Perioperative myocardial ischemia : Current aspects and concepts.

[Perioperative myocardial ischemia : Current aspects and concepts]. Anaesthesist. 2019 Jun 03;: Authors: Bein B, Schiewe R, Renner J Abstract In the future an increasing number of older patients with significant comorbidities will have to undergo major surgical procedures. Perioperative cardiovascular events account for many major complications and even fatalities. While perioperative myocardial infarction (PMI) is a generally well-known and recognized complication, the less severe myocardial injury after non-cardiac surgery (MINS) has not gained widespread scientific attention until recently; however, two large observational trials (VISION 1 and VISION 2) have shown a significantly increased mortality after MINS with even subtle increases in troponin T being associated with an increased risk of death. This review summarizes the current knowledge pertaining to PMI and MINS and proposes a diagnostic and therapeutic framework for optimally guiding patients at risk through the perioperative period. PMID: 31161296 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

Related Links:

ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionTargeted ablation of TRPV-1/TH positive sympathetic neurons induced by RTX stellate microinjection could suppress ischemia-induced cardiac autonomic imbalances and cardiac electrophysiology instability to protect against AMI-induced VAs.
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: Targeted ablation of TRPV-1/TH positive sympathetic neurons induced by RTX stellate microinjection could suppress ischemia-induced cardiac autonomic imbalances and cardiac electrophysiology instability to protect against AMI-induced VAs. PMID: 31600641 [PubMed - as supplied by publisher]
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - Category: Drugs & Pharmacology Authors: Tags: Biomed Pharmacother Source Type: research
HISTORICALLY, carotid endarterectomy (CEA) surgery has generated several disputes regarding the choice of anesthesia provided and intraoperative neuromonitoring. The landmark General Anesthesia versus Local Anesthesia trial,1 which included 3,526 patients, showed no difference in the occurrence of stroke, myocardial infarction, or death at 30 days after surgery with respect to either local or general anesthesia. Harky et al.2 conducted a systematic review and meta-analysis of general versus local anesthesia in CEA surgery and concluded that each of the anesthetic techniques was noninferior to one another.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
CONCLUSIONS: The evidence for early all-cause mortality with perioperative beta-blockers was uncertain. We found no evidence of a difference in cerebrovascular events or ventricular arrhythmias, and the certainty of the evidence for these outcomes was low and very low. We found low-certainty evidence that beta-blockers may reduce atrial fibrillation and myocardial infarctions. However, beta-blockers may increase bradycardia (low-certainty evidence) and probably increase hypotension (moderate-certainty evidence). Further evidence from large placebo-controlled trials is likely to increase the certainty of these findings, and...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
r M Abstract OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
In conclusion, reperfusion injury was blunted through vanillylmandelic acid administration, which seems to be mediated by parasympathetic activation.
Source: Pathophysiology - Category: Pathology Source Type: research
We present here a case of the 29-year-old male patient who developed myocardial infarction after undergoing percutaneous nephrolithotomy. Prompt diagnosis and timely intervention salvaged his myocardium.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Purpose of review Anesthesia for cardiac surgery has traditionally utilized high-dose opioids to blunt the sympathetic response to surgery. However, recent data suggest that opioids prolong postoperative intubation, leading to increased morbidity. Given the increased risk of opioid dependency after in-hospital exposure to opioids, coupled with an increase in morbidity, regional techniques offer an adjunct for perioperative analgesia. The aim of this review is to describe conventional and emerging regional techniques for cardiac surgery. Recent findings Well-studied techniques such as thoracic epidurals and paravertebr...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Nabil Elkassabany Source Type: research
This study analyzed hospital admissions from a large national database to evaluate trends in the incidence, in-hospital management, and outcomes of AMI complicating pregnancy and the puerperium in the United States.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Epidemiologic Reports Surveys Source Type: research
More News: Anesthesia | Anesthesiology | Cardiology | Cardiovascular | Cardiovascular & Thoracic Surgery | Heart | Heart Attack