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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 207 results found since Jan 2013.
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
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
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
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
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
Anesthetics and Cerebral Protection in Patients Undergoing Carotid Endarterectomy
CEREBRAL ISCHEMIA/HYPOXIA may occur in a variety of perioperative circumstances. The main pathophysiologic aspects involved in cerebral ischemia/reperfusion are caused by adenosine triphosphate (ATP) consumption, the excitotoxic actions of glutamate, changes in ionic homeostasis, and formation of free radicals (Fig 1). Outcomes from such events range from subclinical neurocognitive deficits to catastrophic neurologic morbidity or death.1 Stroke is a severe complication that occurs rarely, perioperatively, but when it happens, stroke is associated with a high mortality or results in serious disability.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 3, 2014 Category: Anesthesiology Authors: Miomir Jovic, Dragana Unic-Stojanovic, Esma Isenovic, Rizzo Manfredi, Olivera Cekic, Nenad Ilijevski, Srdjan Babic, Djordje Radak Tags: Review ArticleGiovanni Landoni, MDSection Editors? > Source Type: research
Effect of Increasing Heart Rate and Tidal Volume on Stroke Volume Variability in Vascular Surgery Patients
Because heart rate affects ventricular filling, the aim of the present study was to assess the effects of increasing heart rate and tidal volume on stroke volume variability to determine whether this dynamic index is heart-rate dependent.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 26, 2014 Category: Anesthesiology Authors: Nathan A. Roeth, Timothy R. Ball, William C. Culp, W. Todd Bohannon, Marvin D. Atkins, William E. Johnston 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
Cold Blood Versus Crystalloid Cardioplegia for Myocardial Protection in Adult Cardiac Surgery: A Meta-analysis of Randomized Controlled Studies
Conclusions: Cold blood cardioplegia reduced perioperative myocardial infarction when compared with cold crystalloid cardioplegia. No differences in the overall incidence rates of spontaneous sinus rhythm, mortality (within 30 days), atrial fibrillation or stroke were observed.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 9, 2014 Category: Anesthesiology Authors: Jinming Zeng, Wenwu He, Zhanli Qu, Yanyan Tang, Qiuxi Zhou, Bingdong Zhang Tags: Original Articles Source Type: research
Cardiac Output Calculation and Three-Dimensional Echocardiography
Conclusions: LVOT area is underestimated with the single- axis 2D method when compared with 3D planimetered area. This results in a CO that is approximately 10% lower with the 2D method.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 3, 2014 Category: Anesthesiology Authors: Mario Montealegre-Gallegos, Feroze Mahmood, Khurram Owais, Phillip Hess, Jayant S. Jainandunsing, Robina Matyal Tags: Original Articles Source Type: research
Retrosternal Hematoma After Aortic Valve Replacement: Ultrasound View
We report a case of hemodynamic compromise secondary to an extrapericardial compression caused by the acute formation of a retrosternal hematoma, and we discuss the value of bedside echocardiography after cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 24, 2014 Category: Anesthesiology Authors: Vladimir V. Merenkov, Ivan S. Koshcheev, Yuri E. Monahov, Dmitry A. Movchan Tags: Letters to the Editor 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
Basic Data From 176 Studies on the Immediate Outcome After Aortic Valve Replacement With or Without Coronary Artery Bypass Surgery
Objective: The aim of this study was to summarize the immediate outcome after aortic valve replacement (AVR) with or without coronary artery bypass grafting (CABG).Design: Systematic review and meta-analysis.Setting: University hospitals.Participants: Participants were 683,286 patients who underwent AVR with or without CABG. Patients undergoing other major cardiac procedures were excluded from this analysis.Interventions: AVR with or without CABG.Measurements and Main Results: Operative mortality after AVR with or without concomitant CABG was 4.3%, stroke 2.1%, pacemaker implantation 5.9%, and dialysis 2.2%. After isolated...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 2, 2013 Category: Anesthesiology Authors: Fausto Biancari, Marta Martin, Giulia Bordin, Elia Vettore, Giulia Vinco, Vesa Anttila, Juhani Airaksinen, Francesco Vasques 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
