Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.129018
F. Gharagozloo, M. Meyer
{"title":"Diaphragmatic Flap: Technique of Preparation and Indications for Use","authors":"F. Gharagozloo, M. Meyer","doi":"10.4236/wjcs.2022.129018","DOIUrl":"https://doi.org/10.4236/wjcs.2022.129018","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89496503","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.125008
F. Gharagozloo, M. Meyer, J. Redan
{"title":"Belsey Mark IV Repair for Recurrent Hiatal Hernia and Failed Fundoplication: An Analysis of Outcomes in 206 Patients","authors":"F. Gharagozloo, M. Meyer, J. Redan","doi":"10.4236/wjcs.2022.125008","DOIUrl":"https://doi.org/10.4236/wjcs.2022.125008","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79966102","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.123004
F. Hedayat, Antony H. Walker
Objective: To assess the ability of the logistic EuroSCORE to predict long-term mortality of patients undergoing isolated Surgical Aortic Valve Replacement (SAVR). Methods: A retrospective review of all patients undergoing SAVR between September 1999, and March 2018 was done. Results: 2018 patients were eligible for inclusion in the study. Patients were grouped accord-ing to risk: low (n = 506), intermediate (n = 609), and high-risk (n = 903) depending on their logistic EuroSCORE values. The 30-day mortality of the low-risk group was 0.47%. The one-, five-, 10-, 15-, and 20-year mortality was 1.66%, 4.9%, 14.9%, 24.3%, and 43.8%, respectively. Intermediate-risk group 30-day mortality was 0.66%. The one-, five-, 10-, 15-, and 20-year mortality was 3.28%, 11.9%, 32%, 54.8%, and 82.6%, respectively. The 30-day mortality of the high-risk group was 3.99%. The one-, five-, 10-, 15-, and 20-year mortality was 8.2%, 27%, 55.4%, 78.6%, and 87%, respectively. Conclusion: Our results confirm that the lES is accurate in predicting long-term mortality outcomes of SAVR. This real-world data provides evidence of the potential usefulness of the EuroSCORE to help the heart team and patients decide on appropriate interventions for aortic stenosis.
{"title":"Accuracy of the Logistic EuroSCORE in Predicting Long-Term Survival Following Isolated Aortic Valve Replacement","authors":"F. Hedayat, Antony H. Walker","doi":"10.4236/wjcs.2022.123004","DOIUrl":"https://doi.org/10.4236/wjcs.2022.123004","url":null,"abstract":"Objective: To assess the ability of the logistic EuroSCORE to predict long-term mortality of patients undergoing isolated Surgical Aortic Valve Replacement (SAVR). Methods: A retrospective review of all patients undergoing SAVR between September 1999, and March 2018 was done. Results: 2018 patients were eligible for inclusion in the study. Patients were grouped accord-ing to risk: low (n = 506), intermediate (n = 609), and high-risk (n = 903) depending on their logistic EuroSCORE values. The 30-day mortality of the low-risk group was 0.47%. The one-, five-, 10-, 15-, and 20-year mortality was 1.66%, 4.9%, 14.9%, 24.3%, and 43.8%, respectively. Intermediate-risk group 30-day mortality was 0.66%. The one-, five-, 10-, 15-, and 20-year mortality was 3.28%, 11.9%, 32%, 54.8%, and 82.6%, respectively. The 30-day mortality of the high-risk group was 3.99%. The one-, five-, 10-, 15-, and 20-year mortality was 8.2%, 27%, 55.4%, 78.6%, and 87%, respectively. Conclusion: Our results confirm that the lES is accurate in predicting long-term mortality outcomes of SAVR. This real-world data provides evidence of the potential usefulness of the EuroSCORE to help the heart team and patients decide on appropriate interventions for aortic stenosis.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90582196","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.128014
Suha Zubairi, Mohammad Hassan Mirza, Mohammad Saad Iqbal, M. Z. Khan, M. Amanullah
Background and Aim: Mechanical prosthetic heart valves exert a lifelong thromboembolic complication requiring continuous antithrombotic therapy. Vitamin K antagonist is the recommended therapy of choice along with meticulous INR monitoring to achieve and maintain an INR of 2.0 - 3.0. The study aimed to assess the compliance of anticoagulant therapy in pediatric patients after AVR and to highlight the challenges faced during follow-ups. Methods: A retrospective study was conducted at NICVD Hospital in Kara-chi, Pakistan for a time frame of 2 years from 2020-2021 where 7 patients were selected. Data were collected using hospital medical records and then validated through a phone call mediated structured questionnaire-based in-terview. Results: 2 out of 7 patients in the case series were compliant to regular follow-ups and had their INR in the desired range owing to their higher education status and access to INR clinic for regular follow-up in urban set-ting. Younger patients in the case series were non-compliant. 4 out of 7 patients who were on dual anti-coagulant regimens including warfarin and aspirin were either closer or within the range than compared to those on single drug regimen. Conclusion: Compliance was observed in patients who had fa-vorable demographics and higher education. Multiple recent trials including PROACT and PROACT XA are underway to develop novel treatment options apart from warfarin after mechanical aortic valve replacement. Home-based INR testing kits provide easy access to regular testing in remote areas. Mul-ti-center studies are required for in-depth analysis regarding reasons of non-compliance in pediatric population.
{"title":"Warfarin Compliance after Mechanical AVR in the Pediatric Population: Case Series from a Developing Country","authors":"Suha Zubairi, Mohammad Hassan Mirza, Mohammad Saad Iqbal, M. Z. Khan, M. Amanullah","doi":"10.4236/wjcs.2022.128014","DOIUrl":"https://doi.org/10.4236/wjcs.2022.128014","url":null,"abstract":"Background and Aim: Mechanical prosthetic heart valves exert a lifelong thromboembolic complication requiring continuous antithrombotic therapy. Vitamin K antagonist is the recommended therapy of choice along with meticulous INR monitoring to achieve and maintain an INR of 2.0 - 3.0. The study aimed to assess the compliance of anticoagulant therapy in pediatric patients after AVR and to highlight the challenges faced during follow-ups. Methods: A retrospective study was conducted at NICVD Hospital in Kara-chi, Pakistan for a time frame of 2 years from 2020-2021 where 7 patients were selected. Data were collected using hospital medical records and then validated through a phone call mediated structured questionnaire-based in-terview. Results: 2 out of 7 patients in the case series were compliant to regular follow-ups and had their INR in the desired range owing to their higher education status and access to INR clinic for regular follow-up in urban set-ting. Younger patients in the case series were non-compliant. 4 out of 7 patients who were on dual anti-coagulant regimens including warfarin and aspirin were either closer or within the range than compared to those on single drug regimen. Conclusion: Compliance was observed in patients who had fa-vorable demographics and higher education. Multiple recent trials including PROACT and PROACT XA are underway to develop novel treatment options apart from warfarin after mechanical aortic valve replacement. Home-based INR testing kits provide easy access to regular testing in remote areas. Mul-ti-center studies are required for in-depth analysis regarding reasons of non-compliance in pediatric population.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78283063","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.121023
A. Bhattarai, Arjun Gurung, P. Khakural, R. Baral, B. Koirala
{"title":"Hundred plus Minimally Access Cardiac Surgery: Our Experience","authors":"A. Bhattarai, Arjun Gurung, P. Khakural, R. Baral, B. Koirala","doi":"10.4236/wjcs.2022.121023","DOIUrl":"https://doi.org/10.4236/wjcs.2022.121023","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73514513","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.121020
G. Offei-Larbi, M. Tamatey, M. Tettey, I. Okyere, K. Adomako
{"title":"Thrombus Propagation across an Inferior Vena Cava Filter Resulting in Fatal Pulmonary Embolism: A Case Report","authors":"G. Offei-Larbi, M. Tamatey, M. Tettey, I. Okyere, K. Adomako","doi":"10.4236/wjcs.2022.121020","DOIUrl":"https://doi.org/10.4236/wjcs.2022.121020","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74144952","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.121022
Sergio Soto-Hopkins, J. A. Sánchez-López, Erick Trujillo-Magallón, R. Leder, A. G. Gallardo-Hernández
Background: Acute kidney injury (AKI) is a severe common postoperative complication of cardiac surgery (CS). It increases the risk of mortality by up to 80%. Therefore, it is essential to have preoperative risk evaluation tools. Frailty is a marker of deterioration of physiologic systems and may be associated with AKI. Purpose: The study aimed to determine the utility of frailty as a predictor of AKI after CS. Method: We enrolled 91 patients undergoing CS with cardiopulmonary bypass to determine if they had frailty before surgery and were associated with postoperative AKI. The diagnosis of postoperative AKI was based on the serum creatinine criteria of the Acute Kidney Injury Network classification up to 7 days following CS. Results: The incidence of postoperative AKI was 62% in the frail group and 21% in the non-frail group. Frailty was associated with a higher risk of AKI (relative risk [RR] = 3.00, 95% CI 1.56 - 5.77, p = 0.00). In regression models, there were associa-tions between frailty and postoperative AKI. Conclusion: This study demonstrated that frailty could be a predictor for post-CS AKI. Therefore, frailty assessment should become an essential part of the preoperative evaluation to help the anesthesiologist to estimate the surgical risk and develop preoperative and transoperative strategies to preserve the renal function and improve the cardiac surgery outcome.
背景:急性肾损伤(AKI)是心脏手术(CS)术后常见的严重并发症。它使死亡风险增加高达80%。因此，术前风险评估工具是必不可少的。虚弱是生理系统恶化的标志，可能与AKI有关。目的:本研究旨在确定虚弱作为CS后AKI预测因子的效用。方法:我们招募了91例接受CS合并体外循环的患者，以确定他们在手术前是否有虚弱以及是否与术后AKI相关。术后AKI的诊断是基于CS后7天急性肾损伤网络分类的血清肌酐标准。结果:体弱组术后AKI发生率为62%，非体弱组为21%。虚弱与AKI的高风险相关(相对危险度[RR] = 3.00, 95% CI 1.56 - 5.77, p = 0.00)。在回归模型中，虚弱和术后AKI之间存在关联。结论:本研究表明，虚弱可能是cs后AKI的预测因子。因此，衰弱评估应成为术前评估的重要组成部分，帮助麻醉师评估手术风险，制定术前和术中策略，以保护肾功能，提高心脏手术效果。
{"title":"Patient Frailty Can Increase the Risk of Acute Kidney Injury after Cardiac Surgery: Pilot Study","authors":"Sergio Soto-Hopkins, J. A. Sánchez-López, Erick Trujillo-Magallón, R. Leder, A. G. Gallardo-Hernández","doi":"10.4236/wjcs.2022.121022","DOIUrl":"https://doi.org/10.4236/wjcs.2022.121022","url":null,"abstract":"Background: Acute kidney injury (AKI) is a severe common postoperative complication of cardiac surgery (CS). It increases the risk of mortality by up to 80%. Therefore, it is essential to have preoperative risk evaluation tools. Frailty is a marker of deterioration of physiologic systems and may be associated with AKI. Purpose: The study aimed to determine the utility of frailty as a predictor of AKI after CS. Method: We enrolled 91 patients undergoing CS with cardiopulmonary bypass to determine if they had frailty before surgery and were associated with postoperative AKI. The diagnosis of postoperative AKI was based on the serum creatinine criteria of the Acute Kidney Injury Network classification up to 7 days following CS. Results: The incidence of postoperative AKI was 62% in the frail group and 21% in the non-frail group. Frailty was associated with a higher risk of AKI (relative risk [RR] = 3.00, 95% CI 1.56 - 5.77, p = 0.00). In regression models, there were associa-tions between frailty and postoperative AKI. Conclusion: This study demonstrated that frailty could be a predictor for post-CS AKI. Therefore, frailty assessment should become an essential part of the preoperative evaluation to help the anesthesiologist to estimate the surgical risk and develop preoperative and transoperative strategies to preserve the renal function and improve the cardiac surgery outcome.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81142840","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}
Pub Date : 2022-01-01DOI: 10.4236/wjcs.2022.126010
Ahmed Elagamy Musa, O. Grimmig, J. Sonke
Alkaptonuria is a rare inherited tyrosine metabolism disorder, resulting in homogentisic acid deposition in the connective tissues. The condition is commonly referred to as ochronosis and manifests as skin pigmentation, degenerative arthropathy, and black urine. Among the rare complications of this disease is the involvement of the cardiovascular system. We report a case of a 63-year-old woman with alkaptonuric ochronosis who had already undergone three joint replacements. She was referred to our center for aortic valve replacement after accidentally discovering severe aortic valve stenosis in the preoperative assessment prior to her fourth joint replacement. Intraoperative findings included ochronosis of a severely calcified black-pigmented aortic valve and black pigmentation of the aortic intima. Histopathological analysis and elevated homogentisic acid levels in the patient’s urine confirmed the diagnosis of alkaptonuria. However, alkaptonuria was not diagnosed until aortic valve replacement despite the previous symptoms and signs. This report aims to outline the history, etiology, pathogenesis, clinical presentation, and treatment of aortic valve ochronosis in addition to pre-senting the case.
{"title":"Aortic Valve in Black: A Case of Aortic Valve Ochronosis","authors":"Ahmed Elagamy Musa, O. Grimmig, J. Sonke","doi":"10.4236/wjcs.2022.126010","DOIUrl":"https://doi.org/10.4236/wjcs.2022.126010","url":null,"abstract":"Alkaptonuria is a rare inherited tyrosine metabolism disorder, resulting in homogentisic acid deposition in the connective tissues. The condition is commonly referred to as ochronosis and manifests as skin pigmentation, degenerative arthropathy, and black urine. Among the rare complications of this disease is the involvement of the cardiovascular system. We report a case of a 63-year-old woman with alkaptonuric ochronosis who had already undergone three joint replacements. She was referred to our center for aortic valve replacement after accidentally discovering severe aortic valve stenosis in the preoperative assessment prior to her fourth joint replacement. Intraoperative findings included ochronosis of a severely calcified black-pigmented aortic valve and black pigmentation of the aortic intima. Histopathological analysis and elevated homogentisic acid levels in the patient’s urine confirmed the diagnosis of alkaptonuria. However, alkaptonuria was not diagnosed until aortic valve replacement despite the previous symptoms and signs. This report aims to outline the history, etiology, pathogenesis, clinical presentation, and treatment of aortic valve ochronosis in addition to pre-senting the case.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"152 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389534","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}
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