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  1. Article: The impact of COVID-19 prevention measures on surgical wound infection rates post-cardiac surgery.

    Bashir, Aladdin / Holmes, Matthew / Suresh, Nebumathew / Panahi, Pedram / Atta, Sameh / Perkins, Hannah T / Lloyd, Clinton / Asopa, Sanjay

    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

    2023  

    Abstract: The COVID-19 pandemic had a huge impact on medical services. Several measures have been implemented to reduce the risk of viral transmission. In this paper, we assessed the impact of these measures on surgical wound infection rates in patients post- ... ...

    Abstract The COVID-19 pandemic had a huge impact on medical services. Several measures have been implemented to reduce the risk of viral transmission. In this paper, we assessed the impact of these measures on surgical wound infection rates in patients post-cardiac surgery. Hypothesis testing was used to compare post-cardiac operation infection rates between the year prior to the COVID-19 pandemic being declared and the first 13 months of the pandemic. The infection rates in 969 patients with operations between 01/03/2019 and 29/02/2020 were compared to those of 925 patients with cardiac surgery between 01/03/2020 and 31/03/2021. Infection rates for various operative urgencies and infection types were analysed. To compare infection rates, a two-tailed pooled z-test using the difference in infection proportions was performed. A 5% significance level was used and only categories with at least 10 patients in both the pre-covid and covid populations were tested. For leg infections, only operations involving coronary artery bypass grafting were included. To ensure that any differences in outcomes were not due to differences in patient demographics resulting in unequal operative risks, Euroscore II values, a measure of cardiac operative risk, were compared between the pre-covid and post-covid cohorts. The Mann-Whitney U-test was used to determine whether the distributions of Euroscore II values were likely to be drawn from the same population. A significance level of 5% was used. A total of 1901 patients (932 during the COVID-19 pandemic) were included in this study. Significant reduction in post-operative infections for all patients undergoing cardiac surgery from 4.3% of patients before COVID to 1.5% during the pandemic. During the pandemic, fewer elective and more urgent operations were performed. This study suggests a significant role of iatrogenic causes in wound infections prior to the pandemic. The implementation of COVID-19 prevention measures in healthcare providers can reduce surgical infection rates. As COVID-19-related restrictions have been eased, we suggest maintaining them in healthcare providers to reduce the incidence of surgical wound infections.
    Language English
    Publishing date 2023-10-12
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1160940-0
    ISSN 1122-0643 ; 1120-0391
    ISSN 1122-0643 ; 1120-0391
    DOI 10.4081/monaldi.2023.2604
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Video-assisted thoracic surgery in hemothorax evacuation after cardiac surgery or cardiac interventions.

    Bashir, Aladdin / Daraghma, Omar / Brzeziński, Zbigniew / Imiełowski, Dawid / Daszkiewicz, Piotr / Gwoźdź, Witold / Stupała, Jerzy / Tomaszewski, Paweł / Kaperczak, Jacek

    Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

    2017  Volume 14, Issue 3, Page(s) 154–157

    Abstract: Introduction: Cardiac surgery and cardiac interventions are associated with the risk of iatrogenic complications, including hemothorax. Minimally invasive methods of evacuating hemothorax include video-assisted thoracic surgery (VATS).: Aim: This ... ...

    Abstract Introduction: Cardiac surgery and cardiac interventions are associated with the risk of iatrogenic complications, including hemothorax. Minimally invasive methods of evacuating hemothorax include video-assisted thoracic surgery (VATS).
    Aim: This paper presents this method and provides its detailed analysis.
    Material and methods: The VATS procedures were used to evacuate hemothorax in 8 patients (7 after cardiac surgery and 1 after a cardiac intervention). Complete three-port VATS was performed in 7 patients, while 1 patient underwent assisted VATS due to a large number of adhesions.
    Results: On average, the repeat procedures were performed on the 20th postoperative day (10
    Conclusions: Classic median sternotomy is the standard approach for hemothorax evacuation. However, it may sometimes be burdened with a high perioperative risk due to massive mediastinal adhesions in the late postoperative period. Additionally, access through the postoperative wound appears to be associated with a higher risk of local infection and sternal instability. Hemodynamically stable patients in the late postoperative period, with stable sternums and healed postoperative wounds, are good candidates for VATS aiming to evacuate hemothorax. The VATS is an effective procedure for evacuating hemothorax.
    Language English
    Publishing date 2017-09-30
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2237053-5
    ISSN 1897-4252 ; 1731-5530
    ISSN (online) 1897-4252
    ISSN 1731-5530
    DOI 10.5114/kitp.2017.70528
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Redo aortic valve replacement

    Gatta, Francesca / Haqzad, Yama / Gradinariu, George / Malvindi, Pietro Giorgio / Khalid, Zubair / Suelo-Calanao, Rona L / Moawad, Nader / Bashir, Aladdin / Rogers, Luke J / Lloyd, Clinton / Nguyen, Bao / Booth, Karen / Wang, Lu / Al-Attar, Nawwar / McDowall, Neil / Watkins, Stuart / Sayeed, Rana / Baghdadi, Saleh / D'Alessio, Andrea /
    Monteagudo-Vela, Maria / Djordjevic, Jasmina / Goricar, Matej / Hoppe, Solveig / Bocking, Charlotte / Hussain, Azar / Evans, Betsy / Arif, Salman / Malkin, Christopher / Field, Mark / Sandhu, Kully / Harky, Amer / Torky, Ahmed / Uddin, Mauin / Abdulhakeem, Muhammad / Kenawy, Ayman / Massey, John / Cartwright, Neil / Tyson, Nathan / Nicou, Niki / Baig, Kamran / Jones, Mark / Aljanadi, Firas / Owens, Colum G / Oyebanji, Tunde / Doyle, Joseph / Spence, Mark S / Brennan, Paul F / Manoharan, Ganesh / Ramadan, Taha / Ohri, Sunil / Loubani, Mahmoud

    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

    2023  Volume 94, Issue 1

    Abstract: This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK ... ...

    Abstract This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients underwent valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. The mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR versus 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including intra-aortic balloon pump support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p<0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from the hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve TAVI provides better early outcomes as opposed to redo-AVR, although there was no difference in mid-term survival in patients successfully discharged from the hospital.
    MeSH term(s) Humans ; Aged ; Aged, 80 and over ; Aortic Valve/surgery ; Heart Valve Prosthesis Implantation/adverse effects ; Retrospective Studies ; Heart Valve Prosthesis ; Aortic Valve Stenosis/surgery ; Catheters ; United Kingdom/epidemiology ; Treatment Outcome ; Risk Factors ; Bioprosthesis/adverse effects
    Language English
    Publishing date 2023-04-19
    Publishing country Italy
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1160940-0
    ISSN 1122-0643 ; 1120-0391
    ISSN 1122-0643 ; 1120-0391
    DOI 10.4081/monaldi.2023.2546
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Redo aortic valve replacement vs valve-in-valve trans-catheter aortic valve implantation

    Francesca Gatta / Yama Haqzad / George Gradinariu / Pietro Giorgio Malvindi / Zubair Khalid / Rona L. Suelo-Calanao / Nader Moawad / Aladdin Bashir / Luke J. Rogers / Clinton Lloyd / Bao Nguyen / Karen Booth / Lu Wang / Nawwar Al-Attar / Neil McDowall / Stuart Watkins / Rana Sayeed / Saleh Baghdadi / Andrea D'Alessio /
    Maria Monteagudo-vela / Jasmina Djordjevic / Matej Goricar / Solveig Hoppe / Charlotte Bocking / Azar Hussain / Betsy Evans / Salman Arif / Christopher Malkin / Mark Field / Kully Sandhu / Amer Harky / Ahmed Torky / Mauin Uddin / Muhammad Abdulhakeem / Ayman Kenawy / John Massey / Neil Cartwright / Nathan Tyson / Niki Nicou / Kamran Baig / Mark Jones / Firas Aljanadi / Colum G. Owens / Tunde Oyebanji / Joseph Doyle / Mark S. Spence / Paul F. Brennan / Ganesh Manoharan / Taha Ramadan / Sunil Ohri / Mahmoud Loubani

    Monaldi Archives for Chest Disease (2023)

    a UK propensity-matched analysis

    2023  

    Abstract: This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicentre UK ... ...

    Abstract This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicentre UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. Mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR vs 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including IABP support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p <0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve trans-catheter aortic valve implantation provides better early outcomes, as opposed to redo surgical aortic valve replacement, although there was no difference in mid-term survival in patients successfully discharged from hospital.
    Keywords redo aortic valve replacement ; valve-in-valve TAVI ; aortic valve ; Medicine ; R
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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