AI Article Synopsis
- Mesenteric ischemia (Me-Is) is a serious but underreported complication after cardiac surgery, affecting 0.47% of patients in a large study, with only 49.1% surviving after 30 days post-operation.
- The study found that most affected patients were older males, with many undergoing complex surgeries; both survivors and nonsurvivors showed no significant differences in clinical characteristics but differed in diagnosis methods.
- Key predictors of mortality included high norepinephrine doses and lactate levels, indicating that the prognosis for Me-Is is generally poor despite treatment interventions.
Article Abstract
Background: Mesenteric ischemia (Me-Is) after cardiac surgery is underreported in present literature but has still earned the bad reputation of a dismal prognosis. This study adds clinical outcomes in a large patient cohort.
Methods: Between 2009 and 2019 of the 22,590 patients undergoing cardiac surgery at our facility 106 (0.47%) developed Me-Is postoperatively. Retrospective patient data was analyzed. Additionally, patients were stratified by outcome-survivors and nonsurvivors.
Results: Patients were predominantly male ( = 68, 64.2%), mean age was 71.2 ± 9.3 years. Most procedures were elective ( = 85, 80.2%) and comprised of more complex combined procedures (50.9%) and redos (17.9%). Mean EuroSCORE II averaged 10.9 ± 12.2%. Survival at 30 days was 49.1% ( = 52). Clinical baseline and procedural characteristics did not differ significantly between survivors and nonsurvivors. The median postoperative interval until symptom onset was 5 days in both groups. Survivors were more frequently diagnosed by computed tomography and nonsurvivors based on clinical symptoms. Me-Is was predominantly nonocclusive ( = 84, 79.2%). Laparotomy was the main treatment in both groups ( = 45, 78.8% vs. = 48, 88.9%, = 0.94). Predictors of mortality were maximum norepinephrine doses (hazard ratio [HR] 8.29, confidence interval [CI] 3.39-20.26, < 0.0001), lactate levels (HR 1.06, CI 1.03-1.09), and usage of inotropes (HR 2.46, CI 1.41-4.30).
Conclusion: The prognosis of Me-Is following cardiac surgery is poor-independently from diagnostic or treatment patterns. There exists a significant asymptomatic time period postoperatively, in which pathophysiologic processes seem to cross the Rubicon. After clinical demarcation, the further course can almost no longer be influenced.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/s-0044-1786183 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The impact of lower thoracic versus upper lumbar upper instrumented vertebra in minimally invasive correction of adult spinal deformity.
J Neurosurg Spine
January 2025
15Department of Neurological Surgery, University of California, San Francisco, California.
Objective: The goal of this study was to compare the impact of using a lower thoracic (LT) versus upper lumbar (UL) level as the upper instrumented vertebra (UIV) on clinical and radiographic outcomes following minimally invasive surgery for adult spinal deformity.
Methods: A multicenter retrospective study design was used. Inclusion criteria were age ≥ 18 years, and one of the following: coronal Cobb angle > 20°, sagittal vertical axis > 50 mm, pelvic tilt > 20°, pelvic incidence-lumbar lordosis mismatch > 10°.
Evaluation of endothelialization of an occluder device with cardiac computed tomography and assessment of the pathological validation.
PLoS One
January 2025
Department of Structural Heart Disease, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Assessing the endothelialization of occlusive devices noninvasively remains a challenge. Cardiac computed tomography angiography (CTA) can be employed to evaluate device endothelialization based on contrast uptake within the occluder.
Objective: This study examined device endothelialization using cardiac CTA and investigated the pathological associations.
A national survey of career development according to gender and subspecialties among cardiologists in Japan.
PLoS One
January 2025
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Background: Training opportunities, work satisfaction, and the factors that influence them according to gender and subspecialties are understudied among Japanese cardiologists.
Methods: We investigated the career development of Japanese cardiologists with an e-mail questionnaire. Feelings of inequality in training opportunities, work dissatisfaction, and reasons were assessed by examining the cardiologists' gender and invasiveness of subspecialties.
Analysis of influencing factors for complications of anterior thoracolumbar tuberculosis surgery in adults.
Medicine (Baltimore)
January 2025
Department of Spinal Surgery, Shenzhen Third People's Hospital, Shenzhen, China.
This study analyzes the risk factors related to the complications of anterior thoracolumbar tuberculosis in adults and to provide clinical reference. A total of 98 adult patients with thoracolumbar tuberculosis undergoing anterior surgery in our hospital from February 2020 to December 2023 were selected, and the clinical data and postoperative complications were collected. The clinical characteristics were analyzed, and the risk factors related to surgical complications were analyzed by univariate analysis and multi-factor logistic regression model.
View Article and Find Full Text PDFTunneled Pleural Catheters: An Effective Nonsurgical Alternative for Nonexpandable Lung in Chronic Pleural Infection.
J Bronchology Interv Pulmonol
January 2025
Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School.
Background: Open window thoracostomy (OTW) is the standard of care for debilitated patients with chronic pleural infection and nonexpandable lungs (NEL) who are not candidates for major surgical intervention. Tunneled pleural catheters (TPC) offer tremendous treatment potential in this setting based on their efficacy in malignant pleural effusion and NEL. We aim to assess the efficacy, safety, and health care utilization of TPC in this setting.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!