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The Peripheral Hospital as Focal Point for Pacemaker Activity: Review of the Last 300 Implantations Carried out at the Haute Correze Hospital Center

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World Journal of Cardiovascular Diseases 2024年第9期14卷 547-556页

作者： Mazou Temgoua Alain Berenfeld Lionel Blasco Benoit Guy-Moyat Cardiology Department Haute Correze Hospital Center Ussel France cardiac arrythmia unit Cardiology Department Dupuytren University Hospital Limoges France

Background: Pacemaker implantation is a very old activity which has revolutionized the cardiology practice throughout the world. This activity is effective at the Haute Correze Hospital Center since more than 20 years. Due to progress in this area, and the increasing request within this center located at the outskirts of town, we set out to evaluate our pacemaker activity in general and more specifically to assess the post-procedural complications in our series patients. Methodology: This was a retrospective longitudinal study. Data were recorded for period of 90 months from 27/05/2016 to 19/11/2023. This data collection was possible via a specific register completed by computerized patient data from the SillageTM software. All files of patients implanted with single or dual chamber pacemakers were included, generator replacements, upgrading procedures and addition of leads were excluded. The sampling was non-probabilistic, consecutive and non-exhaustive. Statistical analysis was carried out using the Excel 2019 spreadsheet and SPSS version 23 software. The quantitative variables were presented as mean ± standard deviation, the qualitative data as proportions. Results: A total of 303 first-time pacemaker’s implantations were carried out during the study period (rate of 40 per year). The average age in the population was 79.7 ± 9.4 years (44 - 99 years) with a male predominance of 63.7% (n = 193). Atrioventricular block (2nd and 3rd degree) was the main indication for pacemaker implantation in 42.9% of cases (n = 130). Patients were most often implanted with a dual-chamber pacemaker (57.7%, n = 175). The approach was most often cephalic in 72.6% of cases (n = 220), followed by the subclavian access in 27.4% of cases (n = 84). The average fluoroscopy time was 7.9 min ± 2.4 (1 - 43). The average irradiation dose in gray/cm2 was 12.4 ± 9.3 (0.22 - 117.5). The average length of hospitalization was 7 ± 4 (2 - 26) days. The overall complication rate at one year was 12.9% (

关键词： Peripheral Hospital Pacemaker Haute Correze Hospital Center

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A case report of chylous ascites after cardiac surgery

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Emergency and Critical Care Medicine 2024年第1期4卷 42-45页

作者： Shuaishuai Yuan Pailing Xie Xiantao Liu Peijun Li The University of Hong Kong-Shenzhen Hospital Cardiovascular Medicine Center cardiac Intensive Care unit ShenzhenGuangdongChina.

Background:Chylous ascites(CA),an emulsion rich in triglycerides,is a rare type of ascites,especially after cardiac ***,there are few reports of the occurrence of CA after mitral valve replacement,aortic valve replacement,tricuspid valvuloplasty,and coronary artery bypass *** presentation:We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence,aortic incompetence,tricuspid incompetence,and coronary atherosclerotic heart *** days after surgery,3000 mL of milky-yellow ascites appeared in the abdominal cavity,diagnosed as CA by laboratory *** ascites gradually disappeared after being drained,and the patients *** curative was objective,but the exact cause is not ***:Although CA is rare,it may occur during the surgical intervention in cardiac surgery.

关键词： cardiac intensive care unit cardiac valve replacement Case report Chylous ascites Coronary artery bypass graft Department of cardiac surgery

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Quality of life and functional capacity in patients after cardiac surgery intensive care unit

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World Journal of Cardiology 2024年第8期16卷 436-447页

作者： Vasiliki Raidou Katerina Mitete Christos Kourek Michael Antonopoulos Theodora Soulele Kyriaki Kolovou Ioannis Vlahodimitris Ioannis Vasileiadis Stavros Dimopoulos Clinical Ergospirometry Exerciseand Rehabilitation LaboratoryDepartment of First Critical Care MedicineEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece cardiac Surgery Intensive Care unit Onassis Cardiac Surgery CenterAthens 17674Greece

Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide,leading to morbidity and *** artery bypass grafting(CABG)and surgical aortic valve replacement(SAVR)have therapeutic benefits,including improved postoperative quality of life(QoL)and enhanced patient functional capacity which are key indicators of cardiac surgery *** this article,we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac *** standardized instruments are used to evaluate QoL and functional *** health status,age,length of intensive care unit stay,operative risk,type of procedure,and other pre-,intra-,and postoperative factors affect postoperative *** patients experience impaired physical status soon after cardiac surgery,but it improves in the following *** and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long *** rehabilitation improves patient functional capacity,QoL,and frailty following cardiac surgery.

关键词： Quality of life Health-related quality of life Functional capacity cardiac rehabilitation cardiac surgery Coronary artery bypass grafting Heart valve surgery Heart valve replacement

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Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

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World Journal of Transplantation 2024年第2期14卷 107-118页

作者： Sophia Hatzianastasiou Paraskevas Vlachos Georgios Stravopodis Dimitrios Elaiopoulos Afentra Koukousli Josef Papaparaskevas Themistoklis Chamogeorgakis Kyrillos Papadopoulos Theodora Soulele Despoina Chilidou Kyriaki Kolovou Aggeliki Gkouziouta Michail Bonios Stamatios Adamopoulos Stavros Dimopoulos Microbiology Department and Infection Control Office Onassis Cardiac Surgery CenterAthens 17674Greece Heart Transplantation unit Onassis Cardiac Surgery CenterAthens 17674Greece cardiac Surgery Intensive Care unit Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive *** To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart *** This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation *** was collected regarding MDROs commonly encountered in critical *** Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was *** acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

关键词： Heart transplantation Multi drug resistant organisms Transplantation complications Transplantation outcome

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Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report

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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang Intensive Care unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China Department of cardiac Surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely ***,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important *** the incidence of LVT during VA-ECMO is not high,the consequences of embolization are *** SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 *** excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for *** day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic *** ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral *** LVT with high mobility during VA-ECMO may cause embolism in important ***,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

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cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy

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World Journal of Cardiology 2024年第2期16卷 67-72页

作者： Christos Kourek Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece cardiac Surgery Intensive Care unit Onassis Cardiac Surgery CenterAthens 17674Greece Clinical Ergospirometry Exercise&Rehabilitation Laboratory1st Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece

Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of *** complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality *** the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac *** and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle *** mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance *** exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise *** the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac *** incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.

关键词： cardiac rehabilitation cardiac surgery Cardiopulmonary exercise testing Early mobilization Treatment Technology

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Strategy and technique for surgical treatment of Ebstein’s anomaly

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Chinese Medical Journal 2024年第10期137卷 1218-1224页

作者： Qingyu Wu Xiaoya Zhang Mingkui Zhang Hongyin Li Dongya Zhang Lianyi Wang Qingfeng Wu cardiac Center Division of Cardiac SurgeryThe First Hospital of Tsinghua UniversityBeijing 100016China

Background:Ebstein’s anomaly(EA)is a rare and complex congenital heart anomaly,and the effect of surgical treatment is not *** study aims to introduce our experience in management strategies,surgical techniques,and operative indications for patients with Ebstein’s ***:A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020.32 patients had previously received cardiac surgery in other *** clinical data including diagnosis,operative indications,techniques,pathological changes,and survival rates were collected and ***:Anatomical correction was performed in 203(78.7%)operations,1½ventricle repair in 38(14.7%)operations,tricuspid valve repair only in four operations(1.6%),tricuspid valve replacement in ten(3.9%),total cavopulmonary connection(TCPC)in two(0.8%),and Glenn operation in one operation(0.4%).Reoperation was performed in five patients(2.0%)during *** them,tricuspid valve replacement was performed in one patient,1½ventricle repair in two patients,and tricuspid valve annulus reinforcement in two *** patients died with an early mortality rate of 2.0%.Complete atrioventricular conduction block was complicated in one patient(0.4%).A total of 244 patients was followed up(four in the 253 patients lost)with a duration of 3.0-168.0(87.6±38.4)*** function of 244 patients improved significantly with mean New York Heart Association(NYHA)functional class recovery from 3.5 to *** mean grade of tricuspid valve regurgitation improved from 3.6 to *** late deaths(1.2%)*** survival rates at five and ten years after surgery were 98.6%and 98.2%,*** was performed in five patients(2.0%)during the follow-up ***:Based on our management strategies and operative principles and techniques,anatomical correction of EA is capable of achiev

关键词： Ebstein’s anomaly Anatomical repair Surgical treatment Long-term result

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Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

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World Journal of Cardiology 2024年第1期16卷 27-39页

作者： Christos Kourek Marios Kanellopoulos Vasiliki Raidou Michalis Antonopoulos Eleftherios Karatzanos Irini Patsaki Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Clinical Ergospirometry Exercise and Rehabilitation LaboratoryEvangelismos HospitalAthens 10676Greece Intensive Care unit Onassis Cardiac Surgery CenterKallithea 17674Greece Department of Physiotherapy University of West AtticaAthens 12243Greece

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher *** mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of *** electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these *** To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac *** We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac *** were assessed for methodological rigor and risk of bias via the *** primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and *** Ten studies were included in our systematic review,resulting in 703 *** half of them performed NMES and the other half were included in the control group,treated with usual *** studies investigated patients after cardiac surgery and 1 study before cardiac *** capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac *** studies

关键词： Neuromuscular electrical stimulation cardiac surgery coronary artery bypass grafting Heart valve replacement Peak VO2 Safety

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Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

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World Journal of Cardiology 2024年第5期16卷 221-225页

作者： Stavros Dimopoulos Michael Antonopoulos cardiac Surgery ICU Onassis Cardiac Surgery CenterKallithea 17674Greece

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of *** this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart *** congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and ***,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient *** flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

关键词： Systemic congestion Organ perfusion Hemodynamics Central venous pressure Point of care ultrasound Venous excess ultrasound

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Increasing role of post-intensive care syndrome in quality of life of intensive care unit survivors

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World Journal of Critical Care Medicine 2024年第2期13卷 7-10页

作者： Irini Patsaki Stavros Dimopoulos Department of Physiotherapy University of West AttikaAthens 12243Greece cardiac Surgery Intensive Care unit Onassis Cardiac Surgery CentreAthens 17674Greece

In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidisciplinary rehabilitation from within the ***,the syndrome was identified and well described early in 2012,more awareness has been raised on the long-term PICS related health problems by the increased number of coronavirus disease 2019 ICU *** is well outlined that the syndrome affects both the patient and the family and is described as the appearance or worsening of impairment in physical,cognitive,or mental health as consequence of critical *** was described in order:(1)To raise awareness among clinicians,researchers,even the society;(2)to highlight the need for a multilevel screening of these patients that starts from within the ICU and continues after discharge;(3)to present preventive strategies;and(4)to offer guidelines in terms of *** early multidisci-plinary approach is the key element form minimizing the incidence of PICS and its consequences in health related quality of life of both survivors and their families.

关键词： Intensive care unit acquired weakness Physical impairment Quality of life Mental Cognitive function

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