. Materials and Methods: This was a retrospective case record review of 18 patients with TAPVC in the presence of LSVC without innominate vein (without H-connection) at our institution from January 2007 to February 2021. We detail our experience of our modified surgical technique for this complex anatomy using various modifications for each type of TAPVC with LSVC in the absence of innominate vein. Results: Out of 18 patients of TAPVC with LSVC, 17 patients survived and are being followed up regularly. There was one mortality (5.5%) in a 5-month-old infant with double-outlet right ventricle with ventricular septal defect with severe pulmonary arterial hypertension with infracardiac TAPVC who died in intensive care unit on the 5th postoperative day. Conclusion: In our experience, the modified surgical technique for treating this complex variant of TAPVC is especially useful for favorable long-term outcomes with minimal incidence of recurrent pulmonary venous obstruction.
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引用次数: 0
Adult congenital heart disease: Surgical correction of total anomalous pulmonary venous connection with severe pulmonary hypertension at 16 years of age - Perspective of anaesthetic management 成人先天性心脏病:16岁伴严重肺动脉高压的完全性肺静脉连接异常的手术矫正——麻醉处理的观点
Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.4103/jpcs.jpcs_48_23
Sarvesh Srivastava, Sambhunath Das, Sachin Talwar
Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease with an incidence of 1%–3% of all congenital heart disease patients. The pulmonary veins returning oxygenated blood from the lungs are draining into the right side (right atrium or great veins), causing systemic hypoxia and cyanosis. TAPVC patients are mostly present at an early stage and need surgical correction to sustain life and prevent complications. However, some subsets of patients with TAPVC in whom the mixing of blood is happening may progress into adult life and have associated pulmonary arterial hypertension (PAH) and right ventricular (RV) dysfunction. We report a case of a young adult lady who presented to our hospital at 16 years of age with TAPVC along with severe PAH and RV dysfunction. During the perioperative period, the patient was successfully managed with pulmonary vasodilators and inotropic support. The objective of the case report was to describe the management strategy followed in the successful treatment of the patient. Due to congestive heart failure, low cardiac output status, and other factors, these individuals will also experience comorbidities such as PAH, RV dysfunction, and organ dysfunction. Patients require care in an environment that has experience handling a variety of problems and a PAH crisis. PAH can be controlled with the aid of pulmonary vasodilators such as sildenafil, bosentan, milrinone, NTG, and inhaled nitric oxide. Mechanical hyperventilation to lower pulmonary vascular resistance will also aid in treatment. When combined with intraoperative transesophageal echocardiography monitoring, the balanced anesthetic method can be used to successfully manage the majority of cases.
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引用次数: 0
Expert opinion on the identification and pharmacological management of worsening heart failure: A consensus statement from India 关于心力衰竭恶化的鉴定和药物治疗的专家意见:来自印度的一致声明
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.4103/jpcs.jpcs_32_23
S. Seth, J. Bauersachs, S. Mittal, Vishal Rastogi, R. Rajput, Dheeraj K. Gandotra, Ripen Gupta, M. Sahu, S. Pathak, Mohit M. Bhagwati, Simmi Minocha, P. Sharma, Deepankar Vatsa, R. Aggarwal, Gyanti B Singh, G. Arora, S. Kubba, M. Rajeev, Pratik K. Jha, B. Vivek, M. Gupta, Rameshwar Bishnoi, R. Khare, V. Gupta, N. Goyal, A. Dhall, A. Madan, B. Sharma, A. Abhyankar, P. Kahale, T. Meeran, B. Ezhumalai, B. Kalmath, V. Shah, Sandip Rungta, P. Kumar, S. Christopher, A. Shah, R. Dargad, K. Sheth, A. Khode, S. Mehta, Bommareddy A Ranga Reddy, Puneet Gupta, B. Tripathi, R. Bhuyan
Worsening heart failure (WHF) is a distinct under-diagnosed and under-treated condition, independent of location of care. Heart failure (HF) progression is punctuated by repeated WHF events, each resulting in reduced cardiac function. One-third of the patients with HF with reduced ejection fraction experience a decompensation event. These decompensation events often result in the emergency department visits and HF hospitalization. Despite its inclusion in recent guidelines, there is no precise definition of WHF or its various forms. It is worth noting that WHF signals a need for treatment optimization as per guideline-directed medical therapy and the addition of novel drugs like a stimulator of soluble guanylate cyclase that benefit this high-risk patient population. This practical document is based on the expert opinion of cardiologists, cardiothoracic surgeons, and physicians that discussed the definition, assessment, pharmacological management, and monitoring of WHF patients in a hospitalized setting. In addition, there is also a need for an expert opinion for the management of WHF in an outpatient setting.
恶化的心力衰竭(WHF)是一种明显的诊断不足和治疗不足的情况,与治疗地点无关。心力衰竭(HF)的进展被反复的WHF事件打断,每一次都会导致心脏功能下降。三分之一射血分数降低的HF患者出现失代偿事件。这些失代偿事件通常导致急诊科就诊和HF住院治疗。尽管最近的指导方针中包含了WHF,但对WHF或其各种形式没有确切的定义。值得注意的是,WHF表明需要根据指导方针进行治疗优化,并添加有益于这一高危患者群体的新药,如可溶性鸟苷酸环化酶的刺激剂。本实用文件基于心脏病专家、心胸外科医生和医生的专家意见,他们讨论了WHF患者在住院环境中的定义、评估、药物管理和监测。此外,还需要就门诊环境中WHF的管理提供专家意见。
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引用次数: 0
Coronavirus disease 2019, a popup differential to the postoperative inflammatory state and its impact on outcomes after cardiac surgery – A single-center experience 2019冠状病毒病,术后炎症状态的弹出式差异及其对心脏手术后结果的影响——单中心体验
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.4103/jpcs.jpcs_47_22
K. Ram Kiran, V. Trivedi, Rajesh P. Venuthurupalli, Deepika Gehlot, Sunil Ninama
Introduction: Coronavirus disease 2019 (COVID-19) affected care among surgical patients. Considering the underlying comorbidities, physical status, and intricate perioperative course, the cardiac surgery patient represents a vulnerable cohort. This study describes baseline characteristics, laboratory findings, diagnosis, postoperative course, and their correlation with immediate outcomes in patients undergoing cardiac surgery. Methodology: Patients who underwent cardiac surgery at our institute for 1 year were screened for COVID-19 with the reverse transcription-polymerase chain reaction swab test and then were posted for surgery only after corroborating negative reports, except for emergency cases. Dedicated preoperative areas and COVID-appropriate measures were taken. Data from the electronic patient records of those diagnosed with COVID-19 in the immediate postoperative period were reviewed retrospectively. Continuous normal distributed variables are presented as mean ± standard deviation, alternatively as median ± interquartile range, and categorical variables as percentages. Results: A total of 22 patients were infected in the immediate postoperative period in spite of appropriate screening and had a high mortality of 36.36% (vs. non-COVID 6.27%, P < 0.001). Days from index surgery to diagnosis were 6 (±3.75). The median stay in the intensive care unit and hospital stay was 6 (±2.75) and 10 (±3.2) days, respectively. The moderate and high-risk categories of the European System for Cardiac Operative Risk Evaluation II showed mortality of 33.3% (vs. 2.69% in non-COVID, odds ratio of 18.42) and 71.4% (vs. 11.2% in non-COVID, odds ratio of 19.65). Patients with C-reactive protein >100 mg/lit, D dimer >1000 ng/ml, and neutrophil/lymphocyte ratio >3.5 showed very high mortality. Noninvasive and invasive ventilation in 27.27% and 31.8%, respectively. Two patients acquired acute kidney injury that required hemodialysis. Conclusions: Despite requisite measures, COVID infection still remains a momentous differential to postoperative complications affecting early outcomes. Therefore, more robust preoperative protocols, better strategies for the COVID-free environment, and early clinical suspicion and workup are required to mitigate its effect on this cohort.
2019冠状病毒病(COVID-19)影响手术患者的护理。考虑到潜在的合并症、身体状况和复杂的围手术期过程,心脏手术患者是一个脆弱的群体。本研究描述了心脏手术患者的基线特征、实验室结果、诊断、术后过程及其与即时预后的相关性。方法:在我院行心脏手术1年的患者,除急诊病例外,均采用逆转录聚合酶链反应拭子试验筛查COVID-19,经确证阴性报告后才行手术。采取了专门的术前区域和适合新冠病毒的措施。回顾性分析术后立即诊断为COVID-19的电子病历数据。连续正态分布变量表示为平均值±标准差,或者表示为中位数±四分位数范围,分类变量表示为百分比。结果:22例患者术后立即感染,尽管进行了适当的筛查,但死亡率高达36.36%(与未感染的患者相比为6.27%,P < 0.001)。从手术到诊断为6(±3.75)天。重症监护病房和住院时间的中位数分别为6(±2.75)天和10(±3.2)天。在欧洲心脏手术风险评估系统II中,中等和高危类别的死亡率分别为33.3%(非covid组为2.69%,优势比为18.42)和71.4%(非covid组为11.2%,优势比为19.65)。c反应蛋白>100 mg/lit, D二聚体>1000 ng/ml,中性粒细胞/淋巴细胞比值bbb3.5的患者死亡率非常高。无创通气和有创通气分别占27.27%和31.8%。2例患者获得急性肾损伤,需要血液透析。结论:尽管采取了必要的措施,COVID感染仍然是影响早期预后的术后并发症的重要差异。因此,需要更健全的术前方案,更好的无covid - 19环境策略,以及早期临床怀疑和随访,以减轻其对该队列的影响。
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引用次数: 0
Perceived sleep quality and quantity before acute myocardial infarction: A pilot study 急性心肌梗死前的感知睡眠质量和数量:一项初步研究
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-05-01 DOI: 10.4103/jpcs.jpcs_43_22
HS Kiran, T. Gowthami
Background: Sleep plays a vital role in disease prevention and rejuvenation. Diet and exercise are emphasized in the prevention of diseases, whereas sleep is often overlooked. The consequences of poor sleep often go unnoticed. Insufficient and poor sleep has been associated with various health problems and is considered an important risk factor. The objective of this study was to explore the association between perceived sleep quality and quantity before acute myocardial infarction (MI). Materials and Methods: It was a prospective observational study. Thirty hospitalized patients of acute coronary syndrome with an index event of first-time MI satisfying the inclusion and exclusion criteria were enrolled. The Pittsburgh Sleep Quality Index (PSQI) was administered to the patients. Other basic investigations done for the diagnosis and work-up of the cases by the treating doctors were noted and data were analyzed. Results: In our study, the mean Global PSQI score was 7.16 (standard deviation = 3.79). In our study, based on Global PSQI scores (based on the details of the past 1 month before acute MI), sleep quality was found to be “POOR” (Global PSQI score >5) in 23 (76.7%) patients with acute MI which was statistically significant (Spearman's Rho: r = 1) and “Good” (Global PSQI score <5) in 7 (23.3%) patients. All the patients >60 years of age had poor sleep quality. The average duration of sleep was 5 h 30 min. The majority of the patients (71%) with acute MI slept for <6 h which was statistically significant (Spearman's Rho: r = –1). Conclusion: This pilot study, based on PSQI, establishes the association between perceived sleep quality and quantity and acute MI.
背景:睡眠在疾病预防和恢复中起着至关重要的作用。饮食和锻炼是预防疾病的重点,而睡眠往往被忽视。睡眠不足的后果常常被忽视。睡眠不足和不良与各种健康问题有关,被认为是一个重要的风险因素。本研究的目的是探讨急性心肌梗死(MI)前感知睡眠质量和数量之间的关系。材料和方法:这是一项前瞻性的观察性研究。纳入了30名符合纳入和排除标准的急性冠状动脉综合征住院患者,其首次MI指数事件符合入选和排除标准。匹兹堡睡眠质量指数(PSQI)用于患者。记录了治疗医生为诊断和检查病例所做的其他基本调查,并对数据进行了分析。结果:在我们的研究中,平均全局PSQI评分为7.16(标准差=3.79)。在我们的调查中,基于全局PSQI得分(基于急性心肌梗死前1个月的详细信息),23例(76.7%)急性心肌梗死患者的睡眠质量“较差”(整体PSQI评分>5),具有统计学意义(Spearman’s Rho:r=1)和“良好”(60岁的整体PSQI得分为较差),平均睡眠时间为5小时30分钟。大多数急性心肌梗死患者(71%)睡眠时间<6小时,具有统计学意义(Spearman’s Rho:r=-1)。结论:这项基于PSQI的初步研究建立了感知睡眠质量和数量与急性心肌梗死之间的联系。
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引用次数: 0
Think again: The power of knowing what you don't know 再想想:知道你不知道的东西的力量
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-01-01 DOI: 10.4103/jpcs.jpcs_67_21
L. Giray, Mary Rivas
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引用次数: 36
Simple surgical technique for epicardial pacemaker wire preparation and insertion 心外膜起搏器导线制备和插入的简单手术技术
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-01-01 DOI: 10.4103/jpcs.jpcs_72_21
Amit Mishra, Kartik Patel, Chandrasekaran Ananthanarayananh, Vivek Wadhawa, Himani Pandya
Epicardial pacing wire (EPW) insertion is an integral part of open heart surgery. However, the use of EPW insertion is also associated with complications such as bleeding, tamponade, arrhythmias, and occasionally even death of the patient. Various techniques have been described for preparing, placing, and removing EPW. We present our simple, yet effective technique of preparing, inserting, and removing EPW where the incidence of complications is nil.
心外膜起搏导线(EPW)的插入是心脏直视手术的一个组成部分。然而,EPW插入的使用也会导致并发症,如出血、填塞、心律失常,偶尔甚至导致患者死亡。已经描述了用于制备、放置和移除EPW的各种技术。我们介绍了一种简单而有效的EPW制备、插入和移除技术,并发症发生率为零。
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引用次数: 0
Silent rheumatic severe mitral stenosis with left ventricular noncompaction cardiomyopathy and ramifying normal coronaries: A double whammy in an octogenarian 一位八旬老人的双重打击
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-01-01 DOI: 10.4103/jpcs.jpcs_15_22
Debasish Das, A. Banerjee, Abhinav Kumar, S. Singh, Manaranjan Dixit
We report a unique association of rheumatic heart disease with left ventricular (LV) noncompaction cardiomyopathy in an octogenarian. He had severe mitral stenosis with severe LV systolic dysfunction secondary to noncompaction. Although the association of rheumatic heart disease with LV, noncompaction cardiomyopathy has been described sparsely in the literature, our case is a unique illustration of the presence of LV noncompaction cardiomyopathy contributing toward severe LV systolic dysfunction in rheumatic mitral stenosis in an octogenarian with no coronary artery disease.
我们报告一个独特的关联风湿性心脏病与左心室(LV)非压实性心肌病在八十多岁。他有严重的二尖瓣狭窄和严重的左室收缩功能障碍继发于非压实。虽然风湿性心脏病与左室非压实性心肌病的关系在文献中很少被描述,但我们的病例是一个独特的例子,说明了左室非压实性心肌病的存在,导致了一位没有冠状动脉疾病的八十岁老人风湿性二尖瓣狭窄中严重的左室收缩功能障碍。
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引用次数: 0
Mycotic coronary aneurysm: A rare complication of percutaneous coronary intervention 真菌性冠状动脉瘤:经皮冠状动脉介入治疗中一种罕见的并发症
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-01-01 DOI: 10.4103/jpcs.jpcs_26_22
Pratik Wadhokar, S. Malani, R. Patil, Digvijay D. Nalawade
{"title":"Mycotic coronary aneurysm: A rare complication of percutaneous coronary intervention","authors":"Pratik Wadhokar, S. Malani, R. Patil, Digvijay D. Nalawade","doi":"10.4103/jpcs.jpcs_26_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_26_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of labetalol for treating patients with pregnancy-induced hypertension: A systematic review 拉贝他洛尔治疗妊娠高血压的疗效:系统评价
IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-01-01 DOI: 10.4103/jpcs.jpcs_69_22
Punyatoya Bej, Sambhunath Das
{"title":"Effect of labetalol for treating patients with pregnancy-induced hypertension: A systematic review","authors":"Punyatoya Bej, Sambhunath Das","doi":"10.4103/jpcs.jpcs_69_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_69_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the Practice of Cardiovascular Sciences
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