Management of Challenging Cardiopulmonary Bypass Separation
SEPARATION from cardiopulmonary bypass (CPB) after cardiac surgery is a progressive transition from full mechanical circulatory and respiratory support to spontaneous mechanical activity of the lungs and heart. During the separation phase, measurements of cardiac performance with transesophageal echocardiography (TEE) provide the rationale behind the diagnostic and therapeutic decision-making process. In many cases, it is possible to predict a complex separation from CPB, such as when there is known preoperative left or right ventricular dysfunction, bleeding, hypovolemia, vasoplegia, pulmonary hypertension, or owing to te...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 7, 2020 Category: Anesthesiology Authors: Fabrizio Monaco, Ambra Licia Di Prima, Jun Hyun Kim, Marie-Jo Plamondon, Andrey Yavorovskiy, Valery Likhvantsev, Vladimir Lomivorotov, Ludhmila Abrah ão Hajjar, Giovanni Landoni, H. Riha, A.M.G.A. Farag, G. Gazivoda, F.S. Silva, C. Lei, N. Bradic, M.R. E Tags: Review Article Source Type: research

Clot Formation in Cardiopulmonary Bypass Circuit After Application of Factor XI Concentrate
THE MANAGEMENT of inherited or acquired coagulation disorders can be challenging during cardiac surgery with extracorporeal circulation. Although guidelines recommend preoperative supplementation of factor XI (FXI) with severe hemophilia C, there are certain risks involved with this strategy with the application of cardiac bypass. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 6, 2020 Category: Anesthesiology Authors: Niels Hulsman, Jan van der Meulen, Hanna Talacua, Bachir Essoussi, Henning Hermanns Tags: Case Report Source Type: research

Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients With Suspected or Confirmed Coronavirus Disease 2019
The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and contro...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 6, 2020 Category: Anesthesiology Authors: Yi He, Jinfeng Wei, Jinjun Bian, Kefang Guo, Jiakai Lu, Wei Mei, Jun Ma, Zhongyuan Xia, Meiying Xu, Fuxia Yan, Chunhua Yu, E. Wang, Weijian Wang, Ni Zeng, Sheng Wang, Junmei Xu, Yuguang Huang, Jiapeng Huang Tags: Special article Source Type: research

Perioperative Dexmedetomidine Supplement Decreases Delirium Incidence After Adult Cardiac Surgery: A Randomized, Double-Blind, Controlled Study
Conflicting data exist on the effect of dexmedetomidine on delirium. For the present study, a randomized trial was performed to investigate the effect of perioperative dexmedetomidine on the rate of postoperative delirium after cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 4, 2020 Category: Anesthesiology Authors: Valery V. Likhvantsev, Giovanni Landoni, Oleg A. Grebenchikov, Alexey M. Ovezov, Yuri V. Skripkin, Rosalba Lembo, Dmitry I. Gaevskiy, Anna A. Tereshina, Andrey G. Yavorovskiy Tags: Original Article Source Type: research

Pro: The New Heart Allocation System Is a Positive Change in the Listing of Patients Awaiting Transplant
END-STAGE heart failure remains one of the leading causes of hospitalization in patients older than 65 years and carries a 50% mortality within 5 years of initial diagnosis.1 Heart transplantation once was believed to be associated with increased morbidity; however, dramatic advancements in immunosuppression and preservation techniques have contributed to a significant improvement in survival. One-year survival after heart transplantation in the 1980s was as low as 76%, whereas now it has improved to 85%, with many experienced centers reporting even higher rates. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 4, 2020 Category: Anesthesiology Authors: Aurelie Merlo, Meena Bhatia Tags: Pro and Con Source Type: research

Survey on Anesthesia Services in Fuwai Hospital
Fuwai Hospital is the largest cardiac surgery specialty hospital in China and possibly in the world. The physician –patient relationship in China is strained for multiple reasons, so we designed a survey to investigate patient perception of our present cardiac anesthesia service in Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College from March 2016 to August 2018. This survey provided useful information on cardiac anesthesia specific data. Ethical approval was not necessary under the ethical committee of Fuwai Hospital. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 4, 2020 Category: Anesthesiology Authors: Ling Li, Xiaoming Wang, Yuntai Yao, Lihuan Li Tags: Letter to the Editor Source Type: research

Etiology and Risk Factors for Extubation Failure in Low Birth Weight Infants Undergoing Congenital Heart Surgery
OVER THE past few years, many studies have shown that compared with normal birth weight infants, low birth weight (LBW) infants, namely those whose birth weight is (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 3, 2020 Category: Anesthesiology Authors: Chao Lu, Jinfeng Wei, Bin Cai, Jiexian Liang, Sheng Wang Tags: Original Article Source Type: research

Choosing the Best Method for Postoperative Regional Analgesia After Video-Assisted Thoracoscopic Surgery
VIDEO-ASSISTED thoracoscopic surgery (VATS) is used as an alternative to perform resections for lung cancer. The advantage of VATS includes less postoperative pain and fewer analgesic requirements; in addition, there is a reduction in pulmonary complications, shorter length of hospital stay after surgery, and enhanced recovery.1,2 Nevertheless, there still is a need to have an adequate management of pain control in the postoperative period to decrease the risk of pulmonary complications and post-thoracic surgery pain syndrome. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 3, 2020 Category: Anesthesiology Authors: Javier H. Campos, Dionne Peacher Tags: Editorial Source Type: research

Anesthetic Considerations for Fontan-Associated Liver Disease and the Failing Fontan Circuit
DR FRANCOIS Fontan (1929-2018) was a pioneer in the field of congenital heart surgery. The surgical procedure that bears his name has undergone significant technical modifications since its inception and now provides improved outcomes and hope throughout the world for children born with a functional univentricular heart.1-8 It recently has been estimated that as many as 70,000 patients may be alive worldwide with the Fontan circulation, and the expectation is that this population will double in the next 20 years. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 2, 2020 Category: Anesthesiology Authors: Richard J. Ing, Daniel Mclennan, Mark D. Twite, Michael DiMaria Tags: Review Article Source Type: research

Con: The New United Network for Organ Sharing Heart Allocation System Is Not a Positive Change in Listing Patients for Transplantation
OVER THE last few decades, the number of patients being listed for heart transplant has been growing, although the number of available donor organs has remained relatively constant.1 As the population ages, an increasing volume of patients is expected to develop advanced heart failure and become eligible for heart transplant. This widening gap in supply and demand warrants careful patient selection to optimize these most precious resources. Accordingly, the ideal system to allocate donor organs to prospective recipients simultaneously should minimize mortality for patients on the waiting list and maximize post-transplant s...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 2, 2020 Category: Anesthesiology Authors: Alan M. Smeltz, Harendra Arora, Priya A. Kumar Tags: Pro and Con Source Type: research

Protecting High-Risk Cardiac Patients During the COVID-19 Outbreak
In the effort to face the ongoing Coronavirus Disease 2019 (COVID-19) epidemic, which caused severe pneumonia requiring intensive care unit (ICU) admission in up to 15% of confirmed cases so far, many hospitals in Italy are setting up new ICUs, stopping nonurgent admissions, limiting the access to emergency rooms and wards, and providing separate pathways for suspected COVID-19 and other diseases. In parallel, it is mandatory to continue ensuring the provision of non-postponable treatments (eg, primary percutaneous coronary interventions or urgent/emergency cardiac surgical procedures). (Source: Journal of Cardiothoracic a...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 2, 2020 Category: Anesthesiology Authors: Antonio Pisano, Giovanni Landoni, Alberto Zangrillo Tags: Letter to the Editor Source Type: research

Perioperative Echocardiography: Key Considerations During the Coronavirus Pandemic
THE CURRENT pandemic stemming from severe acute respiratory syndrome –related coronavirus-2 began in December 2019 with an outbreak of pneumonia in Wuhan, China.1,2 Since the initial cases, the outbreak has spread rapidly around the world, presenting health care systems with a global health crisis. This enveloped virus has an incubation period up to 14 days and pro duces a spectrum of clinical disease in humans.3 It can vary from mild upper respiratory tract infection with fever and cough to severe acute respiratory distress syndrome that may progress to sepsis and multiorgan failure. (Source: Journal of Cardiothorac...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 2, 2020 Category: Anesthesiology Authors: John G. Augoustides Tags: Editorial Source Type: research

Functional Tricuspid Regurgitation: Analysis of Percutaneous Transcatheter Techniques and Current Outcomes
THE PREVALENCE of moderate-to-severe tricuspid regurgitation (TR) is estimated to be about 1.6 million in the United States.1 The etiology of TR is commonly divided into primary (organic) and secondary (functional). Primary TR is less common and accounts for 10% to 25% of TR.2 Etiologies of primary TR include congenital/rheumatic heart disease, endocarditis, chordal/papillary muscle rupture, myxomatous denegation, carcinoid disease, trauma, and iatrogenic disease (eg, pacemaker lead-induced TR). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2020 Category: Anesthesiology Authors: Lovkesh Arora, Sundar Krishnan, Sudhakar Subramani, Archit Sharma, Satoshi Hanada, Pedro A. Villablanca, Iv án J. Núñez-Gil, Harish Ramakrishna Tags: Expert Review Source Type: research

Cardiac Calendar 2020-2021
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Right Ventricular Aneurysmal Formation: The Right (La)Place at the Right Time
Aneurysmal formation is a rare but reported complication of myocardial infarction.1 However, a post-infarct aneurysm is commonly diagnosed in the left ventricle. This is most likely because of high left ventricular pressures in the setting of deteriorating myocardium associated with an absent or significantly limited blood supply. Right ventricular (RV) aneurysms develop with substantially less frequency and this may be due to generally lower intraventricular pressures in the right heart. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Authors: Kamrouz Ghadimi Tags: Editorial Source Type: research

Masthead
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Editorial Board
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Contents
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Articles to Appear in Future Issues
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Guide for Authors
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Source Type: research

Cold Agglutinin Disease and Hemolytic Crisis After Hypothermic Circulatory Arrest in a Patient With Beta-Thalassemia Minor
A hemolytic crisis secondary purely to cold agglutinins is a rare, but recognized complication of deep hypothermia during cardiopulmonary bypass. Guidance on perioperative identification and management is limited and largely is based on case reports and expert opinion.1-3 Cold agglutinins are mixed-reactive autoantibodies usually directed at antigens (IH, I, or i) on the red blood cell (RBC) surface. They are detected in vitro by the observation of autoagglutination in microtiter wells when analyzed at 4 °C and other sub-37°C temperatures. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2020 Category: Anesthesiology Authors: Christopher Duffy, Christopher Bain, Sesto A Cairo, Christopher Hogan, Paul Geldard, Marco Larobina, Enjarn Lin, Elli Tutungi, Lachlan F Miles Tags: Case Report Source Type: research

Pediatric Liver Transplantation: Then and Now
This paper reviews the past 50 years of liver transplantation in children from the perspective of patient demographics, perioperative patient management, surgical techniques, immunosuppression and patient outcomes. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2020 Category: Anesthesiology Authors: Lieu T. Tran, Philip C. Carullo, Diem Phuc T. Banh, Chelsea Vitu, Peter J. Davis Tags: Special Article Source Type: research

Less Transfusion, Less Infections —Controversies in Patient Blood Management
Patient blood management (PBM) should be regarded as a standard of care in modern perioperative management.1,2 Its beneficial effect on outcome has been shown in patients undergoing cardiac3 and non-cardiac surgery.4 The concept of PBM consists of a multifactorial sequence of separate blood conservation strategies and interventions.5,6 The use of intraoperative cell salvage and retransfusion of washed autologous blood as integral parts of PBM in cardiac surgery were recently recommended in the PBM guidelines issued by the European Association of Cardiovascular and Thoracic Anesthesiology. (Source: Journal of Cardiothoracic...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2020 Category: Anesthesiology Authors: Daniel Bolliger, Jens Fassl Tags: Editorial Source Type: research

Incorporating Indices of Postoperative Glycemic Variability in Postoperative Outcome Prediction Modeling: How Accurate Can it Get?
PERIOPERATIVE hyperglycemia, as well as the amplitude and frequency of glycemic variation are associated with increased morbidity and mortality after cardiac surgery, regardless of diabetic state.1,2 In patients undergoing coronary artery bypass grafting surgery, early postoperative hyperglycemia (blood glucose concentration [BGC]>250 mg/dL) significantly increases the risks of postoperative complications (nonfatal stroke, myocardial infarction, sepsis, death).3 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2020 Category: Anesthesiology Authors: Kai Yin Hwang, Nian Chih Hwang Tags: Editorial Source Type: research

Antinausea Protocol Reduces Hospital Length of Stay for Laparoscopic Nissen Fundoplication
The perioperative course of patients undergoing laparoscopic Nissen fundoplication (LNF) was reviewed to determine whether the use of a new treatment protocol consisting of total intravenous anesthesia (TIVA) plus triple antiemetic therapy was associated with shorter hospital length of stay (HLOS). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 28, 2020 Category: Anesthesiology Authors: James D. Hannon, Lindsay L. Warner, Thomas M. Stewart, Todd M. Kor, Shanda H. Blackmon, Michael J. Brown, Arun Subramanian Tags: Original Article Source Type: research

Acute Kidney Injury and Postoperative Atrial Fibrillation In Patients Undergoing Cardiac Surgery
To test the hypothesis that acute kidney injury (AKI) in the postoperative period could be an additional risk factor for the development of atrial fibrillation (AF) and to examine the risk factors for postoperative AF in the authors ’ cohort of patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2020 Category: Anesthesiology Authors: Oana M. Cole, Shervin Tosif, Matthew Shaw, Gregory Y.H. Lip Tags: Original Article Source Type: research

Impact of Intraoperative Transesophageal Echocardiography for Noncoronary Sinus of Valsalva Aneurysm With Severe Tricuspid Regurgitation
CONGENITAL sinus of Valsalva (SoV) aneurysm is a rare finding and a dilation of a single SoV caused by a separation between the aortic media and annulus fibrosis. This most commonly originates from the right coronary sinus (65%-85%), less commonly from the noncoronary sinus (10%-30%), and rarely from the left coronary sinus ( (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2020 Category: Anesthesiology Authors: Masataka Kuroda, Kanako Takahashi, Shohei Matsumoto, Masayuki Oshima Tags: Case Report Source Type: research

Comparative Analysis of the Collapsibility Index and Distensibility Index of the Inferior Vena Cava Through Echocardiography with Pulse Pressure Variation That Predicts Fluid Responsiveness in Surgical Patients: An Observational Controlled Trial
The objective for the present study was to compare the collapsibility (IcIVC) and distensibility (IdIVC) indices of the inferior vena cava with pulse pressure variation (PPV) and determine the accuracy and cutoff points of IcIVC and IdIVC that best predict response to intravenous fluid therapy in surgical patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 24, 2020 Category: Anesthesiology Authors: Renan Muralho Pereira, Alvaro Jos é Leite Campelo da Silva, Julio Faller, Brenno Cardoso Gomes, João Manoel Silva Tags: Original Article Source Type: research

Don't Forget the Right Ventricle
In their recent article, Gonz ález-Tallada et al. demonstrated an incidence of myocardial injury after noncardiac surgery (MINS) in 27.3% of patients undergoing thoracic surgery.1 MINS was defined as a postoperative troponin I level>0.04 ng/mL (>99th percentile) without evidence of a nonischemic cause of troponin I elevation. Independent association was demonstrated between occurrence of MINS and both smoking and extent of resection (lobectomy or pneumonectomy compared with other types of resection). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 24, 2020 Category: Anesthesiology Authors: Philip McCall, Brian Lafferty, Ben Shelley Tags: Letter to the Editor Source Type: research

The Challenge of Untangling the Interdependencies Between Complications After Cardiac Surgery
IN THIS edition of the journal, Cole et al. present an investigation of the association between the development of new-onset atrial fibrillation (AF) after cardiac surgery and postoperative acute kidney injury (AKI).1 They also examined the association between published risk factors for atrial fibrillation after cardiac surgery (AFACS) and AKI in their study population. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 24, 2020 Category: Anesthesiology Authors: Benjamin O'Brien, Peter Watkinson Tags: Editorial Source Type: research

Anesthetic Management of Patients Undergoing Aortic Dissection Repair With Suspected Severe Acute Respiratory Syndrome Coronavirus-2 Infection
Severe acute respiratory syndrome coronavirus-2 is still active in Wuhan, China, and is spreading to the rest of the world. Recently, perioperative anesthetic management in patients with suspected or confirmed coronavirus-2 has been reported. However, little has been reported on the anesthetic management of patients undergoing aortic dissection repair in patients with suspected severe acute respiratory syndrome coronavirus-2 infection. During the outbreak in Wuhan, the authors ’ team completed 4 cases of aortic dissection repair successfully in patients with suspected severe acute respiratory syndrome coronavirus-2 i...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 24, 2020 Category: Anesthesiology Authors: Hao He, Shuai Zhao, Linlin Han, Qi Wang, Haifa Xia, Xin Huang, Shanglong Yao, Jiapeng Huang, Xiangdong Chen Tags: Special Article Source Type: research

Early Detection, Prevention, and Management of Acute Limb Ischemia in Adults Supported With Venoarterial Extracorporeal Membrane Oxygenation
Acute limb ischemia caused by peripheral venoarterial extracorporeal membrane oxygenation (ECMO) cannulation is associated with increased mortality. Early detection of limb hypoperfusion may lead to timely intervention and prevent irreversible muscle damage. Methods to determine the adequacy of tissue oxygenation in cannulated extremities include bedside physical examination, trending serum biochemical markers, and somatic near-infrared spectroscopy. To prevent ECMO-related limb ischemia events, interventions include the addition of distal antegrade perfusion catheters to the arterial ECMO canula, minimizing arterial cannu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 23, 2020 Category: Anesthesiology Authors: Emily L. Chanan, Nishan Bingham, Deane E. Smith, Mark E. Nunnally Tags: Review Article Source Type: research

PFO! Should I Stay, or Should I Go?
IN THIS issue of the Journal of Cardiothoracic and Vascular Anesthesia, Villablanca et al. evaluated whether the presence and diagnosis of a patent foramen ovale (PFO) or atrial septal defect (ASD) preoperatively was associated with an increase in perioperative stroke for patients undergoing noncardiac surgery.1 The authors used “big data” to describe the largest study to date of 19,659,191 hospitalizations retrieved from the Healthcare Cost and Utilization Project's National Readmission Database. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 21, 2020 Category: Anesthesiology Authors: Yvonne Lai, Adam A. Dalia Tags: Editorial Source Type: research

Repurposing in 2020: Teaching Old Drugs New Tricks
A ONE-SHOT cure for vasoplegic syndrome remains elusive to modern medicine. However, the search for agents (new and old) to succor patients in times of hypotension and resultant end-organ failure continues to endure. This is likely because of the extreme exasperation felt by clinicians who witness the rapid decline in patients who cannot maintain that magical mean arterial pressure of 60 mmHg. Two agents that were developed for quite different purposes other than the treatment of refractory vasoplegic shock were examined by Furnish et al. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 21, 2020 Category: Anesthesiology Authors: Brent Kidd, Brigid C. Flynn Tags: Editorial Source Type: research

Prognostication of Patients on Venovenous Extracorporeal Membrane Oxygenation for Influenza-Induced Respiratory Failure: Best Practice and Holistic Implications
WITH the increasing incidence of influenza pandemics comes more critically ill patients presenting with respiratory failure for whom intubation and mechanical ventilation alone is inadequate. Patients with respiratory failure from influenza refractory to standard treatment may be placed on venovenous extracorporeal membrane oxygenation (VV-ECMO) to allow their lungs to recover. VV-ECMO may be used for respiratory failure from multiple etiologies, and patient outcomes after ECMO are an area of active research. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 21, 2020 Category: Anesthesiology Authors: Danielle Pulton, Jesse Kiefer, William Vernick, Jacob T. Gutsche, Jesse Raiten Tags: Editorial Source Type: research

Precision Cardiac Anesthesia: Welcome Aboard!
MODERN medicine endorses an increasing trend toward precision or a personalized management approach that essentially strives to customize the therapy in congruence with individual patient characteristics (eg, genetics, environment, and lifestyle) and needs as opposed to the conventional one-size-fits-all regimen.1 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 21, 2020 Category: Anesthesiology Authors: Rohan Magoon Tags: Letter to the Editor Source Type: research

Levosimendan Versus Milrinone for Inotropic Support in Pediatric Cardiac Surgery: Results From a Randomized Trial
INODILATORS ARE widely used to reduce the risk of low cardiac output syndrome (LCOS) after cardiac surgery with cardiopulmonary bypass (CPB) in children. In this setting, milrinone is the drug of choice.1 Levosimendan also is being used for preventing or treating LCOS after pediatric surgery in children.2 It has been demonstrated that levosimendan is safe and at least as effective as milrinone in maintaining cardiac output in the pediatric postcardiac surgery setting.3-5 To the authors ’ knowledge, no studies have compared the effect of these 2 inodilators on myocardial function in children as assessed with longitudi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 20, 2020 Category: Anesthesiology Authors: Elin M. Thorlacius, H åkan Wåhlander, Tiina Ojala, Kaisa Ylänen, Juho Keski-Nisula, Mats Synnergren, Birgitta S. Romlin, Sven-Erik Ricksten, Albert Castellheim Tags: Original Article Source Type: research

Talk About the Echo: The Importance of Effective Communication in the Cardiac Operating Room
AMONG the many contributions that author Malcolm Gladwell has made to the public consciousness is an anecdote involving the airline Korean Air and its unusually high number of crashes during the 1980s and 1990s.1 Gladwell first wrote about this story in his book Outliers: The Story of Success to illustrate the importance of culture and open lines of communication in airline safety. He argued that the issues facing Korean Air during this period were a result of neither poorly trained pilots nor outdated or improperly maintained aircraft, but instead the role that deference to one's superiors plays in traditional Korean cult...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2020 Category: Anesthesiology Authors: Jared Feinman Tags: Editorial Source Type: research

Consumer Electronics Show for the Anesthesiologist: Updates on Cardiac Implantable Electronic Devices
IN THE December issue of Anesthesiology, the updated American Society of Anesthesiologists (ASA) Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices (CIED): Pacemakers and Implantable Cardioverter-Defibrillators (ICD) was published.1 The previous version of this advisory was published almost a decade ago in 2011.2 Much has changed in the field since 2011, and many more patients now are presenting in the periprocedural environment with ICDs and pacemakers. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2020 Category: Anesthesiology Authors: Adam A. Dalia, Scott Streckenbach Tags: Editorial Source Type: research

DEX Marks the Spot: Finding the Optimal Sedation Regimen for Pediatric Patients Undergoing Sedated Transthoracic Echocardiography
In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Sun et al. present a commendable prospective, randomized controlled trial comparing intranasal dexmedetomidine (DEX) and a combination of intranasal DEX and ketamine (DEX-KET) in pediatric subjects with congenital heart disease (CHD) presenting for elective transthoracic echocardiography (TTE).1 This an important study because congenital heart defects are the most common form of birth defect, affecting nearly 1% of all live births in the United States. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2020 Category: Anesthesiology Authors: Genevieve E. Staudt, Susan S. Eagle Tags: Editorial Source Type: research

The Year in Electrophysiology: Selected Highlights from 2019
This article is the second in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the Editor-in-Chief, Dr. Kaplan, the Associate Editor-in-Chief, Dr. Augoustides, and the editorial board for the opportunity to continue this series, namely the highlights of the year that pertain to electrophysiology in relation to cardiothoracic and vascular anesthesia. This second article focuses on cardiac sympathetic denervation, the management of patients with atrial fibrillation, cerebral oximetry for catheter ablation procedures, advancements in leadless pacemaker and subcutaneous implantable ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 17, 2020 Category: Anesthesiology Authors: Adam Dalia, Michael Essandoh, Sophia Poorsattar, Perin Kothari, E Orestes O'Brien, Theodore Dimitrov, David Rudnick, Nasir Hussain, Brett Cronin Tags: Special Article Source Type: research

Monitored Anesthesia Care Is Associated With a Decrease in Morbidity After Endovascular Angioplasty in Aortoiliac Disease
Few studies have evaluated the association between anesthesia type and outcomes after endovascular angioplasty/stents for aortoiliac occlusive disease. The aim of the present study was to evaluate the association between primary anesthesia type and postprocedural complications for endovascular angioplasty of aortoiliac occlusion. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 17, 2020 Category: Anesthesiology Authors: Nancy M. Boulos, Brittany N. Burton, Devon Carter, Rebecca A. Marmor, Rodney A. Gabriel Tags: Original Article Source Type: research

The Limitations of Using Transthoracic Echocardiographic –Derived Normative Values for Grading Intraoperative Transesophageal Echocardiography Examinations of the Right Ventricle: Are They Really Interchangeable?
TRANSESOPHAGEAL echocardiography (TEE) is an indispensable tool for patients undergoing cardiac surgical procedures and for high-risk cases during noncardiac surgery.1 High-resolution imaging of the cardiac chambers enables assessment of cardiac function and guides management of dysfunction. Quantitative assessment and assignment of dysfunction largely rely on guidelines derived from transthoracic echocardiographic (TTE) studies on the awake patient.2,3 Normal and abnormal function are better defined for the left side of the heart than they are for the right side of the heart; however, more recent associations between righ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 14, 2020 Category: Anesthesiology Authors: Brian R. Gebhardt, Shyamal Asher, Andrew Maslow Tags: Editorial Source Type: research

Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures
The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Shuai Zhao, Ken Ling, Hong Yan, Liang Zhong, Xiaohong Peng, Shanglong Yao, Jiapeng Huang, Xiangdong Chen Tags: Special Article Source Type: research

Anesthesia Management for a Patient with Coronary Artery Fistula and Huge Coronary Aneurysm Undergoing Off-Pump Surgery
CORONARY artery fistulas (CAFs) are abnormal communications between the coronary arteries and the cardiac chambers (coronary-cameral fistulas), coronary sinus, or vessels around the heart.1 The prevalence of CAFs in the general population is reportedly only 0.002%.2 CAFs may lead to coronary dilation or even aneurysmal malformation.3 The incidence of aneurysm in CAFs is reportedly only 14%.4 Surgical intervention is the primary treatment for CAFs with symptoms or complications. Surgical data about CAFs are limited owing to low incidence, and surgical techniques vary in different patients. (Source: Journal of Cardiothoracic...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Haibei Liu, Xiang Li, Haibo Song, Wei Wei Tags: Case Report Source Type: research

Extraluminal Placement of the Bronchial Blocker in Infants Undergoing Thoracoscopic Surgery: A Randomized Controlled Study
The purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Jiang Yan, Zhang Rufang, Wei Rong, Zhang Wangping Tags: Original Article Source Type: research

Effects of Cardiac Surgery and Salvaged Blood Transfusion on Coagulation Function Assessed by Thromboelastometry
Coagulation function dynamically changes during cardiac surgery and is normalized after surgery. The authors investigated changes of coagulation function during cardiac surgery and after mimicked salvaged blood transfusion (SBT), and determined background risk factors for coagulation dysfunction by thromboelastmetry including maximum clot firmness of fibrinogen assay (FIBTEM-MCF: primary variable). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Kyongsuk Son, Takayuki Yamada, Kentaroh Tarao, Yuji Kitamura, Junko Okazaki, Yasunori Sato, Shiroh Isono Tags: Original Article Source Type: research

Current Practice of Calcium Use During Cardiopulmonary Bypass Weaning: Results of an International Survey
To describe international practices on the use of calcium salts during cardiopulmonary bypass (CPB) weaning in adult cardiac surgery patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Dmitri Guvakov, Alessandro Belletti, Vladimir Boboshko, Vladimir Shmyrev, Gudrun Kunst, Christian Stoppe, Boris Akselrod, Nikolay Kamenshchikov, Sergey Efremov, Alexander Chernyavskiy, Giovanni Landoni Tags: Original Article Source Type: research

Pulmonary Vein Velocities: A Useful Tool for Cardiac Anesthesiologists in the Management of Lung Transplantation
The patency of the pulmonary vein cuff anastomoses is important to the survival of the lung allograft and impacts morbidity and mortality after bilateral lung transplantation.1-3 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Amar Bhatt, Nicolas Kumar, Nasir Hussain, Manoj H. Iyer, Michael Essandoh Tags: Letter to the Editor Source Type: research

Anesthetic Management of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection During Emergency Procedures
The aim of the present study was to prevent cross-infection in the operating room during emergency procedures for patients with confirmed or suspected 2019 novel coronavirus (2019-nCoV) by following anesthesia management protocols, and to document clinical- and anesthesia-related characteristics of these patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 13, 2020 Category: Anesthesiology Authors: Shuai Zhao, Ken Ling, Hong Yan, Liang Zhong, Xiaohong Peng, Shanglong Yao, Jiapeng Huang, Xiangdong Chen Tags: Special Article Source Type: research