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Valvular Heart Surgery (valvular + heart_surgery)
Selected AbstractsMicrodislodgment of Ventricular Pacing Lead Undetectable During Rapid Pacing One Year After ImplantationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2003YUKO CHINUSHI CHINUSHI, Y., et al.: Microdislodgment of Ventricular Pacing Lead Undetectable During Rapid Pacing One Year After Implantation. A 71-year-old woman had undergone valvular heart surgery in 1981, and implantation of a permanent ventricular pacemaker for ventricular pauses during atrial fibrillation in 2001. One year after pacemaker implantation, she complained of faintness. When pacing at 100 beats/min the pacemaker functioned properly. However, pacing and sensing failure was detected at a pacing rate of 60 beats/min. At rapid pacing rates, the lead tip was in closer contact with the endocardium, and its microdislodgment was undetectable. The symptoms have resolved since the lead was repositioned. (PACE 2003; 26:787,788) [source] Peri-operative oral triiodothyronine replacement therapy to prevent postoperative low triiodothyronine state following valvular heart surgeryANAESTHESIA, Issue 8 2009Y. S. Choi Summary This study evaluated the effect of oral triiodothyronine (T3) replacement therapy, starting on the day of the surgery, on thyroid hormone concentrations and clinical outcome in high-risk patients undergoing valvular heart surgery. Fifty patients were randomly allocated to either T3 or placebo. In the treatment (T3) group patients received 20 ,g of oral or nasogastric T3 every 12 h starting just before induction of anaesthesia and until the first day after surgery. T3 concentrations were significantly higher in the T3 group than the placebo group from 1 to 36 h after removal of the aortic cross clamp. The number of patients requiring vasopressin after discontinuing cardiopulmonary bypass was significantly greater in the placebo group than the T3 group. Significantly fewer patients required vasopressors in the T3 group on the first day after surgery. [source] CT15 RISK STRATIFICATION MODELS FOR HEART VALVE SURGERYANZ JOURNAL OF SURGERY, Issue 2007C. H. Yap Purpose Risk stratification models may be useful in aiding surgical decision-making, preoperative informed consent, quality assurance and healthcare management. While several overseas models exist, no model has been well-validated for use in Australia. We aimed to assess the performance of two valve surgery risk stratification models in an Australian patient cohort. Method The Society of Cardiothoracic Surgeons of Great Britain and Ireland (SCTS) and Northern New England (NNE) models were applied to all patients undergoing valvular heart surgery at St Vincent's Hospital Melbourne and The Geelong Hospital between June 2001 and November 2006. Observed and predicted early mortalities were compared using the chi-square test. Model discrimination was assessed by the area under the receiver operating characteristic (ROC) curve. Model calibration was tested by applying the chi-square test to risk tertiles. Results SCTS model (n = 1095) performed well. Observed mortality was 4.84%, expected mortality 6.64% (chi-square p = 0.20). Model discrimination (area under ROC curve 0.835) and calibration was good (chi-square p = 0.9). the NNE model (n = 1015) over-predicted mortality. Observed mortality 4.83% and expected 7.54% (chi-square p < 0.02). Model discrimination (area under ROC curve 0.835) and calibration was good (chi-square p = 0.9). Conclusion Both models showed good model discrimination and calibration. The NNE model over-predicted early mortality whilst the SCTS model performed well in our cohort of patients. The SCTS model may be useful for use in Australia for risk stratification. [source] | ||||||||||