• Title/Summary/Keyword: Cardiac vascular disease

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Development and Application of a Feeding Program for Infants Postoperatively following Cardiac Surgery (심장수술 받은 영아의 영양중재프로그램 개발 및 적용)

  • Moon, Ju-Ryoung;Cho, Yong Ae;Min, Sun-In;Yang, Ji-Hyuk;Huh, June;Jung, Yeon-Yi
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.508-517
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    • 2009
  • Purpose: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. Methods: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. Results: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. Conclusion: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.

Canonical Transient Receptor Potential Channels and Their Link with Cardio/Cerebro-Vascular Diseases

  • Xiao, Xiong;Liu, Hui-Xia;Shen, Kuo;Cao, Wei;Li, Xiao-Qiang
    • Biomolecules & Therapeutics
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    • v.25 no.5
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    • pp.471-481
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    • 2017
  • The canonical transient receptor potential channels (TRPCs) constitute a series of nonselective cation channels with variable degrees of $Ca^{2+}$ selectivity. TRPCs consist of seven mammalian members, TRPC1, TRPC2, TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7, which are further divided into four subtypes, TRPC1, TRPC2, TRPC4/5, and TRPC3/6/7. These channels take charge of various essential cell functions such as contraction, relaxation, proliferation, and dysfunction. This review, organized into seven main sections, will provide an overview of current knowledge about the underlying pathogenesis of TRPCs in cardio/cerebro-vascular diseases, including hypertension, pulmonary arterial hypertension, cardiac hypertrophy, atherosclerosis, arrhythmia, and cerebrovascular ischemia reperfusion injury. Collectively, TRPCs could become a group of drug targets with important physiological functions for the therapy of human cardio/cerebro-vascular diseases.

Treatment of Pulmonary Hypertensive Crisis Using ECMO - A Case Report - (성인의 선천성 심질환 수술 후 발생한 폐동맥 고혈압 위기증에서 체외막 산소화 장치를 이용한 치험 - 1례 보고 -)

  • 최재성;김기봉
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.664-667
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    • 2002
  • Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

Percutaneous Dilatational Tracheostomy in a Cardiac Surgical Intensive Care Unit: A Single-Center Experience

  • Vignesh Vudatha;Yahya Alwatari;George Ibrahim;Tayler Jacobs;Kyle Alexander;Carlos Puig-Gilbert;Walker Julliard;Rachit Dilip Shah
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.346-352
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    • 2023
  • Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

Minimizing the risk of perioperative cardiovascular complications in homozygous familial hypercholesterolemia: a case report

  • Khan, Saad;Min, Samuel;Willard, Garrett;Lo, Iris;D'Souza, Rachael;Park, Aaron
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.1
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    • pp.39-44
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    • 2020
  • Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

Incidence of Peripheral Cyanosis in Patients with Therapeutic Hypothermia after Cardiac Arrest in the Acute Care Unit of a Tertiary General Hospital (일개 상급종합병원 응급중환자실 내 심정지 후 저체온요법을 적용한 환자의 말초 청색증 발생 현황)

  • Bang, Soo Youn;Yi, Young Hee
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.128-140
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    • 2021
  • Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

A Case of Behçet's Disease with Superior Vena Cava Syndrome (상대정맥증후군을 유발한 Behçet병 1예)

  • Kim, Young-Jee;Kim, Sang-Hun;Lee, Sang Moo;Ahn, Youngsoo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.657-663
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    • 2004
  • As a chronic multisystemic inflammatory disorder, Behçet's disease may manifest vascular, cardiac, neurological and gastrointestinal abnormalities. However, involvement of large veins, such as thrombosis of the superior or inferior vena cava, is a very rare complication. Herein, a case of superior vena cava syndrome, due to the thrombotic obstructions of the subclavian and brachiocephalic vein, is reported in a 27-year old woman with chronic Behçet's disease.

Intractable Coronary Spasm Requiring Percutaneous Coronary Intervention after Coronary Artery Bypass Grafting in a Patient with Moyamoya Disease

  • Kim, Hyeon A;Kim, Young Su;Kim, Wook Sung
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.150-153
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    • 2021
  • Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.

In vitro application of Angiographic PIV technique to blood flows (Angiographic PIV 기법을 이용한 혈액유동의 in-vitro 연구)

  • Kim, Guk-Bae;Lim, Nam-Yun;Jung, Sung-Yong;Lee, Sang-Joon
    • 한국가시화정보학회:학술대회논문집
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    • 2007.11a
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    • pp.105-108
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    • 2007
  • To diagnose the vascular diseases from the viewpoint of hemodynamics, we need detailed quantitative hemodynamic information of related blood flows with a high spatial resolution of tens micrometer and a high temporal resolution in the order of millisecond. For investigating in-vivo hemodynamic phenomena of vascular circulatory diseases, a new diagnosing technique combining a medical radiography and PIV method was newly developed. This technique called 'Angiographic PIV system' consists of a medical X-ray tube, an X-ray CCD camera, a shutter module for generating double pulse-type X-ray, and a synchronizer. Through several preliminary tests, the feasibility of the Angiographic PIV technique was verified. For in-vivo applications to real blood flows, we developed tracer microcapsules, which were optimized to this system, made of a contrast material of iodine and a matrix material of PVA (polyvinylpyrrolidone). In near future, the Angiographic PIV technique will be used for understanding hemodynamic phenomena of vascular diseases and for their early detection.

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Quantitative Flow Field Visualization of a Flow inside an Opaque Tube Using Angiographic PIV Method (X선관을 이용한 불투명한 물체 내부 유동의 정량적 가시화 연구)

  • Kim, Guk-Bae;Lim, Nam-Yun;Ryu, Jae-Chun;Yim, Dae-Hyun;Lee, Hyung-Koo;Lee, Sang-Joon
    • Proceedings of the KSME Conference
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    • 2007.05b
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    • pp.2935-2940
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    • 2007
  • To diagnose circulatory diseases in the viewpoint of hemodynamics, we need to get quantitative hemodynamic information of blood flows related with the vascular diseases with high spatial resolution of tens micrometer and high temporal resolution in the order of millisecond. For investigating in-vivo hemodynamic phenomena, a new diagnosing technique combining medical radiography and PIV method was newly proposed and developed. This angiographic PIV technique consists of a medical X-ray tube, an X-ray CCD camera, a shutter module for double pulses of X-ray, and a synchronizer. The feasibility of the angiographic PIV technique was tested and quantitative flow velocity field distribution of a flow inside an opaque conduit was acquired by the developed system. It can be used for measuring flow phenomena of nontransparent fluids inside opaque conduits.

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