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Analysis of the ESC/EACTS 2020 Atrial Fibrillation Guidelines with Perioperative Implications
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide with an individual lifetime risk of approximately 37% in the United States. Broadly defined as a supraventricular tachyarrhythmia with disorganized atrial activation, AF results in an increased risk of stroke, heart failure (HF), valvular heart disease (VHD), impaired quality of life and confers a significant burden to the health of individuals and society. AF in the perioperative setting is common and a significant source of perioperative morbidity and mortality worldwide.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 15, 2021 Category: Anesthesiology Authors: James A. Nelson, Ying X. Gue, Jon M. Christensen, Gregory Y.H. Lip, Harish Ramakrishna Tags: Expert Review Source Type: research

Predicting Post –Liver Transplant Outcomes—Rise of the Machines or a Foggy Crystal Ball?
ALTHOUGH LIVER transplantation (LT) provides a life-saving therapy to thousands of patients per year, many more die while awaiting transplantation resulting from critical organ shortages. Due to these shortages, patient selection is of paramount importance. Liver transplant programs strive to select recipients with high expected gains in life expectancy and low risks of complications. Major adverse cardiovascular events (MACE), such as myocardial infarction, heart failure, and stroke, may occur in approximately 23% of LT recipients within six months of transplantation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2021 Category: Anesthesiology Authors: Matthew W. Vanneman, Vikram Fielding-Singh, Nima Aghaeepour Tags: Editorial Source Type: research

Predicting post-liver transplant outcomes —rise of the machines or a foggy crystal ball?
Although liver transplantation (LT) provides a life-saving therapy to thousands of patients per year, many more die while awaiting transplantation due to critical organ shortages. Due to these shortages, patient selection is of paramount importance. Liver transplant programs strive to select recipients with high expected gains in life expectancy and low risks of complications. Major adverse cardiovascular events (MACE), such as myocardial infarction, heart failure, and stroke, may occur in approximately 23% of LT recipients within 6 months of transplantation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2021 Category: Anesthesiology Authors: Matthew W. Vanneman, Vikram Fielding-Singh, Nima Aghaeepour Tags: Editorial Source Type: research

CHA2DS2-VASc Score and In-Hospital Mortality in Critically Ill Patients With New-Onset Atrial Fibrillation
To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF).
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2019 Category: Anesthesiology Authors: Kunal Karamchandani, Robert S. Schoaps, Thomas Abendroth, Zyad J. Carr, Tonya S. King, Anthony Bonavia Tags: Original Article Source Type: research

Left Atrial Thrombus Formation in a Patient With Severe Non-rheumatic Mitral Stenosis After Mitral Valve Repair Receiving Dual Antiplatelet Therapy: A Clinical Challenge
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 10, 2019 Category: Anesthesiology Authors: Michael Essandoh, Amir Elhassan, Thomas J. Papadimos, Brandon Pruett, Gregory D. Rushing Tags: Diagnostic Dilemma Source Type: research

Decannulation of a Ventricular Assist Device
BECAUSE OF the donor organ shortage, an increasing number of patients with advanced heart failure are receiving ventricular assist devices (VADs) as a bridge to transplantation or as a destination therapy.1 Patients with advanced heart failure who receive a VAD have significantly greater survival rates compared with those who are treated with only medication.2 However, short- and long-term complications of VADs still are a major concern.3 There are perioperative risks attributed to patient comorbidities; risks of surgery and anesthesia; and postoperative risks such as bleeding, thrombosis, stroke, infection, right ventricu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 4, 2018 Category: Anesthesiology Authors: Tuan-Yen Wu Tags: Case Report Source Type: research

Efficacy and Efficiency of Perioperative Stellate Ganglion Blocks in Cardiac Surgery: A Pilot Study
Nationally, postoperative atrial fibrillation (POAF) occurs in up to 40% of patients after coronary artery bypass grafting (CABG), 50% of patients after valve surgery, 64% of patients after mitral valve and CABG, and 49% after aortic valve replacement.1 Atrial fibrillation worsens a patient ’s hemodynamic status and increases the risk of congestive heart failure, embolic events, and longer intensive care unit stays, leading to increased patient morbidity and strain on financial resources. In the United States, POAF carries a higher risk of stroke, worsened survival, and an additional 4.9 days and $10,000 to $11,500 in hospital stay costs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 20, 2017 Category: Anesthesiology Authors: Christopher W. Connors, Wendy Y. Craig, Scott A. Buchanan, Justin M. Poltak, James B. Gagnon, Craig S. Curry Tags: Letter to the Editor Source Type: research

Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study
To examine the impact of postoperative acute kidney injury (AKI) on the long-term risk of myocardial infarction, heart failure, stroke, and all-cause mortality after elective cardiac surgery. The authors investigated whether time of onset of AKI altered the association between AKI and the adverse events.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 6, 2015 Category: Anesthesiology Authors: Malene Kærslund Hansen, Henrik Gammelager, Carl-Johan Jacobsen, Vibeke Elisabeth Hjortdal, J. Bradley Layton, Bodil Steen Rasmussen, Jan Jesper Andreasen, Søren Paaske Johnsen, Christian Fynbo Christiansen Tags: Original Articles Source Type: research