Volume 9 • Issue 1 • March 2023 – JCE – Journal of Cardiovascular Emergencies

Factors That Influence the Occurrence of Acute Postoperative Complications after Carotid Endarterectomy

Tue, 04 Apr 2023 14:46:33 +0000

ABSTRACT
Background: This study aimed to identify early postoperative complications after carotid endarterectomy and the factors that may influence their occurrence. Methods: This was an observational, analytical, prospective study conducted over a period of 3 years in 2 university hospitals in Târgu Mureș, Romania. One hundred nineteen patients who underwent carotid
endarterectomy for severe carotid stenosis were included. Statistical analysis was used to identify the independent factors with a direct influence on the acute complications in the first 48 h after carotid endarterectomy. Results: We followed up on the acute postoperative complications occurring in the first 2 days after surgery. These were represented by a limited number of neurological complications and major neck hematomas. Among all comorbidities and risk factors, only advanced coronary artery disease (p = 0.05) and smoking (p = 0.03) were independent factors that directly influenced the occurrence of major neck hematomas. Operative time exceeding the median time of 90 minutes increased the risk of neurological complications (p = 0.02). The risk of major neck hematomas was also increased by preoperative treatment with anticoagulants (p = 0.01) and anticoagulants associated with antiplatelet therapy (p = 0.009). Conclusions: This study has identified factors such as advanced coronary artery disease, smoking, operative time, and anticoagulant therapy that may be independently associated with an increased risk of acute postoperative complications after carotid endarterectomy.

Inflammation, Gestational Hypertension, and Preeclampsia – a Dangerous Association

Alina-Georgiana Corduneanu, Ioana Păvăleanu, Mihai Emil Capilna — Tue, 04 Apr 2023 14:38:15 +0000

ABSTRACT
Gestational hypertension and preeclampsia complicate 2–8% of pregnancies, with a great impact on the fetuses, as well as on maternal well-being. Preeclampsia is considered a major cardiovascular emergency due to its potential to evolve to severe eclampsia, a devastating life-threatening condition. Worldwide, preeclampsia is considered to be one of the major factors that lead to maternal and fetal death. On average, hypertensive disorders are responsible for approximately 16% of maternal deaths, and every year, preeclampsia is estimated to cause more than 500,000 deaths of the fetus and 70,000 maternal deaths all over the world. While different studies published so far have not succeeded in identifying the exact mechanisms that cause preeclampsia, ischemic vascular phenomena, immunological disorders, and inflammation have been reported as important factors involved in its pathogenesis. The current review aims to provide updated, relevant literature data regarding the potential link between elevated inflammatory status and preeclampsia, at the same time underlining the role of emerging imaging techniques for the early detection of preeclamptic risk.

Incidental Discovery of a Cardiac Thrombus Mimicking a Right Atrial Myxoma in a Young Female Patient – A Case Report

Monica Alexandra Oltean, Bogdan Caloian, Diana Andrada Irimie, Dana Pop — Fri, 10 Mar 2023 04:37:42 +0000

ABSTRACT
Introduction: Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management. Case report: A 29-year-old female with paresthesia in the left arm and a systolic tricuspid murmur underwent echocardiography, which revealed a mass of 35/20 mm in the right atrium. Due to the high embolic risk, the patient was referred to the cardiac surgery department and underwent surgical removal of the cardiac mass, which presented the macroscopical aspect of a myxoma. However, the histopathological examination revealed a right atrial thrombus. Conclusion: Right heart thrombi represent a challenging diagnosis that involves a multidisciplinary team for the diagnosis and treatment of the patient.