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Source: Journal of Cardiothoracic and Vascular Anesthesia
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Total 207 results found since Jan 2013.
Torsades de Pointes in Coronavirus Disease 2019 Infection
A 73-YEAR-OLD MAN (weight 69 kg, height 175 cm) was transferred to the authors ’ critical care unit with respiratory and acute renal failure secondary to coronavirus disease 2019 (COVID-19) infection. His past medical history included hypertension, diabetes, and previous stroke, from which he had made a full recovery. The patient was treated with mechanical ventilation and p eritoneal dialysis. He was recruited into the hydroxychloroquine arm of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2020 Category: Anesthesiology Authors: Bagrat Lalabekyan, Gudrun Kunst, Vanessa A. Skelton Tags: Diagnostic Dilemma Source Type: research
Doing Simple Things Well: Practice Advisory Implementation Reduces Atrial Fibrillation After Cardiac Surgery
Atrial Fibrillation After Cardiac Surgery (AFACS) is associated with increased morbidity, including thromboembolic stroke, renal failure, gastrointestinal complications, infections, and prolonged ventilation, and a significant increase in the risk of subsequent chronic atrial fibrillation.1-4 Furthermore, it is associated with an increase in mortality and hospital and intensive care unit length of stay.1,3 It has a persistently high incidence, ranging from 30% to more than 50%, depending on the type of surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 29, 2020 Category: Anesthesiology Authors: Martina Buerge, Rosalie Magboo, Dylan Wills, Ioannis Karpouzis, Damian Balmforth, Paul Cooper, Neil Roberts, Ben O'Brien Tags: Special Article Source Type: research
Device-Detected Subclinical Atrial Fibrillation: The Anesthesiologist's Perspective
A RECENT American Heart Association article published in Circulation in December 2019 discussed subclinical atrial fibrillation (SCAF). SCAF, per Noseworthy et al., is defined as asymptomatic atrial fibrillation (AF) episodes captured by various cardiac devices and confirmed by electrocardiogram (ECG) analysis. As more of these devices, including implantable cardiac, wearable, or intracardiac monitors, are implemented, the incidence of SCAF has and will continue to increase. SCAF presents a cardiologist with multiple quandaries, including the initiation of stroke prophylaxis, and if so, how to proceed.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 16, 2020 Category: Anesthesiology Authors: Samit Ghia, Davendra Mehta, Himani V. Bhatt Tags: Editorial Source Type: research
Code Stroke After Cardiac Surgery: Can We Make a Difference?
IN AN editorial in the Journal of Cardiovascular and Thoracic Anesthesia, Kashani et al. reported their systematic review on intraarterial thrombolytic (IAT) and endovascular mechanical treatment (EMT) for stroke after cardiac surgery.1 Unfortunately, few conclusions about the efficacy of either approach could be drawn because of the sparsity of data —a total of 33 patients were reported in case series or case reports. Complete reperfusion was possible in 26% of the IAT group, with 42% of patients also receiving EMT due to poor initial results.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 24, 2020 Category: Anesthesiology Authors: Daniel Bainbridge Tags: Editorial Source Type: research
Brain Oxygen Supply in Older Adults During Coronary Artery Bypass Grafting
The neurological complications after cardiovascular surgery are relatively frequent, and they generate high increases of morbidity and mortality [1, 2]. This problem is especially relevant for elderly patients, because neurological complications, including stroke, often lead to high mortality and poor long-term outcomes [3].
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 9, 2020 Category: Anesthesiology Authors: Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir V. Lomivorotov, Vladimir Shmyrev, Alexander Chernyavskiy Tags: Original Article Source Type: research
Closed-Loop Control of Vasopressor Administration in Patients Undergoing Cardiac Revascularization Surgery
INTRAOPERATIVE hypotension and arterial pressure variability have been shown to affect patient outcomes negatively, increasing the risk of stroke, kidney injury, and myocardical injury, among other conditions.1-5 Vasopressors normally are used to correct hypotension rapidly. Vasopressor infusions typically are administered by standard infusion pump, with the rate adjusted by bedside providers to reach a predefined target mean arterial pressure (MAP); this requires frequent changes in the infusion rate because of the almost constantly changing hemodynamic status of such patients.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 16, 2020 Category: Anesthesiology Authors: Joseph Rinehart, Maxime Cannesson, Sashini Weeraman, Luc Barvais, Luc Van Obbergh, Alexandre Joosten Tags: Case Report Source Type: research
Postcardiac Surgery Acute Stroke Therapies: A Systematic Review
To identify interventions for the treatment of acute ischemic stroke after cardiac surgery and to report the efficacy of these treatments.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2020 Category: Anesthesiology Authors: Hessam H. Kashani, Lucas Mosienko, Bronwen B. Grocott, Bryan A. Glezerson, Hilary P. Grocott Tags: Original Article Source Type: research
Research Needs and Priorities for Catheter Ablation of Atrial Fibrillation
ATRIAL FIBRILLATION (AF) is the most common chronic arrhythmia encountered by physicians. According to the Framingham Heart Study, the lifetime risk of AF at age 80 is 22.7% in men and 21.7% in women.1 Silent AF occurs in about 30% of patients, and, unfortunately, the first clinical manifestation can be a stroke.2 Thus, early diagnosis and management with anticoagulation are imperative. AF may be paroxysmal, usually lasting for minutes to hours before spontaneously converting back to sinus rhythm.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 13, 2020 Category: Anesthesiology Authors: Roger L. Royster, Rohesh J. Fernando, Elijah H. Beaty Tags: Editorial Source Type: research
Incorporating Indices of Postoperative Glycemic Variability in Postoperative Outcome Prediction Modeling: How Accurate Can it Get?
PERIOPERATIVE hyperglycemia, as well as the amplitude and frequency of glycemic variation are associated with increased morbidity and mortality after cardiac surgery, regardless of diabetic state.1,2 In patients undergoing coronary artery bypass grafting surgery, early postoperative hyperglycemia (blood glucose concentration [BGC]>250 mg/dL) significantly increases the risks of postoperative complications (nonfatal stroke, myocardial infarction, sepsis, death).3
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 29, 2020 Category: Anesthesiology Authors: Kai Yin Hwang, Nian Chih Hwang Tags: Editorial Source Type: research
PFO! Should I Stay, or Should I Go?
IN THIS issue of the Journal of Cardiothoracic and Vascular Anesthesia, Villablanca et al. evaluated whether the presence and diagnosis of a patent foramen ovale (PFO) or atrial septal defect (ASD) preoperatively was associated with an increase in perioperative stroke for patients undergoing noncardiac surgery.1 The authors used “big data” to describe the largest study to date of 19,659,191 hospitalizations retrieved from the Healthcare Cost and Utilization Project's National Readmission Database.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 20, 2020 Category: Anesthesiology Authors: Yvonne Lai, Adam A. Dalia Tags: Editorial Source Type: research
Microemboli on Cardiopulmonary Bypass: Should We Care?
CENTRAL nervous system complications after cardiac surgery range from subtle cognitive impairment to clinically evident delirium, confusion, and stroke. It also is important to recognize that even without apparent clinical presentation, a significant number of older patients are diagnosed with covert stroke after both cardiac1 and noncardiac2 surgery. Several mechanisms have been implicated in the pathophysiology of these processes, including global or regional cerebral hypoperfusion, cerebral embolism, and neuroinflammation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 11, 2020 Category: Anesthesiology Authors: V. Melnyk, L. Fedorko, G. Djaiani Tags: Editorial Source Type: research
Congenital Mitral Stenosis
In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Montgomery et al. presented an interesting case of parachute mitral valve in a female young adult as a cause of mitral stenosis (MS) and cardiogenic embolic stroke.1 Because congenital MS very rarely is identified as a de novo diagnosis in the adult patient, a morphologic review of this lesion may be useful to the adult echocardiographer.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 3, 2020 Category: Anesthesiology Authors: Nelson H. Burbano Tags: Editorial Source Type: research
Con: Adult Cardiac Surgery Should Not Proceed in the Event of Cardiac Arrest After Induction of Anesthesia
IT IS ESTIMATED that in-hospital cardiac arrest occurs in greater than 290,000 adults each year in the United States.1 In-hospital cardiac arrest has received significantly less attention than other cardiovascular conditions with high risks of morbidity and mortality, such as myocardial infarction, stroke, and out-of-hospital cardiac arrest. Survival to discharge has been estimated at around only 25%. The etiology of in-hospital cardiac arrest is most often owing to cardiac causes (50%-60%), followed by respiratory insufficiency (15%-40%).
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 2, 2020 Category: Anesthesiology Authors: Hamdy Awad, Scott Smith, Islam Shehata, Samiya Saklayen Tags: Pro and Con Source Type: research
An Unusual Cause of Stroke in a Young Adult
Stroke is an uncommon presentation in young adults, with different causes and risks factors implicated. Cardiogenic cerebral embolus is one of the most common causes in younger patients and must be considered in the investigation of young patients presenting with stroke. The authors describe a case of a young patient presenting with stroke as a result of distal embolization from a previously undiagnosed congenital mitral valve defect.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 28, 2020 Category: Anesthesiology Authors: Claire L. Montgomery, Alexandra M. Murphy, Jijin Joseph Tags: E-Challenge & Clinical Decisions Source Type: research
Increased Risk of Perioperative Ischemic Stroke in Patients Who Undergo Noncardiac Surgery with Preexisting Atrial Septal Defect or Patent Foramen Ovale
To evaluate whether a preoperative diagnosis of atrial septal defect (ASD) or patent foramen ovale (PFO) is associated with perioperative stroke in noncardiac surgery and their outcomes.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 28, 2020 Category: Anesthesiology Authors: Pedro A. Villablanca, Alejandro Lemor, Chak-Yu So, Guson Kang, Tarun Jain, Tanush Gupta, Tomo Ando, Divyanshu Mohananey, Sagar Ranka, Dagmar F. Hernandez-Suarez, Pablo Michel, Tiberio Frisoli, Dee Dee Wang, Marvin Eng, William O'Neill, Harish Ramakrishna Tags: Original Article Source Type: research
