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Impact of Ultrafiltration on Kidney Injury After Cardiac Surgery: The Michigan Experience.
CONCLUSIONS: Patients exposed to CUF had a higher adjusted risk of AKI. Clinical teams should consider lower volumes of CUF among patients with low creatinine clearance to minimize the risk of AKI. PMID: 26209495 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Paugh TA, Dickinson TA, Martin JR, Hanson EC, Fuller J, Heung M, Zhang M, Shann KG, Prager RL, Likosky DS, Michigan Society of Thoracic and Cardiovascular Surgeons and the Perfusion Measures and Outcomes (PERForm) Registry Tags: Ann Thorac Surg Source Type: research

Impact of Ultrafiltration on Kidney Injury After Cardiac Surgery: The Michigan Experience
Conclusions Patients exposed to CUF had a higher adjusted risk of AKI. Clinical teams should consider lower volumes of CUF among patients with low creatinine clearance to minimize the risk of AKI.
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Incidence and Predictors of Cognitive Decline in Patients with Left Ventricular Assist Devices Original Articles
Conclusions— Cognitive decline occurs commonly in patients in the year after LVAD and is associated with older age and destination therapy. These results could have important implications for patient selection and improved communication of risks before LVAD implantation. Additional studies are needed to explore the association between cognitive decline and subsequent stroke, health status, and mortality in patients after LVAD.
Source: Circulation: Cardiovascular Quality and Outcomes - May 19, 2015 Category: Cardiology Authors: Fendler, T. J., Spertus, J. A., Gosch, K. L., Jones, P. G., Bruce, J. M., Nassif, M. E., Flint, K. M., Dunlay, S. M., Allen, L. A., Arnold, S. V. Tags: Other heart failure Original Articles Source Type: research

Abstract 1: Incidence and Predictors of Cognitive Decline in Patients with Left Ventricular Assist Devices Session Title: Concurrent Session IB: Oral Abstracts - QCOR Young Investigator Awards
Conclusion: In a large LVAD registry, cognitive decline occurred in over a quarter of patients in the year after LVAD and was associated with older age, renal disease, higher baseline cognitive function, and more stable heart failure at implant. These results define the frequency of an important adverse event and provide new insights regarding outcomes after LVAD. Future studies are needed to explore the association of transient and permanent cognitive decline with subsequent stroke, health status, and mortality in patients after LVAD placement.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Fendler, T. J., Spertus, J. A., Gosch, K., Jones, P. G., Bruce, J. M., Nassif, M. E., Flint, K. M., Dunlay, S. M., Allen, L. A., Arnold, S. V. Tags: Session Title: Concurrent Session IB: Oral Abstracts - QCOR Young Investigator Awards Source Type: research

Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease The CvLPRIT Trial
ConclusionsIn patients presenting for P-PCI with multivessel disease, index admission complete revascularization significantly lowered the rate of the composite primary endpoint at 12 months compared with treating only the IRA. In such patients, inpatient total revascularization may be considered, but larger clinical trials are required to confirm this result and specifically address whether this strategy is associated with improved survival. (Complete Versus Lesion-only Primary PCI Pilot Study [CvLPRIT]; ISRCTN70913605)
Source: Journal of the American College of Cardiology - March 9, 2015 Category: Cardiology Source Type: research

Atrial fibrillation: effects beyond the atrium?
Atrial fibrillation (AF) is the most common sustained clinical arrhythmia and is associated with significant morbidity, mostly secondary to heart failure and stroke, and an estimated two-fold increase in premature death. Efforts to increase our understanding of AF and its complications have focused on unravelling the mechanisms of electrical and structural remodelling of the atrial myocardium. Yet, it is increasingly recognized that AF is more than an atrial disease, being associated with systemic inflammation, endothelial dysfunction, and adverse effects on the structure and function of the left ventricular myocardium tha...
Source: Cardiovascular Research - February 23, 2015 Category: Cardiology Authors: Wijesurendra, R. S., Casadei, B. Tags: REVIEW Source Type: research

089 * innominate artery cannulation for proximal aortic surgery: outcomes and neurologic events in 263 patients
Conclusion: Innominate artery cannulation can be performed safely and poses a low risk of neurologic events in procedures requiring hypothermic circulatory arrest. This artery may be considered the optimal perfusion site for delivering ACP.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Preventza, O., Garcia, A., Tuluca, A., Henry, M., Bakaeen, F., Omer, S., Cornwell, L., Coselli, J. S. Tags: Part II: Cannulation issues in aortic surgery: Doing things right or doing the right things Source Type: research

Updated Meta-analysis of Hemodilution in Acute Ischemic Stroke (P1.113)
CONCLUSION: Future work includes an additional reviewer to assess trial quality and CENTRAL search up to 2013. Overall, the results of this meta-analysis were comparable to the 2002 meta-analysis with a trend suggesting the possibility of harm with hemodilution therapy.Study Supported by:NIH NCATS UL1TR000427 and NHLBI Fellowship F30HL112491.Disclosure: Dr. Chang has nothing to disclose. Dr. Jensen has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chang, T., Jensen, M. Tags: Cerebrovascular Disease and Interventional Neurology: Antiplatelet Agents and Miscellaneous Source Type: research

Intra-aortic balloon pump (IABP) counterpulsation improves cerebral perfusion in patients with decreased left ventricular function.
CONCLUSIONS: IABP improves cerebral blood flow, particularly in patients with pre-existing heart failure and highly impaired LVEF. Hence, an IABP might be a treatment option to improve cerebral perfusion in selected patients with cerebral misperfusion and simultaneously existing severe heart failure. PMID: 24609841 [PubMed - as supplied by publisher]
Source: Perfusion - March 7, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Pfluecke C, Christoph M, Kolschmann S, Tarnowski D, Forkmann M, Jellinghaus S, Poitz D, Wunderlich C, Strasser R, Schoen S, Ibrahim K Tags: Perfusion Source Type: research

Levosimendan improves contractility in vivo and in vitro in a rodent model of post‐myocardial infarction heart failure
ConclusionIn HF animals LEV improved the contractility by increasing the Ca2+ sensitivity. Furthermore loading conditions were changed, and LEV could consequently change organ perfusion. An observed increase in diastolic Ca2+ following LEV treatment and clinical implications of this should be further addressed.This article is protected by copyright. All rights reserved.
Source: Acta Physiologica - February 5, 2014 Category: Physiology Authors: Solveig Moss Kolseth, Natale Pinheiro Lage Rolim, Øyvind Salvesen, Dag Ole Nordhaug, Alexander Wahba, Morten Andre Høydal Tags: Regular Paper Source Type: research

Interventional Cryoablation Therapy of Paroxysmal Atrial Fibrillation in Young Patients With Low CHADS 2 Score Worth the Risk of Periprocedural and Long-Term Adverse Events?
In this study the long-term effectiveness in the cryoablation group was reported as 69.9% after 12 months, with a mean fluoroscopy exposure time of 63 min. Regarding the adverse events during follow-up, only 1 adverse event (1.2%) occurred in the drug therapy arm (transfusion because of hemorrhage) compared with 32 adverse events (14.2%) in the cryoablation group, not regarding the 24 patients who suffered temporary phrenic nerve palsy. Five strokes, 4 transient ischemic attacks, 2 cases of tamponades, 2 myocardial infarctions, 3 transfusions, 2 atriovenous fistulas, 2 pseudoaneurysms, 4 cases of persistent phrenic nerve...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - September 23, 2013 Category: Cardiology Source Type: research

Use of the Corus ® CAD Gene Expression Test for Assessment of Obstructive Coronary Artery Disease Likelihood in Symptomatic Non-Diabetic Patients
Conclusions The Corus CAD test has been extensively evaluated since it was first derived, including with two prospective multi-center trials. Given the scope of the deleterious effects of CAD and the considerable costs involved in diagnosing obstructive CAD, a blood test that can help in this determination is certainly valuable. The Corus CAD test promises to have an important role in this regard particularly if it continues to perform this well in larger, more diverse cohorts.
Source: PLOS Currents Evidence on Genomic Tests - August 26, 2013 Category: Genetics & Stem Cells Authors: Jose Vargas Source Type: research

Use of the Corus® CAD Gene Expression Test for Assessment of Obstructive Coronary Artery Disease Likelihood in Symptomatic Non-Diabetic Patients
Conclusions The Corus CAD test has been extensively evaluated since it was first derived, including with two prospective multi-center trials. Given the scope of the deleterious effects of CAD and the considerable costs involved in diagnosing obstructive CAD, a blood test that can help in this determination is certainly valuable. The Corus CAD test promises to have an important role in this regard particularly if it continues to perform this well in larger, more diverse cohorts.
Source: PLOS Currents Evidence on Genomic Tests - August 26, 2013 Category: Genetics & Stem Cells Authors: Jose Vargas Source Type: research

Interventional Cryoablation Therapy of Paroxysmal Atrial Fibrillation in Young Patients With Low CHADS2 Score: Worth the Risk of Periprocedural and Long-Term Adverse Events?
In this study the long-term effectiveness in the cryoablation group was reported as 69.9% after 12 months, with a mean fluoroscopy exposure time of 63 min. Regarding the adverse events during follow-up, only 1 adverse event (1.2%) occurred in the drug therapy arm (transfusion because of hemorrhage) compared with 32 adverse events (14.2%) in the cryoablation group, not regarding the 24 patients who suffered temporary phrenic nerve palsy. Five strokes, 4 transient ischemic attacks, 2 cases of tamponades, 2 myocardial infarctions, 3 transfusions, 2 atriovenous fistulas, 2 pseudoaneurysms, 4 cases of persistent phrenic nerve...
Source: Journal of the American College of Cardiology - July 26, 2013 Category: Cardiology Authors: Silke D. Braun Tags: Letters to the Editor Source Type: research

Anaesthesia for carotid surgery
Abstract: Carotid endarterectomy (CEA) is a surgical procedure to prevent strokes in patients with atheromatous disease at the carotid bifurcation. The effectiveness of CEA has been established in large clinical trials. Patients should have surgery performed within 2 weeks from the onset of symptoms. This timeframe presents a challenge to the anaesthetist and surgeon in risk stratifying and optimizing these high-risk patients for surgery. Optimization includes blood pressure (BP) control and use of antiplatelet and lipid-lowering therapy.CEA can be carried out under general anaesthesia (GA) or regional anaesthesia (RA) wit...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Indran Raju, Kenneth Fraser Tags: Vascular Anaesthesia Source Type: research

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