The heart surgery forum最新文献

{"title":"The Mid-Term Outcomes of Cone Repair or Replacement of Tricuspid Valve in Patients with Ebstein's Anomaly: Our Experience.","authors":"Q. I. Talukder, S. Dasgupta, A. Samad, M. Khan, Ziaur Rahman, M. Kabiruzzaman, A. K. Rahman, F. Ahmed","doi":"10.1532/hsf.4165","DOIUrl":"https://doi.org/10.1532/hsf.4165","url":null,"abstract":"BACKGROUND\u0000Cone repair of the tricuspid valve (TV) is a contemporary reproducible technique for surgical reconstruction of Ebstein's anomaly. Different authorities have shown that this technique restores excellent tricuspid valve function. In Bangladesh, this technique still is unfamiliar to many. We hereby present a case series of cone repair and TV replacement with the mid-term outcome (one year to six years) at the National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh.\u0000\u0000\u0000METHODS\u0000We prospectively studied 21 patients, who underwent surgical intervention (cone repair or tricuspid valve replacement) for Ebstein's anomaly of TV from March 2014 to June 2020. We divided the total patient population into the cone repair and TV replacement groups. Preoperative, postoperative, and follow-up data were collected from the hospital records, telephone conversations, and clinic visits. All collected data statistically were analyzed.\u0000\u0000\u0000RESULTS\u0000Our patients showed there were statistically significant improvements after surgical intervention with regard to tricuspid regurgitation (TR) (P < 0.001), tricuspid annular plane systolic excursion (TAPSE) (P < 0.001), right ventricular (RV) function (P < 0.001), and New York Heart Association (NYHA) class (P < 0.001). These developments were sustained throughout the follow-up period.\u0000\u0000\u0000CONCLUSION\u0000Cone repair should be offered to the symptomatic patients of Ebstein's anomaly because symptoms relief, reduction of morbidity, and survival benefits are excellent. Above all, the cone reconstruction shows fantastic results and may well become the surgical technique for patients with Ebstein's anomaly. We hope that new valve repair programs may provide extended longevity and restored quality of life to the patient of Ebstein's anomaly (EA) with the appropriate measures. In case of failed repair, valve replacement is an encouraging option.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127674194","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}

{"title":"Effects of Melatonin for Delirium in Elderly Acute Heart Failure Patients: A Randomized, Single-Center, Double-Blind, and Placebo-Controlled Trial.","authors":"B. Yin, Ting Ye, Xinxia Liu, Ronghua Wan, Lilei Gu, Gangjun Zong","doi":"10.1532/hsf.4325","DOIUrl":"https://doi.org/10.1532/hsf.4325","url":null,"abstract":"BACKGROUND\u0000Delirium is a common, life-threatening, typical clinical syndrome with the main clinical manifestations of temporary organic mental disorder without specific drug treatment. The aim of the study was to explore the benefits of melatonin for the treatment of delirium after acute heart failure in elderly patients.\u0000\u0000\u0000METHODS\u0000This was a randomized, double-blind, and placebo-controlled trial. This study enrolled patients aged more than 60 years after acute heart failure. A computer-generated randomization sequence (in a 1:1 ratio) was used to randomly assign patients to receive either melatonin (3 mg/day, 7 days) or placebos. The primary endpoint was the incidence of delirium, assessed twice daily with the Confusion Assessment Method during the first 7 days. Analyses were performed by intention-to-treat and safety populations.\u0000\u0000\u0000RESULTS\u0000Between October 2015 and October 2019, 584 patients were assessed. A total of 497 patients randomly were assigned to receive either placebo (N = 249) or melatonin (N = 248). The incidence of delirium was significantly lower in the melatonin group than in the placebo group (27.0% vs. 36.9%, P = 0.021). Regarding safety, the occurrence of rhabdomyolysis and abnormal hepatic function did not differ between the two groups.\u0000\u0000\u0000CONCLUSION\u0000The current study (clinical trial registered number: CHWX-904-201511) suggests that acute melatonin treatment can reduce the incidence of delirium for elderly acute heart failure. It also can reduce the time of hospital stays and hospitalization costs. The therapy was safe and worth spreading.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131042585","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}

{"title":"Pulmonary Embolism Caused by Tourniquets in the Lower Extremities Treated with ECMO - A Case Report.","authors":"X. Liao, Miaoyun Guo, Junlin Wen, Weizhao Huang, Hong-yu Ye, Binfei Li","doi":"10.21203/rs.3.rs-1265394/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-1265394/v1","url":null,"abstract":"BACKGROUND\u0000Using tourniquets in the lower extremities can increase the incidence of deep vein thrombosis (DVT). Acute large-area pulmonary embolism (APE) occurs in severe cases, and it is fatal to most patients. Acute large-area pulmonary embolism causes haemodynamic instability, right heart failure, and circulatory failure.\u0000\u0000\u0000CASE PRESENTATION\u0000A 47-year-old female patient was subjected to spinal anaesthesia for a comminuted fracture of the tibia and fibula of the left lower limb. After the tourniquet was released during the operation, she had sudden hypotension and lost consciousness. Thus, ECMO was used to support patient circulation. With ECMO-assisted CT examination, she was diagnosed to have a pulmonary embolism. On the next day, she was subjected to a bilateral pulmonary embolism and embolectomy. Lastly, she was transferred to the general ward and discharged smoothly.\u0000\u0000\u0000CONCLUSIONS\u0000Patients undergoing fracture surgery should be wary of APE caused by the loss of DVT after the release of tourniquets. ECMO, as a rapid and effective temporary life support intervention, provides effective cardiopulmonary support and new treatment plans. It also saves time for further treatment of patients with high-risk APE.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117130174","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}

{"title":"Analysis of Risk Factors of Early Mortality After Pericardiectomy For Constrictive Pericarditis.","authors":"Jing-Bin Huang, Z. Wen, Jian-rong Yang, Jun-jun Li, Min Li, Chang-chao Lu, Da-ying Liang, Chenggang Wei","doi":"10.1532/hsf.4329","DOIUrl":"https://doi.org/10.1532/hsf.4329","url":null,"abstract":"BACKGROUND\u0000We aimed to investigate risk factors of early mortality following pericardiectomy.\u0000\u0000\u0000METHODS\u0000This was a retrospective study of patients undergoing pericardiectomy between January 1994 and May 2021 at The People's Hospital of Guangxi Zhuang Autonomous Region, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, and The People's Hospital of Liuzhou City.\u0000\u0000\u0000RESULTS\u0000This study included 826 patients, who were divided into two groups: group with operative deaths (N = 66) and group without operative deaths (N = 760). There were 66 operative deaths (66/826, 8.0%). The causes of operative deaths were multiorgan failure (86/826, 10.4%). Preoperative CVP (P < 0.001), chest drainage (P < 0.001), surgical duration (P < 0.001), fluid balance postoperative day D2 (P < 0.001), and tuberculosis pericarditis (P = 0.001) in group with operative deaths were significantly higher than those in group without operative deaths. Univariate and multivariate analyses showed that factors associated with operative deaths include male (P < 0.001), age (P < 0.001), ICU retention time (P < 0.001), postoperative hospitalization time (P < 0.001), preoperative central venous pressure (P = 0.018), postoperative central venous pressure (P < 0.001), D0 fluid balance (P < 0.001), D2 fluid balance (P < 0.001), postoperative chest drainage (P = 0.029), surgical duration (P = 0.003), serum creatinine baseline (P = 0.002), serum creatinine 24h after surgery (P < 0.001), serum creatinine 48h after surgery (P < 0.001), blood lactate (P < 0.001), and tuberculosis pericarditis (P = 0.033).\u0000\u0000\u0000CONCLUSION\u0000In our study, incomplete pericardial dissection, fluid overload, and tuberculosis pericarditis are associated with operative deaths following pericardiectomy.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128616543","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}

{"title":"Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study.","authors":"M. Xie, Ya Ting Chen, He Zhang, Hai Tao Zhang, Keyan Pan, Xiao Fang Chen, Xiao-li Xie","doi":"10.1532/hsf.4297","DOIUrl":"https://doi.org/10.1532/hsf.4297","url":null,"abstract":"BACKGROUND\u0000Postoperative pneumonia (PP) is the most common primary infection after cardiac surgery, increasing the hospitalization expense and causing the consumption of healthcare resources. This study aimed to investigate the diagnostic value of procalcitonin (PCT) and interleukin-6 (IL-6) on early postoperative pneumonia after adult cardiac surgery.\u0000\u0000\u0000METHODS\u0000In this prospective observational study, patients with pneumonia and age- and sex-matched cases in our center from October 10, 2020 to January 31, 2021 were included. Patients diagnosed with pneumonia in this study needed meet both clinical and microbiological diagnostic criteria. Blood samples were collected in all patients from postoperative day (POD) 1 to postoperative day 5 to detect PCT, IL-6, white blood cell count, and C-reactive protein. The diagnostic performance of different biomarkers was evaluated by the receiver operating characteristic curves and the area under the curves.\u0000\u0000\u0000RESULTS\u0000Our study enrolled 272 patients, including 24 patients with postoperative pneumonia and 248 age- and sex-matched cases. From POD1 to POD5, the absolute value of PCT and PCT variations showed diagnostic significance for pneumonia (P < .05); the diagnostic value of the absolute value of IL-6 and IL-6 variations was not satisfying. White blood cell count showed no differences; C-reactive protein had no diagnostic value before POD4. Multivariable logistic regression showed that PCT variation and IL-6 variation from POD3 to POD1 were the strongest risk factors for postoperative pneumonia [OR:12.50, 95% CI: (3.40-45.5); OR:13.71, 95% CI: (1.11-168.47)]. According to the above results, we defined the PL Index. PL Index showed the best diagnostic value among those biomarkers in POD3 [AUC: 0.90, 95% CI: (0.79-0.95)]. Multivariable logistic regression showed PL Index POD3 has significant correlation with postoperative pneumonia [OR:1.23, 95% CI: (1.11-1.37), P = .041].\u0000\u0000\u0000CONCLUSIONS\u0000PCT variation and IL-6 were more accurate than C-reactive protein and white blood cell count to predict early postoperative pneumonia, but the diagnostic properties of PCT could not be observed during the first three postoperative days due to the inflammatory process. By combining the variations of PCT and IL-6, we defined the PL Index, which shows the best diagnostic ability on early postoperative pneumonia after adult cardiac surgery.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127461503","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}

{"title":"Expert Opinions on the Debate of Pericardial Reconstruction in Cardiovascular Surgery: To Close or Not to Close?","authors":"A. Rego, W. Boyd, E. Góngora, William E. Johnson, III, N. Munfakh, John P Pirris, R. Wolf","doi":"10.1532/hsf.3943","DOIUrl":"https://doi.org/10.1532/hsf.3943","url":null,"abstract":"BACKGROUND\u0000As of 2019, pericardial closure was performed in only a small portion of the over 320,000 cardiac surgeries performed annually. However, evidence regarding the benefits of pericardial closure or reconstruction has been accruing, particularly with the publication of the RECON study in 2019.  Methods: This group of authors convened to try to arrive at consensus expert opinion regarding pericardial reconstruction. Structured topic questions initially were used to stimulate discussion. Subsequently, a survey of proposed expert opinion statements was conducted among the authors. Based on that survey, consensus expert opinion statements and recommendations were compiled.\u0000\u0000\u0000RESULTS\u0000The expert opinions encompass various topics relating to pericardial reconstruction, including definitions, benefits/risks, and technique. Observed benefits include reductions in: (1) adhesions; (2) postoperative pericardial effusion, atrial fibrillation, and bleeding; and (3) readmissions and length of hospital stay. Expert opinion recommendations regarding surgical technique are compiled into a single chart. Complete pericardial reconstruction should be performed, using native pericardial tissue if available and viable; if not feasible, a patch may be used. Patches that stimulate the formation of site-specific tissue in situ (such as natural extracellular matrix) may have additional benefits (including bioregenerative properties and lack of inflammatory response). Closure should be taut, but tension-free. Adequate drainage of the closed pericardium must be ensured.\u0000\u0000\u0000CONCLUSIONS\u0000Based on available data and collective surgical experience, we endorse pericardial reconstruction as standard approach in appropriately selected patients. We also endorse adoption of standardized pericardial reconstruction techniques to optimize patient outcomes and improve evidence quality in future studies.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129836454","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}

{"title":"Effects of Levosimendan Preconditioning on Left Ventricular Remodeling after Myocardial Reperfusion in Acute Myocardial Infarction Patients Receiving Percutaneous Coronary Intervention.","authors":"Shengqin Yu, Jindong Zhang","doi":"10.1532/hsf.4267","DOIUrl":"https://doi.org/10.1532/hsf.4267","url":null,"abstract":"OBJECTIVE\u0000Levosimendan is a novel drug often used to treat heart failure. We aimed to explore the effects of levosimendan preconditioning on left ventricular remodeling (LVR) after myocardial reperfusion in acute myocardial infarction (AMI) patients receiving the percutaneous coronary intervention (PCI).\u0000\u0000\u0000METHODS\u0000A total of 258 AMI patients treated from January 2018 to September 2020 were randomly divided into control and observation groups. Based on conventional drug therapy, levosimendan was given 30 min before PCI for the observation group, and dobutamine was intravenously injected for the control group. Baseline data, thrombolysis in myocardial infarction (TIMI) blood flow grade, myocardial injury markers, and LVR indices were compared, and the influencing factors for LVR were analyzed.\u0000\u0000\u0000RESULTS\u0000After treatment, various degrees of blood perfusion were found, and the TIMI grade was better than that before treatment in both groups (P < .05). The levels of aspartate aminotransferase, creatine kinase-MB, cardiac troponin T, and brain natriuretic peptide (BNP) declined in both groups, more significantly in the observation group (P < .05). Left ventricular end-systolic diameter, left ventricular end-diastolic diameter and left ventricular end-diastolic volume declined, whereas left ventricular ejection fraction rose in both groups, more significantly in the observation group (P < .05). Age and BNP were risk factors for LVR, whereas levosimendan preconditioning was a protective factor (P < .05).\u0000\u0000\u0000CONCLUSION\u0000Levosimendan preconditioning can protect cardiac function and promote the recovery of the left ventricular structure. Age and BNP are risk factors for LVR after myocardial reperfusion in AMI patients undergoing PCI, and levosimendan preconditioning is a protective factor.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115146586","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}

{"title":"Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) in Adults and Pediatrics; Prevention is the Optimal Management.","authors":"Abdulaziz Alghamdi, Mohammed O Aqeeli, Saud Muhaisin Altalhi Q, Fahad Khaled Alshammari M, A. A., K. Al_ebrahim","doi":"10.22541/au.163966522.24111681/v1","DOIUrl":"https://doi.org/10.22541/au.163966522.24111681/v1","url":null,"abstract":"BACKGROUND\u0000Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant and severe complication that affects morbidity and mortality. We studied both pediatric and adult patients using the Acute Kidney Injury Network (AKIN) definition.\u0000\u0000\u0000METHODS\u0000This was an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and approved by the ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. We included 941 patients in the analysis using statistical software SPSS, version 15.0.\u0000\u0000\u0000RESULTS\u0000Of the total number of patients, 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included the age group 60-69 years, cardiopulmonary bypass (CPB), number of grafts, and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX), and the lower preoperative SCr were the main risk factors Conclusion: Conventional conservative management and preoperative identification of predictor risk factors are essential for preventing CSA-AKI, constituting the primary strategy for optimal management.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"186 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125804806","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}

{"title":"Comparative Efficacy of Local and General Anesthesia for Transcatheter Aortic Valve Implantation: A Meta-Analysis and Systematic Review.","authors":"Lulu Gao, Baihan Jin, C. Chao, Bin Wang, Xiaoying Zhang, Jiang Shen","doi":"10.22541/au.162954536.64482469/v1","DOIUrl":"https://doi.org/10.22541/au.162954536.64482469/v1","url":null,"abstract":"BACKGROUND\u0000This meta-analysis aimed to compare the potential effects of local anesthesia (LA) and general anesthesia (GA) for transcatheter aortic valve implantation (TAVI).\u0000\u0000\u0000MEASUREMENTS\u0000All relevant studies were searched from Pubmed, EMbase, Web of Science, and the Cochrane Library (January 1, 2016, to June 1, 2021). The main outcomes of this literature meta-analysis were 30-day mortality, procedural time, new pacemaker implantation, total stay in the hospital, use of the vasoactive drug, and intra-and postoperative complications and emergencies, including conversion to open, myocardial infarction, pulmonary complication, vascular complication, renal injury/failure, stroke, transesophageal echocardiography, life-threatening/major bleeding, cardiac tamponade, and emergency PCI. Pooled risk ratio (RR) and mean difference (MD) together with a 95% confidence interval (CI) were calculated.\u0000\u0000\u0000RESULTS\u0000A total of 17 studies, including 20938 patients, in the final analysis, fulfilled the inclusion criteria. Intra-and postoperative complications (myocardial infarction, vascular complication, renal injury/failure, stroke, and cardiac tamponade) undergoing TAVI in severe AS patients under GA do not offer a significant difference compared with LA. No differences were observed between LA and GA for new pacemaker implantation, total stay in the hospital, transesophageal echocardiography, and emergency PCI. LA has lower mortality compared with GA (RR 0.69, P = 0.600), pulmonary complications (RR 0.54, P = 0.278), life-threatening/major bleeding (RR 0.85, P = 0.855), and lower times of conversion to open (RR 0.22, P = 0.746). LA has many advantages, including a shorter procedure duration (MD=-0.38, P = 0.000) and reduction of the use of the vasoactive drug (RR 0.57, P = 0.000).\u0000\u0000\u0000CONCLUSIONS\u0000For TAVI, both LA with or without sedation and GA are feasible and safe. LA appears a feasible alternative to GA for AS patients undergoing TAVI.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114487859","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}

{"title":"Evaluation of Early Postoperative Period Results of Patients With Type 2 Diabetes Taking Oral Anti-Diabetics Or Insulin Medications, With Microalbuminuria and Normal Creatinine Levels After Coronary Artery Bypass.","authors":"H. Gemalmaz, C. Yücel","doi":"10.22541/au.162730423.33094139/v1","DOIUrl":"https://doi.org/10.22541/au.162730423.33094139/v1","url":null,"abstract":"BACKGROUND\u0000Acute kidney injury (AKI) is one of the most important complications after cardiac surgery and is one of the main causes of morbidity and mortality. Diabetes mellitus also is one of the main risk factors for renal dysfunction in coronary artery bypass graft (CABG). In this study, we aimed to compare the early postoperative period results of type 2 diabetes patients taking oral antidiabetics (OAD) or insulin medications, with microalbuminuria and normal creatinine levels after CABG.\u0000\u0000\u0000METHODS\u0000Eighty patients with type 2 diabetes and taking OAD or receiving insulin medication all with normal creatinine levels with microalbuminuria were included in this study. Preoperative creatinine values of the patients, albumin levels in spot urine, creatinine levels on the postoperative 3rd day, duration of ventilation, amount of drainage, length of stay in the intensive care unit, length of stay in the hospital, mediastinitis, and mortality rates were recorded.\u0000\u0000\u0000RESULTS\u0000A statistically significant increase in creatinine was found in both taking OAD type 2 diabetes and insulin medication with microalbuminuria. When the two groups were compared with each other, the increase in creatinine levels of the patients using insulin was higher than the patients taking OAD. It also was statistically significant.\u0000\u0000\u0000CONCLUSION\u0000According to the result of our study, it can be suggested that postoperative creatinine elevation is observed in patients with type 2 diabetes mellitus with microalbuminuria and with normal creatinine levels, either having insulin medication or not. The elevation is higher in patients having insulin medication, while other results are similar, except for impaired renal function.","PeriodicalId":257138,"journal":{"name":"The heart surgery forum","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129281569","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}