Better knowledge of the risk factors for PSD should increase the effectiveness GW3965 nmr of preventive strategies in patients with this condition.”
“In morbidly obese patients (MO), adequate levels of venous return (VR) and left ventricular filling pressures (LVFP) are crucial

in order to augment perioperative safety. Rapid weight loss (RWL) preparation with very low calorie diet is commonly used aiming to facilitate bariatric surgery. However, the impact of RWL on VR and LVFP is poorly studied.

In this prospective, controlled, single-center study, we hypothesized that RWL-prepared MO prior to bariatric surgery can be hypovolemic (i.e., low VR) and compared MO to lean controls with conventional overnight fasting. Twenty-eight morbidly obese patients were scheduled consecutively for bariatric surgery and 19 lean individuals (control group, CG) for elective general surgery. Preoperative assessment of VR, LVFP, and biventricular heart function was performed by a transthoracic echocardiography (TTE) protocol to all patients in the awake state. Assessment of VR and LVFP was made by inferior vena cava maximal diameter (IVCmax) and inferior vena cava collapsibility index- (IVCCI) derived right atrial pressure estimations.

A majority of MO (71.4 %) were hypovolemic vs. 15.8 % of lean controls (p < 0.001, odds

ratio = 13.3). IVCmax was shorter in MO than in CG (p < 0.001). IVCCI was higher Z-IETD-FMK order in MO (62.1

+/- 23 %) vs. controls (42.6 +/- 20.8; p < 0.001). Even left atrium anterior-posterior diameter was shorter in MO compared to CG.

Preoperative RWL may induce hypovolemia in morbidly obese patients. Hypovolemia in MO was more common vs. lean controls. TTE is a rapid and feasible tool for assessment of preload even in morbid obesity.”
“Mitral annular calcification is associated with significant morbidity E7438 and mortality at the time of mitral valve surgery. However, few data are available describing the impact of mitral annular calcification on early and late outcomes following mitral valve repair in the current era.

Between 2001 and 2011, 625 patients were referred for mitral valve repair of severe mitral regurgitation due to myxomatous degeneration. The mean patient age was 63.9 +/- 12.7 years and 164 (26%) were female. Concomitant coronary artery bypass grafting was performed in 91 (15%) and 24 (4%) had previous cardiac surgery. Calcification of the mitral annulus was observed in 119 patients (19%), of whom complete debridement and extensive annulus reconstruction were performed in 14. The mean follow-up was for 2.4 +/- 2.3 years.

There were no deaths within 30 days of surgery. Risk factors associated with mitral annular calcification included older age (odds ratio 1.05 +/- 0.02 per increasing year), female gender (odds ratio 1.88 +/- 0.42) and larger preoperative left atrial size (odds ratio 1.04 +/- 0.