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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 207 results found since Jan 2013.
Statins Losing Their Luster?
STATINS HAVE NUMEROUS intriguing and potentially desirable pleiotropic anti-inflammatory effects that may clinically benefit patients undergoing cardiac surgery with/without cardiopulmonary bypass.1,2 Suggested clinical benefits include decreased postoperative morbidity (renal dysfunction, atrial fibrillation, myocardial infarction, stroke, infection) as well as decreased in-hospital mortality. While suppressing perioperative inflammation in patients undergoing cardiac surgery appears to make sense, nothing is ever as simple as it seems.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 19, 2017 Category: Anesthesiology Authors: Richa Dhawan, Mark A. Chaney Tags: Editorial Source Type: research
Inefficacy of Platelet Transfusion in a Heart Transplant Patient Under Continuous Ticagrelor
Antiplatelet agents have a predominant role in the therapeutic treatment of acute coronary syndrome (ACS) and myocardial infarction. Recently, ticagrelor has been incorporated in the European Society of Cardiology guidelines for the management of ACS with ST elevation and non-ST elevation.1 The AHA/ACC guidelines further advocate the choice of ticagrelor over clopidogrel in patients with ACS with non-ST elevation treated with an early invasive strategy.2 In fact, major studies have proven the benefits of ticagrelor on cardiovascular death, myocardial infarction, and stroke without an increase in major bleeding risk.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 15, 2017 Category: Anesthesiology Authors: Laura Filaire, Dat T. Pham, Nicolas d ’Ostrevy, Huyen T. Tran, Lionel Camilleri, Kasra Azarnoush Tags: Case Report Source Type: research
Serum copeptin levels as predictor of cognitive dysfunction after carotid endarterectomy
The incidence of cognitive dysfunction (CD) after carotid surgery is about 10-28%. Copeptin is the C-terminal fragment of provasopressin and is presumably co-secreted with arginine vasopressin from the hypothalamus. Copeptin levels have also been found to be elevated in ischemic stroke. The aim of this study was to evaluate the predictive value of postoperative serum copeptin level in the occurrence of CD in patients undergoing carotid endarterectomy (CEA).
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2017 Category: Anesthesiology Authors: Dragana Unic-Stojanovic, V Maravic-Stojkovic, D Radak, N Aleksic, P Gajin, B Milicic, S Tanaskovic, M Jovic Tags: Oral Presentations 207Thursday, 20 April 201708:30 - 10:30, Auditorium 3 Source Type: research
The influence of mean arterial pressure during cardiopulmonary bypass on cerebral complications
Stroke and postoperative cognitive dysfunction are common complications after cardiac surgery. Furthermore, silent strokes detected by diffusion-weighted magnetic resonance imaging (DWI) have been reported in up to 50% of cardiac surgery patients. The majority of these lesions seems to be caused by emboli, but other mechanisms may induce hypoperfusion and consequently lead to tissue ischaemia. A few randomised controlled trials have previously investigated the influence of mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) on cardiac and neurological endpoints with diverging results.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2017 Category: Anesthesiology Authors: Anne Gr ønborg Vedel, F Holmgaard, L Rasmussen, A Langkilde, OB Paulson, PS Olsen, T Lange, HB Ravn, JC Nilsson Source Type: research
The AngioVac Device and Its Anesthetic Implications
ALTHOUGH THE EXACT incidence of venous thromboembolism (VTE) is not known, about 1 million cases are reported in the United States each year,1 and VTE is the third most frequent cardiovascular disease after myocardial infarction and stroke.2 The term VTE encompasses both deep venous thrombosis (DVT) and pulmonary embolism (PE).3 DVT may be found in any location, with the lower extremities being the most common site. Once formed, venous thrombi either remain in the peripheral veins, undergo endogenous fibrinolysis and recanalization, or embolize to the pulmonary arteries and cause PE.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2017 Category: Anesthesiology Authors: Harish Ram, Rebecca M. Gerlach, Antonio Hernandez Conte, Danny Ramzy, Ashley R. Jaramillo-Huff, Neal S. Gerstein Tags: Emerging Technology Review Source Type: research
Perioperative Strokes and Early Outcomes in Mitral Valve Surgery: A Nationwide Analysis
To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 28, 2017 Category: Anesthesiology Authors: Reshmi Udesh, Amol Mehta, Thomas G. Gleason, Lawrence Wechsler, Parthasarathy D. Thirumala Tags: Original Article Source Type: research
Bivalirudin for Cardiopulmonary Bypass in the Setting of Heparin-Induced Thrombocytopenia and Combined Heart and Kidney Transplantation —Diagnostic and Therapeutic Challenges
SINCE THE PUBLICATION of the first case reports, heparin-induced thrombocytopenia (HIT) has persisted as a serious management dilemma for cardiothoracic anesthesiologists.1 –3 Nonimmune-mediated and immune-mediated forms of HIT, type I and II, respectively, both have been described in the literature.3–6 Of these 2 HIT phenotypes, the devastating and life-threatening thrombotic complications, such as limb ischemia, pulmonary embolism, stroke, and myocardial infarcti on, are almost associated exclusively with type-II HIT disease.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 12, 2016 Category: Anesthesiology Authors: Ankeet A. Choxi, Prakash A. Patel, John G. Augoustides, Julio Benitez-Lopez, Jacob T. Gutsche, Hani Murad, Yiliam F. Rodriguez-Blanco, Michael Fabbro, Kendall P. Crookston, Neal S. Gerstein Tags: Case ConferenceMark A. Chaney, MDSection Editors? > 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
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
A Tight Spot After Pulmonary Vein Catheter Ablation
A 52-YEAR-OLD woman with a history of embolic stroke due to paroxysmal atrial fibrillation was referred to the authors ’ institution for epicardial surgical pulmonary vein isolation with left atrial appendage resection. The patient had 2 previous failed pulmonary vein catheter ablations. Dense fibrous tissue surrounding the left upper pulmonary vein was seen during surgery. Transesophageal echocardiography reveale d the following image (Fig 1). What is the diagnosis?
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 15, 2016 Category: Anesthesiology Authors: Rabia Amir, Lu Yeh, Mario Montealegre-Gallegos, Rabya Saraf, Robina Matyal, Feroze Mahmood Tags: Diagnostic Dilemma Source Type: research
Old Drug, New Route: A Systematic Review of Intravenous Acetaminophen After Adult Cardiac Surgery
THE MANAGEMENT OF postoperative pain after cardiac surgery remains clinically challenging. Well-controlled pain is critical to maintaining the physical and psychologic well-being of each patient and can help facilitate timely extubation, comfortable breathing, and early postoperative ambulation. On the other hand, left poorly managed, postoperative pain can lead to rising catecholamine levels, ultimately triggering myocardial ischemia, stroke, or bleeding complications.1-3 Insufficient pain control also can limit patient mobility, increasing the risk of deep vein thrombosis and pneumonia, in addition to the harmful psychol...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 2, 2016 Category: Anesthesiology Authors: Daniel J. Douzjian, Alexander Kulik Tags: Review ArticleGiovanni Landoni, MDSection Editors? > Source Type: research
Perfusion pressure cerebral infarction (PPCI trial - a protocol for a randomised clinical trial
Debilitating brain injury occurs in 1.6-5 % of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Diffusion-weighed magnetic resonance imaging (DWI) studies have reported stroke-like lesions in up to 51 % of patients after cardiac surgery. The majority of the lesions seem to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During CPB, blood pressure can be below the lower limit of cerebral autoregulation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: Anne G Vedel, F Holmgaard, HB Ravn, JC Nilsson Source Type: research
Left atrial appendage closure without general anaesthesia
Left atrial appendage closure is an important interventional procedure to prevent stroke in patients with permanent atrial fibrillation and contraindication to anticoagulants. Because it requires the patient not to move and the performance of a continuous and prolonged transoesophageal echocardiography (TEE), such procedure is usually performed under general anaesthesia. The risk of general anaesthesia in the elderly is associated with difficult airway control, malignant hyperthermia, residual neuromuscular block, high risk of postoperative pulmonary complications, and the risk of accelerated cognitive decline.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: F Monaco, Evgeny Fominskiy, C D Votta, N Villari, R Capucci, JC Lopez-Delgado, V Camarda, M Baiardo Redaelli, A Oriani, A Zangrillo Source Type: research
Neutrophil-lymphocyte ratio and risk of atrial fibrillation after thoracic surgery
Postoperative atrial fibrillation (POAF) occurs in frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: K Walsh, KS Tan, H Zhang, Dawn Desiderio, D Amar Source Type: research
Does glycemic level affect neurologic outcomes during cardiopulmonary bypass?
In this study, we tried to identify a relationship existence between cerebral arterial oxygen saturation (rSO2) and blood glucose levels, and thus; evaluate changes in rSO2 caused by changes in blood glucose levels measured at predetermined time points of CPB.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: Elvin Kesimci, E Erkýlýc, F Alaybeyoglu, C Balcý, T Dulkadiroglu, T Gumus, O Kanbak Source Type: research
