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Endovascular repair of thoracic aortic pathologies: Postoperative nursing implications
Endovascular stent grafting is increasingly used to manage descending thoracic aortic pathologies. The procedure was introduced at the study hospital in 2001. We sought to examine the short-term clinical outcomes of patients who underwent this endovascular stent grafting, with the aim of using the result as baseline for development of an in-center clinical management protocol. We undertook a single-center, retrospective review of health care records of patients managed with thoracic stent grafts from 2001 to 2009. Patient characteristics, in-hospital data, and procedural data were obtained. SPSS was used to analyze the dat...
Source: Journal of Vascular Nursing - June 1, 2014 Category: Nursing Authors: Tanghua Chen, John A. Crozier Tags: Articles Source Type: research

Fatal dabigatran toxicity secondary to acute renal failure
We describe the case of a 74-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation who presented to the emergency department after 20 mL of hematemesis at home. Laboratory evaluation revealed a partial thromboplastin time of 99 seconds, international normalized ratio of 11.7, and creatine of 3.1 mg/dL (baseline creatine, 0.9 mg/dL). Upper endoscopy revealed diffuse gastritis and bleeding. Despite treatment with packed red blood cells and fresh frozen plasma, the patient's hematemesis persisted resulting in significant aspiration requiring endotracheal intubation. Per poison control center recommendation...
Source: The American Journal of Emergency Medicine - November 19, 2012 Category: Emergency Medicine Authors: Joseph K. Maddry, Mana Kouros Amir, Daniel Sessions, Kennon Heard Tags: Case Reports Source Type: research

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

Is moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion superior to deep hypothermic circulatory arrest in elective aortic arch surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion (SACP) is more beneficial than deep hypothermic circulatory arrest in elective aortic arch surgery. Altogether, 1028 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There were four retrospective obser...
Source: Interactive CardioVascular and Thoracic Surgery - August 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Poon, S. S., Estrera, A., Oo, A., Field, M. Tags: Extracorporeal circulation Adult Cardiac Source Type: research

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

610 Infective Endocarditis, Predictors of Mortality and Morbidity
The outcomes of this study is to assess factors associated with in-hospital mortality in patients with infective endocarditis undergoing surgery and to assess the factors associated with morbidity; namely post operative stroke, renal failure and dialysis, complete heart block and return to theatre.
Source: Heart, Lung and Circulation - November 8, 2020 Category: Cardiology Authors: A. Eranki Source Type: research

Open Repair of Acute Type A Intramural Hematoma in 3 Patients.
Abstract Acute aortic syndrome encompasses classic aortic dissection and less common aortic phenomena, including intramural hematoma (IMH), a hemorrhage within the aortic media that occurs without a discrete intimal tear. We reviewed our experience with treating acute type A IMH to better understand this acute aortic syndrome. A review of our clinical database identified 1,902 proximal aortic repairs that were performed from January 2006 through December 2018; of these, 266 were for acute aortic syndrome, including 3 (1.1%) for acute type A IMH. Operative technique varied considerably. All IMH repairs involved hem...
Source: Texas Heart Institute Journal - August 1, 2020 Category: Cardiology Authors: Frankel WC, Weldon SA, Green SY, Amarasekara HS, LeMaire SA, Coselli JS Tags: Tex Heart Inst J Source Type: research

Open Repair of Acute Type A Intramural Hematoma in 3 Patients
Tex Heart Inst J. 2020 Aug 1;47(4):290-297. doi: 10.14503/THIJ-20-7242.ABSTRACTAcute aortic syndrome encompasses classic aortic dissection and less common aortic phenomena, including intramural hematoma (IMH), a hemorrhage within the aortic media that occurs without a discrete intimal tear. We reviewed our experience with treating acute type A IMH to better understand this acute aortic syndrome. A review of our clinical database identified 1,902 proximal aortic repairs that were performed from January 2006 through December 2018; of these, 266 were for acute aortic syndrome, including 3 (1.1%) for acute type A IMH. Operativ...
Source: Texas Heart Institute Journal - January 20, 2021 Category: Cardiology Authors: William C Frankel Scott A Weldon Susan Y Green Hiruni S Amarasekara Scott A LeMaire Joseph S Coselli Source Type: research

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