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Related Concept Videos

Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

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Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
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Imbalances in Cardiac Output01:26

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
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Updated: Jun 26, 2025

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
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The Risk Of Waiting Up To One Year For Cardiac Surgery.

Márcio Madeira1, Jose Neves1, Tiago Nolasco1

  • 1Cardiothoracic department, Santa Cruz Hospital, Portugal.

Portuguese Journal of Cardiac Thoracic and Vascular Surgery
|May 14, 2024
PubMed
Summary
This summary is machine-generated.

Cardiac surgery waiting times significantly impact patient mortality, with longer waits, especially in 2021, increasing risk. Implementing stricter surgical waiting list (SWL) time limits could reduce deaths.

Keywords:
COVID-19Coronary Artery BypassHealth Services AccessibilityHeart SurgeryPatient Care ManagementSurgery Waiting ListValve Surgery

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Area of Science:

  • Cardiovascular Surgery
  • Health Services Research
  • Epidemiology

Background:

  • Cardiac disease poses significant mortality risks, compounded by comorbidities and extended waiting times for surgical intervention.
  • The COVID-19 pandemic critically impacted surgical capacity and patient health, potentially exacerbating risks associated with delayed cardiac procedures.
  • Understanding the dynamics of surgical waiting lists (SWL) is crucial for managing patient outcomes in cardiovascular care.

Purpose of the Study:

  • To analyze the impact of waiting times on mortality for adult patients on the surgical waiting list (SWL) for cardiac surgery.
  • To evaluate the influence of patient priority, age, and pandemic-related factors on mortality during the waiting period.
  • To assess the potential benefits of implementing stricter time limits for SWL, drawing parallels with oncology waiting time protocols.

Main Methods:

  • A prospective cohort study of 1914 adult patients registered on the SWL between January 2019 and December 2021.
  • Analysis excluded urgent cases and outliers, focusing on waiting times from 4 days to one year.
  • Patient priority was categorized using national criteria for non-oncologic and oncology surgery; mortality predictors were identified using Cox regression.

Main Results:

  • During the study, 74% of patients underwent surgery, 19.2% remained on the SWL, and 4.3% were lost to follow-up.
  • The overall mean waiting time was 167 ± 135 days, with significantly longer waits for higher priority groups (p<0.001).
  • Mortality on the SWL was 2.5%, with independent predictors including age and the year 2021 (HR 2.07 vs. 2019). Applying oncology time limits could have significantly reduced risk (p=0.011).

Conclusions:

  • Increased mortality in 2021, potentially linked to the COVID-19 pandemic, highlights the critical role of waiting time and pandemic-related factors.
  • Waiting time, rather than risk stratification alone, is the most significant factor influencing mortality on the SWL.
  • Implementing stricter time limits for cardiac surgery waiting lists, similar to oncology protocols, could substantially decrease patient mortality.