Opioid free cardiac anesthesia - A flash in the pan?
PMID: 32275021 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Chakravarthy M Tags: Ann Card Anaesth Source Type: research

Anesthesiologists and job satisfaction in cardiac cath lab: Do we need guidelines?
Conclusion: Role of anaesthesiologist and anaesthesia facilities should be given important priority in cath lab units. Healthy attitude of governing members of cathlab as well as standard guidelines for recommendation of infrastructure of cath lab, monitoring and patient care is need of the hour! PMID: 32275022 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Annachhatre AS, Janbure N, Gaddam N, Shinde D, Annachhatre S Tags: Ann Card Anaesth Source Type: research

Prospective evaluation of the utility of CHA2DS2-VASc score in the prediction of postoperative atrial fibrillation after off-pump coronary artery bypass surgery - An observational study.
Conclusions: CHA2DS2-VASc score is useful in predicting POAF after OPCAB surgery. Higher the CHA2DS2-VASc score, greater is the possibility of development of POAF. PMID: 32275023 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Krishna VR, Patil N, Nileshwar A Tags: Ann Card Anaesth Source Type: research

A randomized control trial to compare thoracic epidural with intercostal block plus intravenous morphine infusion for postoperative analgesia in patients undergoing elective thoracotomy.
Conclusion: To summarize, though the results show a slightly better quality of analgesia with the thoracic epidural, the difference being clinically insignificant intercostal blockade could be considered as a valid alternative. PMID: 32275024 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Vilvanathan S, Kuppuswamy B, Sahajanandan R Tags: Ann Card Anaesth Source Type: research

Cardioprotective effects of propofol-dexmedetomidine in open-heart surgery: A prospective double-blind study.
Conclusion: The use of propofol-dexmedetomidine in CPB surgeries offers more cardioprotective effects than the use of propofol alone. PMID: 32275025 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Elgebaly AS, Fathy SM, Sallam AA, Elbarbary Y Tags: Ann Card Anaesth Source Type: research

Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?
Abstract Background: The quest for methods expediting rapid postoperative patient turnover has triggered implementation of various fast-track cardiac anaesthesia protocols. Using three different fast-track protocols in randomized controlled studies (RCT) conducted 2010-2016 we found minimal achievements in ventilation time together with actual and eligible length of stay in cardiac recovery unit. The comparable control group patients were evaluated in this retrospective post hoc analysis, for an association between above mentioned parameters and quality parameters, to assess whether the marginal gains have been at...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Bhavsar R, Ryhammer PK, Greisen J, Jakobsen CJ Tags: Ann Card Anaesth Source Type: research

Blood transfusion and lung surgeries in pediatric age group: A single center retrospective study.
Conclusion: Transfusion group in pediatrics undergoing lung surgeries in our study was more prone to adverse outcomes such as pneumonia, delayed time to remove chest drains, prolonged ICU stay, and hospital stay. PMID: 32275027 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Elgebaly AS, Fathy SM, Elmorad MB, Sallam AA Tags: Ann Card Anaesth Source Type: research

High thoracic epidural decreases perioperative myocardial ischemia and improves left ventricle function in aortic valve replacement alone or in addition to cabg surgery even with increased left ventricle mass index.
Conclusion: HTE reduced the incidence of MI and improved the LV function, even with increased LVM, in patients undergoing AVR alone or in addition to CABG. PMID: 32275028 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Elgebaly AS, Fathy SM, Elbarbary Y, Sallam AA Tags: Ann Card Anaesth Source Type: research

An analysis of prior experience influencing quality of pulmonary artery catheter placement in residents.
Conclusion: Our data suggested that about 20 catheter placements may be required to reach acceptable technical level for the PAC placement. PMID: 32275029 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Hamaba H, Miyata Y, Wada T, Hayasaka T, Hayashi Y Tags: Ann Card Anaesth Source Type: research

Comparison of pectoral Nerve (PECS1) block with combined PECS1 and transversus thoracis muscle (TTM) block in patients undergoing cardiac implantable electronic device insertion - A pilot study.
Abstract Background: Pectoral nerve (PECS1) block has been used for patients undergoing cardiac implantable electronic device (CIED) insertions, however, PECS1 block alone may lead to inadequate analgesia during tunneling and pocket creation because of the highly innervated chest wall. Transversus thoracis muscle plane (TTM) block targeting the anterior branches of T2-T6 intercostal nerves can be effectively used in combination with PECS1 for patients undergoing CIED insertion. The present study hypothesized that combined PECS1 and TTM blocks would provide effective analgesia for patients undergoing CIED insertion...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Arasu T, Ragavendran S, Nagaraja PS, Singh NG, Vikram MN, Basappanavar VS Tags: Ann Card Anaesth Source Type: research

Combined effect of left stellate ganglion blockade and topical administration of papaverine on left internal thoracic artery blood flow in patients undergoing coronary revascularization.
Conclusion: Combining LSGB with papaverine does not increase the LITA blood flow compared to when the papaverine is used alone. However, ganglion blockade reduces radial-femoral arterial pressure difference after CPB. Blockade can be achieved successfully under the ultrasound guidance without any complications. PMID: 32275031 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Chandran R, Sreedhar R, Gadhinglajkar S, Dash P, Karunakaran J, Pillai V Tags: Ann Card Anaesth Source Type: research

A comparative study of the analgesic effects of intravenous ketorolac, paracetamol, and morphine in patients undergoing video-assisted thoracoscopic surgery: A double-blind, active-controlled, randomized clinical trial.
Conclusion: Our study demonstrates the non-inferiority of ketorolac and paracetamol to morphine in controlling post-VATS pain without causing any significant side effects. We also show that ketorolac and paracetamol are superior to morphine in controlling pain during 2 h postsurgery. PMID: 32275032 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Dastan F, Langari ZM, Salamzadeh J, Khalili A, Aqajani S, Jahangirifard A Tags: Ann Card Anaesth Source Type: research

Comparision of upper thoracic epidural analgesia versus low thoracic epidural analgesia in off-pump coronary artery bypass graft for perioperative pain management and fast tracking.
Abstract Background: Upper thoracic epidural analgesia (TEA) is compared with lower thoracic epidural analgesia for the perioperative pain management and fast tracking in patients undergoing off pump coronary artery bypass grafting (OPCAB) surgery for the intraoperative hemodynamic, quality of analgesia, incentive spirometry, time to awakening & extubation and intensive care unit (ICU) duration. Materials and Methods: A prospective, randomized comparative clinical study was conducted with total of 60 patients randomized to either Group U: Upper TEA (n = 30) or Group L: Lower TEA (n = 30). Visual analog sc...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Asai OG, Prabhakar V, Manjunatha N Tags: Ann Card Anaesth Source Type: research

Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients.
Abstract Background: Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS™ with the thermodilution technique using pulmonary artery catheter in post-operative cardiac surgical patients. Materials and Methods: This was a prospective observational clinical study conducted at a tertiary care hospital. 23 adult patients in the age range of 18-65 years who had undergone for elective coronary artery bypass grafting were included in the study. Results:...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Bhavya G, Nagaraja PS, Singh NG, Ragavendran S, Sathish N, Manjunath N, Kumar KA, Nayak VB Tags: Ann Card Anaesth Source Type: research

Antifibrinolytics and cardiac surgery: The past, the present, and the future.
Abstract Cardiac surgery is usually associated with significant blood loss, which often necessitates blood transfusion. In order to decrease the risks associated with the latter, pharmacological as well as nonpharmacological strategies have been used to reduce blood loss. Among the pharmacological approaches, antifibrinolytic drugs are the mainstay. Aprotinin, which was the first ubiquitously used drug, fell into disrepute only to re-emerge after much debate. The decline of aprotinin paved the way for the lysine analogs. However, we must be aware with the side effects of these drugs as well as the dose modificatio...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Aggarwal NK, Subramanian A Tags: Ann Card Anaesth Source Type: research

Pain relief following sternotomy in conventional cardiac surgery: A review of non neuraxial regional nerve blocks.
Abstract Acute post-operative pain following sternotomy in cardiac surgery should be adequately managed so as to avoid adverse hemodynamic consequences and pulmonary complications. In the era of fast tracking, adequate and efficient technique of post-operative analgesia enables early extubation, mobilization and discharge from intensive care unit. Due to increasing expertise in ultrasound guided blocks there is a recent surge in trial of bilateral nerve blocks for pain relief following sternotomy. The aim of this article was to review non-neuraxial regional blocks for analgesia following sternotomy in cardiac surg...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Kar P, Ramachandran G Tags: Ann Card Anaesth Source Type: research

Anaesthetic management of myasthenia gravis in coronary artery bypass grafting.
Abstract Myasthenia gravis (MG) is an autoimmune disease affecting the neuromuscular junction causing weakness and fatigability of muscles. Careful perioperative management is required because of the unpredictable susceptibility to muscle relaxants. In this case report, we describe the successful management of a MG patient for normothermic coronary artery bypass graft (CABG) surgery with titrated doses of rocuronium without prolonged postoperative ventilation. We chose rocuronium because full and rapid recovery of neuromuscular blockade is possible with sugammadex. We conclude that using rocuronium is safe during ...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Vanjari V, Maybauer MO Tags: Ann Card Anaesth Source Type: research

Closure of an iatrogenic ventricular septal defect using a hybrid approach and echocardiographic guidance.
We report a case of using a hybrid approach to treat iatrogenic VSD with surgical right atriotomy and delivery of an Amplatzer system under direct visualization and transesophageal echocardiography guidance. PMID: 32275038 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Parsons C, Zhao CB, Huang J Tags: Ann Card Anaesth Source Type: research

Cecal bascule after cardiac surgery: A case report.
Abstract Cecal bascule is a form of volvulus resulting from upward and anterior cecal folding, and accounts for 0.01% of adult large bowel obstructions. With a competent ileocecal valve, cecal bascule may progress to closed loop obstruction, ischemia, gangrene, or perforation. Failure to treat cecal bascule has a mortality of 50%. Nonoperative management includes nasogastric and colonoscopic decompression, with a 95% failure rate. The gold standard is right hemicolectomy with a near nonexistent recurrence rate. Severe gastrointestinal complications following cardiothoracic surgery may lead to increased morbidity, ...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Johnson AM, Park S, Lytle FT Tags: Ann Card Anaesth Source Type: research

Large venous hemangioma of brachial plexus.
In this report, we present a rare case of a vascular brachial plexus tumor. The patient was a 29-year-old woman with the chief complaint of progressive enlargement of a soft tissue mass in the left upper extremity, without any pain or sensory, motor, or neurologic deficits. The soft tissue mass had presented in the left deltopectoral groove eight years ago. However, the patient had not been evaluated in the past eight years and was only recently admitted to a referral hospital. After complete examination, she underwent surgery for a nerve sheath tumor of the brachial plexus. PMID: 32275040 [PubMed - in process] (Sourc...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Abdolrazaghi H, Riyahi A, Zamenjany MR Tags: Ann Card Anaesth Source Type: research

Erector spinae plane block using clonidine as an adjuvant for excision of chest wall tumor in a pediatric patient.
Abstract Erector spinae plane block has been described to manage post-thoracotomy pain. It is a simple block and shown to be provide effective analgesia. In single shot blocks opioid supplementation may be required to manage pain after the effect of local anesthetic wears off. In this case, we describe a case of chest wall tumor excision in a child who received clonidine in addition to local anesthetic for the erector spinae plane block. This provided long lasting and effective postoperative analgesia and may be considered to prolong the analgesia achieved with erector spinae plane block. PMID: 32275041 [PubM...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Gupta A, Gupta N, Choudhury A, Agrawal N Tags: Ann Card Anaesth Source Type: research

Ultrasound-guided serratus plane block combined with intercostal block for a high-risk patient with pericardial tamponade: A case report.
Abstract Anesthetic management of patients with pericardial tamponade is challenging. A 65-year-old man diagnosed with small-cell lung carcinoma and bilateral malignant pleural effusion in the lungs and pericardial effusion was scheduled for pericardial-window-opening surgery. The severely compromised lung function of the patient led to an anesthetic plan of ultrasound-guided serratus anterior plane block combined with an intercostal block. Although serratus plane block was initially developed for postoperative analgesia, we have shown here that it can be used under deep sedation in combination with an intercostal...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Şahin A, Baran O, Yıldırım L, Arar C Tags: Ann Card Anaesth Source Type: research

Airway management in a child with anterior mediastinal mass complicated by cardiac tamponade - Role of spontaneous ventilation.
Abstract Induction of general anesthesia in patients with mediastinal mass can lead to life threatening respiratory and cardiovascular complications during induction, maintenance and emergence. The inability of pediatric patient to cooperate for local anesthesia further complicates the management of such cases. Here we report the management of a child with anterior mediastinal mass causing airway compression and massive pericardial effusion posted for right pleuropericardial window. PMID: 32275043 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Rudingwa P, Panneerselvam S, Arasu M, Arikrishnan T Tags: Ann Card Anaesth Source Type: research

Congenital giant right coronary artery.
Abstract Giant coronary artery aneurysms are exceptionally uncommon with an incidence of 0.02%. The natural history and prognosis of giant coronary artery aneurysm are still not well known. PMID: 32275044 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Raut MS, Hanjoora VM, Srivastava AR, Khangarot SS, Jyoti A, Mahajan V, Rawal N Tags: Ann Card Anaesth Source Type: research

Pulmonary venous baffle obstruction following senning procedure - Role of transesophageal echocardiography.
We present a case of D-transposition of great arteries with atrial septal defect and patent ductus arteriosus electively posted for Senning's operation at 10 months of age. The patient developed signs of lung congestion immediately after termination of cardiopulmonary bypass. A stenosis in the pulmonary venous baffle was detected in transesophageal echocardiography showing a peak gradient of 10 mmHg and a mean gradient of 5 mmHg. Hence, revision of baffle was planned. The stenotic area was excised and augmented with homologous pericardium. Post-correction, lung compliance improved and the peak and mean gradient decreased t...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Gourav KP, Negi S, Damodaran S, Amburu V Tags: Ann Card Anaesth Source Type: research

Epicardial cardioverter defibrillator implantation due to post-fontan ventricular tachycardia.
Abstract Long-term survival of patients submitted to a Fontan procedure is reduced because of arrhythmias. Late post-Fontan ventricular tachycardia is extremely rare, but it can be fatal. Consequently, the implantation of an implantable cardioverter defibrillator may be required. The implantation of such a device after a Fontan operation can be rather difficult due to anatomic reasons that exclude transvenous approach. Epicardial ICD implantation is a treatment option for these patients. Transatrial approach, shock ICD coils placement in azygos vein or directly in the pericardium are possible alternatives. We here...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Papakonstantinou NA, Patris V, Samiotis I, Koutouzis M, Koutouzi G, Argiriou M Tags: Ann Card Anaesth Source Type: research

An intriguing case of post-operative respiratory failure from an occult diaphragmatic hernia- be aware of the masquerader.
We present here a case of post operative respiratory failure from a delayed presenting diaphragmatic hernia in a 2-month-old boy who underwent corrective surgery for Taussig bing anomaly and hypoplastic aortic arch. Surgical repair of the diaphragmatic defect and reduction of the bowel loops to the abdomen resulted in rapid weaning from ventilation and recovery with subsequent discharge from hospital. PMID: 32275047 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Borthakur B, Hanjoora VM, Mahajan V, Srivastava AR, Jyoti A, Raut M, Nawal A Tags: Ann Card Anaesth Source Type: research

Spontaneous bag mask ventilation for establishing cardiopulmonary bypass via mid-sternotomy in patients with severe tracheal stenosis: A series of three patients.
Abstract In patients with critical tracheal stenosis, particularly involving the lower part of trachea, a highly experienced team of anesthesiologists to tackle the difficulties of securing and maintaining the ventilation, cardiac surgeon who can swiftly establish cardiopulmonary bypass, an experienced surgeon for tracheal reconstruction are a prerequisite for managing these highly complex cases. The present paper describes three patients suffering from severe tracheal narrowing wherein spontaneous bag-mask ventilation was used for establishing cardiopulmonary bypass via mid-sternotomy as a rare life-saving proced...
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Virmani S, Datt V, Tempe DK, Minhas HS, Meher R, Goswami AD, Sharma S, Malik I Tags: Ann Card Anaesth Source Type: research

Abnormal mitral valve apparatus is not an indication for mitral valve replacement in hypertrophic obstructive cardiomyopathy.
PMID: 32275049 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Varma PK, Ahamed H Tags: Ann Card Anaesth Source Type: research

Correction of a malpositioned central venous catheter using point-of-care transthoracic echocardiography.
PMID: 32275050 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Biswas I, Bhat IH, Negi SL Tags: Ann Card Anaesth Source Type: research

Preoperative bronchoscopy before lung isolation: Look before you leap.
PMID: 32275051 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Doctor JR, Solanki SL, Kapila SJ Tags: Ann Card Anaesth Source Type: research

Entrapped tracheal tube, an unusual cause of extubation failure following tracheal resection and reconstruction.
PMID: 32275052 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Pranit P, Sakthirajan P, Priya R Tags: Ann Card Anaesth Source Type: research

Successful anesthetic management of a massive thoracoabdominal impalement injury.
We describe the management, focusing on the anesthetic preparedness, of a 44-year-old man who presented with impalement of a 1 m long serrated rod through the right supraclavicular fossa extending up to the right iliac fossa, along with rib fractures and laceration of the liver and diaphragm. PMID: 32275053 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - April 1, 2020 Category: Anesthesiology Authors: Bhushan DB, Gupta PT, Supriya GA, Butani MT Tags: Ann Card Anaesth Source Type: research

Anaphylaxis-induced atrial fibrillation and anesthesia: Pathophysiologic and therapeutic considerations.
Abstract Atrial fibrillation is the most common cardiac arrhythmia in western society affecting more than 35 million individuals worldwide annually. It is a common postoperative complication and may also occur spontaneously during general and local anesthesia administration. Aging, diabetes mellitus, hypertension, and cardiovascular diseases including cardiomyopathies, congenital cardiac anomalies, heart failure, myocardial ischemia, pericarditis, previous cardiac surgery, vascular disease, and valvular heart disease are some correlated factors. Beyond age, increased incidence of atrial fibrillation has been corre...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Kounis NG, Koniari I, Tzanis G, Soufras GD, Velissaris D, Hahalis G Tags: Ann Card Anaesth Source Type: research

Does minimal invasive cardiac surgery reduce the incidence of post-operative atrial fibrillation?
Abstract Atrial fibrillation (AF) is the most common post-operative complication and tends to be the most common arrhythmia after cardiac surgery. The etiology and risk factors for post-operative AF are poorly understood, but older age, large left atrium, diffuse coronary artery disease, a history of AF paroxysms and in general, pre-existing cardiac conditions that cause restricting and susceptibility towards inflammation have been consistently linked with post-operative atrial fibrillation (POAF). It has been traditionally thought that post-operative AF is transient, well-tolerated, benign to the patient and self...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Maimari M, Baikoussis NG, Gaitanakis S, Dalipi-Triantafillou A, Katsaros A, Kantsos C, Lozos V, Triantafillou K Tags: Ann Card Anaesth Source Type: research

Airway anomalies in cases of anomalous pulmonary venous connection - A single-center experience.
Conclusion: Prudent perioperative management necessitates prior evaluation and preemptive planning for airway anomalies in patients with anomalous venous return, since they can belong to the "Malinosculation Syndrome" group, which involves anomalous communication by means of small openings between the different components of lung tissue, namely, the lung parenchyma, tracheobronchial tree, arteries, and veins. PMID: 31929241 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Kamath A, Punetha P, Doddamane AN, Chalam KS, Hiremath CS Tags: Ann Card Anaesth Source Type: research

Role of central venous - Arterial pCO2 difference in determining microcirculatory hypoperfusion in off-pump coronary artery bypass grafting surgery.
Abstract Background: Cardiac surgery is frequently associated with macro and microcirculatory hypoperfusion. Patients with normal central venous oxygen saturation (Scvo2) also suffer from hypoperfusion. We hypothesized that monitoring central venous-arterial pco2 difference (dCO2) could also serve as additional marker in detecting hypoperfusion in cardiac surgery patient. Methods: This is a prospective observational study. Patients undergoing off-pump coronary artery bypass grafting included in this study. The dCO2 was measured postoperatively. The patients with a ScvO2 ≥70% were divided in to 2 groups, th...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Kanzariya H, Pujara J, Keswani S, Kaushik K, Kaul V, Ronakh R, Pandya H Tags: Ann Card Anaesth Source Type: research

Statin reload before off-pump coronary artery bypass graft: Effect on biomarker release kinetics.
Abstract Objectives: Statins confer protection from ischemia/reperfusion through various pathways including pleiotropic mechanisms. Following chronic administration, activation of intrinsic cellular mechanisms causes attenuation of these pleiotropic effects. Methods: Since coronary artery bypass surgery (CABG) represents a reversible ischemia-reperfusion sequence, we assessed if statin reload is effective in patients undergoing off-pump CABG (n = 100) in limiting myocardial injury. Patients received loading dose of rosuvastatin (40 mg initiated 7 days before surgery) while nonloaded patients continued whateve...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Kaushik A, Kapoor A, Agarwal SK, Pande S, Tewari P, Majumdar G, Sinha A, Kashyap S, Khanna R, Kumar S, Garg N, Tewari S, Goel P Tags: Ann Card Anaesth Source Type: research

Transesophageal echocardiographic evaluation of pulmonary vein diastolic wave deceleration time - As a predictor of left atrial pressure.
This study was conducted to correlate deceleration time of pulmonary venous diastolic wave, DT(D), and left atrial pressure (LAP), obtained noninvasively from mitral early diastolic inflow velocity-to-early diastolic mitral annulus velocity ratio (E/e'), and to assess the ease of each method in patients with coronary artery disease undergoing off-pump coronary artery bypass grafting (OPCAB) by transesophageal echocardiography. Methods: Forty-five adult patients with coronary artery disease, with left ventricular ejection fraction of ≥50% posted for elective OPCAB were enrolled in the study. Results: Forty valu...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Reddy BG, Singh NG, Nagaraja PS, Subhash S, Prabhushankar CG, Manjunatha N, Chintha V Tags: Ann Card Anaesth Source Type: research

Portal venous pulsatility fraction, a novel transesophageal echocardiographic marker for right ventricular dysfunction in cardiac surgical patients.
Conclusion: Portal vein PF is simple and feasible method for assessment of RV function. It complements the existing echocardiographic measures to diagnose RV dysfunction. PMID: 31929245 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Singh NG, Kumar KN, Nagaraja PS, Manjunatha N Tags: Ann Card Anaesth Source Type: research

Role of urinary PO2 analysis during conventional versus conventional and modified ultrafiltration techniques in adult cardiac surgery.
Abstract Background: Medullary hypoxia is the initial critical event for kidney injury during cardiopulmonary bypass, and therefore urinary PO2 with its potential of detecting medullary oxygenation for its management. Therefore, we tested the role of urinary PO2 in predicting kidney injury in those undergoing conventional versus combined (conventional and modified) ultrafiltration during cardiac surgery in adults. Methodology: We prospectively evaluated 32 adults between 18 and 65 years of age undergoing elective on-pump cardiac surgery with ejection fraction>35% by conventional (group C) versus combined u...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Burra V, Sunil PK, Praveen NB, Nagaraja PS, Singh NG, Manjunatha N, Basappanavar VS Tags: Ann Card Anaesth Source Type: research

A comparison of immediate postoperative complications in using left internal mammary artery + vein versus only vein as conduit in patients undergoing off-pump coronary artery bypass grafting.
The objective of the study is to compare the immediate postoperative cardiac complications in patients undergoing off-pump coronary artery bypass grafting (OPCABG) using mixed (arterial and venous grafts) versus only venous grafts and to compare the requirement of packed red cell units and intra-aortic balloon pump (IABP) in both the groups. Materials and Methods: This was an observational, analytical, prospective study. Sample Size: Fifty new patients were included in the study. Inclusion/Exclusion Criteria: Patients diagnosed with triple-vessel coronary artery disease (CAD) undergoing OPCABG with an ejecti...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Chaudhary T, Oberoi D, Mehrotra V Tags: Ann Card Anaesth Source Type: research

A retrospective comparison of preoperative estimated glomerular filtration rate as a predictor of postoperative cardiac surgery associated acute kidney injury.
Conclusion: In patients with preoperative eGFR>40 cc/min/1.73 m2 BSA, a lower preoperative eGFR (40-60 cc/min/1.73 m2) does not predict higher incidence of CSA-AKI as defined by AKIN criteria as compared to higher preoperative eGFR (>100 cc/min/1.73 m2). Lower height is independently associated with higher incidence of CSA-AKI in such patients. PMID: 31929248 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Reazaul Karim HM, Yunus M, Dey S Tags: Ann Card Anaesth Source Type: research

Immediate changes in hemodynamics and gas exchange after initiation of noninvasive ventilation in cardiac surgical patients.
Abstract Introduction: Cardiac surgery is associated with pulmonary dysfunction and complications such as prolonged intubation and reintubation. Bilevel positive airway pressure (BiPAP) machine has been used in the clinical settings to improve oxygenation, reduce work of breathing, and avoid reintubation. The effect of BiPAP on cardiovascular parameters is not well established, and very few studies have targeted hemodynamic changes. The aim of the study was to assess the immediate effect of BiPAP on respiratory and hemodynamic parameters in post-cardiac surgery patients. Materials and Methods: This quasi-expe...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Hamid M, Akhtar MI, Ahmed S Tags: Ann Card Anaesth Source Type: research

Comparison of effectiveness of tranexamic acid and epsilon-amino-caproic-acid in decreasing postoperative bleeding in off-pump CABG surgeries: A prospective, randomized, double-blind study.
Conclusions: Tranexamic acid significantly reduced postoperative bleeding in off-pump CABG at 24 hours as compared to epsilon-amino-caproic-acid. PMID: 31929250 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Verma S, Srinivas U, Sathpathy AK, Mittal P Tags: Ann Card Anaesth Source Type: research

Enhanced recovery and early extubation after pediatric cardiac surgery using single-dose intravenous methadone.
Conclusion: A methadone-based multimodal regimen facilitated early extubation without appreciable adverse events. Further investigations are needed to confirm efficacy of this regimen and to assess whether the excellent safety profile seen here holds in the hands of multiple providers caring for a larger, more heterogeneous population. PMID: 31929251 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Iguidbashian JP, Chang PH, Iguidbashian J, Lines J, Maxwell BG Tags: Ann Card Anaesth Source Type: research

An original backup technique to assess the correct positioning of right-sided double-lumen tubes without fiberoptic bronchoscopy: A pilot feasibility study.
We describe an original backup technique to assess the correct placement of these tubes in cases a fiberopetic bronchoscopy is lacking. Design: Prospective pilot feasibility study with 10 adult patients scheduled for a left thoracic surgery. Setting: Operating theater in a universitary hospital. Materials and Methods: The new technique uses a fluoroscopy and an adult central venous catheter wire. The time needed to perform the new technique, its success rate and its efficacy in properly exclude the left lung were evaluated. Any oxygen desaturation episode (SpO2
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Khalifa C, Fossoul S, Momeni M, Lacroix V, Watremez C Tags: Ann Card Anaesth Source Type: research

Wandering paravertebral catheter detected during thoracoscopy.
We report a case of intrapleural migration of paravertebral catheter inserted under ultrasound guidance, detected during video assisted thoracoscopic surgery. PMID: 31929253 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Sujata N, Tobin R, Gupta A, Girotra G Tags: Ann Card Anaesth Source Type: research

Management of ruptured sinus of valsalva for device closure in a patient with haemophilia.
We report the case of a 29-year-old male patient with Hemophilia type A who presented with a RSOV into right atrium (RA). The patient underwent device closure off the RSOV and received Factor VIII infusions to decrease blood loss. The peri-procedural management is being presented in this case report. PMID: 31929254 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Dhawan I, Choudhury A, Aggarwal S, Chauhan S Tags: Ann Card Anaesth Source Type: research

Incidental finding of a left atrial thrombus during surgical management of a massive pulmonary embolism.
Abstract A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial...
Source: Annals of Cardiac Anaesthesia - January 1, 2020 Category: Anesthesiology Authors: Dunn S, Dave N, Rodriguez-Blanco YF, Aljure O Tags: Ann Card Anaesth Source Type: research