LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 32

Search options

  1. Article: Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report.

    Tesar, Joshua / Favot, Danella / Williams, Livia / Tesar, Peter

    International journal of surgery case reports

    2021  Volume 81, Page(s) 105780

    Abstract: Introduction and importance: Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to ... ...

    Abstract Introduction and importance: Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to dissection or vasculitis. Atherosclerotic disease of the supra-aortic branch vessels is commonly managed via an endovascular approach. We report a rare and atypical presentation of cerebral malperfusion in the setting of atherosclerotic disease of the innominate and carotid arteries managed with an aorto-carotid bypass graft.
    Case presentation: A case report of an 80-year-old female presenting with orthostatic mediated hypoperfusion transient ischaemic attacks with episodes of limb shaking and unilateral weakness with postural changes. The malperfusion was in the setting of severe atherosclerotic disease of the innominate and carotid arteries.
    Clinical discussion and conclusion: Our patient was not amendable to endovascular intervention or a less invasive open approach. The patient underwent an aorto-carotid bypass graft with complete resolution of symptoms. This case highlights a rare manifestation of orthostatic mediated cerebral malperfusion and a successful novel treatment method.
    Language English
    Publishing date 2021-03-16
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2021.105780
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Implementation of Patient Blood Management in Orthotopic Heart Transplants: A Single Centre Retrospective Observational Review.

    Rapier, Jacob J / Daley, Michael / Smith, Susan E / Goh, Sean L / Margale, Swaroop / Smith, Ian / Thomson, Bruce M / Tesar, Peter J / Pearse, Bronwyn L

    Heart, lung & circulation

    2024  

    Abstract: Background: Blood transfusion in the perioperative cardiothoracic setting has accepted risks including deep sternal wound infection, increased intensive care unit length of stay, lung injury, and cost. It has an immunomodulatory effect which may cause ... ...

    Abstract Background: Blood transfusion in the perioperative cardiothoracic setting has accepted risks including deep sternal wound infection, increased intensive care unit length of stay, lung injury, and cost. It has an immunomodulatory effect which may cause allo-immunisation. This may influence long-term survival through immune-mediated factors. Targeting coagulation defects to reduce unnecessary or inappropriate transfusions may reduce these complications.
    Methods: In 2012, an institution-wide patient blood management evidence-based algorithmic bleeding management protocol was implemented at The Prince Charles Hospital, Brisbane, Australia. The benefit of this has been previously reported in our lung transplant and cardiac surgery (excluding transplants) cohorts. This study aimed to investigate the effect of this on our orthotopic heart transplant recipients.
    Results: After the implementation of the protocol, despite no difference in preoperative haemoglobin levels and higher risk patients (EuroSCORE 20 vs 26; p=0.013), the use of packed red blood cells (13.0 U vs 4.4 U; p=0.046) was significantly lower postoperatively and fresh frozen plasma was significantly lower both intra- and postoperatively (7.4 U vs 0.6 U; p<0.001, and 3.3 U vs 0.6 U; p=0.011 respectively). Concurrently, the use of prothrombin complex concentrate (33% vs 78%; p<0.001) and desmopressin (5% vs 22%; p=0.0028) was significantly higher in the post-protocol group, while there was less use of recombinant factor VIIa (15% vs 4%; p=0.058). Intraoperative units of cryoprecipitate also rose from 0.9 to 2.0 (p=0.006).
    Conclusions: We have demonstrated that a targeted patient blood management protocol with point-of-care testing for heart transplant recipients is correlated with fewer blood products used postoperatively, with some increase in haemostatic products and no evidence of increased adverse events.
    Language English
    Publishing date 2024-02-15
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2024.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Risk Factors for Mortality in Patients Undergoing Cardiothoracic Surgery for Infective Endocarditis.

    Kumar, Aashish / Anstey, Chris / Tesar, Peter / Shekar, Kiran

    The Annals of thoracic surgery

    2019  Volume 108, Issue 4, Page(s) 1101–1106

    Abstract: Background: This study aimed to identify risk factors associated with mortality of patients who undergo cardiac surgery for infective endocarditis.: Methods: A retrospective review was performed of patients with infective endocarditis who underwent ... ...

    Abstract Background: This study aimed to identify risk factors associated with mortality of patients who undergo cardiac surgery for infective endocarditis.
    Methods: A retrospective review was performed of patients with infective endocarditis who underwent cardiac surgery at a quaternary Australian hospital between 2004 and 2014. Patient data were collected and prospectively analyzed.
    Results: In all, 465 patients underwent surgery during the study period, with 30 deaths (6.45%). Factors independently associated with in-hospital mortality were increasing age (odds ratio [OR] 1.04; 95% confidence interval [CI], 1.01 to 1.07; P = .009), active bacterial endocarditis at time of operation (OR 4.91; 95% CI, 1.01 to 23.8; P = .048), preoperative invasive positive pressure ventilation (OR 3.65; 95% CI, 1.18 to 11.27; P = .025), increasing cardiopulmonary bypass time (OR 1.01; 95% CI, 1.006 to 1.014; P < .001), and increasing European System for Cardiac Operative Risk Evaluation score (OR 21.73; 95% CI, 2.12 to 223.11; P < .01).
    Conclusions: The in-hospital mortality of patients with infective endocarditis remains significant, with potential risk factors including increasing age, active bacterial endocarditis, preoperative invasive positive pressure ventilation, increasing cardiopulmonary bypass time, and high European System for Cardiac Operative Risk Evaluation score.
    MeSH term(s) Cardiac Surgical Procedures ; Endocarditis/mortality ; Endocarditis/surgery ; Female ; Forecasting ; Hospital Mortality/trends ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Queensland/epidemiology ; Retrospective Studies ; Risk Assessment/methods ; Survival Rate/trends ; Time Factors
    Language English
    Publishing date 2019-07-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2019.05.029
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Redo Aortic Valve Replacement Following Bio-Bentall's Procedure.

    Liu, Chang / Doig, Fiona / Naidoo, Rishendran / Tesar, Peter

    Heart, lung & circulation

    2019  Volume 28, Issue 10, Page(s) e131–e133

    Abstract: Background: Structural valve degeneration is a known sequel of aortic valve replacement with bioprosthetic valves, not infrequently leading to redo valve replacement. Reoperation on the aortic valve is associated with an incumbent increase in ... ...

    Abstract Background: Structural valve degeneration is a known sequel of aortic valve replacement with bioprosthetic valves, not infrequently leading to redo valve replacement. Reoperation on the aortic valve is associated with an incumbent increase in perioperative risk, and this risk is further increased when reoperation is performed on an already replaced aortic root.
    Methods: We present a technique of opening the aortic graft and explanting the bioprosthesis by dividing the plane between the stent frame and the sewing ring of the bioprosthesis, followed by re-implantation of a bioprosthesis using simple sutures incorporating the remaining valve seat.
    Results: The patient experienced an uneventful postoperative course and was discharged on the fifth day postoperatively.
    Conclusions: The author presents a simple and reproducible technique to replace a degenerated bioprosthetic aortic valve while preserving the previous aortic root replacement.
    MeSH term(s) Aged, 80 and over ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Insufficiency/diagnosis ; Aortic Valve Insufficiency/etiology ; Aortic Valve Insufficiency/surgery ; Bioprosthesis/adverse effects ; Echocardiography, Transesophageal ; Heart Valve Prosthesis/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Humans ; Male ; Prosthesis Failure ; Reoperation ; Suture Techniques
    Language English
    Publishing date 2019-05-09
    Publishing country Australia
    Document type Case Reports ; Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2019.04.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Large saccular aneurysm of the distal ascending aorta.

    Nair, Lawrence / Prabhu, Anil / Tesar, Peter

    ANZ journal of surgery

    2019  Volume 90, Issue 3, Page(s) 374–376

    MeSH term(s) Aged, 80 and over ; Aorta/diagnostic imaging ; Aorta/surgery ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/surgery ; Blood Vessel Prosthesis Implantation ; Humans ; Male ; Tomography, X-Ray Computed
    Language English
    Publishing date 2019-04-15
    Publishing country Australia
    Document type Case Reports ; Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.15137
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Heuristics in cardiothoracic surgery.

    Tesar, Peter

    ANZ journal of surgery

    2008  Volume 78, Issue 12, Page(s) 1106–1108

    Abstract: Cardiothoracic surgical operations are complex procedures. Involved are an enormous number of steps that need to be carried out consistently, accurately (as the margin for error in cardiothoracic surgery is small) and in a time-efficient manner - thus ... ...

    Abstract Cardiothoracic surgical operations are complex procedures. Involved are an enormous number of steps that need to be carried out consistently, accurately (as the margin for error in cardiothoracic surgery is small) and in a time-efficient manner - thus the need for repetition in their performance to achieve excellence. Encompassed within the steps is a range of skills - motor and decision-making. The motor skills span from the gross of median sternotomy and thoracotomy, to the fine of coronary anastomoses. It is the challenge of all of this that I believe entices most prospective cardiothoracic surgeons into training, having already witnessed the difference in the ability of surgeons at surgical heuristics as beautifully described by Michael Patkin. Further, the chase for the 'perfect operation' I believe also is what keeps cardiothoracic surgeons enthralled for a career. As a comment, what will be presented is a personal perspective and should be seen as such - to quote Patton 'if everyone is thinking alike, then somebody isn't thinking'. Now surgery in general is made of movement systems as already mentioned, but critically layered upon by intellect and information. This affects the decision-making process throughout an episode of care - preoperatively, intraoperatively and postoperatively. To contemplate surgical heuristics, the two then, the movement systems and the decision-making process, must be discussed individually and then brought together in the end, for it is the gel that determines patient outcomes and then becomes the science to our craft.
    MeSH term(s) Cardiac Surgical Procedures/education ; Cardiac Surgical Procedures/methods ; Clinical Competence ; Cognition ; Humans ; Learning ; Motor Skills ; Perception ; Psychomotor Performance ; Task Performance and Analysis ; Thoracic Surgical Procedures/education ; Thoracic Surgical Procedures/methods
    Language English
    Publishing date 2008-12
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/j.1445-2197.2008.04760.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: A Unique Hybrid Approach to Complex Re-Do Aortic Root Surgery.

    Doig, Fiona / Naidoo, Rishen / Sharma, Vinod / Tesar, Peter

    Heart, lung & circulation

    2017  Volume 26, Issue 11, Page(s) e68–e70

    Abstract: Background: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) ...

    Abstract Background: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) and mitral valve (MV) repair remotely, followed by two further operations for endocarditis and aortic root abscess.
    Methods: The risk associated with the redo surgery required detailed planning and innovative techniques to allow it to be performed safely. These included femoral cannulation for cardiopulmonary bypass, venting the left ventricular apex via a small left anterior thoracotomy, use of a CODA
    Language English
    Publishing date 2017-11
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2017.05.126
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article: Posttraumatic growth in post-surgical coronary artery bypass graft patients.

    Waight, Catherine A / Strodl, Esben / Sheridan, Judith / Tesar, Peter

    Health psychology open

    2015  Volume 2, Issue 1, Page(s) 2055102915571370

    Abstract: Recent research in posttraumatic growth has been applied to people with life-threatening illnesses to optimise recovery. There is a lack of research exploring posttraumatic growth in coronary artery bypass graft patients. This article describes the ... ...

    Abstract Recent research in posttraumatic growth has been applied to people with life-threatening illnesses to optimise recovery. There is a lack of research exploring posttraumatic growth in coronary artery bypass graft patients. This article describes the recovery experience of 14 coronary artery bypass graft patients (13 males and 1 female) at their first outpatient review post-surgery. Grounded theory analysis was used to develop a model of distinct and shared pathways to growth depending on whether patients were symptomatic or asymptomatic pre-coronary artery bypass graft. Outcomes of posttraumatic growth in this sample included action-based healthy lifestyle growth and two forms of cognitive growth: appreciation of life and new possibilities. The model of posttraumatic growth developed in this study may be helpful in guiding future research into promoting posttraumatic growth and behaviour change in coronary artery bypass graft patients.
    Language English
    Publishing date 2015-02-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2779205-5
    ISSN 2055-1029 ; 2055-1029
    ISSN (online) 2055-1029
    ISSN 2055-1029
    DOI 10.1177/2055102915571370
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Study Protocol for a Pilot, Open-Label, Prospective, and Observational Study to Evaluate the Pharmacokinetics of Drugs Administered to Patients during Extracorporeal Circulation; Potential of In Vivo Cytochrome P450 Phenotyping to Optimise Pharmacotherapy.

    Adiraju, Santosh Kumar Sreevatsav / Shekar, Kiran / Tesar, Peter / Naidoo, Rishendran / Rapchuk, Ivan / Belz, Stephen / Fraser, John F / Smith, Maree T / Ghassabian, Sussan

    Methods and protocols

    2019  Volume 2, Issue 2

    Abstract: Pharmacokinetic alterations of medications administered during surgeries involving cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) have been reported. The impact of CPB on the cytochrome P450 (CYP) enzymes' activity is the key ...

    Abstract Pharmacokinetic alterations of medications administered during surgeries involving cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) have been reported. The impact of CPB on the cytochrome P450 (CYP) enzymes' activity is the key factor. The metabolic rates of caffeine, dextromethorphan, midazolam, omeprazole, and Losartan to the CYP-specific metabolites are validated measures of in vivo CYP 1A2, 2D6, 3A4, 2C19, and 2C9 activities, respectively. The study aim is to assess the activities of major CYPs in patients on extracorporeal circulation (EC). This is a pilot, prospective, open-label, observational study in patients undergoing surgery using EC and patients undergoing laparoscopic cholecystectomy as a control group. CYP activities will be measured on the day, and 1-2 days pre-surgery/3-4 days post-surgery (cardiac surgery and Laparoscopic cholecystectomy) and 1-2 days after starting ECMO, 1-2 weeks after starting ECMO, and 1-2 days after discontinuation from ECMO. Aforementioned CYP substrates will be administered to the patient and blood samples will be collected at 0, 1, 2, 4, and 6 h post-dose. Major CYP enzymes' activities will be compared in each participant on the day, and before/after surgery. The CYP activities will be compared in three study groups to investigate the impact of CYPs on EC.
    Language English
    Publishing date 2019-05-13
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2409-9279
    ISSN (online) 2409-9279
    DOI 10.3390/mps2020038
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: Re-do aortic root replacement after an allograft aortic root replacement.

    Vrtik, Marian / Tesar, Peter J

    The Annals of thoracic surgery

    2009  Volume 88, Issue 4, Page(s) 1365–1366

    Abstract: Structural degeneration of allograft aortic root is a global process. In addition to valvular degeneration, the allograft wall calcification poses a risk of systemic calcific embolization and late phase anastomotic aneurysm formation and rupture ( ... ...

    Abstract Structural degeneration of allograft aortic root is a global process. In addition to valvular degeneration, the allograft wall calcification poses a risk of systemic calcific embolization and late phase anastomotic aneurysm formation and rupture (anecdotal). Furthermore, the valve annulus is often small, and the tissues are rigid making the implantation of an adequately sized prosthesis within the allograft wall difficult. To avoid these issues, we routinely perform re-do aortic root replacement with either a mechanical valve conduit or bio-root composite graft. The technique has been successfully used in 22 consecutive patients with no operative mortality and minimal morbidity.
    MeSH term(s) Adult ; Aged ; Aorta, Thoracic ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/etiology ; Aortic Diseases/surgery ; Aortic Valve/surgery ; Female ; Follow-Up Studies ; Heart Valve Diseases/surgery ; Humans ; Male ; Middle Aged ; Prosthesis Design ; Prosthesis Failure ; Radiography ; Reoperation/methods ; Retrospective Studies ; Suture Techniques ; Time Factors ; Transplantation, Homologous ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2009-10
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2008.12.100
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top