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    6001 results match your criteria Perioperative Cardiac Management

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    Blood conservation in cardiac surgery.
    Transfus Med 2017 Sep 21. Epub 2017 Sep 21.
    Department of Anaesthesia and Intensive Care, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
    This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. Read More

    The Journey of Harmless Bullet: The Perioperative Care of Penetrating Cardiac Injury.
    Anesth Essays Res 2017 Jul-Sep;11(3):790-793
    Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
    Traumatic injuries to the heart contribute significantly to trauma are associated with high mortality. Cardiac gunshot wounds (GSW) are considered more lethal compared to other injuries and present several unique challenges to the anesthesia management and perioperative care. We are reporting a rare case of a trauma victim who survived a GSW to the heart. Read More

    Consensus Statement by the Congenital Cardiac Anesthesia Society: Milestones for the Pediatric Cardiac Anesthesia Fellowship.
    Anesth Analg 2017 Sep 14. Epub 2017 Sep 14.
    From the *Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; †Department of Anesthesiology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; ‡Division of Cardiovascular Anesthesia, Department of Anesthesiology, Texas Children's Hospital, Houston, Texas; §Division of Cardiovascular Anesthesia, Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado; ‖Department of Anesthesiology, Seattle Children's Hospital, University of Washington, Seattle, Washington; ¶Division of Cardiac Anesthesia, Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, Texas; and #Division of Cardiothoracic Anesthesia, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
    Pediatric cardiac anesthesiology has evolved as a subspecialty of both pediatric and cardiac anesthesiology and is devoted to caring for individuals with congenital heart disease ranging in age from neonates to adults. Training in pediatric cardiac anesthesia is a second-year fellowship with variability in both training duration and content and is not accredited by the Accreditation Council on Graduate Medical Education. Consequently, in this article and based on the Accreditation Council on Graduate Medical Education Milestones Model, an expert panel of the Congenital Cardiac Anesthesia Society, a section of the Society of Pediatric Anesthesiology, defines 18 milestones as competency-based developmental outcomes for training in the pediatric cardiac anesthesia fellowship. Read More

    Factors Associated With Pediatric Ventilator-Associated Conditions in Six U.S. Hospitals: A Nested Case-Control Study.
    Pediatr Crit Care Med 2017 Sep 13. Epub 2017 Sep 13.
    1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. 2Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA. 3Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Boston, MA. 4Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA. 5Section of Neonatology, Children's Hospital at Dartmouth, Lebanon, NH. 6Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH. 7Division of Critical Care Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT. 8Department of Patient Safety, Intermountain Primary Children's Hospital, Salt Lake City, UT. 9Section of Infectious Diseases, Department of Pediatrics, Rush University Medical Center, Rush Medical College, Chicago, IL. 10Division of Infectious Diseases, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. 11Department of Medicine, Brigham and Women's Hospital, Boston, MA.
    Objectives: A newly proposed surveillance definition for ventilator-associated conditions among neonatal and pediatric patients has been associated with increased morbidity and mortality among ventilated patients in cardiac ICU, neonatal ICU, and PICU. This study aimed to identify potential risk factors associated with pediatric ventilator-associated conditions.

    Design: Retrospective cohort. Read More

    Perioperative Point-of-Care Ultrasound in Pediatric Anesthesiology: A Case Series Highlighting Intraoperative Diagnosis of Hemodynamic Instability and Alteration of Management.
    J Cardiothorac Vasc Anesth 2017 Apr 19. Epub 2017 Apr 19.
    Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX. Electronic address:

    [Surgical decision-making during treatment of a patient with multifocal atherosclerosis based on intraoperative epiaortic scanning].
    Angiol Sosud Khir 2017 ;23(3):47-53
    Perm State Medical University named after Academician E.A. Wagner under the Ministry of Health of the Russian Federation, Perm, Russia.
    The article deals with a clinical case report regarding surgical management of a patient presenting with multifocal atherosclerosis. Taking into consideration critical stenoses of the anterior interventricular artery (80%) and circumflex artery (80%), as well as subocclusion of the left internal carotid artery and stenosis of the right internal carotid artery (60%), there were high risks for intraoperative cerebral circulation impairment. It was decided to perform a two-stage operation on the coronary and carotid beds. Read More

    Perioperative stroke: incidence, etiologic factors, and prevention.
    Minerva Anestesiol 2017 Sep 13. Epub 2017 Sep 13.
    Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA.
    Introduction: Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcomes.

    Evidence Acquisition: The authors performed a systematic search in PubMed and the Cochrane Central Register. Read More

    A randomised comparison of bolus phenylephrine and ephedrine for the management of spinal hypotension in patients with severe preeclampsia and fetal compromise.
    Int J Obstet Anesth 2017 Aug 11. Epub 2017 Aug 11.
    Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
    Background: Studies in healthy patients undergoing elective caesarean delivery show that, compared with phenylephrine, ephedrine used to treat spinal hypotension is associated with increased fetal acidosis. This has not been investigated prospectively in women with severe preeclampsia.

    Methods: Patients with preeclampsia requiring caesarean delivery for a non-reassuring fetal heart tracing were randomised to receive either bolus ephedrine (7. Read More

    Perioperative fluid management: From physiology to improving clinical outcomes.
    Indian J Anaesth 2017 Aug;61(8):614-621
    Department of Intensive Care Medicine, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, United Kingdom.
    Perioperative fluid management is a key component in the care of the surgical patient. It is an area that has seen significant changes and developments, however there remains a wide disparity in practice between clinicians. Historically, patients received large volumes of intravenous fluids perioperatively. Read More

    Transition to Residency: The Successful Development and Implementation of a Nonclinical Elective in Perioperative Management.
    J Surg Educ 2017 Sep 6. Epub 2017 Sep 6.
    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
    Objective: Few medical school programs in Canada address challenges related to the significant increase in responsibility for patient care between medical school and residency. This is particularly important in surgery and anesthesia due to the high-acuity care required during the perioperative period. The purpose of this study was to develop and assess a program that would help students transition to surgical and anesthesia residencies, in terms of knowledge acquisition, clinical decision-making skills, and subjective preparedness. Read More

    Microcirculation measurements: Barriers for use in clinical routine.
    Clin Hemorheol Microcirc 2017 Sep 4. Epub 2017 Sep 4.
    Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr-University Bochum, Klinikum Herford, Herford, Germany.
    Background: In patients with shock, inflammation and sepsis alterations in microcirculation are common problems. Although the pathophysiologic consequences are well understood, measurements of microcirculation have not entered clinical routine so far.

    Objective: To characterize the requirements for clinical microcirculation measurement techniques and the barriers for implementation into routine practice. Read More

    Perioperative Stroke, In-Hospital Mortality, and Postoperative Morbidity Following Transcatheter Aortic Valve Implantation: A Nationwide Study.
    J Clin Neurol 2017 Sep 4. Epub 2017 Sep 4.
    Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
    Background And Purpose: Perioperative stroke is a significant complication of transcatheter aortic valve implantation (TAVI). This study aimed to quantify perioperative stroke as an independent risk factor for in-hospital mortality and postoperative morbidity in patients receiving TAVI.

    Methods: A retrospective cohort study was conducted using the National Inpatient Sample. Read More

    Incidence of Myocardial Infarction After High-Risk Vascular Operations in Adults.
    JAMA Surg 2017 Sep 6:e173360. Epub 2017 Sep 6.
    Center for Advanced Surgical and Interventional Technology, UCLA (University of California, Los Angeles).
    Importance: Advances in perioperative cardiac management and an increase in the number of endovascular procedures have made significant contributions to patients and postoperative myocardial infarction (POMI) risk following high-risk vascular procedures. Whether these changes have translated into real-world improvements in POMI incidence remain unknown.

    Objective: To examine the temporal trends of myocardial infarction (MI) following high-risk vascular procedures. Read More

    Preoperative Assessment for Ambulatory Surgery.
    Curr Pain Headache Rep 2017 Aug 31;21(10):43. Epub 2017 Aug 31.
    Department of Anesthesiology, Louisiana School of Medicine, New Orleans, LA, USA.
    Purpose Of Review: Ambulatory surgery has grown in recent decades in volume and represents a significant number of anesthetics delivered throughout the USA. Preoperative anesthetic assessment in the ambulatory setting has become important because patients with numerous complex comorbidities are now commonplace in this arena. Disease states involving the lungs, the heart, the kidneys, and subpopulations including those who are obese and the elderly commonly receive anesthetics in an ambulatory setting. Read More

    A Protocol for Diagnosis and Management of Aortic Atherosclerosis in Cardiac Surgery Patients.
    Int J Vasc Med 2017 9;2017:1874395. Epub 2017 Aug 9.
    Department of (Thoracic) Anesthesia and Intensive Care, Isala, Dokter van Heesweg 2, 8025 AB Zwolle, Netherlands.
    In patients undergoing cardiac surgery, use of perioperative screening for aortic atherosclerosis with modified TEE (A-View method) was associated with lower postoperative mortality, but not stroke, as compared to patients operated on without such screening. At the time of clinical implementation and validation, we did not yet standardize the indications for modified TEE and the changes in patient management in the presence of aortic atherosclerosis. Therefore, we designed a protocol, which combined the diagnosis of atherosclerosis of thoracic aorta and the subsequent considerations with respect to the intraoperative management and provides a systematic approach to reduce the risk of cerebral complications. Read More

    Perioperative Management of Beta Blockers and Other Antiarrhythmic Medications.
    Curr Clin Pharmacol 2017 Aug 28. Epub 2017 Aug 28.
    Department of General Internal Medicine, Mayo Clinic, Jacksonville, Florida. United States.
    Background: Antiarrhythmic medications are an important tool in preventing recurrence of intraoperative and postoperative arrhythmias.

    Objective: To review current literature and recommendations for perioperative management of antiarrhythmic medications.

    Methods: Literature review is presented along with the pharmacology of antiarrhythmics. Read More

    Technology: Is There Sufficient Evidence to Change Practice in Point-of-Care Management of Coagulopathy?
    J Cardiothorac Vasc Anesth 2017 May 19. Epub 2017 May 19.
    Duke University Hospital, Duke University, Durham, NC.
    Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evidence that algorithmic transfusion using point-of-care (POC) testing can reduce red cell and platelet transfusions and major bleeding after cardiac surgery. Read More

    Perioperative management of antithrombotic therapy in patients receiving cardiovascular implantable electronic devices: a network meta-analysis.
    J Interv Card Electrophysiol 2017 Aug 25. Epub 2017 Aug 25.
    Department of Emergency Cardiology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road Second, Chaoyang District, Beijing, 100029, People's Republic of China.
    Purpose: Network meta-analysis (NMA) has advantages including being able to simultaneously compare and rank multiple treatments over traditional meta-analysis. We evaluated by a NMA the optimal antithrombotic strategy during the perioperative period of implantation of cardiovascular implantable electronic devices (CIEDs).

    Methods: We performed a network meta-analysis of observational studies (cohort and case-control studies). Read More

    Healthcare-Associated Mycobacterium chimaera Infection Subsequent to Heater-Cooler Device Exposure During Cardiac Surgery.
    J Cardiothorac Vasc Anesth 2017 May 17. Epub 2017 May 17.
    Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
    A SERIES of reports in the United States and Europe have linked Mycobacterium chimaera infections to contaminated heater-cooler devices used during cardiac surgery. Heater-cooler devices commonly are used for cardiopulmonary bypass during cardiac surgery. M. Read More

    Unusual Cause of Life-Threatening Hemoptysis During Cardiac Operation: Surgical Management Revisited.
    Ann Thorac Surg 2017 Sep;104(3):e251-e252
    Department of Anesthesiology and Critical Care, Laval University, Québec City, Québec, Canada; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Québec, Canada. Electronic address:
    The surgical management of life-threatening perioperative hemoptysis has been vastly replaced by radiologic embolization. In some situations, surgical therapy can prove useful. This case report describes life-threatening hemoptysis of an unusual cause during coronary artery bypass grafting, managed through an original technique of temporary pulmonary vascular exclusion by thoracotomy. Read More

    Ruptured Papillary Muscles After Chordae-Preserving Bioprosthetic Mitral Valve Replacement.
    Ann Thorac Surg 2017 Sep;104(3):e243-e245
    Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
    Bioprosthetic valve-associated masses in the perioperative period are rare. This report describes the case of a 68-year-old man with perivalvular masses that were initially discovered on a routine postoperative transthoracic echocardiogram 7 days after chordae-preserving mitral valve replacement and coronary artery bypass grafting. An intraoperative transesophageal echocardiogram demonstrated ruptured papillary muscles. Read More

    Post-sternotomy mediastinitis in the modern era.
    J Card Surg 2017 Sep 22;32(9):556-566. Epub 2017 Aug 22.
    Department of Cardiothoracic Surgery, Liverpool Hospital, NSW, Australia.
    Background: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. Read More

    Bariatric Surgery Is Gaining Ground as Treatment of Obesity After Heart Transplantation: Report of Two Cases.
    Obes Surg 2017 Aug 22. Epub 2017 Aug 22.
    General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
    Experience with bariatric surgery in patients after orthotopic heart transplantation (OHT) is still limited. We performed a retrospective review of patients who underwent bariatric surgery after OHT from January 1, 2010 to December 31, 2016. Two post-OHT patients with BMI of 37. Read More

    Preoperative Aspirin Does Not Increase Transfusion or Reoperation in Isolated Valve Surgery.
    J Cardiothorac Vasc Anesth 2017 May 4. Epub 2017 May 4.
    Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
    Objective: Preoperative aspirin has been studied in patients undergoing isolated coronary artery bypass graft surgery. However, there is a paucity of clinical data available evaluating perioperative aspirin in other cardiac surgical procedures. This study was designed to investigate the effects of aspirin on bleeding and transfusion in patients undergoing non-emergent, isolated, heart valve repair or replacement. Read More

    Perioperative Management of Dual-Antiplatelet Therapy in Patients With New-Generation Drug-Eluting Metallic Stents and Bioresorbable Vascular Scaffolds Undergoing Elective Noncardiac Surgery.
    J Cardiothorac Vasc Anesth 2017 Apr 26. Epub 2017 Apr 26.
    Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
    Dual-antiplatelet therapy (DAPT) is considered mandatory after new-generation drug-eluting coronary stent implantation to reduce ischemic complications such as stent thrombosis, but the need for DAPT makes the timing of elective surgery difficult. Interrupting DAPT places patients at risk for stent thrombosis, and surgery in the setting of DAPT may lead to bleeding. The 2016 American College of Cardiology/American Heart Association guideline recommends delaying elective noncardiac surgery for a minimum 6-month period to reduce ischemic risks after the implantation of a second-generation metallic drug-eluting stent (DES). Read More

    How detrimental is reexploration for bleeding after cardiac surgery?
    J Thorac Cardiovasc Surg 2017 Sep 25;154(3):927-935. Epub 2017 May 25.
    Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
    Objective: To establish the risk factors and impact of reexploration for bleeding in a large modern cardiac surgical cohort.

    Methods: At a tertiary referral center, baseline, index procedural, reexploration, outcome, and readmission characteristics of 16,793 consecutive adult cardiac surgery patients were prospectively entered into dedicated clinical databases. Correlates of reexploration for bleeding, as well as its association with outcomes and readmission, were examined with multivariable regression models. Read More

    Mid-Term Performance of Bipolar Radiofrequency Ablation for Isolated Atrial Fibrillation Through a Right Minithoracotomy.
    Semin Thorac Cardiovasc Surg 2017 Summer;29(2):160-172. Epub 2017 Jan 14.
    Department of Cardiac Surgery, GVM Care and Research, Anthea Hospital, Bari, Italy.
    Catheter ablation is considered the first-line treatment for drug-refractory atrial fibrillation (AF). Minimally invasive epicardial pulmonary veins isolation may provide durable freedom from recurrent arrhythmia. However, evidence come from small studies. Read More

    Outcomes Following Noncardiac Surgery in Patients with Ventricular Assist Devices: A Single-Center Experience.
    Am Surg 2017 Aug;83(8):842-846
    the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. Read More

    Perioperative acute myocardial infarction associated with non-cardiac surgery.
    Eur Heart J 2017 Aug;38(31):2409-2417
    Division of Cardiology, Department of Medicine, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY 10016, USA.
    Aims: Acute myocardial infarction (AMI) is a significant cardiovascular complication following non-cardiac surgery. We sought to evaluate national trends in perioperative AMI, its management, and outcomes.

    Methods And Results: Patients who underwent non-cardiac surgery from 2005 to 2013 were identified using the United States National Inpatient Sample. Read More

    Medical treatment strategies to reduce perioperative morbidity and mortality after carotid surgery.
    Semin Vasc Surg 2017 Mar 29;30(1):17-24. Epub 2017 Apr 29.
    Department of Vascular Surgery Division of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE27LX, UK. Electronic address:
    There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. Read More

    Do Institution-Level Blood Utilization and Blood Management Initiatives Meaningfully Impact Transfusion Practices in Cardiac Surgery?
    Anesth Analg 2017 Sep;125(3):731-733
    From the *Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; †Department of Cardiovascular Perfusion, Children's of Alabama, Birmingham, Alabama; ‡Department of Surgery, Division of Cardiovascular Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; and §Department of Pathology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama.

    [Dual Antiplatelet Therapy in the Perioperative Period - To Continue or Discontinue Treatment?]
    Dtsch Med Wochenschr 2017 Aug 15;142(16):1223-1230. Epub 2017 Aug 15.
    Herzzentrum Alter Hof, München.
    Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence. Results These recommendations include instructions for evaluating the patient- and procedure-specific risks of bleeding and ischaemia, general recommendations regarding the DAPT withdrawal strategy, and specific guidance for frequent surgical or diagnostic procedures. Read More

    Point-of-Care Ultrasound Facilitated Detection of Femoral Occlusive Septic Emboli During Mitral Valve Surgery: A Case Report.
    A A Case Rep 2017 Aug 10. Epub 2017 Aug 10.
    From the *Department of Anesthesiology and †Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
    Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. Read More

    Perioperative Statins Do Not Prevent Acute Kidney Injury After Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials.
    J Cardiothorac Vasc Anesth 2017 Apr 21. Epub 2017 Apr 21.
    Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address:
    Objectives: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery.

    Design: Systematic review and meta-analysis of randomized trials.

    Setting: Perioperative management in hospitals that perform cardiac surgery. Read More

    The Role of Psychiatric Diagnoses for Outcome After Hip and Knee Arthroplasty.
    J Arthroplasty 2017 Jul 8. Epub 2017 Jul 8.
    Section of Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen, Denmark.
    Background: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register.

    Methods: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11. Read More

    International survey on the perioperative management of pulmonary endarterectomy: the perfusion perspective.
    Perfusion 2017 Aug 1:267659117724865. Epub 2017 Aug 1.
    12 Department of Anesthesia, Perioperative Medicine and Pain Therapy, Dalhousie University, QEII Health Sciences Centre, Halifax, Canada.
    Introduction: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are traditionally linked to surgical and center experience. However, optimal perfusion care has not been well defined. Read More

    Perioperative management and monitoring of antiplatelet agents: a focused review on aspirin and P2Y12 inhibitors.
    Korean J Anesthesiol 2017 Aug 27;70(4):379-389. Epub 2017 Jul 27.
    Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.
    Platelets play pivotal roles in hemostasis as well as pathological arterial thrombosis. The combination of aspirin and a P2Y12 inhibitor has become the mainstay therapy in the ageing population with cardiovascular conditions, particularly during and after percutaneous coronary intervention. A number of novel P2Y12 inhibitors has become available in the recent years, and they markedly vary in pharmacokinetic and pharmacodynamic properties. Read More

    Dose-Response Head-to-Head Comparison of Inodilators Dobutamine, Milrinone, and Levosimendan in Chronic Experimental Pulmonary Hypertension.
    J Cardiovasc Pharmacol Ther 2017 Sep 1;22(5):485-495. Epub 2017 Mar 1.
    1 Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portugal.
    The choice of inodilator drug in the acute management of patients with pulmonary hypertension (PH) having right ventricular (RV) failure remains unsettled and challenging. Comprehensive experimental evaluations may provide further insight and fundamental translational research clues to support inodilator selection and clinical trial design. Our aim was to compare acute dose-response hemodynamic effects of inodilators dobutamine (DOB), milrinone (MIL), and levosimendan (LEV) in chronic experimental PH. Read More

    [Perioperative Management for Prevention of Cardiac Complications in General Thoracic Surgery].
    Kyobu Geka 2017 Jul;70(8):639-642
    Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
    For general thoracic surgeons, perioperative management for prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac disease. Sever cardiac failure should be detected and treated prior to surgery, and coronary artery may be examined in patients with risk factors for ischemic heart disease. Pulmonary resection sometimes causes right-sided heart failure due to reducing pulmonary vascular bed. Read More

    [Perioperative Management of Patients with Pulmonary Comorbidities Undergoing Lung Resection].
    Kyobu Geka 2017 Jul;70(8):634-638
    Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
    Chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) are 2 major pulmonary comorbidities of primary lung cancer patients. The COPD patients are at risk for respiratory failure after a major lung resection when lung resection exceeds the patient's pulmonary reserve. It is important to assess a postoperative risk based on the patient's cardiopulmonary function. Read More

    [Perioperative Management of Fontan Operation].
    Kyobu Geka 2017 Jul;70(8):627-633
    Department of Cardiovascular Surgery, Kitasato University School of Medicine, Tokyo, Japan.
    Surgical results of Fontan operation has been improved over the decades due to the introduction of the staged operations and some modifications of Fontan route from the classical atrio-pulmonary connection to total cavo-pulmonary connection. However, issues remain because of the single ventricular physiology of Fontan circulation. This article explains about the preoperative checklist for Fontan operation and tips on the postoperative management including an early extubation, use of inhaled nitric oxide after extubation, anticoagulation therapy, and efficacy of angiotensin converting enzyme inhibitor, supported by the cutting-edge evidence. Read More

    [Perioperative Care for Patients with Hypoplastic Left Heart Syndrome].
    Kyobu Geka 2017 Jul;70(8):622-626
    Shizuoka Children's Hospital, Department of Cardiovascular Surgery, Shizuoka, Japan.
    Hypoplastic Left Heart Syndrome (HLHS) is one of the most challenging congenital heart defects which require surgical interventions during neonatal period. In normal risk cohort, its surgical outcome has been improved dramatically since Dr. William Norwood reported the 1st successful case more than 30 years ago. Read More

    [Management of Right Heart Failure after Cardiac Surgery].
    Kyobu Geka 2017 Jul;70(8):617-621
    Department of Advanced Cardiopulmonary Failure, Kyushu University, Fukuoka, Japan.
    Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Read More

    [Prevention and Treatment of Mediastinitis Following Cardiac Surgery].
    Kyobu Geka 2017 Jul;70(8):601-604
    Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University, Saga, Japan.
    Mediastinitis after cardiac surgery occurs about 1% of the time and is associated with adverse effects on both short- and long-term outcomes. Therefore, prevention of mediastinitis is very important. However, when this complication occurs, a radical cure should be performed using a safe and reliable method. Read More

    [Chronic Kidney Disease;Tips and Pitfall of Perioperative Management].
    Kyobu Geka 2017 Jul;70(8):585-589
    Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
    Chronic kidney disease(CKD) is an important risk factor of open heart surgery. In addition, worsening of kidney function after the surgery leads to poor prognosis long-term. It is therefore crucial to protect the kidney function by intensive perioperative management in open heart surgery. Read More

    [Severe Carotid Artery Disease;Preoperative Assessment and Perioperative Management].
    Kyobu Geka 2017 Jul;70(8):578-584
    Department of Cardiovascular Surgery, Chiba University, Chiba, Japan.
    Cerebrovascular complication is the one of the most dreadful complication after open heart surgery which leads to significant decrease of quality of life even if the patients survived. To decrease these complications, carotid doppler echo as one of the non-invasive carotid screening modalities is effective. Carotid artery stenosis is common in the patients with coronary artery disease, and it is more frequent in the patients with more complexed coronary artery lesions. Read More

    Cardiac surgery score (CASUS) improves outcome prediction in patients treated with extracorporal life support (ECLS).
    Perfusion 2017 Aug 1:267659117723456. Epub 2017 Aug 1.
    1 Department of Cardiac Surgery, University Hospital Halle, Germany.
    Introduction: The often-unexpected necessity of extracorporeal life support (ECLS) implies that information on patients and end-organ functions at time of implantation is scarce. However, there is a need for early prognostic indicators and a score predicting the outcome. Therefore, we evaluated established laboratory parameters and widely used intensive care scores - cardiac surgery score (CASUS) and sequential organ failure assessment (SOFA) after ECLS implantation. Read More

    Focused Cardiac Ultrasound for the Regional Anesthesiologist and Pain Specialist.
    Reg Anesth Pain Med 2017 Sep/Oct;42(5):632-644
    From the *Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medical College, New York; †Department of Anesthesiology, Montefiore Medical Center; Albert Einstein College of Medicine, New York, NY; ‡Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA; §Department of Anesthesiology, Johns Hopkins University, Baltimore, MD; ∥Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark; and **Department of Anesthesiology, University of Cape Town, Cape Town, South Africa.
    This article in our point-of-care ultrasound (PoCUS) series discusses the benefits of focused cardiac ultrasound (FoCUS) for the regional anesthesiologist and pain specialist. Focused cardiac US is an important tool for all anesthesiologists assessing patients with critical conditions such as shock and cardiac arrest. However, given that ultrasound-guided regional anesthesia is emerging as the new standard of care, there is an expanding role for ultrasound in the perioperative setting for regional anesthesiologists to help improve patient assessment and management. Read More

    Impact of Pre-operative Cardiology Consultation Prior to Intermediate-risk Surgical Procedures.
    Eur J Clin Invest 2017 Aug 7. Epub 2017 Aug 7.
    Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology.
    Background: Patients undergoing noncardiac, nonvascular surgery (NCNVS) are at risk of perioperative cardiovascular events. However, benefits of cardiology consultation (CC) in patients with known or suspected cardiac disease undergoing intermediate-risk NCNVS is unknown.

    Methods: The study group included 700 consecutive patients referred for CC before intermediate-risk NCNVS in a tertiary-care teaching hospital. Read More

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