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Single Versus Multiarterial Grafts for Coronary Artery Bypass Graft Surgery: Analysis of Recent Data
ACCORDING TO THE Centers for Disease Control and Prevention, there are 37.3 million people with diabetes mellitus (DM) in the United States.1 The main cause of death for patients with DM, types 1 and 2, is coronary artery disease (CAD), with a 2- to 4-fold increased risk of mortality for heart disease.2 The trend of increased morbidity and mortality in patients with DM is likely due to its more complex and diffuse CAD pattern.3 Coronary artery bypass grafting (CABG) remains the gold standard compared to percutaneous coronary intervention for CAD in patients with DM, with reductions in mortality, myocardial infarction, and ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2023 Category: Anesthesiology Authors: Kenneth R. Hassler, Harish Ramakrishna Tags: Expert Review Source Type: research

Single vs Multi-Arterial Grafts for CABG - Analysis of Recent Data
According to the Center for Disease Control and Prevention (CDC) there are 37.3 million people with diabetes mellitus (DM) in the United States.1 The main cause of death for DM patients, type 1 and 2, is coronary artery disease (CAD), with a 2 to 4-fold increased risk of mortality for heart disease.2 The trend of increased morbidity and mortality in DM patients is likely due to its more complex and diffuse CAD pattern.3 Coronary artery bypass grafting (CABG) remains the gold standard when compared to percutaneous coronary intervention (PCI) for CAD in DM with a reduction in mortality, myocardial infarction, and stroke as d...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2023 Category: Anesthesiology Authors: Kenneth R. Hassler, Harish Ramakrishna Tags: Expert Review Source Type: research

Torsades de Pointes in Coronavirus Disease 2019 Infection
A 73-YEAR-OLD MAN (weight 69 kg, height 175 cm) was transferred to the authors ’ critical care unit with respiratory and acute renal failure secondary to coronavirus disease 2019 (COVID-19) infection. His past medical history included hypertension, diabetes, and previous stroke, from which he had made a full recovery. The patient was treated with mechanical ventilation and p eritoneal dialysis. He was recruited into the hydroxychloroquine arm of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2020 Category: Anesthesiology Authors: Bagrat Lalabekyan, Gudrun Kunst, Vanessa A. Skelton Tags: Diagnostic Dilemma Source Type: research

Incorporating Indices of Postoperative Glycemic Variability in Postoperative Outcome Prediction Modeling: How Accurate Can it Get?
PERIOPERATIVE hyperglycemia, as well as the amplitude and frequency of glycemic variation are associated with increased morbidity and mortality after cardiac surgery, regardless of diabetic state.1,2 In patients undergoing coronary artery bypass grafting surgery, early postoperative hyperglycemia (blood glucose concentration [BGC]>250 mg/dL) significantly increases the risks of postoperative complications (nonfatal stroke, myocardial infarction, sepsis, death).3
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 29, 2020 Category: Anesthesiology Authors: Kai Yin Hwang, Nian Chih Hwang 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

A Rare Cause of Stroke FourWeeks After Ascending Aortic Aneurysm Repair
A 71-YEAR-OLD, 97 kg, 178 cm man with a history of a slowly expanding 5.4 cm ascending aortic aneurysm, bicuspid aortic valve disease without stenosis, hypertension, hyperlipidemia, type II diabetes mellitus, and hemodynamically insignificant coronary artery disease underwent ascending aortic replacement using a woven synthetic graft. The patient's postoperative course was complicated by persistent sternal drainage that required exploration, evacuation of pericardial fluid, and antibiotic treatment, but he otherwise made an uneventful recovery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 4, 2018 Category: Anesthesiology Authors: Graham E.D. Hill, Patrick S. Aranda, Julie F. Harvey, Timothy J. Olund, G. Hossein Almassi, Lyle D. Joyce, Paul S. Pagel Tags: Diagnostic Dilemma Source Type: research

A Rare Cause of Stroke Four Weeks After Ascending Aortic Aneurysm Repair
A 71-YEAR-OLD, 97 kg, 178 cm man with a history of a slowly expanding 5.4 cm ascending aortic aneurysm, bicuspid aortic valve disease without stenosis, hypertension, hyperlipidemia, type II diabetes mellitus, and hemodynamically insignificant coronary artery disease underwent ascending aortic replacement using a woven synthetic graft. The patient's postoperative course was complicated by persistent sternal drainage that required exploration, evacuation of pericardial fluid, and antibiotic treatment, but he otherwise made an uneventful recovery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 3, 2018 Category: Anesthesiology Authors: Graham E.D. Hill, Patrick S. Aranda, Julie F. Harvey, Timothy J. Olund, G. Hossein Almassi, Lyle D. Joyce, Paul S. Pagel Tags: Diagnostic Dilemma Source Type: research

High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated With Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients
Conclusion: This large, uniquely matched single-center cohort was generated, and, subject to the listed limitations the authors concluded that supplemental HTEA to general anesthesia had a better outcome in low-risk cardiac surgery patients, with a significantly lower 6-month mortality rate compared with the control group. However, regression analysis revealed that HTEA only had an independently positive effect on the frequency of postoperative dialysis.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2013 Category: Anesthesiology Authors: Michael Stenger, Anja Fabrin, Henrik Schmidt, Jacob Greisen, Poul Erik Mortensen, Carl-Johan Jakobsen Tags: Original Article Source Type: research

HbA1c: A Prognostic Biomarker in the Surgical and Critically Ill Patient Population
HYPERGLYCEMIA CAN OCCUR as part of the catabolic response to stress. Acute hyperglycemia is associated with a poor outcome and increased mortality under a variety of clinical conditions, most notably myocardial infarction, stroke, and major surgical tissue trauma. Data from hospital admissions indicate that nondiabetic patients with newly diagnosed hyperglycemia have an increased risk of death. However, the evidence supporting a link between diabetes mellitus (DM) and increased mortality in critically ill and surgical patients is not as strong. This may be caused partly by the underdiagnosis of DM and, thereby, falsely lab...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 3, 2012 Category: Anesthesiology Authors: Justin Letourneau, Helen Bui, Thomas Schricker, Roupen Hatzakorzian Tags: Review Articles Source Type: research