Impact of modified anesthesia management for pediatric patients with Williams syndrome
This study compared the percent change in systolic blood pressure and the incidence of adverse cardiac events (ACE; defined as cardiac arrest, cardiopulmonary resuscitation, arrhythmias, or ST-segment changes) during anesthesia induction in patients with Williams syndrome (WS) before and after implementation of a perioperative management. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 19, 2021 Category: Anesthesiology Authors: Alexander R. Schmidt, R. Thomas Collins, Yamini Adusumelli, Chandra Ramamoorthy, Yingjie Weng, Kirstie L. MacMillen, Manchula Navaratnam Source Type: research

Tracheobronchial Trauma from Double Lumen Tube Placement in Patients Undergoing Lung Transplantation
Tracheobronchial injury is rare but serious complication of double lumen tube (DLT) insertion. Here, we report two cases of tracheal laceration as a complication of DLT placement in patients undergoing lung transplantation and describe the increased risk for airway trauma in this patient population. We make additional suggestions to increase the margin of safety for DLT placement and present the variation of bronchial lumen size between three manufacturers of DLT commonly used in practice, with implications for DLT size selection. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 19, 2021 Category: Anesthesiology Authors: Sunny S. Lou, Michael Bethel, Andrea B. Reidy, Mohammad A. Helwani Source Type: research

Perioperative management of the Fontan patient for cardiac and non-cardiac surgery
The Fontan circulation is the single-ventricle approach to surgical palliation of complex congenital heart disease where bi-ventricular separation and function cannot be safely achieved. Incremental improvements in this surgical technique, along with improvements in the long-term medical management of these patients, has led to greater survival of these patients and a remarkably steady increase in the number of adults living with this unusual circulation and physiology. This has implications for healthcare providers who now have a greater chance of encountering Fontan patients during in the course of their practice. (Sourc...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 19, 2021 Category: Anesthesiology Authors: Dr. John Richard McNamara, Dr. Aisling McMahon, Dr. Michael Griffin Source Type: research

Understanding Basic Concepts of Supervised Machine Learning Model Development in the Clinical Setting
In the current issue of the Journal of Cardiothoracic and Vascular Anesthesia, Shi et al compared whether machine learning (ML) algorithms could outperform a logistic regression model in the prediction of postoperative liver dysfunction following aortic arch surgery.1 As nonlinear and machine learning methods continue to be applied to the development of prognostic risk models,2-4 it is critically important evaluate the performance of these new models against what is arguably the reference standard in prognostic risk models; logistic regression. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 18, 2021 Category: Anesthesiology Authors: Emily J. MacKay, Michael D. Stubna Tags: Editorial Source Type: research

Extracorporeal Carbon Dioxide Removal (ECCO2R): A Potential Perioperative Tool in End Stage Lung Disease
End-stage lung disease (ESLD) is a prominent cause of mortality and perioperative morbidity worldwide.1, 2 Since ESLD may arise from a diverse range of etiologies, it is imperative that cardiothoracic anesthesiologists tailor their perioperative management to the patient's specific presenting pulmonary pathophysiology.3 Patients with ESLD may present with concomitant cardiac failure, hypoxemic failure, or isolated hypercapnic failure. The utilization of extracorporeal membrane oxygenation (ECMO) is increasing in these clinical situations, however the latter category of isolated hypercapnic failure presents the clinician th...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2021 Category: Anesthesiology Authors: Dr. Archer Kilbourne Martin, Dr. Harish Ramakrishna Tags: Editorial Source Type: research

Simplified Algorithm for Evaluation of Perioperative Hypoxia and Hypotension (SALVATION): A Practical Echo guided Approach Proposal
Despite the valuable use of modern applications of perioperative ultrasound across multiple disciplines, there has been limitations to its implementation restricting its impact on patient-based clinical outcomes. Point of care ultrasound evaluation of hypoxia and hypotension is an important tool to assess the underlying undifferentiated etiologies in a timely manner. However, there is a lack of consensus on the formal role of ultrasound during evaluation of perioperative hypoxia or hypotension. The previous ultrasound algorithms have adopted a complex technique that possibly ignore the pathophysiological mechanisms underly...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2021 Category: Anesthesiology Authors: Huma Fatima, Yannis Amador, Daniel P. Walsh, Nada Qaisar Qureshi, Omar Chaudhary, Syed Hamza Mufarrih, Ruma R Bose, Feroze Mahmood, Robina Matyal Tags: Special Article Source Type: research

Quantification of right atrial indexed end-systolic volumes and emptying fraction in children undergoing cardiac surgery with two-dimensional transesophageal echocardiography: A prospective observational study
Objective: The primary objective of this study was to establish “normal” right atrial (RA) indexed end-systolic volumes (ESV) and emptying fraction (EF) in children undergoing ventricular septal defect (VSD) repair using 2-dimensional (2D) transesophageal echocardiography (TEE). Secondary objectives were to obtain RA indexed ESV and EF in children with RA/ri ght ventricle (RV) volume overload {atrial septal defect (ASD)} and RV pressure overload {tetralogy of Fallot (TOF)} and to determine if baseline differences existed in these indices between the three lesions. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2021 Category: Anesthesiology Authors: Dr Molli Kiran, Dr Satyajeet Misra, Dr Suneel PR, Dr Saravana Babu MS, Dr Asha Anand, Dr Thomas Koshy Source Type: research

The Year in Thoracic Anesthesia: Selected Highlights from 2020
Selected highlights in thoracic anesthesia in 2020 include updates in the preoperative assessment and prehabilitation of patients undergoing thoracic surgery, updates in one lung ventilation (OLV), pertaining to the devices used for OLV, the use of dexmedetomidine for lung protection during OLV, and protective ventilation, recommendations for the care of thoracic surgical patients with Covid-19, a review of recent meta-analyses comparing truncal blocks to paravertebral and thoracic epidural blocks, and a review of outcomes after initiating the enhanced recovery after surgery guidelines for lung and esophageal surgery. (Sou...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 16, 2021 Category: Anesthesiology Authors: Michael L. Boisen, Rohesh J. Fernando, Lavinia Kolarczyk, Emily Teeter, Travis Schisler, Luca LaColla, Vladyslav Melnyk, Constantin Robles, Vidya K. Rao, Theresa A Gelzinis Source Type: research

The 2020 ACC/AHA Guidelines for Management of Patients with Valvular Heart Disease: Highlights and Perioperative Implications
Valvular heart disease contributes to a large burden of morbidity and mortality in the United States. Over the last decade there has been a paradigm shift in the management of valve disease, primarily driven by emergence of novel transcatheter technologies. In this article, we review the latest update of the American College of Cardiology / American Heart Association valve heart disease guidelines. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 16, 2021 Category: Anesthesiology Authors: Divyanshu Mohananey, Michael Aljadah, Aaron AH Smith, Jeremiah F. Haines, Sahishnu Patel, Pedro Villablanca, Harish Ramakrishna Tags: Expert Review Source Type: research

Diagnostic Point-of-Care Ultrasound: Recommendations from an Expert Panel
Diagnostic point-of-care ultrasound (PoCUS) has emerged as a powerful tool to help anesthesiologists guide patient care in both the perioperative setting and the subspecialty arenas. Although anesthesiologists can turn to guideline statements pertaining to other aspects of ultrasound use, to date there remains little in the way of published guidance regarding diagnostic PoCUS. Toward this end, in 2018 the American Society of Anesthesiologists (ASA) chartered an Ad Hoc Committee consisting of 23 ASA members to provide recommendations on this topic. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 16, 2021 Category: Anesthesiology Authors: Yuriy S. Bronshteyn, Thomas A. Anderson, Orode Badakhsh, Jan Boublik, Mary Beth W. Brady, Jonathan E. Charnin, Lev B. Deriy, H. David Hardman, Stephen C. Haskins, McKenzie Hollon, Hung-Lun John Hsia, Jacques P. Neelankavil, Oliver P.F. Panzer, Anahi Perla Tags: Special Article Source Type: research

In Reference to Perioperative Milrinone Infusion Improves One-Year Survival After the Norwood-Sano Procedure
Dear Editor: (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 16, 2021 Category: Anesthesiology Authors: Philip M Jones Tags: Letter to the Editor Source Type: research

Acute kidney injury in pediatric cardiac intensive care children: not all admissions are made equal. Retrospective study
. Describe the incidence, associated characteristics and outcomes of the maximum severity of acute kidney injury (AKI) in a heterogeneous population of critically ill children with cardiac disease. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 16, 2021 Category: Anesthesiology Authors: Zaccaria Ricci, Valeria Raggi, Eleonora Marinari, Leonardo Vallesi, Luca Di Chiara, Caterina Rizzo, Katja M Gist Source Type: research

Airway surgery for laryngotracheal stenosis during the COVID-19 pandemic: institutional guidelines
Coronavirus disease 2019 (COVID-19) is a viral respiratory tract infection caused by a coronavirus which was first documented in Wuhan, China, in December 2019 (1) (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: Hany Hasan Elsayed, Assem Adel Moharram Source Type: research

Levosimendan and Venoarterial ECMO – a promising application
In contemporary clinical practice, venoarterial extracorporeal membrane oxygenation (VA ECMO) has become a common rescue modality for patients with refractory cardiogenic shock.1-2 Although VA ECMO is an effective option in this challenging setting, it still remains a bridging therapy. A critical aspect of subsequent clinical management is to optimize cardiac function in an effort to facilitate successful weaning of VA ECMO.2-3 In a recent multicenter trial, Mariscalco and colleagues demonstrated that duration of VA-ECMO support in patients with postcardiotomy cardiogenic shock plays a significant role in mortality risk. (...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: Saumil J. Patel, John G. Augoustides Source Type: research

A Provocative Dilemma: Liposomal Bupivacaine versus Bupivacaine with epinephrine for Intercostal Nerve Blocks with Enhanced Recovery During Robotic Thoracic Surgery
Enhanced recovery after thoracic surgery (ERATS) has shown multiple benefits such as reduced use of opioids, reduced pulmonary complications, reduction in length of stay (LOS), and decreased hospital costs. [1,2] Even with a minimally invasive approach, surgical access for thoracic surgery requires one of the most painful incisions. [3] The use of a robotic-assisted thoracoscopic surgery (RATS) technique has progressively become widespread in the world, particularly for the treatment of the mediastinal and pulmonary lesions. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: Javier H Campos, Melinda Seering Source Type: research

Analysis of the 2020 European Society of Cardiology( ESC) Guidelines for the Management of Adults with Congenital Heart Disease
Adult congenital heart disease (ACHD) continues to rapidly increase worldwide. With an estimated 1.5 million adults with ACHD alone in the USA, there is a growing need for better education in the management of these complex patients and multiple knowledge gaps exist. This manuscript will comprehensively review the recent (2020) updated ESC Guidelines for the management of adult congenital heart disease created by the Task Force for the management of adult congenital heart disease of the European Society of Cardiology (ESC), with perioperative implications for the adult cardiac anesthesiologist and intensivist who may be ca...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: Jimmy Windsor, Chaitra Mukundan, Joshua Stopak, Harish Ramakrishna Tags: Category: [Expert Review] Source Type: research

Reversal agents for the management of direct oral anticoagulant-related bleeding in cardiac surgical patients: the emperor's new clothes?
In this issue of the journal, Navas-Blanco et al.1 review the 2020 American College of Cardiology (ACC) Expert Consensus Decision Pathway on the approach to bleeding in patients who are prescribed oral anticoagulants.2 This document provides important definitions on bleeding severity; describes assays for laboratory measurement of plasma drug levels; and details specific reversal strategies in the bleeding patient. For the patient taking warfarin, prothrombin complex concentrate is recommended in accordance with recently published guidelines. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: M. Charlesworth, T. Hayes, G. Erdoes Tags: Invited Editorial Source Type: research

Right Ventricular Dysfunction in Patients With COVID-19: a systematic review and meta-analysis
This systematic review and meta-analysis aimed to describe the features of right ventricular impairment and pulmonary hypertension in COVID-19 and assess its effect on mortality. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 11, 2021 Category: Anesthesiology Authors: Gianluca Paternoster, Pietro Bertini, Pasquale Innelli, Paolo Trambaiolo, Giovanni Landoni, Federico Franchi, Sabino Scolletta, Fabio Guarracino Source Type: research

Underutilized Fuel: Angiotensin II for Vasoplegia in Heart Failure Patient Population
We would like to congratulate the authors of their post-hoc analysis of Angiotensin II (ANG-II) for the treatment of vasoplegia in patients following cardiac surgery.1 The study found that patients with vasoplegia after cardiac surgery with cardiopulmonary bypass rapidly responded to ANG-II with swift blood pressure response and rapid down titration of standard of care vasopressors with no reported thrombosis.1 Early recognition and treatment of vasoplegia improves survival and reduces risks of major adverse events. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 10, 2021 Category: Anesthesiology Authors: Amit Alam, Daniel Burkhoff, Daniel H. Enter, Rita Jermyn Source Type: research

Effectiveness of Liposomal Bupivacaine Compared With Standard of Care Measures in Pediatric Cardiothoracic Surgery: A Retrospective Cohort Study
We examined opioid consumption and economic outcomes associated with liposomal bupivacaine (LB) or non-LB analgesia use in pediatric patients undergoing cardiothoracic surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 9, 2021 Category: Anesthesiology Authors: Christopher F. Tirotta, Jennifer H. Lin, Mary Helen Tran Source Type: research

Comparison of high-flow humidified oxygen to the conventional continuous positive airway pressure in non-ventilated lungs during thoracic surgery: a randomized cross-over study
This study assessed the efficacy of high-flow humidified oxygen (HFHO) as an alternative for continuous positive airway pressure (CPAP) for improving oxygenation while preserving non-ventilated lung collapse during one-lung ventilation. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 7, 2021 Category: Anesthesiology Authors: Prasert Sawasdiwipachai, Ratchaya Weerayutwattana, Punnarerk Thongcharoen, Sirilak Suksompong Source Type: research

Efficiency Improvements of Non-operating Room Cardiac Anesthesia Services
: Scheduling and staffing nonoperating room anesthesia (NORA) cases often require cross-service coordination and can result in significant delays in patient care, resource inefficiencies, and provider dissatisfaction. Our objective was to reduce these delays and case cancellations for patients requiring cardiac anesthesia for their transesophageal echocardiography procedure. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 6, 2021 Category: Anesthesiology Authors: Kai Qiu, Krystina Miller, Adam A. Dalia Tags: Original Article Source Type: research

Ultrasound-guided thoracic paravertebral block for pulmonary radiofrequency ablation
Surgical resection is the treatment of choice both for early stage lung cancer and pulmonary metastatic disease. For patients with lung tumors who are not eligible for surgery, the minimally invasive modality of radiofrequency ablation (RFA) may be curative and should thus be considered. However, opinions regarding the optimal anesthetic technique for pulmonary RFA differ. Here we report our experience with the use of ultrasound-guided paravertebral block in minimally sedated patients undergoing pulmonary RFA. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 5, 2021 Category: Anesthesiology Authors: Fernando J. S ánchez García, Encarna Miñana Aragón, Sonsoles Aragón Alvarez, José M Galbis Caravajal, José Jornet Fayos, Miriam Estors Guerrero, Néstor Martinez Hernandez, Jose E. Llopis Calatayud Source Type: research

Learning from failure: The future of quality improvement for early extubation
Since the inception of fast-track extubation protocols in cardiac surgery, there have been several publications describing the positive impact of successful early extubation (now typically defined as extubation (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 4, 2021 Category: Anesthesiology Authors: Alexander J.MD GregoryFRCPC Tags: Editorial Source Type: research

Unilateral pulmonary edema after robotically-assisted mitral valve repair requiring veno-venous extracorporeal membrane oxygenation
We describe a severe case with refractory hypoxemia requiring veno-venous (VV) extracorporeal membrane oxygenation (ECMO) after robotically-assisted MV repair. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 3, 2021 Category: Anesthesiology Authors: Dan Viox, Richa Dhawan, Husam H. Balkhy, Daniel Cormican, Himani Bhatt, Andre Savadjian, Mark A. Chaney Tags: Case Conference Source Type: research

Daytime variation of clinical outcome in cardiac surgery: a propensity-matched cohort study
The purpose of the present study was to investigate the hypothesis of a nychthemeral variation in the tolerance to ischemia and reperfusion injury in adult cardiac surgeries. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 2, 2021 Category: Anesthesiology Authors: Martin Michaud, Vincent B éland, Nicolas Noiseux, Jessica Forcillo, Louis-Mathieu Stevens Tags: Original Article Source Type: research

Downstream Effects: Promise and Challenges of Femoral Vein Pulsatility Assessment
The postoperative course of patients undergoing major cardiovascular and thoracic surgery can be greatly dictated by the state of the right ventricle. Cardiac surgery often involves an onslaught of physiologic derangements, including wide swings of preload and afterload, pulmonary vascular changes, due to alterations in acid —base balance, hypoxia, and hypercarbia, dysrhythmias, and direct mechanical compression and interference that can make the task of the right ventricle incredibly daunting. Intraoperatively, the assessment of the right ventricle is performed under direct visualization in the surgical field and vi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2021 Category: Anesthesiology Authors: Joshua Knight, Theresa A Gelzinis Tags: Editorial Source Type: research

The five reasons why people die of COVID-19
The number of patients dying of COVID-19 exceeds by far the number of patients requiring admission to the intensive care unit. This is confusing for both the members of the scientific community and the public. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2021 Category: Anesthesiology Authors: Marilena Marmiere, Filippo D'Amico, Alberto Zangrillo, Giovanni Landoni Tags: Letter to the Editor Source Type: research

The use of artificial neural networks to determine in-hospital mortality after coronary artery bypass surgery
We aim to present an Artificial Neural Network (ANN) model for the accurate estimation of in-hospital mortality, and demonstrate the validity of the model with real data and a comparison with conventional multiple linear regression models. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2021 Category: Anesthesiology Authors: Elzem Sen, Serap Ulusam Secinker Tags: Original Article Source Type: research

Independent predictors of post-operative stroke with cardiopulmonary bypass
To assess predictive factors of post-operative stroke in cardiac surgery utilising cardiopulmonary bypass (CPB). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2021 Category: Anesthesiology Authors: Eric Yu Wei Lo, Rebecca Dignan, Bruce French Source Type: research

Selected 2020 Highlights in Congenital Cardiac Anesthesia
This article is a review of the highlights of pertinent literature published during the 12 months of 2020, which is of interest to the congenital cardiac anesthesiologist. Following a search of the US National Library of Medicine PubMed database, several topics emerged where significant contributions were made in 2020. The authors of this manuscript considered the following topics noteworthy to be included in this review: Pediatric cardiac care in the COVID-19 era, the use of mechanical circulatory support in COVID-19 related multisystem inflammatory syndrome in children, transfusion and coagulation management in children ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 31, 2021 Category: Anesthesiology Authors: Timothy P. Welch, Premal M. Trivedi, Zhe A. Fang, Richard J. Ing, Alexander J.C. Mittnacht, Emad B. Mossad Source Type: research

Hypertrophic Cardiomyopathy: A Species-Spanning Pathology
Hypertrophic cardiomyopathy (HCM), a leading cause of sudden death among athletes and young adults is not uniquely human.1 The disorder has been diagnosed in a wide range of other mammalian species and is seen with some frequency in certain domestic animals (Figure 1). 2-16 The clinical characteristics, natural history and therapeutic interventions are similar across species. Comparative genomic analyses point to overlapping genetic basis for the disorder in humans and other animals, in particular certain domestic cat breeds. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2021 Category: Anesthesiology Authors: Barbara N. Horowitz Tags: Editorial Source Type: research

The Triple HIT: Perioperative Management of Heparin-induced Thrombocytopenia Using Plasma Exchange, Intravenous Immunoglobulin, and Protamine Infusion for Left Ventricular Assist Device Implantation
We present a patient with HIT who had active thrombosis that successfully underwent urgent left ventricular assist device implantation managed with plasma exchange, intravenous immunoglobulin, and protamine infusion. These therapies reduce the immune response to heparin and minimize thrombosis when heparin re-exposure is planned. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 29, 2021 Category: Anesthesiology Authors: Victor C. Liu, Allan M. Klompas, John M. Stulak, Suraj M. Yalamuri Tags: Case Report Source Type: research

Association between Anaesthetic Dose and Technique and Oncological Outcomes Following Surgical Resection of Non-Small Cell Lung Cancer
This study evaluated the relationship between anaesthetic technique and dose and oncological outcome in NSCLC surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 28, 2021 Category: Anesthesiology Authors: Ms. Sarah de La Motte Watson, Dr. Kathryn Puxty, Dr. Daisy Moran, Dr. David S. Morrison, Mr. Billy Sloan, Prof. Donal Buggy, Dr. Ben Shelley Tags: Original Article Source Type: research

Role of trans-esophageal and epicardial echocardiography to assess surgical repair in double outlet left ventricle
A double outlet left ventricle (DOLV) is a congenital cardiac anomaly that is rarely encountered. This case report demonstrates the echocardiographic features of DOLV in the form of pulmonary artery arising completely from the left ventricle with D-looped ventricles, especially when evaluated by intraoperative transesophageal echocardiography (TEE), along with the correlation of characteristic features with cardiac computerized tomography (CT). The features pertinent to the differentiation of DOLV from Double outlet right ventricle (DORV) and congenitally corrected transposition of great arteries (ccTGA) by echocardiograph...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2021 Category: Anesthesiology Authors: Bhargava V Devarakonda, Nayana Nemani, Javid Raja, Baiju S Dharan, Thomas Koshy Source Type: research

The Year in Perioperative Echocardiography: Selected Highlights from 2020
This article is the fifth of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the  Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series. In most cases, these will be research articles that are targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, these articles will target the use of perioperative echocardiography in general. (Source: Journal of...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2021 Category: Anesthesiology Authors: Swapnil Khoche, Nazish Hashmi, Yuriy S. Bronshteyn, Christine Choi, Sophia Poorsattar, Timothy M. Maus Tags: Special Article Source Type: research

Predictors and Outcomes of Coronary Artery Bypass Grafting: A Systematic and Untargeted Analysis of > 120000 Individuals and > 1300 Disease Traits
Objective: To perform an untargeted data-driven analysis on the correlates and outcomes of coronary artery bypass grafting (CABG).Design: FinnGen cohort study.Setting: We collected information on up to 1327 disease traits preceding and following CABG from nationwide healthcare registers.Participants: A mixed population and patient sample of 127911 individuals including 3784 CABG patients.Interventions: We assessed the association between 1) traits and incident CABG and 2) CABG and incident traits using multivariable-adjusted Cox models. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2021 Category: Anesthesiology Authors: Jenni Aittokallio, Anni Kauko, Joonatan Palmu, Finn Gen, Teemu Niiranen Source Type: research

Perioperative factor concentrate use is associated with more beneficial outcomes and reduced complication rates compared to a pure blood product-based strategy in patients undergoing elective cardiac surgery: a propensity score-matched cohort study
Objective: The goal of this study was to compare factor concentrate- (FC) based and blood product-based hemostasis management of coagulopathy in cardiac surgical patients in terms of postoperative bleeding, required blood products, and outcome.Design: Retrospective, propensity score-matched analysis.Setting: Single, tertiary, academic medical center.Participants: 118 matched pairs of 433 consecutive patients scheduled for cardiac surgery in two isolated periods with distinct strategies of hemostasis management. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2021 Category: Anesthesiology Authors: Endre NEMETH, Tamas VARGA, Adam SOLTESZ, Kristof RACZ, Gergely CSIKOS, Viktor BERZSENYI, Eszter TAMASKA, Zsolt LANG, Gabriella MOLNAR, Kalman BENKE, Ajandek EORY, Bela MERKELY, Janos GAL Source Type: research

Overview of the 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure with Reduced Ejection Fraction
In the past four years since the publication of the 2017 American College of Cardiology (ACC) expert consensus decision pathway for optimization of heart failure with reduced ejection fraction (HFrEF)1, new therapies, trials and data have emerged in the treatment of patients with HFrEF. With this expansion of knowledge, the ACC has provided a 2021 update to include novel therapies, such as angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter-2 inhibitors (SGLT2i) and percutaneous therapy for mitral regurgitation. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: Chinwe Dryer, Elizabeth K. Cotter, Brigid Flynn Tags: Editorial Source Type: research

Effect of high-flow nasal cannula oxygen therapy on pediatric patients with congenital heart disease in procedural sedation: a prospective, randomized trial
The study was conducted to compare the outcome of high-flow nasal cannula (HFNC) oxygen therapy with conventional oxygen therapy through a simple oxygen mask for pediatric patients with congenital heart disease during percutaneous intervention while under procedural sedation. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: Xuefei Duan, Ning Wei, Jinfeng Wei, Yi Zhu, Yin Kang, Yi He, Jiapeng Huang, Sheng Wang Source Type: research

Cardiac disease in pregnancy: hypertrophic obstructive cardiomyopathy and pulmonic stenosis
The prevalence of cardiovascular disease in pregnancy is increasing and cardiovascular disease is the leading cause of pregnancy-related death in the United States.1 The physiologic adaptations to pregnancy include an increased heart rate, stroke volume, and substantial expansion in circulatory volume, which may pose significant cardiac stress to patients with cardiac disease. During labor, cardiac output increases further and maternal expulsive efforts during the second stage of labor, with the decreased preload and increased afterload that accompany the Valsalva maneuver, may provoke decompensation in vulnerable patients...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: David E. Arnolds, Chad Dean, Mohammed Minhaj, William T. Schnettler, Jennifer Banayan, Mark A. Chaney Tags: Case Conference Source Type: research

Pheochromocytoma resection in a patient with chronic thromboembolic pulmonary hypertension and thrombocytopenia
Pheochromocytomas are rare catecholamine secreting neuroendocrine tumors that can produce life-threatening cardiovascular instability.1,2 Preoperative management with alpha blockade and intravascular volume expansion is crucial to intraoperative hemodynamic management, given risk of catecholamine surges with induction of anesthesia, intubation, surgical incision, insufflation, and tumor manipulation. Intraoperative pheochromocytoma resection management focuses on the goals of maintaining hemodynamic stability in the face of catecholamine surge. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: David Keegan Stombaugh, Caroline Thomas, Allison Dalton, Mark A. Chaney, Mark E. Nunnally, Annika M.A. Berends, Michiel N. Kerstens Tags: Case Conference Source Type: research

Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients
To analyze outcomes and risk factors of cardiovascular events in a metropolitan COVID-19 database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: Qian Xu, Harideep Samanapally, Pavani Nathala, Vidyulata Salunkhe, Stephen Furmanek, Meredith N. Cahill, Trevor McGuffin, Tahboub Mohammad, Bradford Marsili, Jessica Petrey, Ruth Carrico, Julio Ramirez, Ozan Akca, Sean P. Clifford, Siddharth Pahwa, Lynn R Source Type: research

Masthead
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 Category: Anesthesiology Source Type: research

Editorial Board
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 Category: Anesthesiology Source Type: research

Contents
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 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 25, 2021 Category: Anesthesiology Source Type: research

Guide for Authors
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 Category: Anesthesiology Source Type: research

Cardiac Calendar 2021-2022
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 Category: Anesthesiology Source Type: research

E-Challenge - Femoral Vein Pulsatility: What Does it Mean?
In this report, the clinical evolution of a 72-year-old patient transferred to the surgical intensive care unit following cardiac surgery is described. The presence of a pulsatile Doppler signal of the common femoral vein was noted following surgery. On post-operative day five, diuretics in addition to combination of inhaled epoprostenol and milrinone were associated with normalization of femoral vein pulsatility. The observations seen in peripheral venous flow reinforce the hypothesis that pulsatility of the common femoral vein represents an associated echocardiographic sign of right ventricular dysfunction and may be use...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 25, 2021 Category: Anesthesiology Authors: Alexander Calderone, Ali Hammoud, St éphanie Jarry, André Denault, Etienne J. Couture Source Type: research