Usefulness of right ventricular longitudinal shortening fraction to detect right ventricular dysfunction in acute cor pulmonale related to COVID-19.
Right ventricular (RV) dysfunction evaluated by echocardiography is a non-rare complication of COVID-19 infection, with an estimated incidence of 27%.1 RV systolic function is classically assessed with transthoracic echocardiography (TTE) by RV-fractional area change (RV-FAC), tricuspid annular plane systolic excursion (TAPSE) or S ’ tricuspid systolic (RV-S’) wave velocity obtained by tissue-Doppler imaging.2 More recently, two-dimensional speckle tracking echocardiography (2D-STE), a semi-automated angle independent method, has been developed to evaluate the RV systolic function. (Source: Journal of Cardiotho...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 18, 2021 Category: Anesthesiology Authors: Christophe Beyls, Yohann Bohbot, Pierre Huette, Thomas Booz, Camille Daumin, Osama Abou-Arab, Yazine Mahjoub Source Type: research

Perioperative course of three-dimensional derived right ventricular strain in coronary artery bypass surgery – A prospective observational pilot trial
Echocardiography is a cornerstone in identifying perioperative right ventricular dysfunction, but there is no consensus on which parameter is best for perioperative diagnosis.1,2 The complex geometry of the right ventricle (RV) makes echocardiographic assessment challenging. Several two-dimensional echocardiographic parameters are commonly used. However, each has several limitations including incomplete imaging of the complex crescent-shaped RV and angle dependency of Doppler and M-mode technique. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 18, 2021 Category: Anesthesiology Authors: Jakob Labus, Johan Winata, Torsten Schmidt, Joachim Nicolai, Matus Tomko, Kunislav Sveric, Manuel Wilbring, Jens Fassl Tags: Original Article Source Type: research

Lung injury after neonatal congenital cardiac surgery is mild and modifiable by corticosteroids
After cardiac surgery with cardiopulmonary bypass (CPB), the release of various inflammatory mediators and a lung ischemia-reperfusion process may lead to lung injury and lung edema (1, 2). However, more recently, very few patients tend to develop severe lung injury, and reperfusion lung edema is mostly a subclinical and self-limited condition (3, 4). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2021 Category: Anesthesiology Authors: Anu K Kaskinen, Juho Keski-Nisula, Laura Martelius, Eeva Moilanen, Mari H ämäläinen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen-Argillander Tags: Original Article Source Type: research

Point of Care Ultrasound (POCUS) for the Cardiothoracic Anesthesiologist
Point of Care Ultrasound (POCUS) is a valuable bedside diagnostic tool for a variety of expeditious clinical assessments or as guidance for a multitude of acute care procedures. Varying aspects of nearly all organ systems can be evaluated using POCUS and with the increasing availability of affordable ultrasound systems over the past decade, many now refer to POCUS as the 21st-century stethoscope. With the current available and growing evidence for the clinical value of POCUS, its utility across the perioperative arena adds enormous benefit to clinical decision-making. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2021 Category: Anesthesiology Authors: Hari Kalagara, Bradley Coker, Neal S. Gerstein, Promil Kukreja, Lev Deriy, Albert Pierce, Matthew M. Townsley Source Type: research

The effectiveness of levosimendan on veno-arterial extracorporeal membrane oxygenation management and outcome: a systematic review and meta-analysis
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides a temporary support system for patients with cardiogenic shock refractory to conventional medical therapies. It has been reported that levosimendan may facilitate VA-ECMO weaning and improve survival. The primary objective of this review is to examine the effect of levosimendan use on VA-ECMO weaning and mortality in critically ill patients on VA-ECMO. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2021 Category: Anesthesiology Authors: Rasha Kaddoura, Amr S Omar, Prof Mohamed Izham Mohamed Ibrahim, Dr Abdulaziz Alkhulaifi, Prof Dr Roberto Lorusso, Hagar Elsherbini, Dr Osama Soliman, Dr Kadir Caliskan Tags: Review Article Source Type: research

Echocardiography to diagnose an evolving Sinus of Valsalva fistula from infective endocarditis
We present a case of a SOV-to-right atrial (RA) fistula from AV IE that was diagnosed by intraoperative transesophageal echocardiography (TEE). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2021 Category: Anesthesiology Authors: Jon Lucaj, Peter Paik, Nazia Siddiqui, Ashley Miller, Kinjal Patel, Ronak Desai, Sandeep Krishnan Tags: Case Report Source Type: research

Removal of the knotted pulmonary artery catheter using a percutaneous tracheostomy set
We report a rare complication: the intracardiac knotting and its successful extraction using a percutaneous tracheostomy set in a hemodynamically compromised patient after a heart transplant. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 16, 2021 Category: Anesthesiology Authors: Rafael Arboleda Salazar, Damaris Rodriguez Delgado, Clara Perosanz Silvo, Andrea Eixeres Esteve Tags: Case Report Source Type: research

Conventional Ultrafiltration - No More Role in Elective Adult Cardiac Surgery?
Introduction of the cardiopulmonary bypass (CPB) machine by John Gibbon in 1952 has revolutionized the field of cardiac surgery by allowing complex open-heart procedures to be performed in a bloodless surgical field and is widely regarded as one of the most significant surgical developments in the 20th century.1 However, the use of CPB is not without its disadvantages. Its non-physiological nature has been shown to trigger a systemic inflammatory response syndrome (SIRS) contributing to the development of multi-organ dysfunction particularly the heart, lungs, kidneys, central nervous and coagulation systems. (Source: Journ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2021 Category: Anesthesiology Authors: Priscilla Hui Yi Phoon, Nian Chih Hwang Tags: Editorial Source Type: research

The Right Ventricle in COVID-19 Lung Injury: Proposed Mechanisms, Management and Research Gaps
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS COV2) infection, is a complex multisystem disorder primarily characterised by pulmonary involvement.1 Although lung injury leading to acute severe respiratory failure is the most feared clinical presentation of COVID-19, cardiac complications in patients without underlying heart disease could also be a feature of the syndrome and ranges from 20 to 30%. 2 –4 Right ventricular (RV) dysfunction (RVD) seems to be particularly frequent (20-39%) in the COVID-19 patient group and often remains undiagnosed. (Source: Journal of...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2021 Category: Anesthesiology Authors: Graziella Isgro, Hakeem O. Yusuff, Vasileios Zochios, PRORV network: Protecting the Right Ventricle network Tags: Invited Editorial Source Type: research

Point of care ultrasonography for evaluation of blunt tracheal injury
We describe the use of point of care ultrasonography as part of initial assessment in such conditions. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 15, 2021 Category: Anesthesiology Authors: Prakash K. Dubey, Kunal Singh, Alok K Bharti Tags: Letter to the Editor Source Type: research

A descriptive study of perioperative hemodynamics in open cardiac surgery patients
The purpose of this study was to describe how perioperative hemodynamic profile before and after cardiopulmonary bypass during cardiac surgery is influenced by age, and to describe the association between postoperative hemodynamics and 1 year mortality. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 14, 2021 Category: Anesthesiology Authors: Hjordis Osk Atladottir, Jacob Greisen, CJ Carl-Johan Jakobsen, Dorthe Viemose Nielsen Source Type: research

The Hero of Haarlem: seeking simple solutions to failures of complex systems
In 1865, Mary Mapes Dodge published a novel about a young Dutch boy's struggle to win a pair of silver ice skates. Hans Brinker: Or, The Silver Skates, contains within it a chapter which has become a classic American tale of ingenuity, grit, and fortitude.1 This hero of Haarlem who, despite frequent misattributions is never actually given a name, is known by all school-age children as the boy who put his finger in the dam. Though universally familiar, the poignant image of a small child standing alone throughout a cold winter night holding back the inevitable flood of a broken dike loses the plot in the imagery. (Source: J...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2021 Category: Anesthesiology Authors: Jennifer E. Smith Tags: Editorial Source Type: research

Pulmonary Complications in Esophagectomy Based on Intraoperative Fluid Rate: A Single-Center Study
: Esophagectomy is associated with significant morbidity and mortality. We assessed the relationship between intraoperative fluid (IOF) administration and postoperative pulmonary outcomes in patients undergoing a transthoracic, transhiatal, or tri-incisional esophagectomy. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2021 Category: Anesthesiology Authors: Ryan S. D'Souza, Charles R. Sims, Nicole Andrijasevic, Thomas M. Stewart, Timothy B. Curry, James A. Hannon, Shanda Blackmon, Stephen D. Cassivi, Robert K. Shen, Janani Reisenauer, Dennis Wigle, Michael J. Brown Tags: Original Research Source Type: research

Posterior Mediastinal Mass Resection Requiring Veno-arterial and Veno-venous Extracorporeal Membrane Oxygenation Support
Management of a mediastinal mass resection remains a challenging anesthetic scenario due to its compression on airway and major cardiovascular structures. In general, anterior mediastinal masses cause the most severe and often life-threatening complications due to the gravity effect leading to high degree of compression on the trachea, the superior vena cava, the pulmonary artery or the right heart. Posterior mediastinal mass is usually considered at lower risk because of its anatomical distance from those vital structures. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2021 Category: Anesthesiology Authors: Pingping Song, Nicholas J. Josten, Aaron M Cheng Tags: Case Report Source Type: research

Pulmonary Vascular Thrombosis in COVID-19 Pneumonia
During SARS-CoV-2 infection, dramatic endothelial cell damage with pulmonary microvascular thrombosis has been hypothesized to occur. Our aim was to assess whether pulmonary vascular thrombosis is due to recurrent thromboembolism from peripheral deep vein thrombosis or rather to local inflammatory endothelial damage with a superimposed thrombotic late complication. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2021 Category: Anesthesiology Authors: Francesco De Cobelli, Diego Palumbo, Fabio Ciceri, Giovanni Landoni, Annalisa Ruggeri, Patrizia Rovere-Querini, Armando D'Angelo, Stephanie Steidler, Laura Galli, Andrea Poli, Evgeny Fominskiy, Maria Grazia Calabr ò, Sergio Colombo, Giacomo Monti, Robert Tags: Original Article Source Type: research

Continuous non-invasive arterial pressure monitoring for transcatheter aortic valve replacement
The objective of the present study conducted in patients undergoing transcatheter aortic valve replacement is to compare continuous non-invasive arterial pressure measured with the ClearSight ™ device (Edwards Lifesciences LTD, Irvine, California, US) with invasive radial artery pressure used as the reference method. We hypothesized that the ClearSight™ device is an accurate, precise, safe, and efficient method for arterial blood pressure measurement comparable to an invasive radial arterial line. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2021 Category: Anesthesiology Authors: Shu D. Lu, Adam A. Dalia Tags: Original Article Source Type: research

Late Diagnosis of a Large Extrapleural Hematoma in a Patient with Stanford type B Aortic Dissection: a Case Report and Review of Literature
Acute aortic dissection is a rare but catastrophic condition. When the dissection extends through the adventitia, blood can extravasate into the extrapleural or intrapleural space, causing an extrapleural hematoma or hemothorax. The early recognition of extrapleural hematoma and distinguishing it from hemothorax is critical because the management of those two entities is different. The authors present a case of a late diagnosis of a large extrapleural hematoma in a patient with Stanford type B acute aortic dissection that requires thoracotomy for hematoma evacuation. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 11, 2021 Category: Anesthesiology Authors: Pingping Song, Allanah Bachman, Livia Kelly Tags: Case Report Source Type: research

Mitral Regurgitation in Patients with Coexisting Chronic Aortic Regurgitation: An Evidence-Based Narrative Review
Chronic aortic regurgitation (AR) frequently leads to significant downstream changes to the left ventricle (LV) and pulmonary vasculature; these structural and physiologic changes result in lower than expected patient survival. Progressive, uncorrected AR can lead to LV dilation and subsequent mitral valve leaflet tethering, as well as mitral annular dilation, resulting in secondary mitral regurgitation (MR) in up to 45% of patients. Surgical aortic valve replacement (AVR) improves secondary MR in most patients, but survival is significantly lower in those patients who do not show improvement in MR after AVR. (Source: Jour...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 8, 2021 Category: Anesthesiology Authors: Kinjal M. Patel, Ronak G. Desai, Sandeep Krishnan Tags: Expert Review Source Type: research

Same Same but Different: Viscoelastic Hemostatic Assays in Cardiac Surgery
Viscoelastic hemostatic assays (VHA) have become increasingly popular to monitor perioperative coagulation status and to timely guide hemostatic therapy in cardiac surgery.1,2 VHA can be performed as point-of-care tests and might track perioperative coagulation disorders more accurately than standard coagulation tests.3,4 Implementation of VHA results in transfusion algorithms has efficaciously reduced the requirements of allogeneic blood products in several studies and meta-analyses.5-7 Accordingly, the use of VHA is recommended by recent clinical guidelines in patient blood management and perioperative coagulation therap...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 7, 2021 Category: Anesthesiology Authors: Daniel Bolliger, Firmin Kamber, Eckhard Mauermann Source Type: research

Protecting the Right Ventricle Network (PRORVNet): Time to Defend the ‘Forgotten Ventricle’?
Historically, insight into the right ventricle's (RV) role in health and disease has lagged behind that of the left ventricle. It is easy to stigmatize the RV as a passive conduit of the heart and thus regarding it as less important given that it only pumps blood into a single organ, the lungs. However, the circulatory system is a complex closed system, and requires both ventricles to interdependently work together. The failure of one deleteriously affects the performance of the other.1 Therapeutic management of RV dysfunction has also lagged behind that of the left ventricle. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 7, 2021 Category: Anesthesiology Authors: Vasileios Zochios, Gary Lau, Hannah Conway, Ken Kuljit S Parhar Source Type: research

Appropriate Clinical Trial Registration is a Key to Transparent Reporting and Publication
What is the purpose of trial registration and why is it so important to the integrity of research? Clinical trial registration serves the following purposes. First, by pre-registering the trials, the primary outcome (why do the study) and method (how to do the study) get disclosed to the public. This makes certain biases unlikely to interfere with the interpretation of the results. Secondly, pre-registration prevents conscious or unconscious manipulation of the results. This protects the integrity of the study. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 7, 2021 Category: Anesthesiology Authors: Satoru Fujii, Daniel Bainbridge Tags: Editorial Source Type: research

Chest pain after intravenous propofol injection in a patient receiving long-term chronic hemodialysis
Pain during intravenous propofol injection occurs in 60% –70% of patients.1 Anterior chest wall pain secondary to propofol injection has not previously been reported. A 54-year-old man with a history of hemodialysis for chronic renal failure presented for arteriovenous graft revision under general anesthesia. Since the left and right forearms, antecubit al fossae, and upper arms had all been previously used for vascular access, the left thigh was selected for a new arteriovenous graft. Computed tomography revealed collateral circulation between the subcutaneous veins in the anterior chest and the veins in the upper e...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 7, 2021 Category: Anesthesiology Authors: Yoshiaki Oshima, Keiichiro Ueda, Saori Tokunaga, Yohei Yurugi, Tsutomu Mano, Shuji Sugihara, Akihiro Otsuki, Yoshimi Inagaki Tags: Letter to the Editor Source Type: research

Pro: General anesthesia is superior to regional anesthesia for patients with pulmonary hypertension undergoing non-cardiac surgery
An increasing prevalence of pulmonary hypertension (PH) and a recent change in the definition of PH contribute to a growing population of patients receiving this diagnosis.1 The modification of the definition of PH in 2019 involved lowering the classification threshold of mean pulmonary artery pressure from 25 mmHg to 20 mmHg, the inflection point for poorer patient outcomes.2 Pulmonary hypertension is a risk factor for patients undergoing non-cardiac surgery. Underlying PH has been independently associated with increased rates of postoperative heart failure, hemodynamic instability, respiratory failure, delayed extubation...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 6, 2021 Category: Anesthesiology Authors: Alan M. Smeltz, Priya A. Kumar Tags: Pro and Con Source Type: research

Con: General Anesthesia is Not Superior to Regional Anesthesia for Patients with Pulmonary Hypertension Undergoing Non-Cardiac Surgery
Patients with significant pulmonary hypertension (PH) are known high-risk surgical candidates due to an increased incidence of adverse cardiopulmonary outcomes.1 –4 Despite the significant morbidity and mortality risk and increasing frequency of PH among surgical candidates,5,6 the optimal anesthetic approach to significant PH remains controversial. Caring for such patients requires continuous evaluation of the delicate balance between maximizing cardiopul monary blood flow and minimizing factors known to worsen this condition. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 6, 2021 Category: Anesthesiology Authors: James C. Krakowski, Harendra Arora Tags: Pro and Con Source Type: research

Echocardiographic Assessment of Left Ventricular Assist Device outflow velocity during percutaneous decommissioning
Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, or in some patients, as a bridge to recovery. LVAD withdrawal with ventricular recovery represents the optimal outcome for patients previously implanted with an LVAD. In this E-Challenge, the authors present a case of percutaneous decommissioning of an LVAD, in which TEE provides critical, real-time evaluation perioperatively. We also review the current perspectives on LVAD decommissioning in terms of patient selection and surgical techniques. (Source: Jou...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Xianying Liu, Carey Kimmelstiel, Gregory S. Couper, Ethan Y. Brovman Source Type: research

Determining optimal treatment to correct preoperative anemia and reduce perioperative allogeneic blood transfusions in cardiac surgery: a retrospective cohort study
: Preoperative anemia management reduces red blood cell (RBC) transfusion and adverse outcomes, but how best to optimize the patient's hemoglobin (Hgb) before cardiac surgery remains unclear. We sought to determine the optimal treatment of anemia using iron and epoetin alfa before cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: John K. Peel, Jacqueline Trudeau, Ruby Tano, Saudia Jadunandan, Jeannie Callum, Fuad Moussa, Yulia Lin Source Type: research

Anesthetic Management for Atrial Fibrillation Ablation: A National Anesthesia Clinical Outcomes Registry Analysis
Atrial fibrillation is the most common sustained cardiac arrhythmia in the United States (US).1 Atrial fibrillation ablation (AFA) procedures have proven to be superior to antiarrhythmic drug therapy.2 –4 Indeed, ablatory procedures significantly decrease arrhythmia-induced symptoms, improve exercise tolerance, arrhythmia-free intervals, and improve quality of life.3,4 A recent meta-analysis, comparing AFA versus medical therapy, reported that patients who underwent ablation had lower risk of ca rdiac hospitalization and recurrent atrial arrhythmias than those who received medical therapy. (Source: Journal of Cardiot...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Rachel S. Dada, Jeremiah Hayanga, Kaitlin Woods, David Schwartzman, Dylan Thibault, Matthew Ellison, Stanley Schmidt, Donald Siddoway, Vinay Badhwar, Heather K. Hayanga Source Type: research

Left ventricular unloading with IABP in patients undergoing ventricular tachycardia ablation with ECMO support
We investigated the pre-procedural predictors of post-procedural intra-aortic balloon pump (IABP) need in patients undergoing transcatheter ventricular tachycardia (VT) ablation on veno-arterial (VA) extra corporeal membrane oxygenation (ECMO). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Fabrizio Monaco, Silvia Ajello, Maria Grazia Calabr ò, Giulio Melisurgo, Giovanni Landoni, Allegra Arata, Caterina Cecilia Lerose, Elisabetta Fumagalli, Nora Di Tomasso, Antonio Frontera, Anna Mara Scandroglio, Paolo Della Bella, Alberto Zangrillo Tags: Original Article Source Type: research

Six-minute walk test predicts postoperative delirium after transcatheter aortic valve replacement
This study aimed to investigate the incidence and risk factors of postoperative delirium (POD) after transcatheter aortic valve replacement (TAVR) and to evaluate the association between preoperative conditions, particularly frailty, and POD. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Atsushi Yamashita, Syoji Suzuki, Tomohisa Otsuka, Hiromi Matsuda, Hisae Ando, Kosuke Sugimura, Emi Maekawa, Kentaro Meguro, Junya Ako, Hirotsugu Okamoto Tags: Original Article Source Type: research

Institutional Experience With Veno-Arterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism: A Retrospective Case Series
Despite advances in treatment, massive pulmonary embolism (PE) remains associated with significant morbidity and mortality. The role of venoarterial extracorporeal membrane oxygenation (V-A ECMO) in the setting of massive PE is evolving and includes potential roles both in initial management and as a rescue strategy. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Maxwell A. Hockstein, Maria Christina Creel-Bulos, Joshua Appelstein, Craig S. Jabaley, Michael J. Stentz Tags: Original Article Source Type: research

Serratus anterior plane block, Erector spinae plane block versus thoracic epidural analgesia for perioperative thoracotomy pain control: A randomized controlled study
This study was designed to evaluate the safety and efficacy of erector spinae plane block and serratus anterior plane block versus thoracic epidural in perioperative pain control for cancer patients undergoing lung surgeries. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Walaa Y Elsabeeny, Mostafa A Ibrahim, Nahla N Shehab, Abdelrahman Mohamed, Mohamed A Wadod Tags: Original Article Source Type: research

The impact of initiation of an intensivist-led patient management protocol on outcomes after cardiac surgery
Prolonged intensive care unit stay after cardiac surgery is associated with high mortality. The aim of this study was to evaluate the impact of the introduction of a quality improvement program under the supervision of an intensivist on the long-term mortality of high-risk patients with prolonged ICU stay after cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Alexander Kogan, Yigal Kassif, Jonathan Frogel, Shany Levin, Ram Eilon, Yael Peled, Ehud Raanani, Leonid Sternik Tags: Original Article Source Type: research

Left ventricular outflow tract gradient is associated with coronary artery obstruction in children with Williams-Beuren syndrome
The objective of this study was to determine the association between transthoracic echocardiogram findings and the presence of coronary obstruction to examine if coronary obstruction can be predicted before anesthesia by transthoracic echocardiogram. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 4, 2021 Category: Anesthesiology Authors: Angela Yun June Tan, Daniel Quiat, Sunil J. Ghelani, Koichi Yuki Tags: Original Article Source Type: research

Volume responsiveness: what it does not tell us
In this study the investigators tested for volume responsiveness by performing passive leg raising (PLR) on 129 cardiac surgical patients at the conclusion of the procedure, prior to transport to the intensive care unit. Their hypothesis was that volume responsiveness at the conclusion of cardiac surgery is predictive of perioperative Acute Kidney Injury (AKI). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 2, 2021 Category: Anesthesiology Authors: Gerard Manecke Tags: Editorial Source Type: research

Rare for a Reason
Kothari et al. present in their E-Challenge a woman in her late fifties recently diagnosed with a congenital heart defect who underwent successful repair.1 Their case highlights a growing phenomenon: adult congenital heart disease (CHD) patients presenting to the operating room. Currently, adults with CHD are outnumbering pediatric cardiac patients.2 This is the result of improved surgical, cardiopulmonary bypass (CPB) and anesthetic techniques treating or palliating children and allowing them to survive to adulthood. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 2, 2021 Category: Anesthesiology Authors: Lauren Kemp Licina Tags: Editorial Commentary Source Type: research

Initial postoperative hemoglobin values are independently associated with one-year mortality in patients undergoing double lung transplantation requiring intraoperative transfusion
To evaluate the association of postoperative hemoglobin values and mortality in patients undergoing double lung transplantation with intraoperative transfusion. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2020 Category: Anesthesiology Authors: Johannes Menger, Stefan Koch, Mohamed Mouhieddine, Stefan Schwarz, Konrad Hoetzenecker, Peter Jaksch, Barbara Steinlechner, Martin Dworschak Tags: Original Article Source Type: research

Unique complications associated with the subclavian intra-aortic balloon pump
The intra-aortic balloon pump (IABP), which has been in in use for over 50 years, is one of the most common forms of mechanical circulatory support, with an estimated 200,000 inserted annually worldwide.1,2 While commonly inserted through a femoral arteriotomy, the increasing usage of the IABP as a bridge-to-transplant (BTT) in patients with advanced heart failure has led to the development of alternative sites, such as the subclavian (SCA) or axillary artery. This technique decreases the risk of infection and allows for ambulation, which limits deconditioning, all which facilitates long-term use. (Source: Journal of Cardi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2020 Category: Anesthesiology Authors: Danisa Daubenspeck, Laura S. Gonz ález, Rebecca M. Gerlach, Mark A. Chaney Source Type: research

Methylene Blue for Vasoplegia during Extracorporeal Membrane Oxygenation Support
: The treatment of refractory vasodilatory shock in patients undergoing Extracorporeal Membrane Oxygenation (ECMO) is an area with minimal literature. Based on previous literature, we hypothesized that at least 40% of ECMO patients with vasoplegia would respond positively to methylene blue administration and that those who responded to methylene blue would have an increase in survival. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2020 Category: Anesthesiology Authors: Jamel Ortoleva, Russel J. Roberts, Lauren T. Devine, Amy French, Masashi Kawabori, Fredrick Chen, Kenneth Shelton, Adam A. Dalia Tags: Original Article Source Type: research

In Celebration of the Life and Contributions of Paul G. Barash
Dr. Paul G Barash, former chair of the Department of Anesthesiology at the Yale University School of Medicine, died on June 8, 2020, at the age of 78. He was one of the giants in anesthesiology: a notable clinician, investigator, teacher, and founding editor of his internationally renowned textbook Clinical Anesthesia. However, he was in particular a pioneer and leader in the subspecialty of cardiac anesthesia. In this review, we summarize his career, the contributions he made to the practice of anesthesiology in general and to cardiac anesthesia in particular and provide comments from his colleagues and friends. (Source: ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 27, 2020 Category: Anesthesiology Authors: Eugene A. Hessel, Robert Hines, Stanton Shernan Tags: Special Article Source Type: research

In Celebration of the Life and Contributions of Paul G Barash
Dr. Paul G Barash, former Chair of the Department Of Anesthesiology at the Yale University School of Medicine, died on June 8, 2020 at the age of 78. He was one of the giants in anesthesiology: a notable clinician, investigator, teacher, and founding editor of his internationally renowned textbook Clinical Anesthesia. However, he was in particular a pioneer and leader in the subspecialty of cardiac anesthesia. In this review, we summarize his career, the contributions he made to the practice of anesthesiology in general and to cardiac anesthesia in particular and provide comments from his colleagues and friends. (Source: J...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 27, 2020 Category: Anesthesiology Authors: Eugene A Hessel, Robert Hines, Stanton Shernan Tags: SPECIAL ARTCLE Source Type: research

In Reply to “Letter to the Editor: AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Corona Virus Disease 2019 Pandemic”
We read with interest the letter to the editor from Labaste et al1. We welcome the initiative of the authors to look for an alternative to intravenous drugs to sedate patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with volatile anesthetics (VA) using the AnaConDa ™ device (Sedana Medical, Uppsala, Sweden) in times of drug shortages. AnaConDa was initially created for inhaled sedation of patients ventilated with intensive care ventilators. Its safe use in the operating theatre has been described for minor gynecological surgery2. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 24, 2020 Category: Anesthesiology Tags: Letter to the Editor Source Type: research

Hepatic Vein Flow Index During Orthotopic Liver Transplantation as a Predictive Factor for Postoperative Early Allograft Dysfunction
The authors devised a hepatic vein flow index (HVFi), using intraoperative transesophageal echocardiography and graft weight, and investigated its predictive value for postoperative graft function in orthotopic liver transplant. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 23, 2020 Category: Anesthesiology Authors: Yoshihisa Morita, Taro Kariya, Shunji Nagai, Ahmad Itani, Michael Isley, Kenichi Tanaka Tags: Original Article Source Type: research

The Dynamics of Heparin-Binding Protein in Cardiothoracic Surgery —A Pilot Study
To explore the preoperative, intraoperative, and postoperative dynamics of heparin-binding protein (HBP) in cardiothoracic surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 23, 2020 Category: Anesthesiology Authors: Niklas Sterner, Jane Fisher, Louise Thelaus, Carolin Ketteler, Špela Lemež, Alain Dardashti, Johan Nilsson, Adam Linder, Igor Zindovic Tags: Original Article Source Type: research

Hepatic vein flow index during orthotopic liver transplantation as predictive factor for postoperative early allograft dysfunction
We devised a hepatic vein flow index (HVFi) using intraoperative transesophageal echocardiography (TEE) and graft weight, and investigated its predictive value for postoperative graft function in orthotopic liver transplant (OLT). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 23, 2020 Category: Anesthesiology Authors: Yoshihisa Morita, Taro Kariya, Shunji Nagai, Ahmad Itani, Michael Isley, Kenichi Tanaka Tags: Original Article Source Type: research

The dynamics of heparin binding protein in cardiothoracic surgery - a pilot study
Cardiac surgery using cardiopulmonary bypass (CPB) induces an acute phase inflammatory reaction including complement activation and secretion of  proinflammatory cytokines (1) . An excessive production and release of cytokines can provoke tissue injury which can result in organ dysfunction (2). Surgical trauma and contact with the non-physiological surfaces of the extracorporeal circuit, endotoxemia, ischemia and reperfusion injury are all stimuli for inflammatory response (3). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 23, 2020 Category: Anesthesiology Authors: Niklas Sterner, Jane Fisher, Louise Thelaus, Carolin Ketteler, Špela Lemež, Alain Dardashti, Johan Nilsson, Adam Linder, Igor Zindovic Tags: Original Article Source Type: research

Paul barash, md: cardiac anesthesia giant
It was with a heavy heart that I learned of the death of Paul G. Barash, MD, in the second half of 2020. He was a good friend and colleague for almost 40 years, and his passing was a great loss to the field of anesthesiology in general and to the subspecialty of cardiac anesthesia in particular. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 23, 2020 Category: Anesthesiology Authors: Joel A. Kaplan Tags: Editorial Source Type: research

Anesthetic Management of Conduction Disturbances following Transcatheter Aortic Valve Replacement: A Review of the 2020 ACC Expert Consensus Decision Pathway
Conduction disturbances remain a common complication following transcatheter aortic valve replacement (TAVR). Despite improvements in device technology and operator experience, the rate of permanent pacemaker (PPM) insertion has not significantly changed over time. Due to a dearth of research into management and treatment of these issues, there is great heterogeneity in practice, leading to significant variability in PPM rates, length of stay and outcomes throughout the United States. The American College of Cardiology sought to address the gaps of care and knowledge in areas where evidence is new or evolving. (Source: Jou...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 22, 2020 Category: Anesthesiology Authors: Peter J. Neuburger, Liliya Pospishil, Homam Ibrahim Tags: Editorial Commentary Source Type: research

Esmolol in Cardiac Surgery: A Randomized Controlled Trial
To assess whether the administration of the ultra-short –acting β-blocker esmolol in cardiac surgery could have a cardioprotective effect that translates into improved postoperative outcomes. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 21, 2020 Category: Anesthesiology Authors: Alberto Zangrillo, Elena Bignami, Beatrice No è, Pasquale Nardelli, Margherita Licheri, Chiara Gerli, Martina Crivellari, Alessandro Oriani, Ambra Licia Di Prima, Evgeny Fominskiy, Nora Di Tomasso, Rosalba Lembo, Giovanni Landoni, Giuseppe Crescenzi, Fab Tags: Original Article Source Type: research

Skeletal Muscle Characteristics May Inform Preprocedural Risk Stratification in Transcatheter Aortic Valve Replacement Patients
Low psoas muscle mass previously has been associated with mortality after transcatheter aortic valve replacement (TAVR). Evidence from other clinical disciplines suggests that psoas density (PD) may be a better predictor than psoas muscle cross-sectional area indexed to body surface area (PI). The authors hypothesized that PD would be more strongly correlated with patient discharge disposition and survival after TAVR than PI. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 21, 2020 Category: Anesthesiology Authors: Alberto Furzan, Sadeq Quraishi, Ethan Brovman, Andrew Weintraub, Ann Connors, David Allen, Prakash A. Patel, Frederick C. Cobey Tags: Original Research Source Type: research

Use of the Hypotension Prediction Index During Cardiac Surgery
The hypotension prediction index (HPI) is a novel parameter developed by Edwards Lifesciences (Irvine, CA) that is obtained through an algorithm based on arterial pressure waveform characteristics. Past studies have demonstrated its accuracy in predicting hypotensive events in noncardiac surgeries. The authors aimed to evaluate the use of the HPI in cardiac surgeries requiring cardiopulmonary bypass (CPB). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 21, 2020 Category: Anesthesiology Authors: Brian Shin, Steven A. Maler, Keerthi Reddy, Neal W. Fleming Tags: Original Research Source Type: research