Heart, lung & circulation
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Pericardiocentesis is an important diagnostic and therapeutic technique, with the potential for significant morbidity and mortality if performed incorrectly. This article attempts to cover the anatomy, preparation, and techniques necessary to successfully perform pericardiocentesis.
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Heart, lung & circulation · Jun 2015
Comparative StudyProcedure-specific Cardiac Surgeon Volume associated with Patient outcome following Valve Surgery, but not Isolated CABG Surgery.
Trends towards surgical sub-specialisation to improve patient-outcomes are well-documented and largely supported by evidence. However few studies have examined whether this benefit exists within adult-cardiac surgery. To answer whether sub-specialisation within adult-cardiac surgery improves patient-outcomes, this study assessed the relationship between procedure-specific and total-cardiac surgeon-volume and mortality and morbidity in cardiac-valve and coronary artery bypass grafting (CABG) surgery. ⋯ Our finding of an association between increased valve-specific surgeon volumes with improved valve-surgery outcomes, and absence of an association between these outcomes and annual total-cardiac surgical experience supports the case for sub-specialisation specifically within the field of valve surgery.
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Heart, lung & circulation · Jun 2015
Comparative StudyComparison of Risk Scores for Prediction of Complications following Aortic Valve Replacement.
Risk models play an important role in stratification of patients for cardiac surgery, but their prognostic utilities for post-operative complications are rarely studied. We compared the EuroSCORE, EuroSCORE II, Society of Thoracic Surgeon's (STS) Score and an Australasian model (Aus-AVR Score) for predicting morbidities after aortic valve replacement (AVR), and also evaluated seven STS complications models in this context. ⋯ The STS Score was best overall at discriminating post-operative complications and their composite for AVR. All STS complications models except for deep sternal wound infection had good discrimination and calibration for post-operative complications.
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Heart, lung & circulation · Jun 2015
Comparative StudyPlatelet distribution width and mean platelet volume in idiopathic pulmonary arterial hypertension.
Previous studies have demonstrated that platelet activation occurs in patients with pulmonary arterial hypertension (PAH). Mean platelet volume (MPV) and platelet distribution width (PDW) are two markers of platelet activation, and have recently been recognised as risk predictors of cardiovascular diseases. This study aimed to investigate whether MPV and PDW would be useful to reflect disease severity and predict prognosis in idiopathic PAH (IPAH). ⋯ Our results suggest that MPV and PDW were elevated in patients with IPAH. They could partly reflect disease severity, but did not predict prognosis.
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Heart, lung & circulation · Jun 2015
Observational StudyImpact of anaemia on mortality and its causes in elderly patients with acute coronary syndromes.
Prognostic impact of anaemia in the elderly with acute coronary syndromes has not been specifically analysed, and little information exists about causes of mortality in this setting. ⋯ The impact of anaemia on cause specific of mortality seem to be different according to age subgroup. The association between anaemia and mortality was not observed in elderly patients from our series.