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Cardiothoracic Surgery News

People Tend to Overestimate Pain From Surgery

Posted 4 Nov 2017 by Drugs.com

FRIDAY, Nov. 3, 2017 – Many patients overestimate the amount of pain they'll experience after surgery, resulting in needless anxiety, a new study reports. "We believe providers need to do a better job of counseling patients on realistic pain expectations," said study co-author Dr. Jaime Baratta, director of regional anesthesia at Thomas Jefferson University Hospital in Philadelphia. The research included 223 patients. Their average age was 61. All had orthopedic, neurological or general surgery. Of these, 96 received some form of regional anesthesia (spinal, epidural or peripheral nerve block). The remaining 127 patients received only general anesthesia. Before their surgery, the patients estimated what level of postoperative pain they expected on a 0-10 scale (10 being the most painful). After surgery, they were asked about their level of pain in the post-anesthesia care unit one hour ... Read more

Related support groups: Suboxone, Oxycodone, Surgery, Tramadol, Hydrocodone, Methadone, Percocet, OxyContin, Vicodin, Norco, Fentanyl, Morphine, Codeine, Lortab, Opana, Subutex, Dilaudid, Opana ER, MS Contin, Roxicodone

Are Stents Really Useless After Chest Pain? Cardiologists Not Sure

Posted 3 Nov 2017 by Drugs.com

FRIDAY, Nov. 3, 2017 – Heart experts are cautiously embracing the results of a new, landmark clinical trial that questions the value of opening blocked arteries to relieve chest pain. Chest pain sufferers who received a stent – a tiny wire mesh tube – to reopen an obstructed artery did not show any more improvement than people who only took medicine to improve their condition, the British researchers reported. "This definitely has made big waves," said Dr. Samin Sharma, director of interventional cardiology at Mount Sinai Health System in New York City. But cardiologists can't say whether the trial, published Nov. 2 in The Lancet journal, will have much immediate impact on clinical decision-making. For one, the trial focused on a set of patients with relatively mild symptoms, and it did not include a long enough follow-up to see whether those who didn't receive stents wound up with ... Read more

Related support groups: Heart Disease, Angina, Nitroglycerin, Ranexa, Imdur, Isosorbide Mononitrate, Angina Pectoris Prophylaxis, Nitrostat, Ranolazine, Nitro-Bid, Isosorbide Dinitrate, Nitro-Dur, NitroQuick, Ismo, Nitrolingual Pumpspray, ISDN, Cardiothoracic Surgery, GoNitro, Minitran, Nitrostat Tablets

Are Artery-Opening Stents for Chest Pain a Waste of Time?

Posted 2 Nov 2017 by Drugs.com

THURSDAY, Nov. 2, 2017 – With findings that some experts believe could change cardiovascular care, a new study suggests that the placebo effect of stents in heart patients with chest pain may be far more pronounced than thought. That could mean that drug therapy alone, rather than the pricey, artery-opening devices, is all that's needed for certain patients, the researchers said. "The most important reason we give patients a stent is to unblock an artery when they are having a heart attack. However, we also place stents into patients who are getting pain only on exertion caused by narrowed, but not blocked, arteries. It's this second group that we studied," explained lead author Rasha Al-Lamee, from the National Heart and Lung Institute at Imperial College London. The study included 200 patients with stable angina who received six weeks of intensive drug treatment for their angina. ... Read more

Related support groups: Angina, Nitroglycerin, Ranexa, Imdur, Isosorbide Mononitrate, Angina Pectoris Prophylaxis, Cardiovascular Risk Reduction, Nitrostat, Ranolazine, Nitro-Bid, Isosorbide Dinitrate, Nitro-Dur, NitroQuick, Ismo, Nitrolingual Pumpspray, ISDN, GoNitro, Minitran, Cardiothoracic Surgery, Nitrostat Tablets

Is Successful Heart Surgery All in the Timing?

Posted 27 Oct 2017 by Drugs.com

THURSDAY, Oct. 26, 2017 – Planning to have open heart surgery anytime soon? You might want to ask your cardiologist to book an afternoon slot in the OR. New research shows that heart operations performed in the afternoon produced better outcomes than those done in the morning. Because afternoon heart surgery syncs with the body's circadian clock (the internal body clock that controls when people sleep, eat and wake up), it reduces the risk of heart damage, the French researchers said. "Currently, there are few other surgical options to reduce the risk of post-surgery heart damage, meaning new techniques to protect patients are needed," said study author Dr. David Montaigne, a professor at the University of Lille. In one part of the study, his team tracked the medical records of nearly 600 people who had heart valve replacement surgery for 500 days, to identify any major cardiac events ... Read more

Related support groups: Surgery, Prevention of Cardiovascular Disease, Cardiovascular Risk Reduction, Ischemic Heart Disease, Cardiothoracic Surgery

Are Women Surgeons Better Than Men?

Posted 11 Oct 2017 by Drugs.com

TUESDAY, Oct. 10, 2017 – The gender of a surgeon appears to have little to do with the outcome of an operation. A Canadian study found that patients operated on by women had no more complications or problems after surgery than did patients whose surgeons were men. "Our findings have important implications for supporting sex equality and diversity in a traditionally male-dominated profession," the study authors wrote. The researchers, led by Dr. Raj Satkunasivam, a Houston Methodist Hospital surgeon previously at the University of Toronto, investigated whether gender plays a role in surgical skills and outcomes. The team analyzed the link between surgeons' gender and the results of 25 common surgical procedures over an eight-year span. The investigators compared the outcomes of over 104,000 procedures performed by 774 female surgeons with the outcomes of the same surgeries performed at ... Read more

Related support groups: Surgery, Orthopedic Surgery, Vascular Surgery, Cardiothoracic Surgery

Which Heart Bypass Surgery Works Best?

Posted 17 Aug 2017 by Drugs.com

THURSDAY, Aug. 17, 2017 – Five years after heart bypass surgery, patients whose operation was done using a heart-lung pump lived longer than those whose surgeons didn't use the device, a new study finds. Since the 1990s, two different approaches have been commonly used by heart surgeons to perform coronary artery bypass graft operations. Coronary artery bypass creates new routes for blood to flow to the heart because old routes are blocked by plaque in the artery. A piece of blood vessel is taken from another area of the body (often the leg) and used to "bypass" a blocked vessel going to the heart, according to the U.S. National Heart, Lung, and Blood Institute. The two different ways to do this surgery have been referred to as "on-pump," assisted by a heart-lung machine, or "off-pump." Which procedure produces better results has been controversial, the researchers said. "The ... Read more

Related support groups: Heart Disease, Coronary Artery Disease (CAD), Acute Coronary Syndrome, Cardiovascular Conditions and Disorders, Acute Coronary Syndrome - Prophylaxis, Cardiothoracic Surgery, Coronary Arteriography

Obesity Slows Recovery for Heart Surgery Patients: Study

Posted 10 Aug 2017 by Drugs.com

THURSDAY, Aug. 10, 2017 – Obese heart surgery patients spend more time in intensive care and take longer to recover than those who aren't obese, a new Canadian study finds. Researchers examined data from nearly 5,400 patients who had heart surgery at the New Brunswick Heart Center between January 2006 and December 2013. Of those, 36 percent were obese. After heart surgery, obese patients were four times more likely to need extra time in the ICU; three times more likely to need extra time on mechanical ventilation; and three times more likely to be readmitted to the ICU, the study showed. Obese patients also had longer overall hospital stays and were more likely to be discharged with home care. It all adds up to more labor-intensive and costly care for these patients, according to the researchers. The study was published online Aug. 10 in The Annals of Thoracic Surgery. "Obesity is a ... Read more

Related support groups: Surgery, Obesity, Prevention of Cardiovascular Disease, Cardiovascular Risk Reduction, Cardiovascular Conditions and Disorders, Surgical Prophylaxis, Cardiothoracic Surgery

Angioplasty Outcomes Almost Equal Among Hospitals

Posted 7 Aug 2017 by Drugs.com

MONDAY, Aug. 7, 2017 – Patients who have an artery-opening procedure called percutaneous coronary intervention (PCI) have similar outcomes whether they're treated at so-called safety-net or non-safety-net hospitals, researchers say. Safety-net hospitals, which provide care to low-income Americans who are uninsured or underinsured, tend to have fewer resources than other hospitals, the researchers said. In this study, at least 10 percent of patients who underwent PCI – also known as angioplasty – at safety net hospitals did not have insurance. California researchers analyzed data from 3.7 million patients who underwent PCI at 282 safety-net hospitals and 1,134 non-safety-net hospitals between 2009 and 2015. The risk of in-hospital death was only slightly higher (4 more per 1,000 PCI procedures) at safety-net hospitals than at non-safety-net hospitals. Patients treated at safety-net ... Read more

Related support groups: Prevention of Cardiovascular Disease, Cardiovascular Risk Reduction, Percutaneous Coronary Intervention, Cardiothoracic Surgery, High Risk Percutaneous Transluminal Angioplasty

Geneticists Repair Mutation in Human Embryo

Posted 2 Aug 2017 by Drugs.com

WEDNESDAY, Aug. 2, 2017 – In a first-ever experiment, geneticists have successfully modified a human embryo to remove a mutation that causes a life-threatening heart condition. This is the first study to demonstrate that a gene-editing technique can be used in human embryos to convert mutant genes back to their normal version, the researchers said. The new procedure tackled a genetic mutation in human embryos that causes hypertrophic cardiomyopathy, an inherited condition in which the heart muscle becomes abnormally thick. The mutation was successfully repaired in 72 percent of 18 embryos that were created in a lab using sperm from a male donor who carries the hereditary heart condition, said team member Dr. Paula Amato. She is an adjunct associate professor of obstetrics and gynecology at Oregon Health & Science University (OHSU) in Portland. The procedure also might work in other ... Read more

Related support groups: Hypertrophic Cardiomyopathy, Brain Anomalies incl Congenital, Labor and Delivery including Augmentation, Cardiothoracic Surgery, Idiopathic Hypertrophic Subaortic Stenosis

Study Spots Cause of Global Outbreak of Infections Tied to Heart Surgeries

Posted 13 Jul 2017 by Drugs.com

THURSDAY, July 13, 2017 – Factory contamination of medical devices likely caused potentially fatal infections in 33 open-heart surgery patients in several countries, investigators say. The patients were sickened with Mycobacterium chimaera bacteria, which can cause infection of the inner lining of the heart and spread to the rest of the body. Genetic examination of M. chimaera samples suggests that heater-cooler units produced by LivaNova in a factory in Germany were the likely source of infection, according to the study. The devices help keep a patient's circulating blood and organs at a set temperature during heart bypass procedures, according to the U.S. Centers for Disease Control and Prevention. Patients became ill in the United States, Australia, Switzerland, Germany, the Netherlands, and the United Kingdom, according to the study. The results appear online July 12 in The Lancet ... Read more

Related support groups: Infections, Bacterial Infection, Diagnosis and Investigation, Atypical Mycobacterial Infection, Wound Infection, Cardiothoracic Surgery

Viagra Might Make for a Safer, More Effective Stent

Posted 11 Jul 2017 by Drugs.com

MONDAY, July 10, 2017 – It's worked wonders for men battling erectile dysfunction, and now early research suggests that Viagra – when added to artery-opening stents – might cut a patient's odds for clots. Stents are tiny mesh tubes surgically inserted to prop up failing blood vessels. But as South Korean researchers explained, these devices can become less effective over time as the growth of tissue around the metal device narrows the artery again. But in their new study in rats, the researchers found that coating stents with Viagra (sildenafil) might help prevent this re-closure from happening. "If similar results are found in clinical trials, sildenafil could be an ideal drug for coating drug-eluting [emitting] stents or to give orally after stent implantation," study lead author Dr. Han-Mo Yang said in a news release from the American Heart Association. Yang is an associate ... Read more

Related support groups: Viagra, Sildenafil, Revatio, Coagulation Defects and Disorders, Cardiothoracic Surgery

Implantable Defibrillator May Not Mean End to Sports

Posted 5 Jun 2017 by Drugs.com

MONDAY, June 5, 2017 – Competitive sports may be safe for many athletes who have an implantable cardioverter defibrillator (ICD), new research suggests. The four-year study followed 440 athletes with ICDs who participated in vigorous sports such as running, basketball, soccer, tennis, volleyball, skiing and snowboarding. An ICD is a battery-powered device placed under the skin. When it detects an abnormal heart rhythm (arrhythmia), it delivers an electric shock to restore normal rhythm. In 2015, the American Heart Association said participating in competitive sports may be considered for athletes with ICDs. That advice was based on a study that followed hundreds of athletes with the devices for two years. This longer study of 10- to 60-year-olds followed competitive athletes at the national and international level, high school and college athletes, and others. During the study period, ... Read more

Related support groups: Arrhythmia, Cardiomyopathy, Hypertrophic Cardiomyopathy, Ventricular Fibrillation, Ventricular Arrhythmia, Cardiothoracic Surgery, Restrictive Cardiomyopathy, Cardiomyopathy Prophylaxis, Idiopathic Hypertrophic Subaortic Stenosis

Busiest Docs Get Best Results With Heart Valve Surgery

Posted 2 May 2017 by Drugs.com

TUESDAY, May 2, 2017 – Patients who have heart valve surgery get better results and are more likely to survive if their surgeon does a lot of the operations, a new study. Researchers from Mount Sinai Health System in New York City studied New York state data on patients who had a type of heart operation called mitral valve surgery between 2002 and 2013. Damaged mitral valves can be either repaired or replaced. Mitral valve repair has several important advantages over valve replacement, including better life expectancy and quality of life, according to background information with the study. However, among heart surgeons, there is a great deal of variability over their choice of surgery, the researchers noted. In the study, those patients whose surgeons did more than 25 of the operations a year were more likely to get valve repair than replacement, and their repair was more durable than ... Read more

Related support groups: Cardiothoracic Surgery, Valvular Heart Disease

Blood Test May Gauge Death Risk After Surgery

Posted 25 Apr 2017 by Drugs.com

TUESDAY, April 25, 2017 – A highly sensitive blood test can identify patients with a raised risk of death in the month after surgery, a large study suggests. On average, 1 percent of patients die within 30 days after noncardiac surgery – most from a heart attack, said researcher Dr. P.J. Devereaux, a professor at McMaster University in Ontario, Canada. Testing for a protein called troponin that's found in heart muscle can help identify those post-op patients most at risk, Devereaux and an international team of researchers reported. However, the study could not prove a direct cause-and-effect relationship between troponin levels and death risk. Surgery is a major stress to the body's organs. Troponin is released into the blood when the heart muscle has been damaged, Devereaux explained. "Most of the heart injuries happen in the first day-and-a-half after surgery, when most patients are ... Read more

Related support groups: Surgery, Heart Attack, Myocardial Infarction, Prevention of Cardiovascular Disease, Cardiovascular Risk Reduction, Surgical Prophylaxis, Cardiothoracic Surgery

Pump Implants May Rejuvenate Heart Failure Patients

Posted 18 Apr 2017 by Drugs.com

TUESDAY, April 18, 2017 – Implanted pumps may be more than a "bridge" to a heart transplant – they might also restore healthy heart function for some heart failure patients, a new British study suggests. As the researchers explained, these battery-operated left ventricular assist devices (LVADs) are often used to support patients with severe heart failure while they await a heart transplant. But this new clinical trial is the first to show that an LVAD, combined with medication, can restore heart function completely, researchers said. "We talk about these devices as a bridge-to-transplant, something which can keep a patient alive until a heart is available for transplantation," said study lead author Djordje Jakovljevic. "However, we knew that sometimes patients recover to such an extent that they no longer need a heart transplant," noted Jakovljevic, a senior research fellow in ... Read more

Related support groups: Congestive Heart Failure, Heart Failure, Left Ventricular Dysfunction, Cardiothoracic Surgery, Left Ventriculography

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