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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

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

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

Cerebral fungal infections as a cause of stroke in cardiac surgery patients: Be Cautious!!
Neurological dysfunction in the postoperative period following cardiac surgery is most commonly attributed to thromboembolism or an intracranial bleed. Fungal infection is a rare cause of cerebral infarction and hemiparesis in an otherwise healthy patient. Cerebral Aspergillus infections are common in immunocompromised patients and is not considered as the first-line differential diagnosis of cerebral infarcts in a cardiac surgery patient. The infection is usually a secondary from lung, paranasal sinuses, or heart and forms microthrombi in large or medium sized cerebral vessels.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 30, 2023 Category: Anesthesiology Authors: Avneet Singh, Arushi Goyal, Manpreet Singh, Sidharth Garg, Sandeep Moudgil, Vipin Gupta Tags: Letter to the Editor Source Type: research

Postpartum Preeclampsia and Extracorporeal Membrane Oxygenation
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

Right Ventricular Failure after Left Ventricular Assist Device Placement —Have We Finally Arrived at the Crux of the Matter?
Pre-left ventricular assist device (LVAD) risk stratification is integral in identifying patients predisposed to right ventricular failure (RVF).1 To date, clinical scoring models such as the Michigan Risk Score in conjunction with specific hemodynamic parameters obtained from the preoperative right heart catheterization, including central venous pressure (CVP), CVP/pulmonary capillary wedge pressure, and right ventricular stroke work index, have been the cornerstone of post-LVAD RVF risk stratification.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 5, 2023 Category: Anesthesiology Authors: Manoj H. Iyer, Nicolas Kumar, Jonathan E. Tang, Leonid Gorelik Tags: Letter to the Editor Source Type: research

Blood Transfusions In Elective Cardiac Surgery- The debate continues
In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Sanaiha et al presented a manuscript entitled “Morbidity and Mortality Associated with Blood Transfusions in Elective Adult Cardiac Surgery.” The authors looked at the association between transfusions of stored packed red blood cells (pRBC) or coagulation products (CP), and the increased risk of 30 day mortality, prolonged mechanical ventil ation, acute kidney injury and stroke in patients undergoing elective cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 26, 2023 Category: Anesthesiology Authors: Sofia A Lifgren, Robert Scott Fiala, Michael Fabbro Tags: Editorial Source Type: research

Blood Transfusions in Elective Cardiac Surgery: The Debate Continues
In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Sanaiha et al. presented a manuscript entitled “Morbidity and Mortality Associated With Blood Transfusions in Elective Adult Cardiac Surgery.” The authors examined the association between transfusions of stored packed red blood cells (pRBC) or coagulation products (CP) and the increased risk of 30-day mortality, prolonged mechanical ventilat ion, acute kidney injury, and stroke in patients undergoing elective cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 26, 2023 Category: Anesthesiology Authors: Sofia A. Lifgren, Robert Scott Fiala, Michael Fabbro Tags: Editorial Source Type: research

The Price of Keeping the Rhythm: Increased Bleeding Risk in Patients with Atrial Fibrillation Concurrently Prescribed Amiodarone and Factor Xa Inhibitors
Atrial fibrillation is the most common sustained cardiac arrhythmia affecting nearly 2% of the population of the United States.1 Patients with atrial fibrillation are twice as likely to have a myocardial infarction and five-times as likely to have a stroke.1 Current guidelines recommend antiarrhythmic pharmacotherapy in patients with symptomatic atrial fibrillation as first-line management.2-4 Amiodarone is a very effective, and therefore, a commonly prescribed agent for this purpose.5 Anticoagulation is a key tenet in the management of atrial fibrillation due to the increased tendency of left atrial appendage clot formati...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 10, 2023 Category: Anesthesiology Authors: Nicolas Kumar, Manoj H. Iyer, Adam Dalia, Amit Bardia Tags: Editorial Source Type: research

Hypothermic Circulatory Arrest (HCA) In Adult Aortic Arch Surgery: A Review of HCA and its Anesthetic Implications
Diseases affecting the aortic arch often require surgical intervention. Hypothermic circulatory arrest (HCA) enables a safe approach during open aortic arch surgeries. Additionally, HCA provides neuroprotection by reducing cerebral metabolism and oxygen requirements. However, HCA comes with significant risk (e.g. neurologic dysfunction, stroke, and coagulopathy), and it is important for the cardiac anesthesiologist to have a complete understanding of the surgical techniques, possible complications, and management strategies.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 22, 2023 Category: Anesthesiology Authors: Samit Ghia, Andre Savadjian, DaWi Shin, Gabriele Diluozzo, Menachem M. Weiner, Himani V. Bhatt Tags: Expert Review Source Type: research

Hypothermic Circulatory Arrest in Adult Aortic Arch Surgery: A Review of Hypothermic Circulatory Arrest and its Anesthetic Implications
Diseases affecting the aortic arch often require surgical intervention. Hypothermic circulatory arrest (HCA) enables a safe approach during open aortic arch surgeries. Additionally, HCA provides neuroprotection by reducing cerebral metabolism and oxygen requirements. However, HCA comes with significant risks (eg, neurologic dysfunction, stroke, and coagulopathy), and the cardiac anesthesiologist must completely understand the surgical techniques, possible complications, and management strategies.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 22, 2023 Category: Anesthesiology Authors: Samit Ghia, Andre Savadjian, DaWi Shin, Gabriele Diluozzo, Menachem M. Weiner, Himani V. Bhatt Tags: Expert Review Source Type: research

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

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