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2,000 results for “Cardiac surgery; .”
Process Flow Diagram of Cardiac Surgery Pathway
<p><em><strong>This image is supplementary material for:</strong></em></p> <p>Currie, C. S.M. Monks, T. (2018) <em>Modelling Diseases: Prevention, Cure, and Management.</em> In M. Rabe, A. Juan, N. Mustafee, A. Skoogh, & B. Johansson (Eds.). Proceedings of the Winter Simulation Conference 2018. Gothenburg, Sweden.</p> <p><em>Relevant to:</em></p> <p><strong>Section 4.1.4. Spend some Time Observing How the Operations of the Disease Pathway are Managed</strong></p> <p>The description of the disease pathway obtained in the initial meeting may be idealized. It is advised that modelers spend at least a few hours in the one or more services in the real pathway to observe how it operates and to interview on-the-ground workforce. Observations of the system under pressure are useful to understand the complexities of the pathway and will reveal aspects that have been missed or that operate differently from described. This Figure illustrates a cardiac surgery pathway at a large hospital that operated on patients from a network of smaller hospitals in the UK. The diagram itself was primarily constructed in an initial meeting with a group of cardiac surgeons. Observation of the system and shadowing of specialist cardiac nurses revealed two differences from the idealized model. Firstly, patients could deteriorate and ‘bounce back’ from post-operative care to higher levels of care. Secondly, in times of pressure, the post operative beds were used flexibly to accommodate patients waiting for surgery and those who had already undergone surgery.</p>
Database used in : Analysis of intermunicipal journeys for cardiac surgery in Brazilian Unified Health System (SUS): an approach based on network theory
<p>Data and scripts referring to the results generated in the article entitled: <strong>Analysis of intermunicipal journeys for cardiac surgery in Brazilian Unified Health System (SUS): an approach based on network theory.</strong></p> <p> </p> <p>To obtain the results of the work the following sequence of database treatment was performed:</p> <p> </p> <p>DATASUS --> BASE_PER_YEAR --> EDGES_BASE --> EDGES_VC_BASE</p> <p>The bases were downloaded from the DATASUS site (link: https://datasus.saude.gov.br/transferencia-de-arquivos/#) in .dbc format separated by month and year; using Tabwin we joined the bases generating a base for each year in csv format. The reformatted bases are gathered together in the file PER_YEAR_BASE.ZIP; from the bases for each year we manually built the files in csv format with the list of the edges with the following fields: "Source", "Target", "Type", "Id", "Label" and "Weight". The "Source" column was filled with data from MUNIC_RES and the "Target" column with data from MUNIC_MOV. The "ID" and "Weight" fields were filled in automatically using Gephi, where the "Weight" column represents the sum of the edge, defined by the pair of Source and Target columns, were repeated throughout the year. This generated the bases containing the list of edges that are grouped in the file EDGES_BASE.ZIP. Each base was filtered to contain only edges related to the city "Vitória da Conquista" and grouped in the file EDGES_VC_BASE.zip</p> <p>INDE BASE --> NODES_BASE</p> <p>To build the list of nodes containing the list of municipalities with their respective geographical locations (in UTM), we used the database of the INDE (available on the link: https://visualizador.inde.gov.br/). The file in shape format was treated in the ArqGis program and the database with the network nodes was created (file NODES_BASE.csv).</p> <p>EDGES_VC_BASE and NODES_BASE --> NETWORK</p> <p>Using the program Gephi we joined the bases referring to the edges (EDGES_VC_BASE) and those referring to the nodes of the network (NODES_BASE) and built the networks for each year studied for the city of "Vitória da Conquista". All networks are in gephi format and compressed in the NETWORKS.zip file.</p> <p>EDGES_VC_BASE and NODES_BASE --> INDICES</p> <p>Using the R script "distance.R" and using as input the files of edges (EDGES_VC_BASE) and nodes (NODES_BASE) we generate files in csv format with the columns: dist_med_in , dist_med_out, Flow_in and flow_out. The indexes dist_med_in and dist_med_out represent the average distance traveled in meters to enter and leave the municipality, respectively; the indexes flow_in and flow_out estimate the quantity of people that entered and left the municipality. All index files are grouped in the compressed file INDICES.zip.</p> <p>The last two digits at the end of all file names represent the year of analysis. </p>
Short-term Atorvastatin's Effect on Acute Kidney Injury Following Cardiac Surgery
ClinicalTrials.gov study NCT00791648. IPD Sharing: YES. Countries: 1. Publications: 3.
Active Preoperative Anemia Management in Patients Undergoing Cardiac Surgery
ClinicalTrials.gov study NCT02189889. IPD Sharing: UNDECIDED. Countries: 1. Publications: 1.
MRI versus CT in the detection of brain lesions in patients with infective endocarditis before/after cardiac surgery
<p>Imaging of brain involvement in infective endocarditis can drive the clinical management of this serious condition. MRI is very sensitive, but CT is more readily available. In this retrospective study, we compared the detection rate of CT and MRI.</p> <p>After Ethics Committee approval, we retrospectively reviewed a series of 20 patients (13 males, median age 64 years) who underwent both CT and MRI before or after cardiac surgery for definite infective endocarditis. Unenhanced CT and MRI were evaluated for acute ischemic lesions, both punctuate and large, intraparenchymal hemorrhages, cerebral microbleeds, subarachnoid hemorrhages, abscesses, microabscesses and meningitis. Qualitative and Cohen κ analysis were performed. The value of contrast-enhanced scans (MRI, <em>n</em> = 14; CT, <em>n</em> = 9) and cognitive status were also assessed.</p> <p>While CT rapidly excludes large hemorrhages before cardiac surgery for infective endocarditis, MRI accurately distinguishes the whole spectrum of brain lesions.</p>
Cardiac patch transplantation instruments for robotic minimally invasive cardiac surgery: initial proof-of-concept designs and surgery in a porcine cadaver
<p>BACKGROUND: Damaged cardiac tissues could potentially be regenerated by transplanting bioengineered cardiac patches to the heart surface. To be fully paradigm-shifting, such patches may need to be transplanted using minimally invasive robotic cardiac surgery (not only traditional open surgery). Here, we present novel robotic designs, initial prototyping and a new surgical operation for instruments to transplant patches <em>via </em>robotic minimally invasive heart surgery. METHODS: Robotic surgical instruments and automated control systems were designed, tested with simulation software and prototyped. Surgical proof-of-concept testing was performed on a pig cadaver. RESULTS: Three robotic instrument designs were developed. The first (called “Claw” for the claw-like patch holder at the tip) operates on a rack and pinion mechanism. The second design (“Shell-Beak”) uses adjustable folding plates and rods with a bevel gear mechanism. The third (“HeartStamp”) utilizes a stamp platform protruding through an adjustable ring. For the HeartStamp, rods run through a cylindrical structure designed to fit a uniportal Video-Assisted Thorascopic Surgery (VATS) surgical port. Designed to work with or without a sterile sheath, the patch is pushed out by the stamp platform as it protrudes. Two instrument robotic control systems were designed, simulated <em>in silico</em> and one of these underwent early ‘sizing and learning’ prototyping as a proof-of-concept. To reflect real surgical conditions, surgery was run “live” and reported exactly (as-it-happened). We successfully picked up, transferred and released a patch onto the heart using the HeartStamp in a pig cadaver model. CONCLUSION: These world-first designs, early prototypes and a novel surgical operation pave the way for robotic instruments for automated keyhole patch transplantation to the heart. Our novel approach is presented for others to build upon free from restrictions or cost – potentially a significant moment in myocardial regeneration surgery which may open a therapeutic avenue for patients unfit for traditional open surgery.</p>
Raw Data for the article: Atrial fibrillation ablation improves late survival after concomitant cardiac surgery
<p><strong>Objective: </strong>Preoperative atrial fibrillation (AF) increases risk of stroke, heart failure, and all-cause mortality after cardiac surgery. Despite encouraging results and guideline recommendations, surgical ablation (SA) for AF concomitant with other heart surgery remains low. In the current study we aimed to address the long-term mortality after SA concomitant with cardiac surgery.</p> <p><strong>Methods: </strong>This report pertains to the HEart surgery In atrial fibrillation and Supraventricular Tachycardia (HEIST) registry. We identified 20,765 adult patients (62% male) with preoperative AF who underwent conventional sternotomy heart surgery between 2010 and 2021 in 8 tertiary centers in Poland, Netherlands, and Italy. We used Cox proportional hazards models for computations and propensity score matching to minimize differences in baseline characteristics.</p> <p><strong>Results: </strong>Of included patients, 2755 (13.4%) underwent SA for AF. The highest rates of SA were observed for mitral interventions (mitral valve repair or replacement and tricuspid intervention, 25.2%), lowest for isolated coronary artery bypass grafting (6.2%). Patients in the SA group were younger (mean age 64.5 ± 9.0 years vs 68.7 ± 16.0 years; P < .001) and lower risk (mean European System for Cardiac Operative Risk Evaluation [EuroSCORE] II, 4.1 vs 5.7; P < .001). During the 11-year study period, there was a mortality reduction associated with SA (hazard ratio, 0.57; 95% CI, 0.52-0.62; P < .001). After propensity matching, 2750 pairs with similar baseline characteristics were identified. SA was associated with 16% mortality decline (hazard ratio, 0.84; 95% CI, 0.75-0.94; P = .003).</p> <p><strong>Conclusions: </strong>In this multicenter, retrospective, propensity matched study, SA concomitant with other cardiac surgery was associated with improved long-term survival regardless of baseline surgical risk.</p>
Impact of Fluid Restriction Policy in Reducing the Use of Red Cells in Cardiac Surgery
ClinicalTrials.gov study NCT00600704. IPD Sharing: Not stated. Countries: 1. Publications: 8.
Accuracy of the Dexcom G6 Continuous Glucose Monitoring System Following Cardiac Surgery
ClinicalTrials.gov study NCT04569240. IPD Sharing: NO. Countries: 1. Publications: 5.
Methadone vs. Fentanyl Administration on Postoperative Pain Control in Pediatric Patients Undergoing Cardiac Surgery
ClinicalTrials.gov study NCT02747875. IPD Sharing: NO. Countries: 1. Publications: 24.
Perioperative Hypothermia and Myocardial Injury After Non-cardiac Surgery
ClinicalTrials.gov study NCT03111875. IPD Sharing: YES. Countries: 2. Publications: 2.
Atrial Deganglionation as a Therapy for Cardiac Surgery Patients With Atrial Fibrillation
ClinicalTrials.gov study NCT05426759. IPD Sharing: NO. Countries: 1. Publications: 0.
The Effects of Corticosteroids, Glucose Control, and Depth-of-Anesthesia on Perioperative Inflammation and Morbidity From Major Non-cardiac Surgery (Dexamethasone, Light Anesthesia and Tight Glucose C
ClinicalTrials.gov study NCT00995501. IPD Sharing: Not stated. Countries: 1. Publications: 4.
Platelet Inhibition and Bleeding in Patients Undergoing Emergent Cardiac Surgery
ClinicalTrials.gov study NCT01468597. IPD Sharing: Not stated. Countries: 1. Publications: 1.
Temperature Monitoring in Cardiac Surgery: Agreement Between Different Clinical Methods
ClinicalTrials.gov study NCT04355013. IPD Sharing: NO. Countries: 1. Publications: 1.
Delirium and EuroSCORE II in Cardiac Surgery
ClinicalTrials.gov study NCT05218720. IPD Sharing: UNDECIDED. Countries: 1. Publications: 5.
Using the SEDLine for the Titration of Sevoflurane in Elderly Patients Recovery Using the SEDLine TM for the Titration of Sevoflurane in Elderly Patients Undergoing Non-Cardiac Surgery After Beta-Adre
ClinicalTrials.gov study NCT00938782. IPD Sharing: Not stated. Countries: 1. Publications: 1.
COmbined pLaTelet and eRythrocyte AutotransfusioN During Cardiac surgEry (COLTRANE) Trial
ClinicalTrials.gov study NCT06425614. IPD Sharing: YES. Countries: 1. Publications: 1.
Active-control Randomized Trial Comparing 4-factor Prothrombin Complex Concentrate With Frozen Plasma in Cardiac Surgery
ClinicalTrials.gov study NCT05523297. IPD Sharing: NO. Countries: 2. Publications: 2.
The ENIGMA II Trial:Nitrous Oxide Anaesthesia and Cardiac Morbidity After Major Surgery: a Randomised Controlled Trial
ClinicalTrials.gov study NCT00430989. IPD Sharing: NO. Countries: 1. Publications: 5.
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