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Predicting Postoperative Atrial Fibrillation: The Search Continues
Atrial fibrillation (AF) has an incredibly large burden on the American health system with approximately 454,000 annual hospital admissions as the primary diagnosis.1 Unfortunately, AF is not a benign entity, with a reported underlying primary cause of death in 26,535 people in 2019 according to the CDC.2 AF is the cause of 1 in 7 strokes,3 and increases the risk of ischemic stroke five-fold.4 These statistics are alarming when it is considered that the incidence of postoperative atrial fibrillation (POAF) has been reported to be as high as 65% after cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 12, 2022 Category: Anesthesiology Authors: Kenneth R. Hassler, Harish Ramakrishna Tags: Editorial Source Type: research

Neurological Injury in COVID-19 Patients Who Receive VV-ECMO Therapy: A Cohort Study
Both thrombotic and bleeding events have been implicated in the progression of Coronavirus disease 2019 (COVID-19).1,2 Such dysregulation of coagulation has been associated with poor prognosis.3,4 Neurologic sequelae, such as ischemic stroke and intracranial hemorrhage (ICH), have been reported in COVID-19 patients at rates of 0.9%-2.3% and 0.9%, respectively.5,6,7,8 Limited data exists on neurological events in COVID-19 patients in the intensive care unit (ICU) who require extracorporeal membrane oxygenation (ECMO) due to severe acute respiratory distress syndrome (ARDS).
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2021 Category: Anesthesiology Authors: Nivedha V. Kannapadi, Meghana Jami, Lavienraj Premraj, Eric W. Etchill, Katherine Giuliano, Errol L. Bush, Bo Soo Kim, Stella Seal, Glenn Whitman, Sung-Min Cho Tags: Letter to the Editor Source Type: research

Neurologic Injury in Patients With COVID-19 Who Receive VV-ECMO Therapy: A Cohort Study
THROMBOTIC AND BLEEDING events have been implicated in the progression of coronavirus disease 2019 (COVID-19).1,2 This dysregulation of coagulation has been associated with poor prognoses.3,4 Neurologic sequelae, such as ischemic stroke and intracranial hemorrhage (ICH), have been reported in patients with COVID-19 at rates of 0.9%-to-2.3% and 0.9%, respectively.5,6,7,8 Limited data exist on neurologic events in patients with COVID-19 in the intensive care unit who require extracorporeal membrane oxygenation (ECMO) due to severe acute respiratory distress syndrome (ARDS).
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2021 Category: Anesthesiology Authors: Nivedha V. Kannapadi, Meghana Jami, Lavienraj Premraj, Eric W. Etchill, Katherine Giuliano, Errol L. Bush, Bo Soo Kim, Stella Seal, Glenn Whitman, Sung-Min Cho Tags: Letters to the Editor Source Type: research

Cerebral Oximetry Monitoring in Patients Undergoing Surgery for Stanford Type-A Aortic Dissection
Brain ischemic injury is a frequent complication occurring after surgery for Stanford Type A aortic dissection (TAAD).1,2 In these patients, acute neurological events are often present at admission and are further aggravated or induced by perioperative hypotension, severe anemia, hypothermic circulatory arrest and extensive surgical repair.1,2 Postoperative stroke in TAAD patients is associated with markedly increased risk of early and mid-term mortality.3 Non-invasive monitoring of oxygen delivery to the brain has the potential to guide therapeutic interventions during the perioperative period to prevent these neurologica...
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 13, 2020 Category: Anesthesiology Authors: Fausto Biancari, Mikko Jormalainen, Peter Raivio, Caius Mustonen, Hannu-Pekka Honkanen, Johanna Valo, Antti Vento, Tatu Juvonen Tags: Original Article Source Type: research

Left Atrial Myxoma Presenting as Cerebral Infarct
ACUTE embolic cerebral stroke is a major health setback for any individual, with increased mortality and morbidity. Embolus arising from cardiac chambers constitutes about 20% of ischemic strokes. Atrial fibrillation is the root cause of more than 50% of cardiogenic emboli, whereas congenital heart diseases, such as atrial septal defect, patent foramen ovale, prosthetic heart valves, rheumatic heart valvular disease, dilated cardiomyopathy, and endocarditis are predisposing factors for cardiogenic emboli.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 5, 2020 Category: Anesthesiology Authors: Hemant Digambar Waikar, Aylliath Gosalakkal Jayakrishnan, Bodiabaduge Senaka Nimalakeerthi Bandusena, Prakash Priyadarshan, Peter Parthepan Kamalaneson, Abhaya Ileperuma, Praveen Kumar Neema, Richa Dhawan, Mark A. Chaney Tags: Case Conference Source Type: research

Left Atrial Myxoma Presenting as Cerebral Embolism
ACUTE embolic cerebral stroke is a major health setback for any individual, with increased mortality and morbidity. Embolus arising from cardiac chambers constitutes about 20% of ischemic strokes. Atrial fibrillation is the root cause of more than 50% of cardiogenic emboli, whereas congenital heart diseases, such as atrial septal defect, patent foramen ovale, prosthetic heart valves, rheumatic heart valvular disease, dilated cardiomyopathy, and endocarditis are predisposing factors for cardiogenic emboli.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 5, 2020 Category: Anesthesiology Authors: Hemant Digambar Waikar, Aylliath Gosalakkal Jayakrishnan, Bodiabaduge Senaka Nimalakeerthi Bandusena, Prakash Priyadarshan, Peter Parthepan Kamalaneson, Abhaya Ileperuma, Praveen Kumar Neema, Richa Dhawan, Mark A. Chaney Tags: Case Conference Source Type: research

Postcardiac Surgery Acute Stroke Therapies: A Systematic Review
To identify interventions for the treatment of acute ischemic stroke after cardiac surgery and to report the efficacy of these treatments.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2020 Category: Anesthesiology Authors: Hessam H. Kashani, Lucas Mosienko, Bronwen B. Grocott, Bryan A. Glezerson, Hilary P. Grocott Tags: Original Article Source Type: research

Increased Risk of Perioperative Ischemic Stroke in Patients Who Undergo Noncardiac Surgery with Preexisting Atrial Septal Defect or Patent Foramen Ovale
To evaluate whether a preoperative diagnosis of atrial septal defect (ASD) or patent foramen ovale (PFO) is associated with perioperative stroke in noncardiac surgery and their outcomes.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 28, 2020 Category: Anesthesiology Authors: Pedro A. Villablanca, Alejandro Lemor, Chak-Yu So, Guson Kang, Tarun Jain, Tanush Gupta, Tomo Ando, Divyanshu Mohananey, Sagar Ranka, Dagmar F. Hernandez-Suarez, Pablo Michel, Tiberio Frisoli, Dee Dee Wang, Marvin Eng, William O'Neill, Harish Ramakrishna Tags: Original Article 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

Stroke at 4 Years Unravels a Rare Diagnosis
ISCHEMIC stroke in children is very rare, with a reported incidence of 2 to 13 cases per 100,000 children.1 Tumors, endocarditis, vasculopathy, thrombotic disorders, and inflammatory disorders are the usual causes of an ischemic stroke in children.2,3 Transient cutaneous eruptions involving the extremities often precede the onset of neurologic symptoms in children with cardiac myxomas.4 Very few cases of ischemic stroke resulting from myxoma in children younger than 18 years have been reported in the literature.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 5, 2019 Category: Anesthesiology Authors: Madan Mohan Maddali, Pranav Subbaraya Kandahar, Ramachandhiran Venkatachlam, Sunny Zacharias Tags: Case Report Source Type: research

A Case-Based Discussion on the Management of Cryptogenic Stroke and Patent Foramen Ovale in the Patient With a Hypercoagulable Disorder
UP TO 40% of all ischemic strokes are considered cryptogenic, implying a stroke without a definitive etiology.1,2 With a dearth of evidence-guided treatment strategies, the literature surrounding cryptogenic stroke is highly variable and not well-standardized. Even though existing guidelines do not specify the exact testing required, the cryptogenic stroke evaluation includes a variety of imaging modalities (eg, echocardiography, angiography, magnetic resonance imaging, carotid ultrasound) and laboratory investigations (eg, genetic testing, hypercoagulable disorder panels, erythrocyte sedimentation rate).
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 27, 2019 Category: Anesthesiology Authors: Neal S. Gerstein, Stacey D. Clegg, Daniel B. Levin, Adam C. Fish, Kirsten Tolstrup, Koki Nakanishi, Yuriko Yoshida, Shunichi Homma Tags: Case Conference Source Type: research

Intraoperative Stroke During Robotic Totally Endoscopic Coronary Artery Bypass
THE INCIDENCE OF stroke after coronary artery bypass graft (CABG) surgery is between 1% and 5% and is one of the most detrimental complications.1 Off-pump CABG is associated with a lower stroke rate than traditional on-pump CABG (0.7% v 1.4%).2 Stroke after CABG is associated with increased morbidity and mortality and increased cost secondary to longer hospital stays and rehabilitation. The authors ’ presented case demonstrates the complexity of perioperative management of a patient scheduled for elective off-pump total endoscopic coronary artery bypass (TECAB) grafting with recent transient ischemic attack (TIA), stroke...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 7, 2019 Category: Anesthesiology Authors: Jennette D. Hansen, Mark A. Chaney, Michael Essandoh, Jean Starr, BobbieJean Sweitzer Tags: Case Conference 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

Perioperative Acute Ischemic Stroke Increases Mortality After Noncardiac, Nonvascular, and Non-Neurologic Surgery: A Retrospective Case Series
To identify the predictors of in-hospital mortality in patients who develop perioperative acute ischemic stroke (PAIS) associated with noncardiac, nonvascular, and non-neurologic surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 3, 2019 Category: Anesthesiology Authors: Hong Wang, Shuang-ling Li, Jing Bai, Dong-xin Wang Tags: Original Article Source Type: research

Short-Term Outcomes After Off-Pump or On-Pump Coronary Artery Bypass Grafting in the Octogenarian Patients
Despite large randomized controlled trials demonstrating similar outcomes for of-pump or on-pump coronary artery bypass grafting, the debate between proponents of each technique remains current.1 On-pump technique improves surgical exposure on a nonbeating heart but exposes the patient to a powerful inflammatory response and to ischemic stroke owing to cross clamping and cannulation. Off-pump coronary artery bypass (OPCAB) may reduce blood transfusion, postoperative length of hospital stay, postoperative neurocognitive decline, and systemic anticoagulation, but heart repositioning may be associated with hemodynamic instabi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 2, 2019 Category: Anesthesiology Authors: B érénice Tiquet, Jean David Blossier, Isabelle Orsel, Frank Pihan, Alessandro Piccardo, Jean Phillippe Marsaud, David Vandroux Tags: Letter to the Editor Source Type: research

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