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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 16 results found since Jan 2013.
Combined coronary and carotid artery disease: what to operate on first? or both at the same time?
Heart disease and stroke rank amongst the top four leading causes of death in the United States.1 Studies have demonstrated a positive correlation between the two, even suggesting that carotid artery disease may predict the presence of coronary artery disease (CAD).2,3 In fact, some have found that the prevalence of carotid artery stenosis (CAS) in those undergoing coronary artery bypass grafting (CABG) may be as high as 8-14%.4 Despite such co-existence, there remains no clear consensus Guidelines for revascularization in patients with co-existing CAD and CAS.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 20, 2023 Category: Anesthesiology Authors: Sherman Yu, Mark A. Chaney Tags: Case Conference Source Type: research
Invited Commentary on the Postpartum Preeclampsia ECMO Case Conference
PREGNANCY, DESPITE its common nature and reputation as a “natural stage” of female existence, has profound physiologic effects. The cardiovascular system evolves as early as 6 weeks' gestation to establish appropriate uteroplacental circulation to support a growing fetus and supply the increased demands on maternal metabolism.1 Cardiac output increase s throughout pregnancy and can reach up to 150% of prepregnancy levels by the twenty-fourth week, and is largely achieved by an increase in stroke volume; cardiac magnetic resonance imaging demonstrates increases in left ventricular end-diastolic volume and left ventricular mass.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 8, 2023 Category: Anesthesiology Authors: Kristin Constantine Trela Tags: Invited Commentary Source Type: research
Invited Commentary to Postpartum Preeclampsia ECMO Case Conference
Pregnancy, despite its common nature and reputation as a “natural stage” of female existence, has profound physiological effects. The cardiovascular system evolves as early as six weeks gestation to establish appropriate uteroplacental circulation to support a growing fetus and supply the increased demands on maternal metabolism.1 Cardiac output incre ases throughout pregnancy and can reach up to 150% of pre-pregnancy levels by the twenty-fourth week and is largely achieved by an increase in stroke volume; cardiac magnetic resonance imaging demonstrates an increase in left ventricular end diastolic volume and left ventricular mass.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 8, 2023 Category: Anesthesiology Authors: Dr. Kristin Constantine Trela Tags: Invited Commentary Source Type: research
Opioid-Free Cardiac Surgery: A Multimodal Pain Management Strategy With a Focus on Bilateral Erector Spinae Plane Block Catheters
CARDIAC SURGERY REQUIRING STERNOTOMY presents unique challenges for perioperative and postoperative analgesia. Intraoperatively, the sympathetic response to surgical stimulation must be modulated carefully to prevent excessive bleeding, maintain the integrity of surgical repairs, and decrease the risk of stroke or iatrogenic aortic injury without compromising myocardial and systemic perfusion. This must be achieved in patients whose underlying abnormal physiology, coupled with the effects of the surgical procedure, often result in tenuous hemodynamics.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 7, 2022 Category: Anesthesiology Authors: Nabil K. Thalji, Saumil Jayant Patel, John G. Augoustides, Robin J Schiller, Adam A. Dalia, Yinghui Low, Rawad I. Hamzi, Rohesh J. Fernando Tags: Case Conference Source Type: research
Opioid Free Cardiac Surgery: A Multimodal Pain Management Strategy with a Focus on Bilateral Erector Spinae Plane Block Catheters
Cardiac surgery requiring sternotomy presents unique challenges for perioperative and postoperative analgesia. Intraoperatively, the sympathetic response to surgical stimulation must be carefully modulated to prevent excessive bleeding, maintain the integrity of surgical repairs, and decrease the risk of stroke or iatrogenic aortic injury without compromising myocardial and systemic perfusion. This must be achieved in patients whose underlying abnormal physiology coupled with the effects of the surgical procedure often result in tenuous hemodynamics.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 7, 2022 Category: Anesthesiology Authors: Nabil K. Thalji, Saumil Jayant Patel, John G. Augoustides, Robin J Schiller, Adam A Dalia, Yinghui Low, Rawad I. Hamzi, Rohesh J. Fernando Tags: Case Conference Source Type: research
DUPLICATE: Combined Stroke and Spinal Cord Infarction in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.endend.2014.06.001. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 11, 2022 Category: Anesthesiology Authors: Hamdy Awad, Arwa Raza, Samiya Saklayen, Sujatha Bhandary, Hesham Kelani, Ciaran Powers, Eric Bourekas, Michael Essandoh Tags: Case Conference Source Type: research
Combined Stroke and Spinal Cord Infarction in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery
Introduction
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 11, 2022 Category: Anesthesiology Authors: Hamdy Awad, Arwa Raza, Samiya Saklayen, Sujatha Bhandary, Hesham Kelani, Ciaran Powers, Eric Bourekas, Michael Essandoh Tags: Case Conference Source Type: research
Combined Stroke and Spinal Cord Ischemia in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery
AORTIC ARCH PATHOLOGY, as a part of acute aortic syndrome, is a difficult clinical problem to address. Whether it presents as an intramural hematoma with impending rupture, isolated aneurysmal disease, or acute localized dissection, it creates a clinical challenge to the perioperative team. Some of the difficulty stems from determining the best operative strategy, either an open approach, total endovascular repair, or a hybrid of the two. Hybrid aortic arch repair involves two steps: open aortic branch revascularization and endovascular aortic repair.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 24, 2021 Category: Anesthesiology Authors: Hamdy Awad, Arwa Raza, Samiya Saklayen, Sujatha Bhandary, Hesham Kelani, Ciaran Powers, Eric Bourekas, Ian Stine, Ross Milner, Elizabeth Valentine, Michael Essandoh Tags: Case Conference Source Type: research
Cardiac disease in pregnancy: hypertrophic obstructive cardiomyopathy and pulmonic stenosis
The prevalence of cardiovascular disease in pregnancy is increasing and cardiovascular disease is the leading cause of pregnancy-related death in the United States.1 The physiologic adaptations to pregnancy include an increased heart rate, stroke volume, and substantial expansion in circulatory volume, which may pose significant cardiac stress to patients with cardiac disease. During labor, cardiac output increases further and maternal expulsive efforts during the second stage of labor, with the decreased preload and increased afterload that accompany the Valsalva maneuver, may provoke decompensation in vulnerable patients.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2021 Category: Anesthesiology Authors: David E. Arnolds, Chad Dean, Mohammed Minhaj, William T. Schnettler, Jennifer Banayan, Mark A. Chaney Tags: Case Conference 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
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
Transcatheter Aortic Valve Replacement After Intraoperative Discovery of Porcelain Aorta in a Patient With Aortic Stenosis
PORCELAIN AORTA IS a major risk factor for stroke after cardiac surgery and may prompt alterations in surgical technique.1,2 Transcatheter aortic valve replacement (TAVR) has become a preferred treatment for patients with aortic stenosis and porcelain aorta.2 –4 Although TAVR has become a common procedure worldwide, this procedure typically is characterized by extensive preprocedural planning by a multidisciplinary heart team.5–9 This case conference describes a scenario in which TAVR was performed successfully on an urgent basis after intraoperative discovery of a porcelain aorta in a patient with severe aortic stenos...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 17, 2016 Category: Anesthesiology Authors: Rohesh Fernando, Jacob T. Gutsche, John G.T. Augoustides, Jeremy D. Kukafka, Warren Spitz, Jonathan Frogel, Michael Fabbro, Prakash A. Patel Tags: Case ConferenceVictor C. Baum, MDSection Editors? > Source Type: research
CASE 9—2015 Anesthetic Management of a Patient With Esophago-Pericardial Fistula Complicating Atrial Fibrillation Radiofrequency Ablation
ATRIAL FIBRILLATION (AF) REMAINS the most common arrhythmia in the elderly population.1,2 Treatment of AF is tailored toward rhythm and heart rate control using antiarrhythmic medications and anticoagulation therapy to prevent embolic stroke. However, antiarrhythmic therapy fails in a significant number of patients. Drug-refractory AF currently is managed with catheter ablation (CA) procedures, which are associated with a complication rate of about 5% and a mortality rate of approximately 0.001%.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 16, 2015 Category: Anesthesiology Authors: Michael Essandoh, Andrew J Otey, Juan Crestanello, Jonathan Keshishian, Patrick G. Brady, Rebecca M. Gerlach Tags: Case Conferences Source Type: research
