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High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated With Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients
Conclusion: This large, uniquely matched single-center cohort was generated, and, subject to the listed limitations the authors concluded that supplemental HTEA to general anesthesia had a better outcome in low-risk cardiac surgery patients, with a significantly lower 6-month mortality rate compared with the control group. However, regression analysis revealed that HTEA only had an independently positive effect on the frequency of postoperative dialysis.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2013 Category: Anesthesiology Authors: Michael Stenger, Anja Fabrin, Henrik Schmidt, Jacob Greisen, Poul Erik Mortensen, Carl-Johan Jakobsen Tags: Original Article 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

Pooled Estimates of Immediate and Late Outcome of Mitral Valve Surgery in Octogenarians: A Meta-analysis and Meta-regression
Objective: The authors evaluated the outcome of patients≥80 years undergoing mitral valve (MV) surgery.Design: Systematic review of the literature and meta-analysis.Setting: None.Participants: None.Interventions: None.Main Results: Twenty-four studies reporting on 5,572 patients ≥80 years of age who underwent MV surgery were included in this analysis. Pooled proportion of operative mortality was 15.0% (95% confidence interval [CI] 11.9-18.1), stroke was 3.9% (95% CI 2.6-5.2), and dialysis was 2.7% (95% CI 0.5-4.9). Early date of study (p = 0.014), increased age (p = 0.006), MV replacement (p = 0.008), procedure other t...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2013 Category: Anesthesiology Authors: Fausto Biancari, Paola Schifano, Michele Pighi, Francesco Vasques, Tatu Juvonen, Giulia Vinco Tags: Original Articles Source Type: research

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

The Effect of Cardiopulmonary Bypass on Dabigatran Levels
DABIGATRAN IS a novel anticoagulant that is licensed for use for the prevention of stroke in the presence of atrial fibrillation. Its use has expanded rapidly in New Zealand, primarily due to there being no requirement for routine monitoring of its effect, as there is for warfarin. There are case reports in the literature describing management of patients coming for urgent cardiac surgery, which revolve mainly around the use of dialysis and massive transfusion of clotting factors to manage the bleeding associated with surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 31, 2015 Category: Anesthesiology Authors: Kelly Byrne Tags: CASE REPORT Source Type: research

Post‐operative serious adverse events in a mixed surgical population – a retrospective register study
ConclusionWe found a risk of one or more events in the composite outcome within 342 days after inclusion of the last patients of 8.3% (7.8–9.0). The results are applicable in estimations of adequate sample sizes in future clinical trials investigating effects of interventions on SAEs.
Source: Acta Anaesthesiologica Scandinavica - July 15, 2016 Category: Anesthesiology Authors: M. S. Hansen, E. E. Petersen, J. B. Dahl, J. Wetterslev Tags: Original Article Source Type: research

Post ‐operative serious adverse events in a mixed surgical population – a retrospective register study
ConclusionWe found a risk of one or more events in the composite outcome within 342 days after inclusion of the last patients of 8.3% (7.8–9.0). The results are applicable in estimations of adequate sample sizes in future clinical trials investigating effects of interventions on SAEs.
Source: Acta Anaesthesiologica Scandinavica - July 13, 2016 Category: Anesthesiology Authors: M. S. Hansen, E. E. Petersen, J. B. Dahl, J. Wetterslev Tags: Original Article Source Type: research

The Effect of Cardiopulmonary Bypass on Dabigatran Levels
DABIGATRAN IS a novel anticoagulant that is licensed for use for the prevention of stroke in the presence of atrial fibrillation. Its use has expanded rapidly in New Zealand, primarily due to there being no requirement for routine monitoring of its effect, as there is for warfarin. There are case reports in the literature describing management of patients coming for urgent cardiac surgery, which revolve mainly around the use of dialysis and massive transfusion of clotting factors to manage the bleeding associated with surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 30, 2015 Category: Anesthesiology Authors: Kelly Byrne Tags: CASE REPORT Source Type: research

Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries A Retrospective Cohort Analysis
Conclusions An active cannabis use disorder is associated with an increased perioperative risk of myocardial infarction.Editor ’s PerspectiveWhat We Already Know about This TopicCannabis is known to have cardiovascular and psychoactive effectsThe association between active cannabis use disorder and postoperative outcomes remains unclearWhat This Article Tells Us That Is NewIn the United States, administrative data demonstrate that cannabis use disorder has increased in prevalence from 2010 to 2015Active cannabis use disorder is not associated with a change in overall perioperative morbidity, mortality, length of stay, or...
Source: Anesthesiology - March 10, 2020 Category: Anesthesiology Source Type: research

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