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Journal of Visualized Experiments : JoVE Apr 2010Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model for pressure overload-induced cardiac hypertrophy and heart failure. TAC...
Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model for pressure overload-induced cardiac hypertrophy and heart failure. TAC initially leads to compensated hypertrophy of the heart, which often is associated with a temporary enhancement of cardiac contractility. Over time, however, the response to the chronic hemodynamic overload becomes maladaptive, resulting in cardiac dilatation and heart failure. The murine TAC model was first validated by Rockman et al., and has since been extensively used as a valuable tool to mimic human cardiovascular diseases and elucidate fundamental signaling processes involved in the cardiac hypertrophic response and heart failure development. When compared to other experimental models of heart failure, such as complete occlusion of the left anterior descending (LAD) coronary artery, TAC provides a more reproducible model of cardiac hypertrophy and a more gradual time course in the development of heart failure. Here, we describe a step-by-step procedure to perform surgical TAC in mice. To determine the level of pressure overload produced by the aortic ligation, a high frequency Doppler probe is used to measure the ratio between blood flow velocities in the right and left carotid arteries. With surgical survival rates of 80-90%, transverse aortic banding is an effective technique of inducing left ventricular hypertrophy and heart failure in mice.
Topics: Animals; Aorta, Thoracic; Cardiomegaly; Cardiovascular Surgical Procedures; Constriction, Pathologic; Disease Models, Animal; Heart Failure; Humans; Ligation; Mice
PubMed: 20410870
DOI: 10.3791/1729 -
The Journal of Thoracic and... Jan 2022
Topics: Cardiology; Cardiovascular Surgical Procedures; Clinical Competence; Education; Humans; Inservice Training; Internship and Residency; Japan; Needs Assessment; Quality Improvement
PubMed: 33589313
DOI: 10.1016/j.jtcvs.2020.12.090 -
The Journal of Thoracic and... Jan 2022
Topics: Cardiovascular Surgical Procedures; Editorial Policies; Humans; Organizational Culture; Organizational Objectives; Periodicals as Topic; Publishing; Societies, Medical; Thoracic Surgery; United States
PubMed: 34785072
DOI: 10.1016/j.jtcvs.2021.10.055 -
Anesthesia and Analgesia Apr 2017Older adults make up an ever-increasing number of patients presenting for surgery, and a significant percentage of these patients will be frail. Frailty is a geriatric... (Review)
Review
Older adults make up an ever-increasing number of patients presenting for surgery, and a significant percentage of these patients will be frail. Frailty is a geriatric syndrome that has been conceptualized as decreased reserve when confronted with stressors, although the precise definition of frailty has not been easy to standardize. The 2 most popular approaches to define frailty are the phenotypic approach and the deficit accumulation approach, although at least 20 tools have been developed, which has made comparison across studies difficult. In epidemiologic studies, baseline frailty has been associated with poor outcomes in both community cohorts and hospitalized patients. Specifically in cardiac surgery (including transcatheter aortic valve implantation procedures), frailty has been strongly associated with postoperative mortality and morbidity, and thus frailty likely improves the identification of high-risk patients beyond known risk scores. For perioperative physicians then, the question arises of how to incorporate this information into perioperative care. To date, 2 thrusts of research and clinical practice have emerged: (1) preoperative identification of high-risk patients to guide both patient expectations and surgical decision-making; and (2) perioperative optimization strategies for frail patients. However, despite the strong association of frailty and poor outcomes, there is a lack of well-designed trials that have examined perioperative interventions with a specific focus on frail patients undergoing cardiac surgery. Thus, in many cases, principles of geriatric care may need to be applied. Further research is needed to standardize and implement the feasible definitions of frailty and examine perioperative interventions for frail patients undergoing cardiac surgery.
Topics: Aged; Aged, 80 and over; Aging; Cardiovascular Surgical Procedures; Clinical Decision-Making; Frail Elderly; Geriatric Assessment; Humans; Length of Stay; Postoperative Complications; Risk Factors
PubMed: 27622718
DOI: 10.1213/ANE.0000000000001560 -
The Journal of Thoracic and... Jan 2022
Topics: Adult; Cardiovascular Surgical Procedures; Female; Humans; Infant; Long Term Adverse Effects; Male; Postoperative Complications; Reoperation; Risk Assessment; Risk Factors; Survival Analysis; Truncus Arteriosus, Persistent
PubMed: 33726910
DOI: 10.1016/j.jtcvs.2021.01.137 -
Methodist DeBakey Cardiovascular Journal 2016Throughout the modern era of cardiac surgery, most operations have been performed via median sternotomy with cardiopulmonary bypass. This paradigm is changing, however,... (Review)
Review
Throughout the modern era of cardiac surgery, most operations have been performed via median sternotomy with cardiopulmonary bypass. This paradigm is changing, however, as cardiovascular surgery is increasingly adopting minimally invasive techniques. Advances in patient evaluation, instrumentation, and operative technique have allowed surgeons to perform a wide variety of complex operations through smaller incisions and, in some cases, without cardiopulmonary bypass. With patients desiring less invasive operations and the literature supporting decreased blood loss, shorter hospital length of stay, improved postoperative pain, and better cosmesis, minimally invasive cardiac surgery should be widely practiced. Here, we review the incisions and approaches currently used in minimally invasive cardiovascular surgery.
Topics: Cardiac Surgical Procedures; Heart Diseases; Humans; Minimally Invasive Surgical Procedures
PubMed: 27127555
DOI: 10.14797/mdcj-12-1-4 -
International Journal of Cardiology Feb 2019Both cardiac surgery and cardiac interventions are rare in pregnancy but are generally more common in the developing world. Women with known cardiac disease should... (Review)
Review
Both cardiac surgery and cardiac interventions are rare in pregnancy but are generally more common in the developing world. Women with known cardiac disease should receive contemporaneous preconception counselling to assess all risks associated with pregnancy including whether surgery or cardiac interventions may need to be considered prior to pregnancy. Some women may need to undergo emergency surgery or procedures during pregnancy and decisions regarding this should be multidisciplinary including cardiologists, cardiac surgeons, anaesthetists, obstetricians and neonatologists. In this review we discuss both conditions where surgery or percutaneous interventions may need to be considered and both the outcomes for the mother and her baby.
Topics: Cardiac Surgical Procedures; Female; Heart Diseases; Humans; Infant, Newborn; Percutaneous Coronary Intervention; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors
PubMed: 30287057
DOI: 10.1016/j.ijcard.2018.09.100 -
The Journal of Thoracic and... Dec 2016
Topics: Cardiovascular Surgical Procedures; Educational Measurement; Manuscripts as Topic; Statistics as Topic
PubMed: 27726878
DOI: 10.1016/j.jtcvs.2016.09.003 -
Revista Brasileira de Cirurgia... 2013
Topics: Animal Experimentation; Animals; Brazil; Cardiovascular Surgical Procedures; Periodicals as Topic
PubMed: 24598967
DOI: 10.5935/1678-9741.20130068 -
Journal of Cardiology Oct 2015Peroxisome proliferation-activated receptor gamma (PPARγ) is a nuclear receptor regulating transcription of several genes involved mainly in fatty acid and energy... (Review)
Review
Peroxisome proliferation-activated receptor gamma (PPARγ) is a nuclear receptor regulating transcription of several genes involved mainly in fatty acid and energy metabolism. PPARγ agonists are used as insulin sensitizers for treatment of diabetes. However, according to the results of recent studies, their clinical application can be broadened. Activation of PPARγ has a wide spectrum of biological functions, regulating metabolism, reducing inflammation, influencing the balance of immune cells, inhibiting apoptosis and oxidative stress, and improving endothelial function. These effects appear to be beneficial not only in diabetes and atherosclerosis, but also in a number of other conditions, including cardiovascular surgical interventions. In this review we discuss the role of PPARγ in various conditions associated with cardiovascular risk, including diabetes mellitus, atherosclerosis, and hypertension, and will focus on current applications of PPARγ activators and their therapeutic use. We will also give an overview of the potential use of PPARγ agonists in cardiovascular surgical intervention.
Topics: Atherosclerosis; Cardiovascular Diseases; Cardiovascular Surgical Procedures; Diabetes Mellitus; Humans; Hypertension; PPAR gamma; Risk Factors
PubMed: 26072262
DOI: 10.1016/j.jjcc.2015.05.004