The 30 day stroke rate following carotid endarterectomy (CEA) ranges between 2-6%. Such periprocedural strokes are associated with a three-fold increased risk of mortality. Our primary aim was to determine the diagnostic accuracy of electroencephalogram (EEG) in predicting perioperative strokes through meta-analysis of existing literature. An extensive search for relevant literature was undertaken using PubMed and Web of Science databases. Studies were included after screening using predetermined criteria. Data was extracted and analyzed. Summary sensitivity, specificity and diagnostic odds ratio were obtained. Subgroup analysis of studies using eight or more EEG channels was done. Perioperative stroke rate for the cohort of 8765 patients was 1.75%. Pooled sensitivity and specificity of EEG changes in predicting these strokes were 52% (95% confidence interval [CI], 43-61%) and 84% (95% CI, 81-86%) respectively. Summary estimates of the subgroup were similar. The diagnostic odds ratio was 5.85 (95% CI, 3.71-9.22). For the observed stroke rate, the positive likelihood ratio was 3.25 while the negative predictive value was 98.99%. According to these results, patients with perioperative strokes have six times greater odds of experiencing an intraoperative change in EEG during CEA. EEG monitoring was found to be highly specific in predicting perioperative strokes after CEA.
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http://dx.doi.org/10.1016/j.jocn.2015.08.014 | DOI Listing |
JTCVS Open
December 2024
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
Objective: Recent advancements in chest tube technologies have gained interest for their ability to enhance postoperative recovery via reduction of retained blood syndrome after cardiothoracic surgery. The present study investigates the effect of the Centese Thoraguard automated line-clearance chest tube system on postoperative pain and recovery after cardiac surgery.
Methods: This was a single-center retrospective review of 1771 adult patients undergoing nonemergency cardiac surgery between January 2021 and December 2022.
JTCVS Open
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine, The University of Alabama at Birmingham, Birmingham, Ala.
Objective: The optimal method for cerebral protection during aortic arch reconstruction in neonates and infants is unknown. We compare the outcomes of deep hypothermic circulatory arrest and selective antegrade cerebral perfusion strategies in neonatal and infant cardiac surgery.
Methods: We retrospectively identified all patients aged less than 1 year who underwent aortic arch reconstruction from 2012 to 2023.
JTCVS Open
December 2024
Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Objectives: This study aims to investigate the association between interatrial conduction block and postoperative atrial fibrillation, which can precipitate acute cardiopulmonary instability and is associated with subsequent heart failure, stroke, and mortality following cardiac surgery.
Methods: Perioperative 12-channel electrocardiograms from 3405 patients undergoing myocardial revascularization, valve surgery, aortic surgery, or combinations thereof, were considered. Clinical and electrographic parameters were compared between patients with and without atrial fibrillation, and significant variables were analyzed using univariate and multivariate logistic regression.
Syst Rev
January 2025
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Background: The inadequate inclusion of sex and gender in medical research has resulted in biased clinical guidance and disparities in knowledge and patient outcomes. Despite efforts by regulatory and funding agencies, opportunities to generate sex-specific knowledge are frequently overlooked. While certain disciplines in cardiovascular medicine have made notable progress, these advances have yet to permeate the literature on perioperative cardiovascular complications in non-cardiac surgery.
View Article and Find Full Text PDFCardiol Rev
November 2024
From the Department of Cardiology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, China.
Pulsed field ablation (PFA) is a novel nonthermal ablation technique for the treatment of atrial fibrillation (AF) patients, with safety comparable to traditional catheter ablation surgery. The present study aims to evaluate and compare the procedural efficiency and safety profiles of PFA and cryoballoon ablation (CBA) in the management of AF. We performed a systematic search across PubMed, the Cochrane Library, and Embase databases, encompassing the literature up to February 2024, to inform our systematic review and meta-analysis.
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