The heart surgery forum最新文献_第3页

A Single-Centre, Retrospective Research Evaluation of the Effect of Extended Intervention Model Based on Case Management of Treatment Compliance and Cardiac Function on Patients with Chronic Heart Failure 基于治疗依从性和心功能个案管理的扩展干预模式对慢性心力衰竭患者的影响的单中心回顾性研究评估

The heart surgery forum Pub Date : 2023-12-13 DOI: 10.59958/hsf.6729

Songna Ren, Xuemian Yang, Yuan Niu, Xiaohui Hao, Suosuo Wang, Songjie Ren, Yiqing Liu

{"title":"A Single-Centre, Retrospective Research Evaluation of the Effect of Extended Intervention Model Based on Case Management of Treatment Compliance and Cardiac Function on Patients with Chronic Heart Failure","authors":"Songna Ren, Xuemian Yang, Yuan Niu, Xiaohui Hao, Suosuo Wang, Songjie Ren, Yiqing Liu","doi":"10.59958/hsf.6729","DOIUrl":"https://doi.org/10.59958/hsf.6729","url":null,"abstract":"Objective: To explore the effect of case management-based extended intervention model on treatment compliance and cardiac function in patients with chronic heart failure. Methods: This study retrospectively analysed the clinical data of 203 patients with chronic heart failure at Xingtai Third Hospital from January 2019 to January 2022. In accordance with different intervention programs, the patients were divided into a study group (SG, n = 102) and a reference group (RG, n = 101). The SG received the extended intervention model based on case management, and the RG adopted the conventional intervention model. Comparison was conducted on the treatment compliance, cardiac function, activity of daily living scale (ADL) scores and readmission rates in both groups. Results: After intervention, the SG showed higher treatment compliance (p < 0.05), lower heart rate, higher left ventricular ejection fraction, ratio of transmitral peak rapid filling velocity to transmitral peak atrial filling velocity at mitral orifice and six-minute walk distance (p < 0.001) and significantly lower ADL score and readmission rates than the RG (p < 0.05). Conclusion: The extended intervention model based on case management positively influences the treatment compliance of patients with chronic heart failure and continuously improves patients' cardiac function, reduces the readmission rate, enhances daily living ability, comprehensively increases clinical efficacy and benefits patients for a long period.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Costs and Readmissions Associated with Type A Aortic Dissections at High- and Low-Volume Centers 高容量和低容量中心 A 型主动脉夹层的相关费用和再住院率

The heart surgery forum Pub Date : 2023-12-13 DOI: 10.59958/hsf.6821

Alice L Zhou, L. Yesantharao, E. Etchill, I. Barbur, Benjamin L. Shou, Hamza Aziz, C. W. Choi, Jennifer S. Lawton, Ahmet Kilic

{"title":"Costs and Readmissions Associated with Type A Aortic Dissections at High- and Low-Volume Centers","authors":"Alice L Zhou, L. Yesantharao, E. Etchill, I. Barbur, Benjamin L. Shou, Hamza Aziz, C. W. Choi, Jennifer S. Lawton, Ahmet Kilic","doi":"10.59958/hsf.6821","DOIUrl":"https://doi.org/10.59958/hsf.6821","url":null,"abstract":"Background: Costs and readmissions associated with type A aortic dissection repairs are not well understood. We investigated statewide readmissions, costs, and outcomes associated with the surgical management of type A aortic dissection repairs at low- and high-volume centers. Methods: We identified all adult type A aortic dissection patients who underwent operative repair in the Maryland Health Services Cost Review Commission's database (2012–2020). Hospitals were stratified into high- (top quartile of total repairs) or low-volume centers. Results: Of the 249 patients included, 193 (77.5%) were treated at a high-volume center. Patients treated at high- and low-volume centers had no differences in age, sex, race, primary payer, or severity (all p > 0.5). High- compared to low-volume centers had a greater proportion of patients transferred in (71.5% vs. 17.9%, p < 0.001). High-volume centers also had longer lengths of stay (12 vs. 8 days, p < 0.001), similar inpatient mortality (13.0% vs. 16.1%, p = 0.6), and similar proportion of patients readmitted (54.9% vs. 51.8%, p = 0.7). High-volume centers had greater index admission costs ($114,859 vs. $72,090, p < 0.001) and similar readmission costs ($48,367 vs. $42,204, p = 0.5). At high-volume centers, transferred patients compared to direct admissions had greater severity of illness (p = 0.05), similar mortality (p = 0.53), and greater lengths of stay (p = 0.05). Conclusions: High-volume centers had a greater number of patients transferred from other institutions compared to low-volume centers. High-volume centers were associated with increased index admission resource utilization, with transfer patients having higher illness severity and greater resource utilization, yet similar mortality, compared to direct admission patients.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"82 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Novel Risk Score to Predict Thirty-Day Readmissions after Acute Type A Aortic Dissections 预测急性 A 型主动脉夹层术后三十天再入院的新型风险评分法

The heart surgery forum Pub Date : 2023-12-13 DOI: 10.59958/hsf.6819

Danial Ahmad, E. Aranda-Michel, Derek Serna-Gallegos, G. Arnaoutakis, James A. Brown, Sarah Yousef, Rashmi Rao, Yisi Wang, Julie Phillippi, Ibrahim Sultan

{"title":"A Novel Risk Score to Predict Thirty-Day Readmissions after Acute Type A Aortic Dissections","authors":"Danial Ahmad, E. Aranda-Michel, Derek Serna-Gallegos, G. Arnaoutakis, James A. Brown, Sarah Yousef, Rashmi Rao, Yisi Wang, Julie Phillippi, Ibrahim Sultan","doi":"10.59958/hsf.6819","DOIUrl":"https://doi.org/10.59958/hsf.6819","url":null,"abstract":"Background: Readmissions following acute type A aortic dissections (ATAAD) are associated with potentially worse clinical outcomes and increased hospital costs. Predicting which patients are at risk for readmission may guide patient management prior to discharge. Methods: The National Readmissions Database was utilized to identify patients treated for ATAAD between 2010 and 2018. Univariate mixed effects logistic regression was used to assess each variable. Variables were assigned risk points based off the bootstrapped (bias-corrected) odds ratio of the final variable model according to the Johnson's scoring system. A mixed effect logistic regression was run on the risk score (sum of risk points) and 30-day readmission. Calibration plots and predicted readmission curves were generated for model assessment. Results: A total of 30,727 type A aortic dissections were identified. The majority of ATAAD (66%) were in men with a median age of 61 years and 30-day readmission rate of 19.4%. The risk scores ranging from –1 to 14 mapped to readmission probabilities between 3.5% and 29% for ATAAD. The predictive model showed good calibration and receiver operator characteristics with an area under the curve (AUC) of 0.81. Being a resident of the hospital state (OR: 2.01 [1.64, 2.47], p < 0.001) was the highest contributor to readmissions followed by chronic kidney disease (1.35 [1.16, 1.56], p = 0), discharge to a short-term facility (1.31 [1.09, 1.57], p = 0.003), and developing a myocardial infarction (1.20 [1.00, 1.45], p = 0.048). Conclusions: The readmission model had good predictive capability given by the large AUC. Being a resident in the State of the index admission was the most significant contributor to readmission.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Comparative Study of 64-Slice Coronary CT Angiography (CCTA) and Myocardial Perfusion Imaging (MPI) in the Identification of Coronary Artery Stenosis 64 片冠状动脉 CT 血管造影 (CCTA) 与心肌灌注成像 (MPI) 在识别冠状动脉狭窄方面的比较研究

The heart surgery forum Pub Date : 2023-12-13 DOI: 10.59958/hsf.6685

Bin Li, Dandan Wu

{"title":"A Comparative Study of 64-Slice Coronary CT Angiography (CCTA) and Myocardial Perfusion Imaging (MPI) in the Identification of Coronary Artery Stenosis","authors":"Bin Li, Dandan Wu","doi":"10.59958/hsf.6685","DOIUrl":"https://doi.org/10.59958/hsf.6685","url":null,"abstract":"Objective: The aim of this study was to compare the diagnostic accuracy of 64-Slice Coronary Computer Tomography Angiography (CCTA) and Myocardial Perfusion Imaging (MPI) in the identification of significant coronary artery stenosis (>50% luminal narrowing). Methods: A total of 120 patients suspected of having coronary artery disease were divided into two groups, with 60 patients in each group. Group 1 underwent CCTA and group 2 underwent MPI. Diagnostic accuracy parameters, image quality, radiation exposure, and procedure time were compared. Results: CCTA demonstrated higher sensitivity (90% vs. 80%, p = 0.049) and similar specificity (75% vs. 70%, p = 0.453) compared to MPI. Image quality was slightly superior in the CCTA group. Radiation exposure was significantly lower in the CCTA group compared to the MPI group (3.5 ± 1.2 mSv vs. 9.4 ± 1.7 mSv, p < 0.001). The procedure time for CCTA was also significantly less than that for MPI (10.3 ± 2.1 minutes vs. 45.2 ± 5.3 minutes, p < 0.001). Conclusion: CCTA showed superior sensitivity, image quality, and efficiency compared to MPI while exposing patients to a lower radiation dose. Further multicenter studies with larger patient populations are needed to validate these findings.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Female Gender in Cardiac Surgery: Is it Still a Significant Risk? A Retrospective Study in Saudi Arabia 心脏手术中的女性性别：是否仍有重大风险？沙特阿拉伯的一项回顾性研究

The heart surgery forum Pub Date : 2023-12-13 DOI: 10.59958/hsf.6929

Khaled Ebrahim Al-Ebrahim, Abdullah Hisham Baghaffar, M. Fatani, Lamis Award Alassiri, S. A. Albishri, Atheer Mohammed Althaqafi, Reem Abdulkhaliq Alghamdi, Nura Fikri Alshoaibi, S. S. Algarni, Marah Meshal Alsulami, Saud Abdulaziz Albukhari, A. K. Alassiri, A. Elassal

{"title":"Female Gender in Cardiac Surgery: Is it Still a Significant Risk? A Retrospective Study in Saudi Arabia","authors":"Khaled Ebrahim Al-Ebrahim, Abdullah Hisham Baghaffar, M. Fatani, Lamis Award Alassiri, S. A. Albishri, Atheer Mohammed Althaqafi, Reem Abdulkhaliq Alghamdi, Nura Fikri Alshoaibi, S. S. Algarni, Marah Meshal Alsulami, Saud Abdulaziz Albukhari, A. K. Alassiri, A. Elassal","doi":"10.59958/hsf.6929","DOIUrl":"https://doi.org/10.59958/hsf.6929","url":null,"abstract":"Background: Female sex is considered an independent predictor for mortality and morbidity following cardiac surgery. This study is to review the outcomes of adult cardiac surgery between males and females in a Saudi tertiary referral hospital. Method: This was a retrospective study for 925 adult patients operated on for ischemic coronary artery disease and acquired aortic and mitral valvular heart disease from 2015 to August 2023. We analyzed patient characteristics, intraoperative data, and postoperative results to compare outcomes between males and females. Results: Preoperative risk factors were not significantly different in both groups. Postoperative outcomes showed gender-based differences. In univariable analysis, females, compared to males, had significantly greater odds of prolonged postoperative ventilation (>24 hours), 32.8% of females compared to 20.7% of males (p < 0.001). Also, sternal wound infection was notably higher among females (13.3%) (p < 0.001). Mortality also exhibited a significant association, with 14.2% of females experiencing mortality compared to 9.4% of males (p = 0.049). In the multivariable analysis for elevated postoperative troponin, the use of pre-operative intra-aortic balloon pump, urgent/emergent surgery, elevated pre-operative troponin and combined bypass grafting with valve surgery, were also predictive of higher post-operative troponin concentrations (beta = 0.43, 95% CI: 0.25 to 0.62, p < 0.001). Conclusion: Females in Saudi Arabia have an increased risk of short-term morbidity and mortality after cardiac surgery compared to males. Vague and delayed presentation and then the late diagnosis and referral are likely the main contributing factors. This highlights the need to implement preoperative measures to improve early diagnosis and referral to eliminate gender bias.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"63 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peak Blood Lactate at 24 h after ECMO Can Predict 30-day Mortality in Infants after Complex Cardiac Surgery ECMO 术后 24 小时的血乳酸峰值可预测复杂心脏手术后婴儿的 30 天死亡率

The heart surgery forum Pub Date : 2023-12-07 DOI: 10.59958/hsf.5639

Fanwei Meng, Jianchao Li, Weijie Liang, Haoju Dong, Bing Li, Xiaoliang Qian, Leiyi Yang, Zhaoyun Cheng

{"title":"Peak Blood Lactate at 24 h after ECMO Can Predict 30-day Mortality in Infants after Complex Cardiac Surgery","authors":"Fanwei Meng, Jianchao Li, Weijie Liang, Haoju Dong, Bing Li, Xiaoliang Qian, Leiyi Yang, Zhaoyun Cheng","doi":"10.59958/hsf.5639","DOIUrl":"https://doi.org/10.59958/hsf.5639","url":null,"abstract":"Objective: Peak blood lactate at 24 h after extracorporeal membrane oxygenation (ECMO) can predict 30-day mortality in infants after complex cardiac surgery. Methods: Twenty-eight infants with ECMO after complex congenital heart disease surgery were selected from March 2019 to March 2022 in our hospital. The infants were divided into survival group (n = 11) and non-survival group (n = 17) according to 30-day survival after discharge from hospital. The risk factors at 30-day mortality after discharge were analyzed by Cox regression analysis. Results: When compared to the non-survival group, there were significant differences in peak blood lactate at 24 h after ECMO, liver dysfunction and multiple organ dysfunction syndrome (MODS) in the survival group (p < 0.05). Cox regression analysis showed that peak blood lactate at 24 h after ECMO (HR = 1.074, 95% CI: 1.005–1.149, p = 0.036) and MODS (HR = 4.120, 95% CI: 1.373–12.362, p = 0.012) were related risk factors affecting the prognosis of infants. The best cutoff value for the peak blood lactate at 24 h after ECMO was 10.2 mmol/L. The area under the curve (AUC) for predicting the 30-day survival rate of the ECMO assisted infants after discharge from hospital was 0.770 (95% CI: 0.592–0.948, p = 0.018), with a sensitivity of 94.1% and specificity of 54.5%. Conclusion: The peak blood lactate at 24 h after ECMO can predict the 30-day mortality after discharge of infants treated with ECMO after complex cardiac surgery. The best cut-off value for peak blood lactate at 24 h after ECMO was 10.2 mmol/L.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"8 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation between Mean Platelet Volume and Gensini Score in Patients with Coronary Heart Disease in Different Diabetic States 不同糖尿病状态下冠心病患者的平均血小板体积与 Gensini 评分之间的相关性

The heart surgery forum Pub Date : 2023-12-07 DOI: 10.59958/hsf.6937

Qining Qiu, Guohong Zhu, Gang Peng, Lumin Wang, Hao Lu, Ye Xu, Wenjun Zhang, Yun Shen, Yanrong Ye, QianZhou Lv, Qingle Wang

{"title":"Correlation between Mean Platelet Volume and Gensini Score in Patients with Coronary Heart Disease in Different Diabetic States","authors":"Qining Qiu, Guohong Zhu, Gang Peng, Lumin Wang, Hao Lu, Ye Xu, Wenjun Zhang, Yun Shen, Yanrong Ye, QianZhou Lv, Qingle Wang","doi":"10.59958/hsf.6937","DOIUrl":"https://doi.org/10.59958/hsf.6937","url":null,"abstract":"Subject: To investigate the correlation between mean platelet volume (MPV) levels and Gensini scores in stable coronary heart disease (CHD) patients with or without diabetes. Methods: A retrospective analysis was conducted on 2525 patients with stable CHD in Zhongshan Hospital, Fudan University. There were 1274 in the low MPV group and 1251 in the high MPV group, divided by a median MPV level of 10.9 fL. In the total population, 1605 patients were non-diabetic and 920 were diabetic. The severity of coronary artery disease was quantified using the Gensini score. Results: The Gensini score was significantly higher in the high MPV group than in the low MPV group (p < 0.001). MPV levels increased significantly with the number of stenotic (>50%) coronary vessels (p < 0.001). The Spearman analysis showed a positive correlation between MPV and Gensini score (r = 0.189, p < 0.001), which was more significant in the diabetic subgroup (r = 0.232, p < 0.001). Receiver operating characteristic (ROC) curves were employed to assess the predictive value of MPV for high Gensini scores, using the median value of 32 points as the cutoff. MPV levels in the diabetes cohort exhibited a higher predictive value for high Gensini scores (area under the curve: 0.635 [0.614–0.657], p < 0.001). Multivariate linear regression analysis showed that diabetes and MPV were independently associated with Gensini scores. Conclusion: MPV levels in stable CHD patients can predict the severity of coronary artery stenosis. This correlation is more significant in the presence of diabetes.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case Report of Arteriovenous Fistula Penetrating into the Ascending Aorta Due to Right Internal Jugular Vein Placement. 右颈内静脉置管致动静脉瘘穿透升主动脉1例。

IF 0.6

The heart surgery forum Pub Date : 2022-10-31 DOI: 10.1532/hsf.4937

Fanwei Meng, Zhi-Ping Liu, Jian Wang

引用次数: 0

Short-Term Nutritional Support Improves The Preoperative Nutritional Status of Infants With Non-Restrictive Ventricular Septal Defect: A Prospective Controlled Study. 短期营养支持改善非限制性室间隔缺损婴儿术前营养状况:一项前瞻性对照研究。

IF 0.6

The heart surgery forum Pub Date : 2022-10-31 DOI: 10.1532/hsf.5009

Li-Ping Xu, Shi-Hao Lin, Qi-Liang Zhang, Yirong Zheng, Guangming Lin

{"title":"Short-Term Nutritional Support Improves The Preoperative Nutritional Status of Infants With Non-Restrictive Ventricular Septal Defect: A Prospective Controlled Study.","authors":"Li-Ping Xu, Shi-Hao Lin, Qi-Liang Zhang, Yirong Zheng, Guangming Lin","doi":"10.1532/hsf.5009","DOIUrl":"https://doi.org/10.1532/hsf.5009","url":null,"abstract":"Objective: To investigate the effect of short-term nutritional support on improving preoperative nutritional status of infants with non-restrictive ventricular septal defect.Methods: A prospective randomized controlled study was conducted from June 2021 to December 2021 at a provincial children's hospital in China. The difference of nutritional status between the intervention group and the control group after short-term nutritional support was compared.Results: After one month of nutritional support, the weight, STRONGkids score, albumin, prealbumin, and hemoglobin in the intervention group significantly were higher than those in the control group (P < 0.05). The postoperative intensive care time and discharge time of the two groups significantly were lower in the intervention group than those in the control group (P < 0.05).Conclusion: The preoperative nutritional support of 1 month for infants with non-restrictive ventricular septal defect can effectively improve their preoperative nutritional status and promote postoperative recovery.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":" ","pages":"E745-E749"},"PeriodicalIF":0.6,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40460498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mesenteric Ischemia After Cardiac Surgery in Dialysis Patients: An Overlooked Risk Factor. 透析患者心脏手术后肠系膜缺血:一个被忽视的危险因素。

IF 0.6

The heart surgery forum Pub Date : 2022-10-31 DOI: 10.1532/hsf.4859

Daisuke Takeyoshi, Tomonori Shirasaka, Keisuke Shibagaki, Ryo Okubo, Shingo Kunioka, Yuta Kikuchi, Hiroyuki Kamiya

{"title":"Mesenteric Ischemia After Cardiac Surgery in Dialysis Patients: An Overlooked Risk Factor.","authors":"Daisuke Takeyoshi, Tomonori Shirasaka, Keisuke Shibagaki, Ryo Okubo, Shingo Kunioka, Yuta Kikuchi, Hiroyuki Kamiya","doi":"10.1532/hsf.4859","DOIUrl":"https://doi.org/10.1532/hsf.4859","url":null,"abstract":"Background: No study has examined the association of the calcification of abdominal artery orifices with nonocclusive mesenteric ischemia (NOMI) in dialysis patients undergoing cardiac surgery. Thus, this study aimed to determine whether calcification of abdominal blood vessel orifices in hemodialysis patients may be a risk factor for NOMI and examine the long-term survival of dialysis patients after undergoing cardiac surgery.Methods: From April 2014 to September 2020, 100 dialysis patients underwent cardiac surgery at our hospital. The calcification of the celiac artery (CA) and superior mesenteric artery (SMA) was evaluated by computed tomography, and the degree of orifice stenosis was graded as follows: patent, 0; partial occlusion, 1; and complete occlusion, 2.Results: Eight patients experienced NOMI, and all of them died. SMA calcification scores were not significantly different between the NOMI and non-NOMI groups (1.38±0.52 vs. 1.13±0.69; P = 0.247). However, the average CA orifice calcification score was significantly greater in the NOMI group than in the non-NOMI group (1.63±0.52 vs. 1.15±0.65; P = 0.039), and the SMA+CA orifice calcification scores were significantly different between the groups (3.00±0.76 vs. [non-NOMI] 2.25±1.18; P = 0.028). In all patients, the 30-day and in-hospital mortality rates were 13% and 18%, respectively. All patients were completely followed up with a mean follow-up period of 604±585 days. Kaplan-Meier survival curves showed that patients with SMA and CA calcification tended to have a shorter overall survival than patients without calcification; however, no significant difference was noted.Conclusions: The calcification of CA and/or SMA orifices was associated with postoperative NOMI and poor long-term survival among dialysis patients undergoing cardiac surgery.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":" ","pages":"E732-E738"},"PeriodicalIF":0.6,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40660001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1