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  1. Article ; Online: Internal hernias in pregnant females with Roux-en-Y gastric bypass: a systematic review.

    Dave, Devangi M / Clarke, Kevin O / Manicone, John A / Kopelan, Adam M / Saber, Alan A

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2019  Volume 15, Issue 9, Page(s) 1633–1640

    Abstract: Improved fertility following a Roux-en-Y gastric bypass (RYGB) can lead to pregnancy and increase the risk of internal herniation. A developing fetus and symptoms of pregnancy can mask the diagnosis and delay intervention, leading to deleterious maternal ...

    Abstract Improved fertility following a Roux-en-Y gastric bypass (RYGB) can lead to pregnancy and increase the risk of internal herniation. A developing fetus and symptoms of pregnancy can mask the diagnosis and delay intervention, leading to deleterious maternal and fetal consequences. The aim of this systematic review is to summarize the literature regarding internal hernias during pregnancy, their management, and patient outcomes. A comprehensive literature search was undertaken on PubMed and Google Scholar to identify cases of internal hernias presenting during pregnancy after RYGB. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for eligibility and inclusion of articles. Twenty-seven articles, with a total of 59 patients, regarding internal herniation during pregnancy after RYGB were identified. Epigastric pain and nausea and vomiting was the most common presentation. Regardless of orientation of the Roux limb and despite previous closure of mesenteric defects, internal herniation can still occur. A triad of epigastric pain, pregnancy, and a history of RYGB should be a red flag for clinicians to consider internal hernias as a top differential diagnosis. Prompt bariatric consultation and rapid intervention will improve maternal and fetal outcomes.
    MeSH term(s) Female ; Gastric Bypass/adverse effects ; Hernia, Abdominal/diagnosis ; Hernia, Abdominal/etiology ; Hernia, Abdominal/therapy ; Humans ; Obesity, Morbid/surgery ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/etiology ; Pregnancy Complications/therapy
    Language English
    Publishing date 2019-06-20
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2019.06.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Left Ventricular Function Recovery After Transapical TAVR in Patients With Previous Coronary Artery Bypass Graft Surgery.

    Okoh, Alexis K / Sossou, Christoph / Kang, Nathan / Decker, Jonathan / Dave, Devangi / Haik, Bruce / Chen, Chunguang / Cohen, Marc / Russo, Mark

    Innovations (Philadelphia, Pa.)

    2019  Volume 14, Issue 5, Page(s) 405–411

    Abstract: Objective: The transapical (TA) approach is an alternative access technique for transcatheter aortic valve replacement (TAVR) in patients with symptomatic aortic valve stenosis. The impact of prior coronary artery bypass graft (CABG) surgery and how it ... ...

    Abstract Objective: The transapical (TA) approach is an alternative access technique for transcatheter aortic valve replacement (TAVR) in patients with symptomatic aortic valve stenosis. The impact of prior coronary artery bypass graft (CABG) surgery and how it affects left ventricular function recovery is not well defined.
    Methods: Patients who had TAVR at a single center between June 2012 and December 2016 were reviewed. High-risk patients who underwent the procedure via a TA approach were divided into 2 groups based on their history of CABG surgery. Postoperative outcomes were compared between groups. CABG/TA-TAVR patients were subdivided into 2 per baseline left ventricular ejection fraction (LVEF) <50%. The changes in LVEF and valve function at follow-up (1 to 12 months) were analyzed using paired
    Results: Of 923 cases in total, 183 (19.8%) were performed via a TA approach. The mean ± SD Society of Thoracic Surgeons risk score of TA patients was 10.2 ± 4.6. Forty-nine (27%) had a surgical history of CABG. Overall all-cause mortality rates at 30 days, 1 year, and 2 years were similar for both groups (
    Conclusions: TA-TAVR can be safely performed with acceptable postoperative outcomes in patients with a history of CABG surgery. In those with reduced EF, significant improvements in LV and valve functions are seen at 1-year follow-up.
    MeSH term(s) Aged, 80 and over ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/physiopathology ; Aortic Valve Stenosis/surgery ; Coronary Artery Bypass/adverse effects ; Coronary Artery Bypass/mortality ; Coronary Disease/complications ; Coronary Disease/physiopathology ; Coronary Disease/surgery ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Retrospective Studies ; Transcatheter Aortic Valve Replacement/methods ; Transcatheter Aortic Valve Replacement/mortality ; Treatment Outcome ; Ventricular Function, Left
    Language English
    Publishing date 2019-07-29
    Publishing country United States
    Document type Journal Article
    ISSN 1559-0879
    ISSN (online) 1559-0879
    DOI 10.1177/1556984519864080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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