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Preoperative Stroke and Outcomes after Coronary Artery Bypass Graft Surgery
Conclusions: The authors found no evidence that more recent preoperative stroke predisposed patients undergoing CABG surgery to suffer postoperative stroke, death, or prolonged length of stay. The combination of prior stroke and myocardial infarction substantially increased perioperative risk.
Source: Anesthesiology - February 20, 2013 Category: Anesthesiology Tags: Perioperative Medicine Source Type: research

Challenges After the First Decade of Transcatheter Aortic Valve Replacement: Focus on Vascular Complications, Stroke, and Paravalvular Leak
Transcatheter aortic valve replacement (TAVR) is entering its second decade. Three major clinical challenges have emerged from the first decade of experience: vascular complications, stroke, and paravalvular leak (PVL). Major vascular complications remain common and independently predict major bleeding, transfusion, renal failure, and mortality. Although women are more prone to vascular complications, overall they have better survival than men. Further predictors of major vascular complications include heavily diseased femoral arteries and operator experience. Strategies to minimize vascular complications include a multimo...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 12, 2012 Category: Anesthesiology Authors: Christopher Reidy, Aris Sophocles, Harish Ramakrishna, Kamrouz Ghadimi, Prakash A. Patel, John G.T. Augoustides Tags: Expert Review Source Type: research

The Use of Corticosteroids for Cardiopulmonary Bypass in Adults
AbstractPurpose of ReviewCardiopulmonary bypass for on-pump cardiac surgery induces a systemic inflammation that may contribute to postoperative major complications. To reduce this inflammatory response in patients undergoing heart surgery, the perioperative use of anti-inflammatory corticosteroids has long been recommended to improve clinical outcomes. However, the efficacy and safety of steroids remain still unclear.Recent FindingsWe reviewed recent published literature, including the large clinical trials DECS and SIRS and the two meta-analysis by Dvirnik et al. (2018) and Ng et al. (2020), on mortality and major postop...
Source: Current Anesthesiology Reports - August 10, 2021 Category: Anesthesiology Source Type: research

The application of European system for cardiac operative risk evaluation II (EuroSCORE II) and Society of Thoracic Surgeons (STS) risk-score for risk stratification in Indian patients undergoing cardiac surgery.
Conclusions: EuroSCORE II and STS risk-scores have satisfactory calibration power in Indian patients but their discriminatory power is poor. Mortality risk was over-estimated by both the scoring systems in high-risk patients. The present study highlights the need for forming a national database and formulating risk stratification tools to provide better quality care to cardiac surgical patients in India. PMID: 23816669 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - July 1, 2013 Category: Anesthesiology Authors: Borde D, Gandhe U, Hargave N, Pandey K, Khullar V Tags: Ann Card Anaesth Source Type: research

Patient with acute renal injury presenting dabigatran overdose: Hemodialysis for surgery.
We report a case of an 80-year-old man presenting hemorrhage with dabigatran overdose caused by obstructive acute renal failure. Before nephrostomy, several hemodialysis sessions were necessary to remove dabigatran probably because of its large volume of distribution. PMID: 24378048 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - December 27, 2013 Category: Anesthesiology Authors: Bachellerie B, Ruiz S, Conil JM, Crognier L, Seguin T, Georges B, Fourcade O Tags: Ann Fr Anesth Reanim Source Type: research

Increased Glycemic Variability in Patients with Elevated Preoperative HbA1C Predicts Adverse Outcomes Following Coronary Artery Bypass Grafting Surgery.
CONCLUSIONS: Postoperative glycemic variability is associated with MAEs after cardiac surgery. Glycemic variability is only measured when the patient leaves the intensive care unit, and there is no opportunity to intervene earlier. Preoperative HbA1C identifies risk for postoperative glycemic variability and may provide a more rational guide for targeting measures to reduce variability. PMID: 24445629 [PubMed - in process]
Source: Anesthesia and Analgesia - January 24, 2014 Category: Anesthesiology Authors: Subramaniam B, Lerner A, Novack V, Khabbaz K, Paryente-Wiesmann M, Hess P, Talmor D Tags: Anesth Analg Source Type: research

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

Remote Ischemic Preconditioning Reduces Cardiac Troponin I Release in Cardiac Surgery: A Meta-Analysis
Conclusions: Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 7, 2013 Category: Anesthesiology Authors: Lijing Yang, Guyan Wang, Yingjie Du, Bingyang Ji, Zhe Zheng Tags: Original Articles Source Type: research

EuroSCORE II and N-terminal pro-B-type natriuretic peptide for risk evaluation: an observational longitudinal study in patients undergoing coronary artery bypass graft surgery
Conclusions Combining EuroSCORE II and preoperative NT-proBNP appears to improve risk prediction with regard to severe circulatory failure after isolated CABG for ACS. NT-proBNP may be particularly useful in patients at intermediate risk according to EuroSCORE II. Clinical trial registration NCT00489827.
Source: British Journal of Anaesthesia - June 18, 2014 Category: Anesthesiology Authors: Holm, J., Vidlund, M., Vanky, F., Friberg, O., Hakanson, E., Walther, S., Svedjeholm, R. Tags: Cardiovascular Source Type: research

The impact of anesthesiologists on coronary artery bypass graft surgery outcomes.
CONCLUSIONS: The rate of death or major complications among patients undergoing coronary artery bypass graft surgery varies markedly across anesthesiologists. These findings suggest that there may be opportunities to improve perioperative management to improve outcomes among high-risk surgical patients. PMID: 25695571 [PubMed - in process]
Source: Anesthesia and Analgesia - February 21, 2015 Category: Anesthesiology Authors: Glance LG, Kellermann AL, Hannan EL, Fleisher LA, Eaton MP, Dutton RP, Lustik SJ, Li Y, Dick AW Tags: Anesth Analg Source Type: research

Perioperative glucose monitoring and treatment of patients undergoing vascular surgery in a community hospital setting.
This article discusses the glucose monitoring and treatment practices of a small community hospital and aims to determine how these practices relate to postoperative complications in patients undergoing vascular surgery. Previous studies in patients undergoing cardiovascular surgery have demonstrated that glucose control directly affects outcomes, including length of stay and incidence of infection, stroke, renal failure, myocardial infarction, and readmissions within 30 days of the initial surgery. A retrospective analysis of 101 patients who underwent vascular surgery was performed. After informed consent was obtained, p...
Source: AANA Journal - December 1, 2014 Category: Anesthesiology Authors: Morrison S, O'Donnell J, Ren D, Henker R Tags: AANA J Source Type: research

Feasibility of Report Cards for Measuring Anesthesiologist Quality for Cardiac Surgery.
CONCLUSIONS: The impact of anesthesiologists on the total variability in cardiac surgical outcomes was probably about one-fourth as large as the surgeons' contribution. None of the anesthesiologists caring for cardiac surgical patients in New York State over a 3+ year period were identified as performance outliers. The use of a performance metric based on death or major complications for P4P may not be feasible for cardiac anesthesiologists. PMID: 27101502 [PubMed - in process]
Source: Anesthesia and Analgesia - April 24, 2016 Category: Anesthesiology Authors: Glance LG, Hannan EL, Fleisher LA, Eaton MP, Dutton RP, Lustik SJ, Li Y, Dick AW Tags: Anesth Analg Source Type: research

Impact of aspirin use on morbidity and mortality in massively transfused cardiac surgery patients: a propensity score matched cohort study
Conclusions Preoperative aspirin use is not associated with decreased in-hospital mortality in massively transfused cardiac surgery patients, but may be associated with less mechanical lung ventilation time.
Source: Journal of Anesthesia - July 4, 2016 Category: Anesthesiology Source Type: research

Acute risk change (ARC) identifies outlier institutions in perioperative cardiac surgical care when the standardized mortality ratio cannot
Conclusions Acute risk change was able to discriminate between units where SMR could not. Outliers had more adverse events. Acute risk change can be calculated before mortality outcome and identifies outliers with lower patient numbers. This may allow early recognition and investigation of outlier units.
Source: British Journal of Anaesthesia - July 19, 2016 Category: Anesthesiology Authors: Coulson, T. G., Bailey, M., Reid, C. M., Tran, L., Mullany, D. V., Parker, J., Hicks, P., Pilcher, D. Tags: Cardiovascular Source Type: research

Immediate ICU Care for Patients Following Aortic Arch Surgery
Patients undergoing aortic arch surgery are at high risk for stroke, delirium, low cardiac output, respiratory failure, renal failure, and coagulopathy. A significantly higher mortality is seen in patients experiencing any of these complications when compared with those without complications. As surgical, perfusion, and anesthetic techniques improve, the incidence of major complications have decreased. A recent paradigm shift in cardiac surgery has focused on rapid postoperative recovery, and a similar change has affected the care of patients after arch surgery. Nevertheless, a small subset of patients experience significa...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Hlaing, M. Tags: Reviews Source Type: research

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