Publications by authors named "Mircea Cristinar"
Background: Heparin-induced thrombocytopenia (HIT) is a severe complication of heparin therapy associated with thrombosis that requires a quick diagnosis. Therefore, laboratory assays must provide an accurate and swift answer. This work aims to evaluate the performances of an ELISA assay, especially when combined with 4T risk score, and a functional assay.
View Article and Find Full Text PDFBackground: Left ventricular assist device (LVAD)-associated infections are major complications that can lead to critical outcomes. The aims of this study were to assess the incidence of and to determine the risk factors for LVAD-associated infections.
Methods: We included all consecutive patients undergoing LVAD implantation between January 1, 2010, and January 1, 2019, in a single institution.
Article Synopsis
- Thromboembolic ischemic stroke (IS) is a serious risk following the placement of a left ventricular assist device (LVAD), complicating surgical treatment due to the use of anticoagulants.
- A 39-year-old man experienced cardiogenic shock and underwent LVAD placement, but developed acute neurological deficits indicative of IS, which was confirmed by a CT scan; he then underwent emergency decompressive hemicraniectomy.
- The case highlights that a careful approach to anticoagulation and teamwork in managing post-stroke care following LVAD surgery can lead to improved patient outcomes, including eventual heart transplantation.
Article Synopsis
- * RVF occurred in 32 patients (47.1%), with significant predictors being high preoperative vasoactive inotropic scores and serum glutamic oxaloacetic transaminase levels, while a thoracotomy approach significantly lowered RVF risk.
- * Mortality rates were high, with 53.1% in the RVF group vs. 5.6% in controls, and one-year survival rates were significantly better for the non-RVF group (85.4% vs. 33.5%).
Aims: The role of extracorporeal membrane oxygenation (ECMO) remains ill defined in pulmonary embolism (PE). We investigated outcomes in patients with high-risk PE undergoing ECMO according to initial therapeutic strategy.
Methods And Results: From 01 January 2014 to 31 December 2015, 180 patients from 13 Departments in nine centres with high-risk PE were retrospectively included.
Effect of Xenon Anesthesia Compared to Sevoflurane and Total Intravenous Anesthesia for Coronary Artery Bypass Graft Surgery on Postoperative Cardiac Troponin Release: An International, Multicenter, Phase 3, Single-blinded, Randomized Noninferiority Trial.
Anesthesiology
December 2017
Background: Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models.
Methods: In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance.
Impact of prosthesis-patient mismatch on early haemodynamic status after aortic valve replacement.
Interact Cardiovasc Thorac Surg
January 2017
Article Synopsis
- The study aimed to investigate how prosthesis-patient mismatch (PPM) affects early haemodynamic status and mortality in patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS).
- It included 183 patients and found that PPM was present in about 28% of cases, but there were no significant differences in the vasoactive-inotropic dependency index (VDI) or other critical postoperative measurements between patients with and without PPM on the first days after surgery.
- The conclusions indicated that PPM does not significantly impact the early haemodynamic status or organ performance after AVR, suggesting that patients with PPM may not be at higher risk for complications in the immediate postoperative period.
Article Synopsis
- This study investigates the relationship between fibrinogen levels and postoperative bleeding in cardiac surgery patients who underwent cardiopulmonary bypass, involving 1,956 participants.* -
- It found that patients with excessive bleeding had lower fibrinogen levels upon admission to the ICU, with a significant correlation between Day 0 fibrinogen levels and chest tube output within the first 24 hours.* -
- The research concluded that fibrinogen levels measured on the day of ICU admission can effectively predict the risk of excessive postoperative bleeding, suggesting a potential need for using fibrinogen concentrates to manage blood loss.*
Background: Unfractionated heparin has been the standard anticoagulant used immediately after mechanical heart valve replacement (MHVR). The purpose of this study was to assess a postoperative anticoagulation protocol with low-molecular-weight heparin (LMWH) immediately after MHVR without the use of unfractionated heparin or anti-factor Xa monitoring.
Methods: We performed a prospective, single-center, observational study of 1,063 consecutive patients undergoing elective MHVR with postoperative LMWH anticoagulation treatment.