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Source: Journal of Cardiothoracic and Vascular Anesthesia

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Total 207 results found since Jan 2013.

Socioeconomic Disparities in Carotid Revascularization Procedures
The objective of the present study was to examine the intersectionality between race/ethnicity, insurance status, and postoperative outcomes in carotid procedures.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 12, 2020 Category: Anesthesiology Authors: Latha Panchap, Seyed A. Safavynia, Virginia Tangel, Robert S. White Tags: Original Article Source Type: research

CHA2DS2-VASc Score and In-Hospital Mortality in Critically Ill Patients With New-Onset Atrial Fibrillation
To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF).
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 29, 2019 Category: Anesthesiology Authors: Kunal Karamchandani, Robert S. Schoaps, Thomas Abendroth, Zyad J. Carr, Tonya S. King, Anthony Bonavia Tags: Original Article Source Type: research

A Case of Successful Treatment of Cerebral Embolism Using Endovascular Thrombectomy Immediately After Transcatheter Aortic Valve Implantation
TRANSCATHETER aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement in high-risk patients with severe aortic stenosis. However, there are increasing concerns about the potential complications of TAVI now that its indications have been expanded to include patients with low-to-intermediate surgical risk.1,2 One of the serious complications of TAVI is stroke. It is known that there is an increase in 30-day mortality, rates of respiratory insufficiency and postprocedural delirium, and duration of hospital stay if stroke occurs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 17, 2019 Category: Anesthesiology Authors: Shunichi Murakami, Kazuyoshi Ishida, Hideyuki Ishihara, Takayuki Okamura, Tetsuro Oda, Ryo Suzuki, Atsuo Yamashita, Satoshi Yamashita, Hiroshi Kurazumi, Michiyasu Suzuki, Mishiya Matsumoto Tags: Case Report Source Type: research

Stroke at 4 Years Unravels a Rare Diagnosis
ISCHEMIC stroke in children is very rare, with a reported incidence of 2 to 13 cases per 100,000 children.1 Tumors, endocarditis, vasculopathy, thrombotic disorders, and inflammatory disorders are the usual causes of an ischemic stroke in children.2,3 Transient cutaneous eruptions involving the extremities often precede the onset of neurologic symptoms in children with cardiac myxomas.4 Very few cases of ischemic stroke resulting from myxoma in children younger than 18 years have been reported in the literature.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 5, 2019 Category: Anesthesiology Authors: Madan Mohan Maddali, Pranav Subbaraya Kandahar, Ramachandhiran Venkatachlam, Sunny Zacharias Tags: Case Report Source Type: research

Changes in Stroke Volume Variation Induced by Passive Leg Raising to Predict Fluid Responsiveness in Cardiac Surgical Patients With Protective Ventilation
Stroke volume variation (SVV) has been used to predict fluid responsiveness. The authors hypothesized the changes in SVV induced by passive leg raising (PLR) might be an indicator of fluid responsiveness in patients with protective ventilation after cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 17, 2019 Category: Anesthesiology Authors: Guo-Guang Ma, Guo-Wei Tu, Ji-Li Zheng, Du-Ming Zhu, Guang-Wei Hao, Jun-Yi Hou, Ying Su, Jing-Chao Luo, Kai Liu, Zhe Luo Tags: Original Article Source Type: research

Xenon Anesthesia: Is it in Due Course for a Mainstream Comeback?
HISTORICALLY, carotid endarterectomy (CEA) surgery has generated several disputes regarding the choice of anesthesia provided and intraoperative neuromonitoring. The landmark General Anesthesia versus Local Anesthesia trial,1 which included 3,526 patients, showed no difference in the occurrence of stroke, myocardial infarction, or death at 30 days after surgery with respect to either local or general anesthesia. Harky et al.2 conducted a systematic review and meta-analysis of general versus local anesthesia in CEA surgery and concluded that each of the anesthetic techniques was noninferior to one another.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 2, 2019 Category: Anesthesiology Authors: V. Melnyk, L. Fedorko, G. Djaiani Tags: Editorial Source Type: research

A Case-Based Discussion on the Management of Cryptogenic Stroke and Patent Foramen Ovale in the Patient With a Hypercoagulable Disorder
UP TO 40% of all ischemic strokes are considered cryptogenic, implying a stroke without a definitive etiology.1,2 With a dearth of evidence-guided treatment strategies, the literature surrounding cryptogenic stroke is highly variable and not well-standardized. Even though existing guidelines do not specify the exact testing required, the cryptogenic stroke evaluation includes a variety of imaging modalities (eg, echocardiography, angiography, magnetic resonance imaging, carotid ultrasound) and laboratory investigations (eg, genetic testing, hypercoagulable disorder panels, erythrocyte sedimentation rate).
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 27, 2019 Category: Anesthesiology Authors: Neal S. Gerstein, Stacey D. Clegg, Daniel B. Levin, Adam C. Fish, Kirsten Tolstrup, Koki Nakanishi, Yuriko Yoshida, Shunichi Homma Tags: Case Conference Source Type: research

Intraoperative Stroke During Robotic Totally Endoscopic Coronary Artery Bypass
THE INCIDENCE OF stroke after coronary artery bypass graft (CABG) surgery is between 1% and 5% and is one of the most detrimental complications.1 Off-pump CABG is associated with a lower stroke rate than traditional on-pump CABG (0.7% v 1.4%).2 Stroke after CABG is associated with increased morbidity and mortality and increased cost secondary to longer hospital stays and rehabilitation. The authors ’ presented case demonstrates the complexity of perioperative management of a patient scheduled for elective off-pump total endoscopic coronary artery bypass (TECAB) grafting with recent transient ischemic attack (TIA), stroke...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 7, 2019 Category: Anesthesiology Authors: Jennette D. Hansen, Mark A. Chaney, Michael Essandoh, Jean Starr, BobbieJean Sweitzer Tags: Case Conference Source Type: research

The Effect of Steroids in Patients Undergoing Cardiopulmonary Bypass: An Individual Patient Meta-Analysis of Two Randomized Trials
Steroids suppress the inflammatory response to cardiopulmonary bypass, but the impact on death at 30 days, myocardial infarction or injury, stroke, renal failure, respiratory failure, new atrial fibrillation, transfusion requirement, infection, and length of intensive care unit (ICU) and hospital stays are uncertain.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 6, 2019 Category: Anesthesiology Authors: Richard P. Whitlock, Jan M. Dieleman, Emilie Belley-Cote, Jessica Vincent, Michelle Zhang, P.J. Devereaux, Cor J. Kalkman, Diederik van Dijk, Salim Yusuf Tags: Original Article Source Type: research

Calcium Administration During Weaning From Cardiopulmonary Bypass: A Narrative Literature Review
The search for safe and effective patient management strategies during weaning from cardiopulmonary bypass is ongoing; intravenous calcium is occasionally used as a first-line drug. The physiologic role of calcium suggests that it can support the function of the cardiovascular system during this critical period. Patients may be mildly hypocalcemic after cardiopulmonary bypass; however, this degree of hypocalcemia does not significantly impair the cardiovascular system. The transient beneficial effects of calcium administration (increase in arterial blood pressure, systemic vascular resistance, cardiac index, stroke volume,...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2019 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Elizaveta A. Leonova, Alessandro Belletti, Vladimir A. Shmyrev, Giovanni Landoni Tags: Review Article Source Type: research

Left Atrial Thrombus Formation in a Patient With Severe Non-rheumatic Mitral Stenosis After Mitral Valve Repair Receiving Dual Antiplatelet Therapy: A Clinical Challenge
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 10, 2019 Category: Anesthesiology Authors: Michael Essandoh, Amir Elhassan, Thomas J. Papadimos, Brandon Pruett, Gregory D. Rushing Tags: Diagnostic Dilemma Source Type: research

Patent Foramen Ovale and Risk of Cryptogenic Stroke – Analysis of Outcomes and Perioperative Implications
PATENT FORAMEN OVALE (PFO) is the most common congenital defect of the atrial septum, with reported incidences ranging between 27% and 34% in autopsy studies.1 During embryonic life, the PFO is a physiological discontinuity of the septum secundum that allows the oxygenated placental blood to bypass the non-functional lungs of the fetus. There are 2 overlapping components of the developing atrial septum. On the right, the septum secundum stems from an infolding of the atrial walls and contains a posteroinferior oval-shaped opening, the foramen ovale.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 14, 2019 Category: Anesthesiology Authors: Pablo Michel, Pedro A. Villablanca, Sagar Ranka, Alejandro Lemor, Tarun Jain, Harish Ramakrishna Tags: Expert Review Source Type: research

Perioperative Acute Ischemic Stroke Increases Mortality After Noncardiac, Nonvascular, and Non-Neurologic Surgery: A Retrospective Case Series
To identify the predictors of in-hospital mortality in patients who develop perioperative acute ischemic stroke (PAIS) associated with noncardiac, nonvascular, and non-neurologic surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 3, 2019 Category: Anesthesiology Authors: Hong Wang, Shuang-ling Li, Jing Bai, Dong-xin Wang Tags: Original Article Source Type: research

Short-Term Outcomes After Off-Pump or On-Pump Coronary Artery Bypass Grafting in the Octogenarian Patients
Despite large randomized controlled trials demonstrating similar outcomes for of-pump or on-pump coronary artery bypass grafting, the debate between proponents of each technique remains current.1 On-pump technique improves surgical exposure on a nonbeating heart but exposes the patient to a powerful inflammatory response and to ischemic stroke owing to cross clamping and cannulation. Off-pump coronary artery bypass (OPCAB) may reduce blood transfusion, postoperative length of hospital stay, postoperative neurocognitive decline, and systemic anticoagulation, but heart repositioning may be associated with hemodynamic instabi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 2, 2019 Category: Anesthesiology Authors: B érénice Tiquet, Jean David Blossier, Isabelle Orsel, Frank Pihan, Alessandro Piccardo, Jean Phillippe Marsaud, David Vandroux Tags: Letter to the Editor Source Type: research

Anesthetic Management of Total Thoracoscopic Left Atrial Maze Procedure for Chronic Atrial Fibrillation —A Single-Institution Experience
ATRIAL FIBRILLATION (AF) is an increasingly common health problem with a prevalence of 1% to 2% that is expected to double within 20 years.1,2 As an independent risk factor for death and stroke, patients with AF have a 5-fold higher risk for those adverse outcomes compared to the general population.3 The goal of treatment is to interrupt the re-entrant circuits causing AF. Pharmacologic cardioversion is successful in only 35% to 75% of cases,4 leaving many to rely on transcatheter radiofrequency (RF) ablation or surgical treatment.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2019 Category: Anesthesiology Authors: Zhuo Sun, Ping Fu, Nadine Odo, Vijay Patel, Gyanendra Sharma, Shvetank Agarwal Tags: Special Article Source Type: research