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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 207 results found since Jan 2013.
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
Calcium Administration During Weaning From Cardiopulmonary Bypass: A Narrative Literature Review
The search for safe and effective patient management strategies during weaning from cardiopulmonary bypass is ongoing; intravenous calcium is occasionally used as a first-line drug. The physiologic role of calcium suggests that it can support the function of the cardiovascular system during this critical period. Patients may be mildly hypocalcemic after cardiopulmonary bypass; however, this degree of hypocalcemia does not significantly impair the cardiovascular system. The transient beneficial effects of calcium administration (increase in arterial blood pressure, systemic vascular resistance, cardiac index, stroke volume,...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2019 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Elizaveta A. Leonova, Alessandro Belletti, Vladimir A. Shmyrev, Giovanni Landoni Tags: Review Article Source Type: research
The Effect of Steroids in Patients Undergoing Cardiopulmonary Bypass: An Individual Patient Meta-Analysis of Two Randomized Trials
Steroids suppress the inflammatory response to cardiopulmonary bypass, but the impact on death at 30 days, myocardial infarction or injury, stroke, renal failure, respiratory failure, new atrial fibrillation, transfusion requirement, infection, and length of intensive care unit (ICU) and hospital stays are uncertain.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 6, 2019 Category: Anesthesiology Authors: Richard P. Whitlock, Jan M. Dieleman, Emilie Belley-Cote, Jessica Vincent, Michelle Zhang, P.J. Devereaux, Cor J. Kalkman, Diederik van Dijk, Salim Yusuf Tags: Original Article Source Type: research
Xenon Anesthesia: Is it in Due Course for a Mainstream Comeback?
HISTORICALLY, carotid endarterectomy (CEA) surgery has generated several disputes regarding the choice of anesthesia provided and intraoperative neuromonitoring. The landmark General Anesthesia versus Local Anesthesia trial,1 which included 3,526 patients, showed no difference in the occurrence of stroke, myocardial infarction, or death at 30 days after surgery with respect to either local or general anesthesia. Harky et al.2 conducted a systematic review and meta-analysis of general versus local anesthesia in CEA surgery and concluded that each of the anesthetic techniques was noninferior to one another.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 2, 2019 Category: Anesthesiology Authors: V. Melnyk, L. Fedorko, G. Djaiani 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
Socioeconomic Disparities in Carotid Revascularization Procedures
The objective of the present study was to examine the intersectionality between race/ethnicity, insurance status, and postoperative outcomes in carotid procedures.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2020 Category: Anesthesiology Authors: Latha Panchap, Seyed A. Safavynia, Virginia Tangel, Robert S. White Tags: Original Article Source Type: research
Con: Adult Cardiac Surgery Should Not Proceed in the Event of Cardiac Arrest After Induction of Anesthesia
IT IS ESTIMATED that in-hospital cardiac arrest occurs in greater than 290,000 adults each year in the United States.1 In-hospital cardiac arrest has received significantly less attention than other cardiovascular conditions with high risks of morbidity and mortality, such as myocardial infarction, stroke, and out-of-hospital cardiac arrest. Survival to discharge has been estimated at around only 25%. The etiology of in-hospital cardiac arrest is most often owing to cardiac causes (50%-60%), followed by respiratory insufficiency (15%-40%).
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 2, 2020 Category: Anesthesiology Authors: Hamdy Awad, Scott Smith, Islam Shehata, Samiya Saklayen Tags: Pro and Con Source Type: research
Congenital Mitral Stenosis
In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Montgomery et al. presented an interesting case of parachute mitral valve in a female young adult as a cause of mitral stenosis (MS) and cardiogenic embolic stroke.1 Because congenital MS very rarely is identified as a de novo diagnosis in the adult patient, a morphologic review of this lesion may be useful to the adult echocardiographer.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 3, 2020 Category: Anesthesiology Authors: Nelson H. Burbano Tags: Editorial Source Type: research
PFO! Should I Stay, or Should I Go?
IN THIS issue of the Journal of Cardiothoracic and Vascular Anesthesia, Villablanca et al. evaluated whether the presence and diagnosis of a patent foramen ovale (PFO) or atrial septal defect (ASD) preoperatively was associated with an increase in perioperative stroke for patients undergoing noncardiac surgery.1 The authors used “big data” to describe the largest study to date of 19,659,191 hospitalizations retrieved from the Healthcare Cost and Utilization Project's National Readmission Database.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 20, 2020 Category: Anesthesiology Authors: Yvonne Lai, Adam A. Dalia Tags: Editorial 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
Research Needs and Priorities for Catheter Ablation of Atrial Fibrillation
ATRIAL FIBRILLATION (AF) is the most common chronic arrhythmia encountered by physicians. According to the Framingham Heart Study, the lifetime risk of AF at age 80 is 22.7% in men and 21.7% in women.1 Silent AF occurs in about 30% of patients, and, unfortunately, the first clinical manifestation can be a stroke.2 Thus, early diagnosis and management with anticoagulation are imperative. AF may be paroxysmal, usually lasting for minutes to hours before spontaneously converting back to sinus rhythm.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2020 Category: Anesthesiology Authors: Roger L. Royster, Rohesh J. Fernando, Elijah H. Beaty Tags: Editorial Source Type: research
Closed-Loop Control of Vasopressor Administration in Patients Undergoing Cardiac Revascularization Surgery
INTRAOPERATIVE hypotension and arterial pressure variability have been shown to affect patient outcomes negatively, increasing the risk of stroke, kidney injury, and myocardical injury, among other conditions.1-5 Vasopressors normally are used to correct hypotension rapidly. Vasopressor infusions typically are administered by standard infusion pump, with the rate adjusted by bedside providers to reach a predefined target mean arterial pressure (MAP); this requires frequent changes in the infusion rate because of the almost constantly changing hemodynamic status of such patients.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 16, 2020 Category: Anesthesiology Authors: Joseph Rinehart, Maxime Cannesson, Sashini Weeraman, Luc Barvais, Luc Van Obbergh, Alexandre Joosten Tags: Case Report Source Type: research
Brain Oxygen Supply in Older Adults During Coronary Artery Bypass Grafting
The neurological complications after cardiovascular surgery are relatively frequent, and they generate high increases of morbidity and mortality [1, 2]. This problem is especially relevant for elderly patients, because neurological complications, including stroke, often lead to high mortality and poor long-term outcomes [3].
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 9, 2020 Category: Anesthesiology Authors: Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir V. Lomivorotov, Vladimir Shmyrev, Alexander Chernyavskiy Tags: Original Article Source Type: research
Device-Detected Subclinical Atrial Fibrillation: The Anesthesiologist's Perspective
A RECENT American Heart Association article published in Circulation in December 2019 discussed subclinical atrial fibrillation (SCAF). SCAF, per Noseworthy et al., is defined as asymptomatic atrial fibrillation (AF) episodes captured by various cardiac devices and confirmed by electrocardiogram (ECG) analysis. As more of these devices, including implantable cardiac, wearable, or intracardiac monitors, are implemented, the incidence of SCAF has and will continue to increase. SCAF presents a cardiologist with multiple quandaries, including the initiation of stroke prophylaxis, and if so, how to proceed.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 16, 2020 Category: Anesthesiology Authors: Samit Ghia, Davendra Mehta, Himani V. Bhatt Tags: Editorial Source Type: research
Doing Simple Things Well: Practice Advisory Implementation Reduces Atrial Fibrillation After Cardiac Surgery
Atrial Fibrillation After Cardiac Surgery (AFACS) is associated with increased morbidity, including thromboembolic stroke, renal failure, gastrointestinal complications, infections, and prolonged ventilation, and a significant increase in the risk of subsequent chronic atrial fibrillation.1-4 Furthermore, it is associated with an increase in mortality and hospital and intensive care unit length of stay.1,3 It has a persistently high incidence, ranging from 30% to more than 50%, depending on the type of surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 29, 2020 Category: Anesthesiology Authors: Martina Buerge, Rosalie Magboo, Dylan Wills, Ioannis Karpouzis, Damian Balmforth, Paul Cooper, Neil Roberts, Ben O'Brien Tags: Special Article Source Type: research
