Journal of Cardiothoracic and Vascular Anesthesia Journal of Cardiothoracic and Vascular Anesthesia RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

2023 Clinical Updates in Liver Transplantation
Liver transplantation continues to provide life-saving treatment for patients with end-stage liver disease. Advances in the field of transplant anesthesiology continue to support the care of more complex patients. The use of extracorporeal membrane oxygenation has been described in critical care settings and cardiac surgery but may be a valuable option for specific conditions for patients undergoing liver transplantation. Changes to the allocation process for liver grafts now focus on acuity circles to reduce regional disparities. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 24, 2024 Category: Anesthesiology Authors: Chantal C. Mercier Laporte, Brittany Brown, Trevor J. Wilke, Cale A. Kassel Tags: Review Article Source Type: research

Beyond the Beat: A Cardiac Anesthesiologist's Perspective on Cardiovascular-Kidney-Metabolic Health in Perioperative Care
Cardiac anesthesiologists play a pivotal role in perioperative risk assessment for patients undergoing cardiac and thoracic surgeries, given the intricate interplay of cardiovascular, kidney, and metabolic factors. This necessitates a thorough evaluation of patients' health status, enabling tailored anesthesia regimens and perioperative care plans to mitigate risks and optimize outcomes. Ndumele et al, in their recent article published in Circulation titled “Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory from the American Heart Association,” emphasize the high burden of cardiovascular-kidney-metabolic ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 23, 2024 Category: Anesthesiology Authors: Brian Gebhardt, Ankit Jain Tags: Editorial Source Type: research

Invasive Cardiac Therapies in Older People –Can We Raise the Bar?
The authors recently read a provocative publication in the Journal of the American College of Cardiology (JACC) by Berg et al. titled “Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients with non-ST-Segment Elevation Acute Coronary Syndrome”.1 This was a long-term follow-up of the patients in the After Eighty Study, originally published in 2016 in the Lancet.2 The original study found that patients>80 years old who experienced non –ST-segment elevation acute coronary syndrome (NSTE-ACS) had reduced composite events if they underwent an invasive treatment strategy rather than a conservative on...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: S. Michael Roberts, Anita Malhotra, Theodore J. Cios Tags: Editorial Source Type: research

Development of a Low-Cost Medium-Fidelity On-Site Cardiothoracic Anesthesia Simulation Program
Simulation-based training (SBT) is well-established to improve patient safety and problem-based learning in anesthesia.1 Medium-fidelity anesthesia simulation, using mannequins that allow simple task performance with moderate anatomic visual realism, is common in obstetric, pediatric, and general anesthesia. However, cardiothoracic simulation typically focuses on specific task training. Furthermore, immersive cardiothoracic simulations usually are performed in high-fidelity simulation centers,2,3 whereas cardiothoracic anesthesia trainee teaching is predominantly based on clinical practice in the operating room. (Source: J...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Elisheva Fiszer, Ruth Shaylor, Dana Karol, Jonathan Rozeznic, Gaby Kaplan, Carolyn F. Weiniger, Yitzhak Brzezinski Sinai Tags: Letter to the Editor Source Type: research

Diagnosis and Management of Vasoplegia in Temporary Mechanical Circulatory Support: A Narrative Review
Refractory vasodilatory shock, or vasoplegia, is a pathophysiologic state observed in the intensive care unit and operating room in patients with a variety of primary diagnoses. Definitions of vasoplegia vary by source but are qualitatively defined clinically as a normal or high cardiac index and low systemic vascular resistance causing hypotension despite high dose vasopressors in the setting of euvolemia. This definition can be difficult to apply to patients undergoing mechanical circulatory support (MCS). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Jamel Ortoleva, Adam A. Dalia, Dominic V. Pisano, Alexander Shapeton Tags: Review Article Source Type: research

Thyroid Hormone Supplementation in Heart Transplantation: Who's on First?
2023 was a record-breaking year for organ donation and transplantation, including a record for heart transplants in the United States (4,545).1 The donor pool was notable for an increase in donation after circulatory death (DCD) and donation from older donors.1 Improvements in organ perfusion and DCD practices contributed to the increase in heart transplants. Despite these improvements, there are more heart transplant candidates than there are available donor hearts. While organ allocation is examined and adjusted periodically to prioritize transplantation in patients with the greatest need (most recently in 2018 for heart...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Jenny Kwak, Rebecca Lee, Eric Pedone Tags: Editorial Source Type: research

Development of a Low-cost Medium Fidelity On-site Cardiothoracic Anesthesia Simulation Program
Simulation-based training (SBT) is well-established to improve patient safety and problem-based learning in Anesthesia. (1) Medium-fidelity anesthesia simulation, using manikins that allow simple task performance with moderate anatomical visual realism, is common in obstetric, pediatric, and general anesthesia. However, cardiothoracic simulation typically focuses on specific task training. Furthermore, immersive cardiothoracic simulations are usually performed in high-fidelity simulation centers, (2,3) while cardiothoracic anesthesia trainee teaching is predominantly based on clinical practice in the operating theatre. (So...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Elisheva Fiszer, Ruth Shaylor, Dana Karol, Jonathan Rozeznic, Gaby Kaplan, Carolyn F. Weiniger, Yitzhak Brzezinski Sinai Tags: Letter to the Editor Source Type: research

Transversus thoracic muscle plane block for postoperative pain in pediatric cardiac surgery: a systematic review and meta-analysis of randomized and observational studies
Pediatric patients undergoing open mid-sternum cardiac surgery can experience significant perioperative pain with poor analgesia[1, 2]. Adequate pain management is crucial for pediatric patients undergoing cardiac surgery as severe pain can result in devastating consequences such as pulmonary hypertensive crisis, tachyarrhythmia, hypertension, hypoxia, and increased morbidity and length of stay[3-6]. Currently, analgesia for pediatric cardiac surgery is still predominantly managed with opioids, with other alternative modalities such as regional/neuraxial analgesia and nonsteroidal anti-inflammatory drugs[7, 8]. (Source: Jo...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Yi-yang Cui, Zi-qing Xu, Huai-jing Hou, Jie Zhang, Jian-jun Xue Tags: Review Article Source Type: research

Challenges and Perioperative Implications of Anomalous Aortic Origin of the Coronary Arteries
Coronary artery anomalies (CAA) are congenital abnormalities that may or may not be clinically relevant. When symptomatic, treatment options include medical management, percutaneous treatment, or surgical intervention. Some variants, such as an anomalous left circumflex artery (LCx) off the right Sinus of Valsalva (SoV) may be mostly benign, but could have implications during cardiac surgery.1 Other anomalies such as anomalous origin of the left coronary artery (LCA) from the pulmonary artery often result in death without treatment. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: Bryan E. Marchant, Rohesh J. Fernando Tags: Editorial Source Type: research

Invasive Cardiac Therapies in the Elderly – Can We Raise the Bar?
We recently read a provocative publication in the Journal of the American College of Cardiology (JACC) by Berg et al. titled Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients with non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS).1 This is a long term follow-up of the patients in the After Eighty Study, originally published in 2016 in Lancet.2 The original study found that patients> 80 years old who suffered a NSTE-ACS had reduced composite events if they underwent an invasive treatment strategy rather than a conservative one of optimal medical therapy. (Source: Journal of Cardiothoraci...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 22, 2024 Category: Anesthesiology Authors: S. Michael Roberts, Anita Malhotra, Theodore J. Cios Tags: Editorial Source Type: research

Methadone Should Not Be Used in Cardiac Surgery as Part of Enhanced Recovery After Cardiac Surgery Protocol
METHADONE, originally synthesized during World War II as an analgesic substitute for morphine, is well-known in the world of addiction medicine.1 Methadone's mechanism of action is multifaceted: acting as a primary mu-receptor agonist with some kappa- and delta-receptor activity, pre-synaptic N-methyl-D-aspartate-receptor antagonist, and inhibitor of norepinephrine and serotonin reuptake in the brain.2,3 With the introduction of investigations by Gourlay et al.4,5 in the 1980s, integration of intravenous methadone into perioperative management has shown promise, but strong clinical research remains lacking, particularly in...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 21, 2024 Category: Anesthesiology Authors: Stephanie O. Ibekwe, Lauren Everett, Samhati Mondal Tags: Pro and Con Source Type: research

Carbon Footprint of Total Intravenous and Inhalation Anesthesia in the Transcatheter Aortic Valve Replacement Procedure
To quantify and compare the emissions for deep sedation with total intravenous anesthesia (TIVA) and general anesthesia with inhaled agents during the transcatheter aortic valve replacement procedure. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 21, 2024 Category: Anesthesiology Authors: Lei Yang, Joshua Hubert, Samwel Gitundu, Ethan Brovman, Frederick Cobey Tags: Original Article Source Type: research

Aviptadil as a Promising Intervention: A Case Study for Transfusion-Related Acute Lung Injury Treatment in a Cardiac Patient
Aviptadil is a synthetic form of vasoactive intestinal polypeptide (VIP) discovered in 1970 by Said and Mutt.1 VIP binds to the VPAC1 receptor of alveolar-type (AT) II cells, and has been shown to block replication of SARS-COV2, resulting in clinical and radiographic improvement. Sars-COV2 virus binds to AT II cells via the angiotensin-converting enzyme 2 receptor. Unlike other anticytokine drugs, aviptadil has a specific role in preserving lung surfactant production and protecting AT II cells. In the face of the COVID-19 pandemic, when all possible therapies were being explored, aviptadil was found to improve COVID-19 acu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 21, 2024 Category: Anesthesiology Authors: Chinmaya Nanda, Chitra Mehta, Yatin Mehta, Swati Joshi, Anmol Bhan, Anil Bhan Tags: Letter to the Editor Source Type: research

Pro: Methadone Should Be Used as a Part of Enhanced Recovery After Cardiac Surgery Protocol
METHADONE IS A HIGHLY effective synthetic opioid (Food and Drug Administration-approved in 1947) used primarily in opioid use disorder treatment, but has been studied and used for acute perioperative pain treatment. Its duration of action is highly dependent on dose and frequency. Methadone has a short speed of onset of 6-to-8 minutes, and a redistribution half-life of approximately 6 minutes, but with increasing dosage ( ≥20 mg), its elimination half-life is extended to approximately 30 hours (range 8 ≥ 59 hours). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 21, 2024 Category: Anesthesiology Authors: Shelby Garcia, Mitali Mali, Ashanpreet Grewal Tags: Pro and Con Source Type: research

Sex-Based Differences in Opioid Administration: A Puzzle Yet to Be Solved
We read with great interest the paper published by Karamesinis et al. comparing sex-based differences in opioid administration after cardiac surgery.1 The authors concluded that female sex was associated with a significantly lower amount of opioid administration. Although the authors did a commendable job of accounting for many potential covariates, ongoing concerns about sex disparities in pain management and the complex nature of pain warrant a close examination of the results presented in the manuscript. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 21, 2024 Category: Anesthesiology Authors: Aimee Pak, Hannah Smith, Hisako Okada, Amir L. Butt Tags: Letter to the Editor Source Type: research