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Improving care in the older and/or cardiac surgical patient. KU Leuven

Danny Hoogma
Aging is a complex process that is accompanied by diminishing physiological reserves resulting in a decreased tolerance for stressors, which is considered the basis for frailty. The demographic evolution of the population in the Western world, in conjunction with the increased incidence of cardiovascular disease, has resulted in a significant increase in older persons requiring cardiac surgery. In addition, the older surgical population ...

Polyurethane cuffed endotracheal tubes to prevent early postoperative pneumonia after cardiac surgery Vrije Universiteit Brussel KU Leuven Ghent University

Jan Poelaert, Pieter Depuydt, Annick De Wolf, Stijn Van de Velde, Ingrid Herck, Stijn Blot

OBJECTIVE: Patients receiving mechanical ventilation through an endotracheal tube are at increased risk for pneumonia. Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of ventilator-associated and postoperative pneumonia, better sealing of the upper trachea by the endotracheal tube cuff could possibly reduce this risk. We therefore postulated that ...

Hallucinations after Cardiac Surgery Vrije Universiteit Brussel

Thomas H Ottens, Iris E C Sommer, Marieke J Begemann, Maya J L Schutte, Maarten Jan Cramer, Willem J Suyker, Diederik van Dijk, Arjen J C Slooter

Background and Objective: Hallucinations after cardiac surgery can be a burden, but their prevalence and phenomenology have not been studied well. Risk factors for postoperative hallucinations, as well as their relation to delirium are unclear. We aimed to study the prevalence and phenomenology of hallucinations after cardiac surgery, and to study the association between hallucinations and delirium in this population. Materials and Methods: ...

Case-control study on the interplay between immunoparalysis and delirium after cardiac surgery Vrije Universiteit Brussel

Shokoufeh CheheiliSobbi, Annemieke M Peters van Ton, Esther M Wesselink, Marjolein F Looije, Jelle Gerretsen, Wim J Morshuis, Arjen J C Slooter, Wilson F Abdo, Peter Pickkers, Mark van den Boogaard, et al.

BACKGROUND: Delirium occurs frequently following cardiothoracic surgery, and infectious disease is an important risk factor for delirium. Surgery and cardiopulmonary bypass induce suppression of the immune response known as immunoparalysis. We aimed to investigate whether delirious patients had more pronounced immunoparalysis following cardiothoracic surgery than patients without delirium, to explain this delirium-infection association.

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Hybrid thoracoscopic surgical and transvenous catheter ablation versus transvenous catheter ablation in persistent and longstanding persistent atrial fibrillation (HARTCAP-AF) Vrije Universiteit Brussel

Mindy Vroomen, Mark La Meir, Justin G L Luermans, Kevin Vernooy, Brigitte A B Essers, Bianca T A de Greef, Jos G. Maessen, Harry J. G. M. Crijns, Laurent Pison

BACKGROUND: Success rates with conventional transvenous endocardial pulmonary vein isolation in patients with persistent and longstanding persistent atrial fibrillation (AF) are variable due to advanced electrical and structural remodeling of the atria. As a consequence, more extensive endocardial lesions, minimally invasive thoracoscopic surgical techniques, and hybrid ablation (combining thoracoscopic epicardial surgical and endocardial ...

Dementia development during long-term follow-up after surgical aortic valve replacement with a biological prosthesis in a geriatric population University of Antwerp

Ivo Deblier, Karl Dossche, Anthony Vanermen, Wilhelm Mistiaen
Surgical aortic valve replacement (SAVR) with a biological heart valve prosthesis (BHV) is often used as a treatment in elderly patients with symptomatic aortic valve disease. This age group is also at risk for the development of dementia in the years following SAVR. The research question is “what are the predictors for the development of dementia?”. In 1500 patients undergoing SAVR with or without an associated procedure, preoperative ...

Predictors for and consequences of acute kidney injury after surgical aortic valve replacement: an observational retrospective study University of Antwerp

Wilhelm Mistiaen
Background/Objectives: Acute renal injury (AKI) after surgical aortic valve replacement (SAVR) is a serious postoperative complication, associated with an increased need for resources and an increase in early mortality. Methods: In 2006–2017, 1548 patients underwent SAVR with or without an associated procedure. Preoperative and operative factors, as well as adverse postoperative events, were registered. The outcome was AKI defined by a decrease ...

Tricuspid annuloplasty concomitant with left-sided cardiac surgery induces right ventricular remodeling Hasselt University

Philippe BERTRAND, Gille Koppers, Frederik VERBRUGGE, Wilfried MULLENS, Rozette Reyskens, Herbert GUTERMANN, Christiaan VAN KERREBROECK, Robert DION, Pieter VANDERVOORT, David Verhaert, et al.
Background: Tricuspid valve annuloplasty (TVP) has been advocated concomitantly with complex left-sided cardiac surgery in case of severe functional tricuspid regurgitation (TR) or isolated tricuspid annular dilatation (TAD, diameter > 4,0cm or 2,1cm/m2) in the absence of TR. Data on postoperative right ventricular (RV) remodeling are lacking in these patients. Methods: Pre- and postoperative echocardiographical data from 45 consecutive TVP ...

Barbed sutures in cardiac surgery University of Antwerp

Filip Haenen
Barbed sutures, which have mono-directional barbs on their exterior surfaces and a needle on one or both ends, were already described in the patent issued to Dr. John H. Alcamo in 1964. In 1999, Dr. Harry J. Buncke received a patent for his advancements in the technology and in 2004, the US Food and Drug Administration approved the first widely commercialized barbed suture. Since then, several companies have released their own proprietary ...

The cost-utility of left ventricular assist devices for end-stage heart failure patients ineligible for cardiac transplantation: a systematic review and critical appraisal of economic evaluations KU Leuven

Ann Van den Bruel
BACKGROUND: A health technology assessment (HTA) of left ventricular assist devices (LVADs) as destination therapy in patients with end-stage heart failure was commissioned by the Dutch Health Care Insurance Board [College voor Zorgverzekeringen (CVZ)]. In this context, a systematic review of the economic literature was performed to assess the procedure's value for money. METHODS: A systematic search (updated in December 2013) for economic ...