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[American heart surgery--and Swedish]

https://arctichealth.org/en/permalink/ahliterature56439
Source
Lakartidningen. 1968 Feb 14;65(7):657-61
Publication Type
Article
Date
Feb-14-1968
Author
T. Aberg
Source
Lakartidningen. 1968 Feb 14;65(7):657-61
Date
Feb-14-1968
Language
Swedish
Publication Type
Article
Keywords
Canada
Cardiac Surgical Procedures
Female
Heart Diseases - surgery
Humans
Male
Methods
Statistics
Sweden
United States
PubMed ID
5723562 View in PubMed
Less detail

An internist's role in perioperative medicine: a survey of surgeons' opinions.

https://arctichealth.org/en/permalink/ahliterature159268
Source
BMC Fam Pract. 2008;9:4
Publication Type
Article
Date
2008
Author
Lisa Pausjenssen
Heather A Ward
Sharon E Card
Author Affiliation
Department of Internal Medicine, University of Saskatchewan, Saskatoon, Canada. lisa.pj@usask.ca
Source
BMC Fam Pract. 2008;9:4
Date
2008
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cooperative Behavior
General Surgery - statistics & numerical data
Health Care Surveys
Heart Diseases - surgery
Humans
Internal Medicine - standards
Interprofessional Relations
Perioperative Care - methods - standards
Physician's Role
Physician-Patient Relations
Preoperative Care - methods - standards
Questionnaires
Referral and Consultation - standards
Saskatchewan
Surgery Department, Hospital - manpower
Abstract
Literature exists regarding the perioperative role of internists. Internists rely on this literature assuming it meets the needs of surgeons without actually knowing their perspective. We sought to understand why surgeons ask for preoperative consultations and their view on the internist's role in perioperative medicine.
Survey of surgeons in Saskatoon, Saskatchewan, Canada regarding an internist's potential role in perioperative care.
Fifty-nine percent responded. The majority request a preoperative consultation for a difficult case (83%) or specific problem (81%). While almost half feel that a preoperative consultation is to "clear" a patient for surgery, 33% disagree with this statement. The majority believe the internist should discuss risk with the patient. Aspects of the preoperative consultation deemed most important are cardiac medication optimization (93%), cardiac risk stratification (83%), addition of beta-blockers (76%), and diabetes management (74%).
Surgeons perceive the most important roles for the internist as cardiac risk stratification and medication management. Areas of controversy identified amongst the surgeons included who should inform the patient of their operative risk, and whether the internist should follow the patient daily postoperatively. Unclear expectations have the potential to impact on patient safety and informed consent unless acknowledged and acted on by all. We recommend that internists performing perioperative consults communicate directly with the consulting physician to ensure that all parties are in accordance as to each others duties. We also recommend that the teaching of perioperative consults emphasizes the interdisciplinary communication needed to ensure that patient needs are not neglected when one specialty assumes the other will perform a function.
Notes
Cites: Neth J Med. 2000 Jan;56(1):7-1110667035
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Cites: Circulation. 1996 Mar 15;93(6):1278-3178653858
Cites: Ann Intern Med. 1997 Aug 15;127(4):309-129265433
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Cites: Circulation. 1999 Sep 7;100(10):1043-910477528
Cites: Can J Anaesth. 2005 Aug-Sep;52(7):697-70216103381
Cites: J Gen Intern Med. 2002 Dec;17(12):933-612472929
PubMed ID
18208614 View in PubMed
Less detail

Assessment and reporting of perioperative cardiac risk by Canadian general internists: art or science?

https://arctichealth.org/en/permalink/ahliterature187449
Source
J Gen Intern Med. 2002 Dec;17(12):933-6
Publication Type
Article
Date
Dec-2002
Author
Taha Taher
Nadia A Khan
P J Devereaux
Bruce W Fisher
William A Ghali
Finlay A McAlister
Author Affiliation
Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada.
Source
J Gen Intern Med. 2002 Dec;17(12):933-6
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Female
Health Care Surveys
Heart Diseases - surgery
Humans
Intraoperative Complications
Male
Middle Aged
Perioperative Care
Physicians
Risk assessment
Risk factors
Abstract
Physicians may use several validated risk indices to estimate perioperative cardiac risk, but there is little evidence for interventions to reduce this risk. We were interested in evaluating how general internists assess, define, communicate, and attempt to modify perioperative cardiac risk.
Cross-sectional survey of all 312 general internists in the Canadian Society of Internal Medicine with Canadian mailing addresses; 117 (38%) responded.
Respondents' mean age was 46 years, 79% were male, and on average they did 17 preoperative consults per month. Of the 104 respondents who routinely performed preoperative assessments, 96% (100/104) informed patients of their perioperative cardiac risk, but 77% did so only subjectively (i.e., stating risk as low, moderate, or high). Respondents provided 8, 27, and 12 different definitions for low, moderate, and high risk, respectively, with marked variability in the range of definitions they provided: from 2% to >50% for "high risk." The 67% of respondents who reported using a perioperative cardiac risk index used a variety of indices and exhibited just as much variability in their risk estimates and definitions as those who didn't use risk indices. While virtually all advised perioperative beta blockade in patients with known coronary artery disease, they varied substantially in the recommended agent or dose; further, these internists were evenly split on whether antiplatelet agents should be held or continued perioperatively.
These physicians differed widely in their assessment of perioperative cardiac risk and their definitions of low, moderate, or high risk. This raises concerns about whether patients (and surgeons) are provided with adequate information to make fully informed decisions about the potential risks of elective surgical operations.
Notes
Cites: N Engl J Med. 1999 Dec 9;341(24):1789-9410588963
Cites: BMJ. 1999 Sep 18;319(7212):731-410487995
Cites: Clin Invest Med. 2000 Apr;23(2):116-2310852661
Cites: N Engl J Med. 1977 Oct 20;297(16):845-50904659
Cites: J Gen Intern Med. 1986 Jul-Aug;1(4):211-93772593
Cites: Ann Intern Med. 1989 Jun 1;110(11):859-662655519
Cites: N Engl J Med. 1995 Dec 28;333(26):1750-67491140
Cites: J Am Coll Cardiol. 1996 Mar 15;27(4):779-868613603
Cites: J Am Coll Cardiol. 1996 Mar 15;27(4):910-488613622
Cites: N Engl J Med. 1996 Dec 5;335(23):1713-208929262
Cites: Ann Intern Med. 1997 Aug 15;127(4):309-129265433
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Cites: J Gen Intern Med. 1999 Apr;14(4):236-4210203636
Cites: Arch Intern Med. 1999 Apr 12;159(7):713-710218751
Cites: Circulation. 1999 Sep 7;100(10):1043-910477528
Cites: Lancet. 2000 Apr 15;355(9212):1295-30210776741
PubMed ID
12472929 View in PubMed
Less detail

[Balcan children with severe heart diseases surgically treated in Sweden. Report on 41 children from a successful treatment program]

https://arctichealth.org/en/permalink/ahliterature78620
Source
Lakartidningen. 2006 Dec 13;103(50-52):4038-41
Publication Type
Article
Date
Dec-13-2006

Bridge to heart transplantation with the HeartMate device in Gothenburg, Sweden.

https://arctichealth.org/en/permalink/ahliterature53070
Source
Transplant Proc. 2005 Oct;37(8):3321-2
Publication Type
Article
Date
Oct-2005
Author
H. Liden
P. Wierup
M. Westerberg
F. Nilsson
L. Wiklund
Author Affiliation
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
Source
Transplant Proc. 2005 Oct;37(8):3321-2
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Defibrillators, Implantable
Female
Heart Diseases - surgery - therapy
Heart Transplantation - statistics & numerical data
Heart-Assist Devices
Humans
Male
Middle Aged
Retrospective Studies
Sweden
Waiting Lists
Abstract
BACKGROUND: Patients rapidly deteriorating while waiting for heart transplantation present a major problem. Our strategy for this entity is the HeartMate left ventricular assist device (LVAD) VELVAS, an electrically driven implantable LVAD. Herein we report our initial experience. METHODS: The medical records of all the patients who received HeartMate LVAS at our institution were reviewed. RESULTS: From January 1997 through May 2004, 19 patients received a HeartMate. The mean age was 39 (15 to 61) years and 84% were men. The diagnoses were: dilated cardiomyopathy (n = 8), ischemic heart disease (n = 6), myocarditis (n = 3), congenital heart disease (n = 1), and hypertrophic cardiomyopathy (n = 1). Mean time on LVAD was 113 (10 to 353) days. Ten patients were discharged from the hospital to their homes awaiting transplant or recovery. Three patients showed recovery of heart function and were subsequently weaned from mechanical support. Thirteen patients underwent heart transplantation. Three patients died during LVAD treatment. Major adverse events occurred in nine patients, including severe right heart failure (n = 3), severe bleeding (n = 3), stroke (n = 1), hepatic failure (n = 1), and septicemia (n = 2). Nine of the 13 transplanted patients are alive and well today. CONCLUSION: HeartMate LVAS is a valuable option for patients rapidly deteriorating while awaiting a heart transplant. Our results are comparable with those reported from larger centers.
PubMed ID
16298585 View in PubMed
Less detail

[Brief outline of the development of cardiological surgery in the Ukraine]

https://arctichealth.org/en/permalink/ahliterature55596
Source
Klin Khir. 1987;(11):5-10
Publication Type
Article
Date
1987

Canadian Cardiovascular Society atrial fibrillation guidelines 2010: prevention and treatment of atrial fibrillation following cardiac surgery.

https://arctichealth.org/en/permalink/ahliterature136938
Source
Can J Cardiol. 2011 Jan-Feb;27(1):91-7
Publication Type
Conference/Meeting Material
Article
Author
L Brent Mitchell
Author Affiliation
Libin Cardiovascular Institute of Alberta, Alberta Health Services and University of Calgary, Foothills Hospital, Calgary, Alberta, Canada. brent.mitchell@albertahealthservices.ca
Source
Can J Cardiol. 2011 Jan-Feb;27(1):91-7
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Adrenergic beta-Antagonists - adverse effects - therapeutic use
Amiodarone - adverse effects - contraindications - therapeutic use
Anti-Arrhythmia Agents - adverse effects - contraindications - therapeutic use
Anticoagulants - adverse effects - therapeutic use
Atrial Fibrillation - drug therapy - etiology - prevention & control
Atrial Flutter - drug therapy - etiology - prevention & control
Canada
Cardiac Pacing, Artificial
Drug Therapy, Combination
Evidence-Based Medicine
Heart Diseases - surgery
Humans
Intensive Care Units
Length of Stay
Magnesium Sulfate - therapeutic use
Postoperative Complications - drug therapy - etiology - prevention & control
Premedication
Randomized Controlled Trials as Topic
Risk factors
Abstract
Postoperative atrial fibrillation and atrial flutter (POAF) are the most common complications of cardiac surgery that require intervention or prolong intensive care unit and total hospital stay. For some patients, these tachyarrhythmias have important consequences including patient discomfort/anxiety, hemodynamic deterioration, cognitive impairment, thromboembolic events including stroke, exposure to the risks of antiarrhythmic treatments, longer hospital stay, and increased health care costs. We conclude that prevention of POAF is a worthwhile exercise and recommend that the dominant therapy for this purpose be ß-blocker therapy, especially the continuation of ß-blocker therapy that is already in place. When ß-blocker therapy is contraindicated, amiodarone prophylaxis is recommended. If both of these therapies are contraindicated, therapy with either intravenous magnesium or biatrial pacing is suggested. Patients at high risk of POAF may be considered for first-line amiodarone therapy, first-line sotalol therapy, or combination prophylactic therapy. The treatment of POAF may follow either a rate-control approach (with the dominant therapy being ß-blocking drugs) or a rhythm-control approach. Anticoagulation should be considered if persistent POAF lasts >72 hours and at the point of hospital discharge. The ongoing need for any POAF treatment (including anticoagulation) should be reconsidered 6-12 weeks after the surgical procedure.
PubMed ID
21329866 View in PubMed
Less detail

[Cardiac surgery in children at l'Institut de cardiologie de Qu├ębec. 5 year evaluation (1967 to 1971)].

https://arctichealth.org/en/permalink/ahliterature255029
Source
Vie Med Can Fr. 1973;2(2):118-22
Publication Type
Article
Date
1973

Changes in the appearance and treatment of deep sternal infections.

https://arctichealth.org/en/permalink/ahliterature53739
Source
J Hosp Infect. 2002 Apr;50(4):298-303
Publication Type
Article
Date
Apr-2002
Author
A. Tegnell
B. Isaksson
H. Granfeldt
L. Ohman
Author Affiliation
Division of Infectious Diseases, Department of Health and Environment, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden. Anders.Tegnell@inf.liu.se
Source
J Hosp Infect. 2002 Apr;50(4):298-303
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Female
Heart Diseases - surgery
Humans
Male
Reoperation
Research Support, Non-U.S. Gov't
Sternum - microbiology
Surgical Wound Infection - drug therapy - pathology - surgery
Sweden
Abstract
The Department of Thoracic Surgery at the University Hospital, Linköping, Sweden, has actively followed up infectious complications of cardiac surgery since 1989. The aim of this study was to investigate whether changes occurred during the 1990s in the appearance and the management of deep infections. This was done by studying patients undergoing surgical revision of infected wounds. We studied 42 patients during 1990-94 and 49 during 1997-98 (total number of operations in these periods, 3075 and 1646, respectively). Pre-operative and intra-operative variables were recorded for the two patient populations. The proportion of cardiac surgery procedures followed by a surgical revision for an infection in the sternal wound increased between the two periods (1.4% vs. 3.0%). Variables associated with the surgical procedures preceding the infection remained unchanged. In the later period, treatment was started earlier (64 vs. 24 days), and the length of antibiotic treatment was decreased (115 vs. 72 days). The incidence of osteomyelitis of the sternal bone was lower (61% vs. 27%). It appears that as the proportion of patients undergoing surgical revision increased, management of the infections became more effective, with aggressive surgical and antibiotic treatment policies and shorter treatment periods. This indicates that in order to evaluate the overall impact of measures designed to reduce infections after cardiac surgery, not only the incidence of infection needs to be followed up but other factors also need to be taken into account.
PubMed ID
12014904 View in PubMed
Less detail

40 records – page 1 of 4.