Abstract:
OBJECTIVES:Bowel ischaemia following cardiac surgery is associated with a high postoperative mortality. No scoring system exists as yet to predict this complication following surgery. In addition, the long-term survival is not known. We sought to evaluate in-hospital outcomes and long-term outcomes in bowel ischaemia following cardiac surgery. We also sought to devise a simple risk prediction model for this catastrophic entity. METHODS:This was a retrospective study of data entered prospectively into our cardiac surgical database between July 1999 and May 2014. We compared the short- and long-term outcomes of patients who developed bowel ischaemia following cardiac surgery with those who did not develop bowel ischaemia using propensity-matched analysis. We developed a prediction model for bowel ischaemia from logistic regression. RESULTS:In total, 13 853 patients underwent cardiac surgery. Of these, 85 had confirmed bowel ischaemia following surgery. The in-hospital mortality rate for those with bowel ischaemia was 60%, while in those without bowel ischaemia, the mortality rate was 3% (P < 0.0001). In those bowel ischaemia patients who had a laparotomy for corrective surgery, the in-hospital mortality was significantly less compared with those who did not have a laparotomy (39.2 vs 91.2%, P < 0.0001). The long-term survival for bowel ischaemia at 2, 6 and 10 years was 35% (±5), 31% (±5) and 26% (+/6), respectively. Multivariable analysis revealed that advanced age at surgery, peripheral vascular disease, intra-aortic balloon pump usage, NYHA IV and postoperative atrial fibrillation were the significant (P < 0.005) determinants of developing postoperative bowel ischaemia. We developed a model to predict bowel ischaemia and validated it within our population (c-index = 0.781). CONCLUSIONS:We have shown that whilst bowel ischaemia carries a higher short-term mortality, the long-term mortality is not significantly greater for those few who survive to discharge. We have developed a simple prediction model to identify those at high risk of developing bowel ischaemia following cardiac surgery in order to optimize perioperative strategies in future.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Ariyaratnam P,Vijayan A,Cale AR,Cowen ME,Haqzad Y,Balasubramanian S,Loubani Mdoi
10.1093/icvts/ivv148subject
Has Abstractpub_date
2015-09-01 00:00:00pages
336-41issue
3eissn
1569-9293issn
1569-9285pii
ivv148journal_volume
21pub_type
杂志文章abstract::This article describes the case of a 62-year-old female who had had minimally invasive esophagectomy (Ivor-Lewis) for squamous cell carcinoma of the distal third of the esophagus. The anastomotic stenosis was accompanied by solid food dysphagia and the presence of a foreign body in the esophagus. The foreign body was ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.273383
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate abdominal aortic remodelling after the standard compared with the elongated frozen elephant trunk (FET) technique in patients with aortic dissection. METHODS:Twenty-six patients underwent surgery and were randomized into 2 groups. Fifteen patients were treated with the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/icvts/ivz026
更新日期:2019-07-01 00:00:00
abstract::A 66-year-old female underwent elective coronary artery bypass grafting (CABG). Massive pulmonary embolism developed intraoperatively shortly after weaning from cardiopulmonary bypass. A 25-cm large venous embolus was extracted from pulmonary artery by consequently performed open pulmonary embolectomy on the beating h...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.107433
更新日期:2005-08-01 00:00:00
abstract::This study was planned to observe prospectively the effects of standard open pulmonary lobectomy on leukocyte subsets and their connection with oncological outcome. Leukocyte subsets from 200 patients undergoing pulmonary lobectomy were analyzed: 151 patients had non-small-cell lung cancer, and 49 had non-malignant di...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.270512
更新日期:2011-09-01 00:00:00
abstract::Pulmonary venous obstruction after repair of total anomalous pulmonary venous connection remains potential and understanding of its mechanisms is warranted. Morphology of the pulmonary vein was qualitatively analyzed in 48 consecutive patients undergoing repair of non-isomeric total anomalous pulmonary venous connecti...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/j.icvts.2004.06.004
更新日期:2004-12-01 00:00:00
abstract:Objectives:Autologous pericardium, which is widely used in the field of cardiovascular surgery, is usually fixed with glutaraldehyde (GA) to improve handling and provide biomechanical stability. However, an optimal method of GA fixation of autologous pericardium is not known. The objective of this study was to evaluate...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw356
更新日期:2017-03-01 00:00:00
abstract::To determine whether coronary artery bypass grafting (CABG) with complete revascularization improves survival in patients with multivessel disease (MVD) over CABG with incomplete revascularization, we performed a meta-analysis of adjusted (but not unadjusted) risk estimates from observational studies. Databases includ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivu012
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:The goal of this study was to describe non-supervised daily physical activity in patients during the period immediately following anatomical lung resection. METHODS:The study was an observational study on 50 consecutive patients (33 men) admitted for anatomical lung resection over a 4-month period. All case...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx100
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:Absent pulmonary valve syndrome (APVS) is a rare cardiac malformation that is usually associated with aneurysmal dilatation of pulmonary arteries and respiratory distress. The surgical mortality of neonates and infants with APVS has decreased tremendously, from 60% in 1980s to 10-20% recently. This study ret...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt050
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) was developed to update EuroSCORE and incorporated refinement and modification of several risk factors. SinoSCORE was designed by Chinese scholars based on 9839 patients who underwent coronary artery bypass grafting (CABG) at 43 part...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw224
更新日期:2016-11-01 00:00:00
abstract::From April 1996 to July 1999, 241 consecutive patients underwent complete arterial revascularization with composite T-graft, including right coronary artery grafting with free right internal thoracic artery (ITA) (ITA group). They were compared with 127 bilateral ITA patients in whom saphenous vein grafts (SVG) was us...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/s1569-9293(02)00062-2
更新日期:2002-12-01 00:00:00
abstract::We report a case of a patient who underwent removal of an external stent of the bronchus. She had undergone external stenting for tracheobronchomalacia. After removal of the external stent, the bronchus was just as widely patent as preoperative state. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.217372
更新日期:2010-03-01 00:00:00
abstract::The surgical approach to esophagectomy is variable. A number of factors are considered when determining the optimal approach to esophagectomy: location and extent of disease, fibrosis, additional patient factors and surgeon preference. One of the disadvantages to some approaches is the need for a change in position, w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.240853
更新日期:2010-11-01 00:00:00
abstract::Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surg...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 历史文章,杂志文章
doi:10.1093/icvts/ivu440
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:Minimally invasive cardiac valve surgery is safe, effective and increasingly popular. It is performed worldwide with the use of either external aortic clamping or endoaortic balloon occlusion. METHODS:We conducted a literature search using MEDLINE, EMBASE, Scopus and Web of Science. Primary outcomes include...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy016
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:A prosthetic system to repair secondary tricuspid valve regurgitation was developed. The conceptual engineering of the current device is based on 3D segmental remodelling of the tricuspid valve annulus in lieu of reductive annuloplasty. This study was designed to investigate the operational safety of the cur...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx102
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:The anti-fibrillatory effect of potassium is well recognized from experimental models. There have, however, been very few clinical reports on the use of potassium to convert ventricular fibrillation (VF) after cardioplegic arrest. METHODS:In total, 8465 adult patients undergoing cardiac operations on cardio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs455
更新日期:2013-02-01 00:00:00
abstract::Aortic valve replacement (AVR) is currently the treatment of choice in patients with symptomatic aortic stenosis, but transcatheter off-pump aortic valve implantation is a novel and emerging technique, which might be performed more frequently in the near future and may be a less invasive alternative to conventional AV...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.201798
更新日期:2009-06-01 00:00:00
abstract::We investigated the impact of hydrogen sulfide (H(2)S) on myocardium in the setting of cold crystalloid cardioplegia and cardiopulmonary bypass (CP/CPB). Eighteen male Yorkshire pigs underwent 1 h CP/CPB followed by 2 h of reperfusion. Pigs received either: placebo (control, n=9), or H(2)S (as NaHS) as a bolus/infusio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.219535
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:The Synergy CircuLite micropump is a novel partial-support miniature left ventricular assist device that propels 2-3 l/min blood from the left atrium into the right subclavian artery. The ability of currently available investigative modalities to confirm Synergy pump malfunction is limited. The Synergy speed...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu236
更新日期:2014-11-01 00:00:00
abstract::Para-aortic malignant lymphoma invading the thoracic aorta can cause aortic rupture. Thoracic endovascular aortic repair (TEVAR) is a good option to treat aortic rupture associated with para-aortic malignancies. It is essential to detect the exact tumour location during TEVAR; however, it is often difficult to confirm...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz104
更新日期:2019-09-01 00:00:00
abstract::We report our experience with repair of a variety of congenital heart defects utilizing a ministernotomy incision. A ministernotomy was used in 79 patients with a variety of congenital heart diseases from November 2004 to August 2007. Patients included 36 males and 43 females with ages ranging from 1 month to 122 mont...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.209593
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to evaluate operative and long-term results after surgery of acute aortic dissection involving the root, in which the proximal repair consisted of curative resection of all dissected aortic sinuses and was performed using either valve-sparing root repair or complete root replacement ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw002
更新日期:2016-05-01 00:00:00
abstract::A best evidence topic was written according to a structured protocol. The question addressed was whether embolization is superior to surveillance for a type II endoleak associated with a static sac size post-endovascular abdominal aortic aneurysm repair (EVAR). Four hundred and sixty-one papers were identified, of whi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs201
更新日期:2012-09-01 00:00:00
abstract::The objective of this report is to share our experience with the different types of cardiac tumors, surgical management, postoperative complications and mid-term outcome of patients in an Australian tertiary hospital. Nineteen patients underwent cardiac surgery for tumors between 2001 and 2008. Their data was prospect...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.230029
更新日期:2010-06-01 00:00:00
abstract::Miniaturized cardiopulmonary bypass (CPB) systems, though more biocompatible, are limited by not being adaptable to all cardiac surgical operations. We evaluate a versatile CPB system [extracorporeal vacuum-assisted device optimized (EVADO)] based on the elimination of roller pumps, separation of extracavitary suction...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1510/icvts.2010.258921
更新日期:2011-04-01 00:00:00
abstract::Based on the natural mathematical relationships between the components of the human tri-leaflet aortic valve, new calibrated cusp sizers were developed in order to facilitate aortic valve assessment in the operating room and enhance the chance for a perfect restoration of aortic valve competence. These sizers were use...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr082
更新日期:2012-02-01 00:00:00
abstract::Ventricular catheterization in the rat is a widely deployed procedure. Current options allow a one-time catheterization procedure, introducing an error due to the inter-individual variability. Six Fischer rats underwent left ventricular catheterization through the right carotid artery, repeated seven days later via th...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.184119
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the impact of surgical aortic root enlargement (ARE) on the perioperative outcomes of aortic valve replacement (AVR). METHODS:Databases were searched for studies published until April 2018 to carry out a systematic review followed by meta-analysis of results. RESULTS:The searc...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivy364
更新日期:2019-07-01 00:00:00
abstract::We report on an uncommon case of a 10-month-old patient who required early surgical closure of an ostium secumdum atrial septal defect due to the concomitant presence of a big subcarinal bronchogenic cyst compressing the left atrium and, therefore, increasing the left-to-right shunt. It led to refractory congestive he...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.171280
更新日期:2008-05-01 00:00:00