http://xoomer.virgilio.it/lusebra/NuoviFile/PrevenzioneTVP.pdf

Prevention of venous thromboembolism

https://www.chpso.org/sites/main/files/file-attachments/chest-2008-geerts-381s-453s.pdf

Prevention of Venous Thromboembolism* American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th Edition)

https://www.srcv.ro/en/ghiduri/Preventia%20trombembolismului%20la%20pacientii%20nonortopedici%20-%20Ghidurile%20ACCP%202012.pdf

Prevention of VTE in Nonorthopedic Surgical Patients : Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

http://gavecelt.it/nuovo/sites/default/files/uploads/epic_guidelines_2013.pdf

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Until the 1990s, venous thromboembolism (VTE) was viewed primarily as a complication of hospitalization for major surgery (or associated with the late stage of terminal illness). However, recent trials in patients hospitalized with a wide variety of acute medical illnesses have demonstrated a risk of VTE in medical patients comparable with that seen after major general surgery. In addition, epidemiologic studies have shown that between one quarter and one half of all clinically recognized symptomatic VTEs occur in individuals who are neither hospitalized nor recovering from a major illness. This expanding understanding of the population at risk challenges physicians to carefully examine risk factors for VTE to identify high-risk patients who could benefit from prophylaxis. Factors sufficient by themselves to prompt physicians to consider VTE prophylaxis include major surgery, multiple trauma, hip fracture, or lower extremity paralysis because of spinal cord injury. Additional risk factors, such as previous VTE, increasing age, cardiac or respiratory failure, prolonged immobility, presence of central venous lines, estrogens, and a wide variety of inherited and acquired hematological conditions contribute to an increased risk for VTE. These predisposing factors are seldom sufficient by themselves to justify the use of prophylaxis. Nevertheless, individual risk factors, or combinations thereof, can have important implications for the type and duration of appropriate prophylaxis and should be carefully reviewed to assess the overall risk of VTE in each patient.

Risk factors for venous thromboembolism

https://www.annalsthoracicsurgery.org/article/S0003-4975(10)66580-0/pdf

An Experimental and Clinical Study

Although approximately 20,000 glutaraldehyde-fixed porcine cardiac valve prostheses have been implanted in patients there is a lack of detailed pathologic studies of valves removed surgically or examined at necropsy. In this study, of 363 valves implanted in 311 patients, 26 valves (7 percent) from 23 patients (7 percent) were examined morphologically. Of the 23 patients, 14 died intraoperatively or less than 1 month after valve replacement—3 from coronary artery disease, 4 from hemorrhagic myocardial necrosis, 2 from postoperative hemorrhage, 2 from pulmonary disease and 1 from phycomycosis of the prosthesis; in 2 patients no anatomic cause of death was found. Six patients died 1 to 9 months after valve replacement—one from prosthetic thrombotic stenosis, one from prosthetic endocarditis and four from causes unrelated to their prosthesis. Three patients underwent surgical excision of a malfunctioning valve 12 to 31 months after implantation; incompetence was due to infective endocarditis in two patients and to a torn cusp in one. Fourteen of 15 valves implanted for 1 month or less were normal. Eight of 11 valves implanted for more than 1 month were abnormal: 3 were infected, 2 (from one patient) had focal calcification and thrombosis, 1 had only focal thrombosis, 1 had diffuse thrombosis causing stenosis and 1 had a torn cusp. In our experience, clinical cardiovascular deterioration in the early postoperative period in patients with glutaraldehyde-fixed porcine valves is unlikely to be related to dysfunction due to pathologic processes affecting the implanted valve. Although postoperative valve dysfunction has been unusual to date, clinical cardiovascular deterioration in the late postoperative period may be related to pathologic processes (infection, thrombosis or degeneration) affecting the implanted valve.

Pathologic findings after cardiac valve replacement with glutaraldehyde-fixed porcine valves.

Echocardiography showed a large anterior chamber communicating with the left ventricle cavity through the interventricular septum in a patient with a previous left ventricular aneurysmectomy. At postmortem examination this chamber proved to be an 11-cm diameter pseudoaneurysm that opened into the left ventricle through a 3-cm orifice. A review of the literature showed 67 cases of histologically proven left ventricular pseudoaneurysm, most of which occurred after myocardial infarction and cardiac surgery. Twenty-six of 32 left ventricular pseudoaneurysms were successfully operated upon. Among 35 patients with pseudoaneurysms not operated upon, rupture was a cause of death in 11.

Ernest M. Barsamian

Papers

An Experimental and Clinical Study

Pathologic findings after cardiac valve replacement with glutaraldehyde-fixed porcine valves.

Pseudoaneurysm of the Left Ventricle: an Unusual Echocardiographic Presentation: Review of the Literature

Micturitional Static Urethral Pressure Profile: A Method of Recording Urethral Pressure Profile During Voiding and the Implications

First report of intramyocardial pH in man. II. Assessment of adequacy of myocardial preservation.