Complex High and Indicated Percutaneous Coronary Intervention for Stable Angina: Does Operator Volume Influence Patient Outcome?

Publication date: Available online 7 January 2020Source: American Heart JournalAuthor(s): Tim Kinnaird, Sean Gallagher, James C. Spratt, Peter Ludman, Mark de Belder, Samuel Copt, Richard Anderson, Simon Walsh, Colm Hanratty, Nick Curzen, Adrian Banning, Mamas MamasAbstractBackgroundComplex high-risk and indicated revascularisation using percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly studied.ObjectivesTo define temporal changes in CHIP-PCI volumes, and the relationship between operator CHIP-PCI volume and patient outcomes.Methods and ResultsData were analysed on all CHIP-PCI procedures undertaken for stable angina in England and Wales between 2007 and 2014. Operator volume data was available for 2012-14. CHIP-PCI was defined by patient characteristics (age ≥80years, left ventricular (LV) ejection fraction
Source: American Heart Journal - Category: Cardiology Source Type: research

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ConclusionFemales were associated with persistently reduced odds of receipt of CRT-D compared to males over an eleven-year period. The present study identifies important factors that predict the choice of CRT device offered to patients in the US.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Conclusions: Leukopenia could be an objective prognostic factor for left colonic perforation. Although HP is the gold standard for septic left colonic perforation, it did not improve overall mortality of the patients without leukopenia. For such patients, PR or PA could be a good option for left colonic perforation. PMID: 32054246 [PubMed - as supplied by publisher]
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Conclusions In patients supported for PGD, peripheral and central cannulation strategies are safe and feasible for prolonged venoarterial ECMO support. There was no increase in bleeding after central implantation. With regard to the potential complications of a pECMO, we think that aortic cannulation with tunneling of the cannula and closure of the chest could be a good option in patients with PGD after htx. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research
CONCLUSIONS:  In patients supported for PGD, peripheral and central cannulation strategies are safe and feasible for prolonged venoarterial ECMO support. There was no increase in bleeding after central implantation. With regard to the potential complications of a pECMO, we think that aortic cannulation with tunneling of the cannula and closure of the chest could be a good option in patients with PGD after htx. PMID: 32035427 [PubMed - as supplied by publisher]
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Thorac Cardiovasc Surg Source Type: research
Authors: Ichikawa S, Saito K, Fukuhara N, Tanaka Y, Lee Y, Onodera K, Onishi Y, Yokoyama H, Fujiwara M, Harigae H Abstract Acquired factor X deficiency (AFXD) is a very rare coagulation disorder. A 40-year-old man with no comorbidities suffering from a fever, malaise, and severe hemorrhagic symptoms, including massive hematuria, was emergently admitted. His platelet count was normal, but his prothrombin time and activated partial thromboplastin time were markedly prolonged, which was thought to be due to autoantibody against a coagulation factor in the common pathway. Despite severe massive hematuria resulting in t...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Publication date: April 2020Source: American Heart Journal, Volume 222Author(s): Tim Kinnaird, Sean Gallagher, James C. Spratt, Peter Ludman, Mark de Belder, Samuel Copt, Richard Anderson, Simon Walsh, Colm Hanratty, Nick Curzen, Adrian Banning, Mamas MamasBackgroundComplex high-risk and indicated revascularization using percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly studied.ObjectiveTo define temporal changes in CHIP-PCI volumes, and the relationship between operator CHIP-PCI volume and patient outcomes.Methods and ResultsData were analyzed on all CHIP-PCI procedures undertaken for sta...
Source: American Heart Journal - Category: Cardiology Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0039-3402478Disseminated intravascular coagulation (DIC) is a relatively rare but life-threatening condition, the outcome of which depends largely on timely and accurate therapeutic management. Inhibiting the activation of blood coagulation is an effective option for limiting the burden of diffuse intravascular thrombosis for attenuating consumption of clotting factors and platelets and ultimately preventing massive bleeding. Direct oral anticoagulants (DOACs) are a relatively new generation of drugs that specifically inhibit activated factors II (thrombin) and X, thus providing effective...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
Implantable continuous-flow left ventricular assist devices (CF-LVADs) are used for long-term LV support in bridging patients to heart transplantation or as destination therapy. With prolonged support times, some patients will have repeat complications necessitating multiple device exchanges. To elucidate the safety and efficacy of repeat device exchange, we retrospectively reviewed data from 25 patients who underwent two or more CF-LVAD implantations between July 2005 and August 2017. Indications for exchange were thrombus/hemolysis (n = 8, 32%), electromechanical device malfunction (n = 14, 56%), and infection (n = 3, 12...
Source: ASAIO Journal - Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research
Publication date: Available online 20 December 2019Source: The Annals of Thoracic SurgeryAuthor(s): Chetan Pasrija, Mehrdad Ghoreishi, Glenn Whitman, Niv Ad, Diane E. Alejo, Sari D. Holmes, Stefano Schena, Rawn Salenger, Michael A. Mazzeffi, Clifford E. Fonner, Bradley Taylor, Investigators for the Maryland Cardiac Surgery Quality InitiativeAbstractBackgroundSeveral studies have established morbidity associated with bleeding after cardiac surgery. While reoperation has been implicated as the marker for this morbidity, there remains limited understanding regarding relative morbidities of reoperation and substantial transfus...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
We report our 10-year experience of performing presternotomy ECC for cardiac reoperation and the clinical results. Fifty-seven consecutive cardiac reoperations involving resternotomy were performed between January 2006 and December 2015. ECC was established prior to median sternotomy in all patients. Two patients sustained injury to the right ventricle during sternotomy. Eleven patients sustained injury to the mediastinal structures during dissection (right atrium in 3; superior vena cava in 2; inferior vena cava in 3; left internal thoracic artery in 1; and saphenous vein graft in 2 patients). Longer ECC time and greater ...
Source: Nagoya Journal of Medical Science - Category: International Medicine & Public Health Tags: Nagoya J Med Sci Source Type: research
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