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Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association
Circulation. 2021 Apr 8:CIR0000000000000968. doi: 10.1161/CIR.0000000000000968. Online ahead of print.ABSTRACTPerioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including...
Source: Circulation - April 8, 2021 Category: Cardiology Authors: Curtis Benesch Laurent G Glance Colin P Derdeyn Lee A Fleisher Robert G Holloway Steven R Mess é Christina Mijalski M Timothy Nelson Martha Power Babu G Welch American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Source Type: research

Frequency of and Determinants of Stroke After Surgical Aortic Valve Replacement in Patients With Previous Cardiac Surgery (from the Multicenter RECORD Initiative)
In conclusion, the risk of postoperative stroke after S-AVR in patients with previous cardiac surgery is high and has an impact on the immediate and late mortality. Excessive bleeding requiring blood transfusion and/or reexploration, prolonged cardiopulmonary bypass time, and use of intra-aortic balloon pump were associated with an extremely high rate of stroke.
Source: The American Journal of Cardiology - September 3, 2013 Category: Cardiology Authors: Fausto Biancari, Francesco Onorati, Giovanni Mariscalco, Marisa De Feo, Antonio Messina, Giuseppe Santarpino, Francesco Santini, Cesare Beghi, Gianantonio Nappi, Giovanni Troise, Theodor Fischlein, Giancarlo Passerone, Jouni Heikkinen, Giuseppe Faggian Tags: Valvular Heart Disease Source Type: research

The impact of surgical left atrial appendage amputation/ligation on stroke prevention in patients undergoing off-pump coronary artery bypass grafting
AbstractStroke is a major adverse event in patients developing atrial fibrillation (AF) after cardiac surgery. Surgical left atrial appendage amputation/ligation (LAA-A/L) during off-pump coronary artery bypass grafting (OPCAB) is routinely performed in our institution. We analyzed 578 consecutive patients (mean age 69  years, male 82%) undergoing OPCAB with or without concomitant LAA-A/L from 2011 to 2014 at our institution in a prospective observational manner. The safety and efficacy of the concomitant LAA-A/L on preventing early (<30  days) and overall postoperative stroke were examined. A total of 193 patients (3...
Source: Heart and Vessels - November 8, 2016 Category: Cardiology Source Type: research

Incidence of perioperative stroke in clampless aortic anastomosis during off-pump coronary artery bypass grafting
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed. In-hospital ...
Source: Heart and Vessels - December 12, 2017 Category: Cardiology Source Type: research

Clinical outcomes and management associated with major bleeding in patients with atrial fibrillation treated with apixaban or warfarin: insights from the ARISTOTLE trial
Conclusion Major bleeding was associated with substantially increased risk of death, ischaemic stroke, or MI, especially following ICH, and this risk was similarly elevated regardless of treatment with apixaban or warfarin. These results underscore the importance of preventing bleeding in anti-coagulated patients. Clinical Trials.gov identifier NCT00412984.
Source: European Heart Journal - May 21, 2015 Category: Cardiology Authors: Held, C., Hylek, E. M., Alexander, J. H., Hanna, M., Lopes, R. D., Wojdyla, D. M., Thomas, L., Al-Khalidi, H., Alings, M., Xavier, D., Ansell, J., Goto, S., Ruzyllo, W., Rosenqvist, M., Verheugt, F. W. A., Zhu, J., Granger, C. B., Wallentin, L. Tags: Thrombosis and antithrombotic therapy Source Type: research

Long-term outcomes in patients after left atrial appendage occlusion. The results from the LAAO SILESIA registry
CONCLUSIONS: Based on a "real-life" cohort of patients from the Silesian Province, we concluded that LAAO is related to low in-hospital MACE. In the long-term follow up, LAAO reduced the rates of stroke and bleeding.PMID:35167113 | DOI:10.33963/KP.a2022.0047
Source: Polish Heart Journal - February 15, 2022 Category: Cardiology Authors: Krzysztof Myrda Witold Streb Wojciech Wojakowski Jacek Piegza Katarzyna Mitr ęga Grzegorz Smolka Jolanta Nowak Tomasz Podolecki Ewa Gasiewska- Żurek Alicja Nowowiejska-Wiewi óra Malwina Smolarek-Nicpo ń Micha ł Skrzypek Mariusz G ąsior Zbigniew Kala Source Type: research

Abstract 198: Racial Disparity In Resuming Anticoagulation For Atrial Fibrillation After An Episode Of Major Gastrointestinal Bleeding Poster Session II
Conclusion: In conclusion, the racial disparity in resuming warfarin after an episode of major GIB in anticoagulated patients for atrial fibrillation was more for Caucasians than African American. This may be explained by uncertainty of outcomes that frequently leads to overtreatment of minority patients. Cultural beliefs for not resuming warfarin might have also played a role.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Qureshi, W., Garikapati, K., Patsias, I., Cheema, G., Mittal, C., Alirhayim, Z., Paje, D. Tags: Poster Session II Source Type: research

Novel Oral Anticoagulants in Cardiovascular Disease
Nonvalvular atrial fibrillation (AF) confers an increased risk of thromboembolism, with a 5-fold higher risk of ischemic stroke. Oral anticoagulation (OAC) has shown to be highly effective in preventing stroke and mortality compared to placebo and is also used in patients without AF for both treatment and prophylaxis of venous thromboembolism. The OAC halts the coagulation by different mechanisms. Until recently, the only option was the vitamin K antagonists (VKAs), but their inherent limitations have promoted the development of novel oral anticoagulants (NOACs), which may offer efficacious and safer alternatives. Patients...
Source: Journal of Cardiovascular Pharmacology and Therapeutics - December 17, 2013 Category: Cardiology Authors: Gallego, P., Roldan, V., Lip, G. Y. H. Tags: Cardiovascular Pharmacology Core Reviews Source Type: research

Clinical outcomes after hybrid coronary revascularization versus coronary artery bypass surgery: a meta-analysis of 1,190 patients
Conclusions: Hybrid coronary revascularization is associated with lower morbidity and similar in-hospital and 1-year major adverse cerebrovascular or cardiac events rates, but greater requirement for repeat revascularization compared with CABG. Further exploration of this strategy with adequately powered randomized trials is warranted.
Source: American Heart Journal - January 30, 2014 Category: Cardiology Authors: Ralf E. Harskamp, Akshay Bagai, Michael E. Halkos, Sunil V. Rao, William B. Bachinsky, Manesh R. Patel, Robbert J. de Winter, Eric D. Peterson, John H. Alexander, Renato D. Lopes Tags: Interventional Cardiology Source Type: research

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