Perioperative Lung Ultrasound in the Pediatric Intensive Care Unit —Beyond the Vasculature and Parenchyma
IN THE United States, lung ultrasound is being used increasingly in intensive care units (ICUs) for both surgical and medical patients. Moreover, we are seeing a trend toward the use of bedside ultrasound to reduce reliance on diagnostic techniques that require radiation and/or intra-hospital transport of patients. However, the utility of ultrasound in pediatric cardiac surgery has not been established, and its adoption by intensivists is far from uniform. In this context, the work by Cantinotti et al. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 13, 2020 Category: Anesthesiology Authors: Diana Steppan, Matthew DiGiusto, Jochen Steppan Tags: Editorial Source Type: research

Publication Challenges, Past, Present, and Future
In this edition of the Journal of Cardiothoracic and Vascular Anesthesia, Dr. Pagel et al. examined the rate of positive versus negative studies published in the journal over the last 15 years.1 Their objective was to examine the role publication bias may play in interpretation of trial results, and the potential impact this may have on interpretation of clinical care, either through direct interpretation of the trial itself, or from the subsequent incorporation of the trial results into meta-analyses or practice guidelines. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 13, 2020 Category: Anesthesiology Authors: Daniel Bainbridge Tags: Editorial Source Type: research

Implementation of On-table Extubation After Pediatric Cardiac Surgery in the Developing World
In the recent years there has been increasing trend towards the practice of on-table extubation after pediatric cardiac surgery among practitioner in European and non-European countries. In this article we share our experience with on-table extubation among children after cardiac surgery in the developing world supported with the currently available literature. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 10, 2020 Category: Anesthesiology Authors: Rajnish K. Garg, Jameel K. Thareen, Akhter Mehmood, Masakazu Nakao, Vikram Basappanavar, Richie Jain, Monsy Sam, Abdul Ahad Khan, Roberto M. Di Donato Tags: Special Article Source Type: research

Reduction of Inflammation by High-Dose Methylprednisolone Does not Attenuate Oxidative Stress in Children Undergoing Bidirectional Glenn Procedure With or Without Aortic Arch or Pulmonary Arterial Repair
Corticosteroids attenuate an inflammatory reaction in pediatric heart surgery. Inflammation is a source of free oxygen radicals. Children with a cyanotic heart defect are prone to increased radical stress during heart surgery. The authors hypothesized that high-dose methylprednisolone reduces inflammatory reaction and thereby also oxidative stress in infants with a univentricular heart defect undergoing the bidirectional Glenn procedure. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 7, 2020 Category: Anesthesiology Authors: Juho Keski-Nisula, Oiva Arvola, Timo Jahnukainen, Sture Andersson, Eero Pesonen Tags: Original Article Source Type: research

Intraoperative Plasma Transfusion Volumes and Outcomes in Cardiac Surgery
Assess outcomes after intraoperative plasma transfusion in patients undergoing cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 7, 2020 Category: Anesthesiology Authors: Mark M. Smith, Daryl J. Kor, Ryan D. Frank, Timothy J. Weister, Joseph A. Dearani, Matthew A. Warner Tags: Original Article Source Type: research

Preliminary Experience Using Diastolic Right Ventricular Pressure Gradient Monitoring in Cardiac Surgery
Right ventricular (RV) dysfunction in cardiac surgery is associated with increased mortality and morbidity and difficult separation from cardiopulmonary bypass (DSB). The primary objective of the present study was to describe the prevalence and characteristics of patients with abnormal RV diastolic pressure gradient (PG). The secondary objective was to explore the association among abnormal diastolic PG and DSB, postoperative complications, high central venous pressure (CVP), and high RV end-diastolic pressure (RVEDP). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 6, 2020 Category: Anesthesiology Authors: Lars Gr ønlykke, Etienne J. Couture, Francois Haddad, Myriam Amsallem, Hanne Berg Ravn, Meggie Raymond, William Beaubien-Souligny, Philippe Demers, Antoine Rochon, Mahsa Elmi Sarabi, Yoan Lamarche, Georges Desjardins, André Y. Denault Tags: Original Article Source Type: research

Lack of Association Between Gaseous Microembolisms Assessed by a Single Detection Device and Cerebral Complications in Cardiac Surgery Patients
To assess the association between total volume and number of gaseous microemboli (GME) in the cardiopulmonary bypass (CPB) circuit and the occurrence of new postoperative cerebral infarctions and postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 5, 2020 Category: Anesthesiology Authors: Sebastian Wiberg, Anne Gr ønborg Vedel, Frederik Holmgaard, Jesper Kjaergaard, Annika R. Langkilde, Christian Hassager, Jens Steensgaard, Lars S. Rasmussen, Jens-Christian Nilsson Tags: Original Article Source Type: research

Traumatic Rupture of the Left Atrial Appendage: Perioperative Management and Echocardiographic Challenges
CARDIAC TRAUMA represents less than 10% of all trauma admissions, but it carries a high mortality, whether penetrating or blunt in nature.1,2 Blunt cardiac traumatic injury often is related to motor vehicle accidents and rarely includes rupture of the left atrium that may be a life-threatening emergency.1-3 The authors report such a complex case in which a focal rupture of the left atrial appendage was managed successfully in a multidisciplinary setting. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 5, 2020 Category: Anesthesiology Authors: Rohesh J. Fernando, Brittany Y. Anderson, John G.T. Augoustides, Elizabeth Zhou, Brian Radvansky, Bryan E. Marchant, Benjamin E. Morris, Stuart J. Weiss, Prakash A. Patel Tags: Case Conference Source Type: research

Postpandemic Influenza Mortality of Venovenous Extracorporeal Membrane Oxygenation –Treated Patients in Reunion Island: A Retrospective Single Center Study
The aim of the present study was to assess the post-pandemic mortality of influenza in patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) in Reunion Island, France, by comparing the incidence with other patients undergoing VV-ECMO. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 5, 2020 Category: Anesthesiology Authors: David Vandroux, Hugo Kerambrun, Cyril Ferdynus, Nicolas Allou, J érôme Allyn, Bernard-Alex Gaüzère, Olivier Martinet, Julien Jabot Tags: Original Article Source Type: research

Pilot Study Suggests Smartphone Application Knowledge Improves Resident Transesophageal Echocardiography Knowledge: A Randomized Controlled Trial
The objective of this study was to determine whether an asynchronous smartphone-based application with image-based questions would improve anesthesiology resident transesophageal echocardiography (TEE) knowledge compared with standard intraoperative teaching alone. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 5, 2020 Category: Anesthesiology Authors: Regina E. Linganna, Samuel J. Patel, Lourdes Al Ghofaily, Emily J. Mackay, Audrey E. Spelde, Elizabeth Y. Zhou, Jeremy D. Kukafka, Jared W. Feinman, John G. Augoustides, Stuart Weiss Tags: Original Article Source Type: research

Comparison of Glycemic Variability Indices Blood Glucose Risk Index and Coefficient of Variation in Predicting Adverse Outcomes for Patients Undergoing Cardiac Surgery
Fluctuations in blood glucose (glycemic variability) increase the risk of adverse outcomes. No universally accepted tool for glycemic variability exists during the perioperative period. The authors compared 2 measures of glycemic variability —(1) coefficient of variation (CV) and (2) the Blood Glucose Risk Index (BGRI)—in predicting adverse outcomes after cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2020 Category: Anesthesiology Authors: Valluvan Rangasamy, Xinling Xu, Ammu Thampi Susheela, Balachundhar Subramaniam Tags: Original Article Source Type: research

Multivariate Analysis: A Cautionary Tale of Mediators and Confounders
“The model lays its structure on the data ie, it draws curves of some form through vast empty spaces of our data, trying to connect hopelessly distant points by some smooth curvature.”— Jan P. Vandenbroucke1 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2020 Category: Anesthesiology Authors: Kelly Byrne, Peter Simmons Tags: Editorial Source Type: research

Acute Aortic Dissection —Refining Contemporary Outcomes With the Penn Classification for This Aortic Emergency
Acute aortic dissections can be life-threatening emergencies.1 These aortic emergencies historically were categorized by extent according to the DeBakey classification.1,2 According to this classification, type I dissections involve the entire thoracic aorta, whereas type II dissections are limited to the ascending aorta, and type III dissections to the descending thoracic aorta.1,2 The subsequent Stanford classification highlighted that acute dissections of the ascending aorta merit urgent surgical intervention, including streamlined triage to the operating room. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2020 Category: Anesthesiology Authors: Lourdes Al-Ghofaily, Jared W. Feinman, John G. Augoustides Tags: Editorial Source Type: research

Position-Related Subclavian and Internal Carotid Artery Compression During Robotic Thymectomy
Cerebral regional oxygen saturation (rScO2) measurement by near-infrared spectroscopy (NIRS) monitoring is based on sending infrared waves to the brain tissue with probes affixed to the frontal region. These infrared waves are sent back from a 1- to 1.5-cm depth called the watershed zone, which is composed of one-third arterial blood and two-thirds venous mixture.1 Slater et al. have shown that low values in cerebral oximetry follow-up may be a predictor for hypoxic-ischemic damage, increased risk of neurocognitive decline, and prolonged hospital stay. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2020 Category: Anesthesiology Authors: Melis Tosun, Emir K ılınç, Fevzi Toraman Tags: Case Report Source Type: research

Continuation of Angiotensin-Converting Enzyme Inhibitors on the Day of Surgery Is Not Associated With Increased Risk of Hypotension Upon Induction of General Anesthesia in Elective Noncardiac Surgeries
The aim of this study was to find out whether the preoperative continuation of angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) treatment is associated with intraoperative hypotension immediately after induction of general anesthesia in elective noncardiac surgeries. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2020 Category: Anesthesiology Authors: Uzung Yoon, Adam Setren, Alexander Chen, Tho Nguyen, Marc Torjman, Tara Kennedy Tags: Original Article Source Type: research

A Plague on Both Your Monitors! Are Bispectral Index and Cerebral Oximetry Useful for Reducing Postoperative Cognitive Impairment?
Perioperative neurocognitive disorders, such as postoperative delirium and neurocognitive disorder postoperative (also known as postoperative cognitive dysfunction), plague many older patients after cardiac surgery.1 The pathophysiology of these conditions remains poorly understood,2 which likely explains in part why there is currently a lack of effective preventative techniques or therapeutic modalities for these disorders. Both processed electroencephalogram (EEG) monitoring to titrate anesthetic dosage and regional cerebral oxygen saturation (rScO2) monitoring to improve cerebral oxygen delivery have been proposed as me...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 3, 2020 Category: Anesthesiology Authors: Rebecca Y. Klinger, Brandi Bottiger, Miles Berger Tags: Editorial Source Type: research

Intraoperative Transvalvular Regurgitation Immediately After Mitral Bioprosthetic Valve Implantation
BIOPROSTHETIC VALVES are being used increasingly1 because of their excellent durability2,3 and lesser need for anticoagulation.4 Bioprosthetic valve dysfunction, such as pannus formation, thrombosis, calcification, and endocarditis, may occur in the months or years after valve replacement.5 However, intraoperative issues regarding newly implanted bioprosthetic valves themselves are extremely rare, and only a few cases have been reported.6-9 Here, we present 2 cases of significant mitral bioprosthetic valve regurgitation that occurred immediately after valve implantation while the patients were on cardiopulmonary bypass (CP...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 3, 2020 Category: Anesthesiology Authors: Kyosuke Takahashi, Takeyuki Sajima, Yoshiki Ishiguro Tags: Letter to the Editor Source Type: research

In Vivo Protamine Titration Using Activated Coagulation Time to Neutralize Heparin Anticoagulation in Cardiac Surgery: Proof of Concept
In vivo protamine titration (IVPT) is based on the observation of a plateau on the decay curve of the celite activated clotting times (ACTs) during protamine infusion for heparin reversal. The aim of the present study was to determine the optimal protamine/heparin ratio to reverse anticoagulation using IVPT curves. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 31, 2020 Category: Anesthesiology Authors: Antoine G. Rochon, Sylvain B élisle, Pierre Couture, Annik Fortier, Jean-Sébastien Lebon, Alain Deschamps Tags: Original Article Source Type: research

Corrigendum to ‘Abdominal Aortic Aneurysm Repair Readmissions and Disparities of Socioeconomic Status: A Multistate Analysis, 2007-2014’ [Journal of Cardiothoracic and Vascular Anesthesia 33 (2019) 2737-2745]
The authors would like to inform you that their study, “Abdominal Aortic Aneurysm Repair Readmissions and Disparities of Socioeconomic Status: A Multistate Analysis, 2007-2014” published October 2019 in the Journal of Cardiothoracic and Vascular Anesthesia, is an analysis of the State Inpatient Database (SID), a restricted-access, publicly available dataset that is maintained by the Agency for Healthcare Research and Quality (AHRQ). One of the provisions of the State Data Use Agreement (DUA), which was signed when purchasing the data, is that no data observation involving less than or equal to 10 observations i...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 31, 2020 Category: Anesthesiology Authors: Matthew D. Perlstein, Soham Gupta, Xiaoyue Ma, Lisa Q. Rong, Gulce Askin, Robert S. White Tags: Corrigendum Source Type: research

Perioperative Echocardiography in the Adult With Congenital Heart Disease
Survival of patients with congenital heart disease has significantly improved over the last 2 decades, confronting interventionalists, surgeons, anesthesiologists, cardiologists, and intensivists with often unfamiliar complex pathophysiology in the perioperative setting. Aside from cardiac catheterization, echocardiography has become the main imaging modality in the hospitalized adult with congenital heart disease. The great variety of congenital lesions and their prior surgical management challenges practitioners to generate optimal imaging, reporting, and interpretation of these complex anatomic structures. (Source: Jour...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 27, 2020 Category: Anesthesiology Authors: Tiffany Williams, Gentian Lluri, Eva K. Boyd, Wolf B. Kratzert Tags: Review Article Source Type: research

Preoperative Pulse Pressure and Adverse Postoperative Outcomes: A Meta-Analysis
To evaluate the association between preoperative pulse pressure (PP) and the incidences of renal, neurologic, cardiac, and mortality outcomes after surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Authors: Jin Zeng, Guoquan Zheng, Yalan Li, Yuanyuan Yang Tags: Original Article Source Type: research

Masthead
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Source Type: research

Editorial Board
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Source Type: research

Contents
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 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 - January 24, 2020 Category: Anesthesiology Source Type: research

Guide for Authors
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Source Type: research

Cardiac Calendar 2020-2021
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Source Type: research

Does the Analgesic Technique in the Intraoperative Period Have Any Influence on Chronic Pain after Uniportal Video-Assisted Thoracoscopic Surgery?
VIDEO-ASSISTED THORASCOPIC SURGERY (VATS) is increasingly used as an approach to pulmonary resections, including lobectomy, segmentectomy, and lung wedge resection. These patients require multiple surgical and intercostal port incisions and chest tube placement. The incidence of chronic postoperative pain after VATS has been reported to be as high as 25%-47% after 3 or 6 months, mostly owing to surgical incisions, local trauma, and the presence of shoulder pain syndrome.1,2 The treatment of acute or chronic postoperative pain after VATS continues to be controversial. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Authors: Javier H Campos, Melinda Seering Tags: Editorial Source Type: research

Right Ventricular Hypertrophy in Patients Undergoing Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome
We read with interest the article by Lazzeri et al., which observed that in patients with severe acute respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV ECMO), right ventricle (RV) hypertrophy (RVH) was present in 61% of patients (28 of 46) before ECMO cannulation, and all patients showed RVH at intensive care unit (ICU) discharge.1 RVH was defined as RV end-diastolic free wall thickness (RVFWT) greater than 5 mm. The results of this study, which for the first time assessed the incidence of RVH in mechanically ventilated ARDS patients before and after ECMO support, trigger...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2020 Category: Anesthesiology Authors: Tommaso Pettenuzzo, Maxime Pichette, Ghislaine Doufl é, Eddy Fan Tags: Letters to the Editor Source Type: research

Risk Factors for Prolonged Mechanical Ventilation After Total Cavopulmonary Connection Surgery: 8 Years of Experience at Fuwai Hospital
Prolonged mechanical ventilation (PMV) is closely associated with higher morbidity and mortality after total cavopulmonary surgery. The aim of the present study was to identify the clinical risk factors for PMV. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 23, 2020 Category: Anesthesiology Authors: Qipeng Luo, Zhanhao Su, Yuan Jia, Yiwei Liu, Hongbai Wang, Liang Zhang, Yinan Li, Xie Wu, Qiao Liu, Fuxia Yan Tags: Original Article Source Type: research

Implementing a Cardiac Enhanced Recovery After Surgery Protocol: Nuts and Bolts
The use of Enhanced Recovery After Surgery (ERAS) protocols among various surgical subspecialties is increasing, including in cardiac surgery. The goal of these protocols is to optimize patient outcomes and satisfaction and improve the value of healthcare delivered. Cardiac ERAS protocols are divided into the following 3 stages of perioperative care: preoperative, intraoperative, and postoperative. ERAS strategies have been shown to work synergistically to reduce the length of hospital stay, postoperative complications, hospital cost, and opioid consumption; increase patient satisfaction; and result in less and early extub...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 23, 2020 Category: Anesthesiology Authors: Shu Y. Lu, Yvonne Lai, Adam A. Dalia Tags: Review Article Source Type: research

Heart Transplantation in the USSR and Former Soviet Countries
Experimental and clinical heart transplantation programs in the USSR, Russia, and post-Soviet states are described, including information about early experimental studies conducted by Russian and Soviet scientists in the early to mid-20th century. The novel research of V.P. Demikhov, a Soviet transplantologist famous for performing the first experimental heart transplantations and coronary artery bypass surgeries in the world is highlighted. In addition, the preparation and implementation of the USSR's first clinical heart transplantations during the pre-cyclosporine era (1960-1970s) are described, and the features of anes...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 22, 2020 Category: Anesthesiology Authors: Igor A. Kozlov, Lev A. Krichevskiy Tags: Review Article Source Type: research

Guidelines for the Evaluation of Valvular Regurgitation After Percutaneous Valve Repair or Replacement: A Focused Review for the Cardiac Anesthesiologist
PERCUTANEOUS REPAIR and replacement increasingly are being used to treat valvular heart disease. Adoption of these catheter-based techniques necessitates standardized methods for evaluating new or residual regurgitation after percutaneous valve repair or replacement. The American Society of Echocardiography guidelines document, “Guidelines for the Evaluation of Valvular Regurgitation After Percutaneous Valve Repair or Replacement,” addresses this need and provides a framework for evaluating regurgitation using echocardiography, invasive hemodynamic assessment, and cardiac magnetic resonance (CMR) imaging. (Sour...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 17, 2020 Category: Anesthesiology Authors: Kurt J. Hoffmeister, Zachary T. Henderson, Patrick T. Hussey, Isaac Y. Wu Tags: Review Article Source Type: research

Cardiac interventions in pregnancy and peripartum – a narrative review of the literature
In the UK, mortality rate during pregnancy/in the peripartal period is 14.1 per 100,000 maternities with heart disease being the leading cause of non-obstetric maternal mortality (10% to 15% of all maternal deaths). Owing to the advances in the treatment of congenital heart disease (CHD), an increasing percentage of women has reached childbearing age, making CHD nowadays the most frequent cardiovascular disease during pregnancy in the Western world. In the pregnant woman, several adaptive changes occur in the cardiovascular and pulmonary system that in the worst case can lead to cardiovascular collapse in women with pre-ex...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2020 Category: Anesthesiology Authors: Laurence Carlier, Sarah Devroe, Werner Budts, Kristel Van Calsteren, Filip Rega, Marc Van de Velde, Steffen Rex Tags: Review Article Source Type: research

Reply to Groome et al.
We were glad to receive the comments from Groome et al.1 regarding our recently published article.2 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2020 Category: Anesthesiology Authors: Haitao Xu, Hansong Sun, Hongwen Ji Tags: Letter to the Editor Source Type: research

High-Risk and Hepatitis C –Positive Organ Donors: Current Practice in Heart, Lung, and Liver Transplantation
THE UNITED Network for Organ Sharing (UNOS) adopted the label “high risk” from the Public Health Service (PHS) in 2004 in order to improve organ safety by reducing disease transmission. This has resulted in nonutilization of organs from patients who are otherwise healthy but deemed high risk because of social behaviors or illicit drug use. Organ availabili ty remains the limiting factor to organ transplantation, and the number of patients awaiting transplantation is outpacing the number of transplantations being performed. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2020 Category: Anesthesiology Authors: M. Megan Chacon, Austin J. Adams, Cale A. Kassel, Nicholas W. Markin Tags: Review Article Source Type: research

Circulatory Management Using FloTrac/Vigileo and Transesophageal Echocardiography for Mesenteric Traction Syndrome During Colectomy in a Patient With Hypertrophic Cardiomyopathy
HYPERTROPHIC CARDIOMYOPATHY (HCM) is a relatively common inherited cardiac disease characterized by asymmetrical left ventricle (LV) wall thickening. Because left ventricular outflow tract (LVOT) obstruction occurs in HCM and can lead to catastrophic circulatory collapse, its prevention is one of the most important issues in perioperative circulatory management. LVOT obstruction is induced or aggravated by a decrease in the preload or afterload; an increase in cardiac contractility or heart rate; or any combination of these factors. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2020 Category: Anesthesiology Authors: Masato Hara, Teruyuki Hiraki Tags: Case Report Source Type: research

Perioperative Opioid Use and Chronic Post-Surgical Pain after Liver Transplantation: A Single Center Observational Study
To investigate the opioid requirements and prevalence of chronic postsurgical pain (CPSP) in liver transplant (LT) recipients and to evaluate the association of opioid use with postoperative survival. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2020 Category: Anesthesiology Authors: Kyota Fukazawa, Patricia J. Rodriguez, Christine T. Fong, Edward Gologorsky Tags: Original Article Source Type: research

Epidural Intravascular Injection Detection by Transthoracic Echocardiography
Accidental intravascular injection of local anesthetic during attempted administration of epidural anesthesia can be life-threatening. The authors report a case in which standard means of detecting epidural intravascular injection were equivocal. Transthoracic echocardiography (TTE) with injection of agitated saline into the epidural catheter facilitated the rapid and definitive diagnosis of intravascular placement. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2020 Category: Anesthesiology Authors: Deborah Fretwell, Marietta Smith, Erin Martin, Gerard R. Manecke, Brett Cronin Tags: Case Report Source Type: research

A Penny Saved Should Be a Penny Earned
The avoidance of complications is an area of clinical care where patient benefit, caregiver satisfaction, and the interests of healthcare funders are fully aligned. So it is with disappointment even in 2019 to sit in lectures at scientific meetings listening to speakers claiming that atrial fibrillation after cardiac surgery (AFACS) is inevitable and inconsequential. Clearly, neither is true. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2020 Category: Anesthesiology Authors: Benjamin O'Brien, J. Daniel Muehlschlegel Tags: Editorial Source Type: research

The Physiology of Oxygen Transport by the Cardiovascular System: Evolution of Knowledge
The heart, vascular system, and red blood cells play fundamental roles in O2 transport. The fascinating research history that led to the current understanding of the physiology of O2 transport began in ancient Egypt in 3000 BC, when it was postulated that the heart was a pump serving a system of distributing vessels. Over 4 millennia elapsed before William Harvey (1578-1657) made the revolutionary discovery of blood circulation, but it was not until the 20th century that a lucid and integrative picture of O2 transport finally emerged. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 14, 2020 Category: Anesthesiology Authors: George J. Crystal, Paul S. Pagel Tags: Special Article Source Type: research

Are Serum Potassium and Magnesium Levels Associated with Atrial Fibrillation After Cardiac Surgery?
This study was designed to evaluate the relationship between serum potassium and magnesium levels and AF after cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Samuel H. Howitt, Stuart W. Grant, Niall G. Campbell, Ignacio Malagon, Charles McCollum Tags: Original Article Source Type: research

Thiamine – Essential Post Cardiopulmonary Bypass?
IN THIS ISSUE of the Journal of Cardiothoracic and Vascular Anesthesia, Lomivorotov et al. report the findings of APPLY (sustAined high-dose thiamine supplementation in high-risk cardiac patients undergoing cardiopulmonarY bypass: a pilot feasibility study), a pilot randomized controlled trial (RCT) designed to assess the feasibility of perioperative thiamine therapy to improve cardiovascular function in patients undergoing cardiac bypass surgery.1 The proposal is intriguing, not least because the candidate intervention is relatively cheap, safe, simple to administer, and there is a clear and well-established chain of caus...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Stefanie Wenger, Edward Litton Tags: Editorial Source Type: research

Intraoperative Assessment of Hepatic Vein Tracings in Constrictive Pericarditis During Surgical Pericardiectomy
CONSTRICTIVE PERICARDITIS is characterized by progressive inflammation and fibrosis of the pericardium. It manifests with symptoms of heart failure. The only effective treatment is surgical pericardiectomy. The assessment and diagnosis of constrictive pericarditis with echocardiography is well described with spontaneous ventilation. However, there are limited data on constrictive pericarditis assessment with transesophageal echocardiography with positive pressure ventilation. Also, intraoperative hepatic venous Doppler flow mostly is used intraoperatively to assess the severity of tricuspid regurgitation by focusing on the...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Mohammad A. Helwani, Sarah Alber, Charl J. DeWet, Jonathan K. Zoller Tags: E-Challenges & Clinical Decisions Source Type: research

The Safety and Feasibility of Transesophageal Echocardiography in Patients With Esophageal Stricture
Expert guidelines consistently list esophageal stricture (ES) as a contraindication to the performance of transesophageal echocardiography (TEE), although anecdotally the authors are aware of patients with ES undergoing TEE without apparent complication. Therefore the authors sought to determine the outcomes of patients with ES who had undergone TEE at their institution. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Kent H. Rehfeldt, J. Ross Renew, Arun Subramanian, Juan N. Pulido, William J. Mauermann Tags: Original Article Source Type: research

Expert Consensus Systems of Care Proposal to Optimize Care for Patients With Valvular Heart Disease Review of the 2019 Document for the Cardiac Anesthesiologist
Valvular heart disease requiring intervention is increasing in prevalence in the adult population. With advancement in transcatheter and surgical procedures for valvular heart disease, optimization of patient selection, availability of resources and personnel, appropriate training and certification, and optimal periprocedural management rely on clinical evaluation, accurate echocardiographic interpretation, and understanding of valvular pathophysiology by the cardiac anesthesiologist. To optimize care and improve access for patients with valvular heart disease the Expert Consensus Systems of Care Document by Nishimura et a...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Soojie Yu, Michael Fabbro, Oscar Aljure Tags: Review Article Source Type: research

Strain Imaging: An Everyday Tool for the Perioperative Echocardiographer
Strain analysis allows for global and regional analysis of myocardial function and has been shown to be an independent predictor of outcomes after cardiac surgery. Strain imaging offers advantages over traditional EF measurements in that it is relatively angle independent, it is less dependent upon loading conditions, it is reproducible, it does not rely on geometric assumptions, and it can detect subclinical systolic dysfunction. Limitations of strain analysis include high temporal resolution requirements, a strong dependence on image quality, and inter-vendor variability. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Michael J. Benson, Natalie Silverton, Candice Morrissey, Joshua Zimmerman Tags: Review Article Source Type: research

Socioeconomic Disparities in Carotid Revascularization Procedures
The objective of the present study was to examine the intersectionality between race/ethnicity, insurance status, and postoperative outcomes in carotid procedures. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Latha Panchap, Seyed A. Safavynia, Virginia Tangel, Robert S. White Tags: Original Article Source Type: research

Anesthetic Management of Emergency Cesarean Delivery Followed Immediately by Thoracic Endovascular Aortic Repair for a Peripartum Dissecting Aorta Aneurysm With Impending Rupture (Stanford Type B Dissection) in a Pregnant Patient With Takayasu's Arteritis
TAKAYASU'S ARTERITIS (TA) is a rare clinical condition, with an incidence of 1 to 2 cases per million in Japan.1 It is characterized by chronic panarteritis of the aorta and its primary branches, including the subclavian, common carotid, coronary, and renal arteries, and may result in localized stenosis, vascular occlusion, dilatation, and aneurysm formation.2 The disease can cause various circulatory complications, such as hypertension, heart failure, aortic regurgitation, coronary stenosis, and aortic aneurysm. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Yuki Kikuchi, Masataka Kuroda, Shigeru Saito Tags: Case Report Source Type: research

The Effect of Common Interventions in the Intensive Care Unit on Right Ventricular Function After Cardiac Surgery —An Intervention Study
Critical care therapy after cardiac surgery includes interventions to aid pulmonary and cardiac function. The aim of this study was to investigate the effect of such interventions on right ventricular function (RVF). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Lars Gr ønlykke, André Korshin, Finn Gustafsson, Jens Chr. Nilsson, Hanne Berg Ravn Tags: Original Article Source Type: research