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Source: Journal of Cardiothoracic and Vascular Anesthesia

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Total 207 results found since Jan 2013.

Effects of Body Surface Area-Indexed Calculations in the Morbidly Obese: A Mathematical Analysis
Conclusion: In morbidly obese patients, cardiac and stroke indices can be misleading relative to the underlying raw values (CO and SV) as a result of distortion by widely used BSA formulae. The authors caution against relying on threshold cardiac and stroke indices as triggers for the initiation of hemodynamic therapies in the morbidly obese. Further research on what BSA formula should be used on patients with very extreme body types is warranted.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 2, 2013 Category: Anesthesiology Authors: Adam C. Adler, Brian H. Nathanson, Karthik Raghunathan, William T. McGee Tags: Original Article Source Type: research

Detailed Insight Into the Impact of Postoperative Neuropsychiatric Complications on Mortality in a Cohort of Cardiac Surgery Subjects: A 23,000-Patient-Year Analysis
This study sought to evaluate the impact of postoperative delirium with/without cerebral ischemia on short- and long-term mortality in a large cohort of cardiac surgery patients.Design: The study constituted a prospective cohort observation of patients following various cardiac surgery procedures.Setting: The investigation was conducted in a single high-volume tertiary cardiac surgery center.Participants: Consecutive candidates for cardiac surgery (n = 8,792) from 2003 to 2008 were subjected to the following exclusion criteria: History of any psychiatric disorders, alcohol abuse and intake of psychoactive drugs and incompl...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 27, 2013 Category: Anesthesiology Authors: Łukasz J. Krzych, Maciej T. Wybraniec, Irena Krupka-Matuszczyk, Michał Skrzypek, Anna Bolkowska, Mirosław Wilczyński, Andrzej A. Bochenek Tags: Original Articles Source Type: research

Lack of Evidence for a Remote Effect of Renal Ischemia/Reperfusion Acute Kidney Injury on Outcome from Temporary Focal Cerebral Ischemia in the Rat
Objective: Acute kidney injury (AKI) and ischemic stroke may occur in the same cardiac surgical patient. It is not known if an interaction exists between these organ injuries. Isolated renal ischemia/reperfusion is associated with dysfunction in remote, otherwise normal organs, including the brain. In a rat model of simultaneous bilateral renal artery occlusion (BRAO) and middle cerebral artery occlusion (MCAO), the authors tested the hypothesis that AKI would worsen experimental stroke outcome. Design: Sixty thermoregulated anesthetized rats were randomized to (1) 40-minute BRAO, (2) 80-minute MCAO, or (3) simultaneous...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 30, 2012 Category: Anesthesiology Authors: Robert B. Yates, Huaxin Sheng, Hiroaki Sakai, Daniel T. Kleven, Noelle A. DeSimone, Mark Stafford-Smith, David S. Warner Tags: Original Articles Source Type: research

Predicting Fluid Responsiveness During Infrarenal Aortic Cross-Clamping in Pigs
Objective: Infrarenal aortic cross-clamping (ACC) induces hemodynamic disturbances that may affect respiratory-induced variations in stroke volume and, therefore, affect the ability of dynamic parameters such as pulse-pressure variation (PPV) to predict fluid responsiveness. Since this issue has not been investigated yet to authors’ knowledge, the hypothesis was tested that ACC may change PPV and impair its ability to predict fluid responsiveness.Design: Prospective laboratory experiment.Setting: A university research laboratory.Participants: Nineteen anesthetized and mechanically ventilated pigs.Interventions: Two cours...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 23, 2013 Category: Anesthesiology Authors: Matthieu Biais, Joachim Calderon, Mathieu Pernot, Laurent Barandon, Thierry Couffinhal, Alexandre Ouattara, François Sztark Tags: Original Article Source Type: research

Case 4–2015
ATRIAL FIBRILLATION (AF) is the most common cardiac arrhythmia in the world and is estimated to affect more than 3 million people in the United States, with a projected increase to more than 5 million people in the US by the year 2050.1 AF is an independent risk factor for stroke and is associated with a four- to five-fold increased risk of embolic stroke compared with those individuals without AF. Oral anticoagulation therapy with warfarin or other agents (dabigatran, apixaban) significantly reduces the risk of stroke in this population; however, anticoagulation carries inherent risks.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2015 Category: Anesthesiology Authors: Megan J. Lanigan, Mark A. Chaney, Sandeep Nathan, Atman P. Shah, Andrew J. Feider Tags: Case Conference Source Type: research

Carotid endarterectomy in octogenarians: A 5-years single centre experience
Surgical carotid endarterectomy still remains the most effective treatment for reducing the risk of stroke in patients with significant carotid stenosis. In fact, endovascular carotid stenting is associated with a higher incidence of perioperative and long-term minor stroke when compared to carotid endarterectomy although long-term functional outcome and risk of major stroke are comparable.1 However, advanced age resulted to be associated with an increased risk of complications after carotid endarterectomy.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 1, 2015 Category: Anesthesiology Authors: Laura Pasin, Pasquale Nardelli, Daniela Febres, Alessandro Belletti, Omar Saleh, Mattia Bellandi, Livia Manfredini, Gianluca Paternoster, Giovanni Landoni, Alberto Zangrillo Source Type: research

Surgical Versus Percutaneous Therapy of Carotid Artery Disease: An Evidence-Based Outcomes Analysis
STROKE IS A MAJOR cause of morbidity and mortality worldwide and is a leading cause of long-term, acquired adult disability in most developed countries.1,2 In the United States, stroke affects approximately 800,000 people each year and currently is the fifth leading cause of death.2 Carotid artery stenosis from atherosclerotic changes of the vessel wall contributes to 10% to 20% of all strokes.2 –4 As such, carotid artery stenosis is considered to be a modifiable and treatable factor for the risk reduction of subsequent stroke.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 2, 2016 Category: Anesthesiology Authors: Elvera L. Baron, Daniel I. Fremed, Rami O. Tadros, Pedro A. Villablanca, Adam S. Evans, Menachem M. Weiner, Eric H. Yang, John T. Augoustides, Farouk Mookadam, Harish Ramakrishna Tags: Expert Review Harish Ramakrishna, MDSection Editors? > Source Type: research

Analysis of Neurologic Complications After Surgical Versus Transcatheter Aortic Valve Replacement
Ove the last decade, transcatheter aortic valve replacement (TAVR) has emerged as the recommended approach over surgical aortic valve replacement (SAVR) for many patients with aortic stenosis. While initial trials demonstrated a higher incidence of stroke with TAVR compared to SAVR, the incidence of stroke appears to have improved over time. With the increasing number of patients expected to undergo TAVR in the coming decades, it is important to review the incidence and etiology of stroke after SAVR and TAVR.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 27, 2018 Category: Anesthesiology Authors: Sundar Krishnan, Archit Sharma, Sudhakar Subramani, Lovkesh Arora, Divyanshu Mohananey, Pedro Villablanca, Harish Ramakrishna Tags: Expert Review Source Type: research

Changes in End-Tidal Carbon Dioxide and Volumetric Carbon Dioxide as Predictors of Volume Responsiveness in Hemodynamically Unstable Patients
Conclusions: Dynamic changes in PETCO2 and VCO2 may be used as adjunctive indicators of fluid responsiveness in patients without underlying lung disease.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 21, 2012 Category: Anesthesiology Authors: Alisha Young, Paul E. Marik, Steven Sibole, David Grooms, Alex Levitov Tags: Original Articles Source Type: research

Beta-Blocking Agents for Surgery: Influence on Mortality and Major Outcomes. A Meta-Analysis
Conclusions: β-blockers reduced the 1-year risk of death, and this effect seemed greater than the risk of inducing a stroke.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 21, 2013 Category: Anesthesiology Authors: Joanne Guay, E. Andrew Ochroch Tags: Original Articles Source Type: research

Goal-Directed Therapy in Cardiac Surgery: Are We There Yet?
GOAL-DIRECTED THERAPY (GDT) is the practice of using hemodynamic parameters, beyond standard ones such as heart rate and blood pressure, to optimize oxygen delivery. These parameters might include stroke volume (SV), cardiac output (CO), and central venous oxygen saturation (ScO2), or dynamic ones such as stroke volume variation or pulse pressure variation. Optimization of oxygen delivery using such parameters was described by Shoemaker in the 1980s. He observed that shock survivors had significantly higher cardiac index (CI), oxygen delivery (DO2), and oxygen consumption (VO2) than non-survivors. He then hypothesized that...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 27, 2013 Category: Anesthesiology Authors: Byron D. Fergerson, Gerard R. Manecke Tags: Editorial Source Type: research

Prediction of Volume-Responsiveness During One-Lung Ventilation: A Comparison of Static, Volumetric, and Dynamic Parameters of Cardiac Preload
Conclusions: Under these OLV experimental conditions, the volumetric and dynamic parameters of preload, as well as CVP, seemed to be of similar value in predicting volume responsiveness.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 26, 2013 Category: Anesthesiology Authors: Constantin J.C. Trepte, Sebastian A. Haas, Rainer Nitzschke, Cornelie Salzwedel, Alwin E. Goetz, Daniel A. Reuter Tags: Original Article 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

General Versus Regional Anesthesia for Carotid Endarterectomy
THE FIRST CAROTID ENDARTERECTOMY (CEA) was performed at St Mary Hospital, London, England, in 1954. This is a surgical procedure performed to reduce the incidences of embolic and thrombotic stroke. The incidence of perioperative stroke during CEA is approximately 2.3%. The incidence of perioperative myocardial infarction (MI), which is defined by Q-wave criteria on an electrocardiogram, in patients undergoing CEA is
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 2, 2013 Category: Anesthesiology Authors: Dragana Unic-Stojanovic, Srdjan Babic, Vojislava Neskovic Tags: Review Articles Source Type: research