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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 207 results found since Jan 2013.
Remote Ischemic Preconditioning Reduces Cardiac Troponin I Release in Cardiac Surgery: A Meta-Analysis
Conclusions: Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 7, 2013 Category: Anesthesiology Authors: Lijing Yang, Guyan Wang, Yingjie Du, Bingyang Ji, Zhe Zheng Tags: Original Articles Source Type: research
Electrical Bioimpedance Cardiography: An Old Technology With New Hopes for the Future
THE POSITIVE IMPACT of early goal-directed hemodynamic therapy on postoperative outcome increasingly has been investigated over the last few years in high-risk patients undergoing noncardiac and cardiac surgeries. However, these preemptive strategies require advanced hemodynamic monitoring to assess cardiac output and stroke volume. The classic available tools (intermittent pulmonary arterial or transpulmonary thermodilution or esophageal Doppler), either invasive or operator-dependent and necessitating a learning curve, are not convenient for routine practice. Therefore, they remain insufficiently used among North America...
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 1, 2014 Category: Anesthesiology Authors: Jean-Luc Fellahi, Marc-Olivier Fischer Tags: Review Articles Source Type: research
Relationship Between Tricuspid Annular Excursion and Velocity in Cardiac Surgical Patients
Objectives: The primary objective of this study was to establish the relationship among tricuspid annular velocity (S’), tricuspid annular plane systolic excursion (TAPSE), and stroke volume (SV) in a cardiac surgical population with and without right ventricular (RV) dysfunction. The secondary objective was to assess the effect of ephedrine on these relationships in a population without RV dysfunction.Design: Prospective, nonrandomized, unblinded study.Setting: Single tertiary-level, university-affiliated hospital.Participants: Twenty-seven patients undergoing elective coronary artery bypass grafting with no evidence of...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 21, 2014 Category: Anesthesiology Authors: Raymond Hu, C. David Mazer, Claude Tousignant Tags: Original Articles Source Type: research
Arterial Closure Devices for Treatment of Inadvertent Large-Caliber Catheter Insertion Into the Subclavian or Carotid Artery: A Case Series of Five Patients
CENTRAL VENOUS CATHETERIZATION is a common procedure in today`s medicine. Iatrogenic complications occur in up to 34% of catheter placements including 5% of arterial puncture. A variety of complications by arterial puncture have recently been described, including airway obstruction, pseudoaneurysms, arteriovenous fistulas, and even stroke caused by arterial thrombosis or embolization. Although 2-D ultrasound assisted insertion of large central venous catheters may reduce adverse events, it might not be available in an emergency setting, and the use of ultrasound guidance requires training. Depending on anatomic localizatio...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 9, 2013 Category: Anesthesiology Authors: Arno Stellmes, Nicolas Diehm, Malte Book, Jürg Schmidli, Dai-Do Do, Jan Gralla Tags: Case Reports Source Type: research
Postoperative Stroke Following Administration of Intraoperative Recombinant Tissue Plasminogen Activator for the Treatment of Intracardiac Thrombus During Liver Transplantation: A Report of Two Cases
MASSIVE INTRACARDIAC AND PULMONARY thromboembolism have an extremely high mortality during liver transplantation.1,2 The authors describe 2 cases in which intraoperative use of tissue plasminogen activator was able to reduce the thrombus size and improve hemodynamics during liver transplantation. Although both patients survived the surgery, they suffered neurologic sequelae postoperatively. The authors discuss the current understanding of the pathophysiology, diagnosis, and management of intracardiac thromboembolism during liver transplantation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 22, 2014 Category: Anesthesiology Authors: Stephen Aniskevich, Beth L. Ladlie, Sher-Lu Pai, Dana K. Perry, Juan M. Canabal, C. Burcin Taner Tags: Case Report Source Type: research
Double-Barrel Proximal Thoracic Aorta or Horrific Complication of Endocarditis?
A 76-YEAR-OLD man with hypertension, hyperlipidemia, and a recent embolic stroke was admitted to the authors’ institution for evaluation of progressive dyspnea. The patient’s past medical history was notable for an aortic valve replacement with a mechanical prosthesis. He did well for approximately 30 years after surgery before he presented to a community hospital with a non-ST segment elevation myocardial infarction that was treated with metoprolol and a bare metal stent (first obtuse marginal branch of the left circumflex coronary artery).
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 8, 2014 Category: Anesthesiology Authors: Andrew R. Schroeder, Joseph E. Strosin, Izabela Jugovac, Zahir A. Rashid, Paul S. Pagel Tags: Diagnostic DilemmasSection Editor? > Source Type: research
Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study
To examine the impact of postoperative acute kidney injury (AKI) on the long-term risk of myocardial infarction, heart failure, stroke, and all-cause mortality after elective cardiac surgery. The authors investigated whether time of onset of AKI altered the association between AKI and the adverse events.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 6, 2015 Category: Anesthesiology Authors: Malene Kærslund Hansen, Henrik Gammelager, Carl-Johan Jacobsen, Vibeke Elisabeth Hjortdal, J. Bradley Layton, Bodil Steen Rasmussen, Jan Jesper Andreasen, Søren Paaske Johnsen, Christian Fynbo Christiansen Tags: Original Articles Source Type: research
Neurologic Injury and Protection in Adult Cardiac and Aortic Surgery
NEUROLOGIC INJURY can be defined as any temporary or permanent injury to the central and peripheral nervous system, including the brain, spinal cord, and peripheral nerves. This is a major perioperative complication of cardiac and aortic surgery, which can manifest as short-term coma or a state of confusion and long-term decline in cognitive function, behavioral changes, or physical dysfunction. Stroke occurs in approximately 2% to 3% of adult cardiac surgery patients. The rate of postoperative cognitive decline is less clear, due to heterogenous testing methods, but is reported in 50% to 70% of patients at 1 week, 30% to ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2015 Category: Anesthesiology Authors: Michael Seco, J. James B. Edelman, Benjamin Van Boxtel, Paul Forrest, Michael J. Byrom, Michael K. Wilson, John Fraser, Paul G. Bannon, Michael P. Vallely Tags: Review Article Source Type: research
Arterial-Pressure-Based Cardiac Output Analysis Reveals the Usefulness of Pericardiocentesis
Cardiac tamponade can develop as a complication of pericardial effusion and needs urgent invasive intervention, such as pericardiocentesis.1,2 Reports on hemodynamic changes during pericardiocentesis in humans are limited. Previous studies have measured changes in cardiac output (CO) and stroke volume (SV) using invasive pulmonary artery catheterization, once the pericardial effusion has been treated. More recently developed techniques, such as the FloTrac/Vigileo system (Edwards Lifesciences, Irvine, CA), enable continuous measurement of CO and SV less invasively, using pulse contour analysis.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 4, 2015 Category: Anesthesiology Authors: Masahiro Yamazoe, Atsushi Mizuno, Yutaro Nishi, Koichiro Niwa Tags: Letters To The Editor Source Type: research
Management of Direct Oral Anticoagulants in the Perioperative Setting
AN INCREASING NUMBER of patients undergoing surgical procedures are treated chronically by oral anticoagulants (OAC). Vitamin K antagonists (VKAs) have been standard practice in chronic anticoagulant therapy for decades. Despite a proved efficacy, they have several disadvantages. Over the past 5 years, direct oral anticoagulants (DOAs) such as dabigatran, rivaroxaban, apixaban, and edoxaban have been approved for several indications for long-term anticoagulation. Consequently, with the aging population and the extension of the indication of anticoagulation for stroke prevention in nonvalvular atrial fibrillation (AF), ther...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 24, 2015 Category: Anesthesiology Authors: Olivier Untereiner, Pierre-François Seince, Vladimir Chterev, Isabelle Leblanc, Clarisse Berroëta, Patrick Bourel, Ivan Philip Tags: Review ArticlesGiovanni Landoni, MDSection Editors? > Source Type: research
Regional cerebral oxygen desaturation measured by Near-Infrared-Spectroscopy is not a reliable indicator for cerebral outcome after aortic arch surgery
In this retrospective study in adults the relationship between intraoperative regional oxygen cerebral (de)saturation (rScO2) and the incidence of neurological deficit (stroke, delirium) after aortic arch surgery was investigated
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 1, 2015 Category: Anesthesiology Authors: Werner Baulig, Philipp Buehler, Karin Brueckner, Dominique Bettex, Marco Bosshart Source Type: research
Left Atrial Appendage, Intraoperative Echocardiography, and the Anesthesiologist
THE ANATOMY and function of the left atrial appendage (LAA) recently have received clinical attention. The LAA’s role in the generation of intracardiac thrombi and eventual embolism has been investigated significantly.1 The LAA is not merely an embryologic remnant but an integral anatomic and physiologic component of the left atrium (LA). It has a complex shape and functions as a reservoir and a neurosecretory organ with arrhythmogenic potential.2 Importantly, the LAA is the most common cardiac source of embolism with resultant stroke.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 25, 2015 Category: Anesthesiology Authors: Khurram Owais, Feroze Mahmood, Mario Montealegre-Gallegos, Kamal R. Khabbaz, Robina Matyal Tags: Review Article Source Type: research
The Problem With Predicting Postoperative Atrial Fibrillation
ATRIAL FIBRILLATION (AF) is the most common cardiac arrhythmia, with significant effects on patient quality of life and healthcare costs. Currently, more than 400,000 hospitalizations and 80,000 deaths annually are attributed to AF, with a substantial associated healthcare cost of $26 billion.1,2 Postoperative atrial fibrillation (POAF) is a unique entity seen in 16% to 30% of patients undergoing cardiac surgery and is associated with increased stroke, mortality, and hospital length of stay.3–5 The exact mechanism of POAF remains unknown, although it likely is multifactorial, caused by a combination of surgical stress an...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 16, 2015 Category: Anesthesiology Authors: Emily Methangkool, Kimberly Howard-Quijano, Aman Mahajan Tags: Editorial 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
New-Onset Atrial Fibrillation After Cardiac Surgery: Pathophysiology, Prophylaxis, and Treatment
AMONG ALL CARDIOVASCULAR complications, new-onset postoperative atrial fibrillation (POAF) is one of the most common complications, occurring in 30% to 50% of patients after cardiac surgery.1 POAF occurs most frequently in the first 5 days after cardiac surgery, with a peak incidence on postoperative day 2.2,3 POAF is associated with an increased risk of mortality and morbidity, predisposes patients to a higher risk of stroke, requires additional treatment, and increases postoperative costs.4–6 Thus, POAF is a significant problem because its impact on hospital resources is substantial.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 17, 2015 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Sergey M. Efremov, Eugeniy A. Pokushalov, Alexander M. Karaskov Tags: Review ArticleGiovanni Liandoni, MDSection Editors? > Source Type: research
