7,760 results match your criteria Perioperative Cardiac Management


Perioperative dual antiplatelets management for ventriculoperitoneal shunt operation in patients with hydrocephalus after stent-assisted coil embolization of the ruptured intracranial aneurysm.

Clin Neurol Neurosurg 2020 Jul 6;195:106067. Epub 2020 Jul 6.

Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: Ventriculoperitoneal shunt (VPS) surgery is sometimes necessary in patients who present with symptomatic hydrocephalus after undergoing stent-assisted coil embolization of ruptured intracranial aneurysms. However, there are no guidelines for the perioperative management of VPS using dual antiplatelet therapy (DAPT) and balancing between the thromboembolic and hemorrhagic complications. Studies regarding discontinuation of DAPT and its substitution with a less potent drug for reducing the risk of hemorrhage have been previously attempted; however, the sample size in these studies was small. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.106067DOI Listing

Liver resection in Cirrhotic liver: Are there any limits?

Int J Surg 2020 Jul 8. Epub 2020 Jul 8.

Chairman of HPB Surgical Division. Miguel Servet University Hospital. Zaragoza, Spain.

Liver resection remains one of the most technically challenging surgical procedure in abdominal surgery due to the complex anatomical arrangement in the liver and its rich blood supply that constitutes about 20% of the cardiac output per cycle. The challenge for resection in cirrhotic livers is even higher because of the impact of surgical stress and trauma imposed on borderline liver function and the impaired ability for liver regeneration in cirrhotic livers. Nonetheless, evolution and advancement in surgical techniques as well as knowledge in perioperative management of liver resection has led to a substantial improvement in surgical outcome in recent decade. Read More

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http://dx.doi.org/10.1016/j.ijsu.2020.06.050DOI Listing

Intraoperative venous air embolism in the non-cardiac surgery-the role of perioperative echocardiography in a case series report.

Ann Transl Med 2020 Jun;8(12):798

Department of Anesthesia, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.

Venous air embolism (VAE) is commonly one of the iatrogenic complications associated with divergent high-risk surgeries. In this case-series report, we presented a series of VAE cases in our institute during the last 6 consecutive years. There were total of nine cases suspected to be VAE according the clinical symptom and signs, of which seven cases were definitively diagnosed VAE using transthoracic echocardiography (TTE). Read More

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http://dx.doi.org/10.21037/atm-20-497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333140PMC

Interventions with Music in PECTus excavatum treatment (IMPECT trial): a study protocol for a randomised controlled trial investigating the clinical effects of perioperative music interventions.

BMJ Open 2020 Jul 8;10(7):e036380. Epub 2020 Jul 8.

Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, The Netherlands.

Introduction: Pectus excavatum repair is associated with substantial postoperative pain, despite the use of epidural analgesia and other analgesic regimens. Perioperative recorded music interventions have been shown to alleviate pain and anxiety in adults, but evidence for children and adolescents is still lacking. This study protocol describes a randomised controlled trial that evaluates the effects of recorded music interventions on postoperative pain relief in children and adolescents after pectus excavatum repair. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-036380DOI Listing

Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use.

J Cardiovasc Pharmacol 2020 Jul;76(1):4-22

Critical Care Proprietary Products, Orion Pharma, Espoo, Finland.

Levosimendan was first approved for clinical use in 2000, when authorization was granted by Swedish regulatory authorities for the hemodynamic stabilization of patients with acutely decompensated chronic heart failure (HF). In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitization and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced HF, right ventricular failure, pulmonary hypertension, cardiac surgery, critical care, and emergency medicine. Read More

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http://dx.doi.org/10.1097/FJC.0000000000000859DOI Listing

Levosimendan Efficacy and Safety: 20 years of SIMDAX in Clinical Use.

J Cardiovasc Pharmacol 2020 Jun 22. Epub 2020 Jun 22.

Critical Care Proprietary Products, Orion Pharma, Espoo, Finland.

Levosimendan was first approved for clinic use in 2000, when authorisation was granted by Swedish regulatory authorities for the haemodynamic stabilisation of patients with acutely decompensated chronic heart failure. In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitisation and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced heart failure, right ventricular failure and pulmonary hypertension, cardiac surgery, critical care and emergency medicine. Read More

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http://dx.doi.org/10.1097/FJC.0000000000000859DOI Listing

Postoperative Pain Management for Cardiac Surgery: Do We Need New Blocks?

J Cardiothorac Vasc Anesth 2020 Jun 17. Epub 2020 Jun 17.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN.

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http://dx.doi.org/10.1053/j.jvca.2020.06.039DOI Listing

Management of Tracheoesophageal Fistula Repair With Cardiac Dextroposition and Right Lung Agenesis: A Case Report.

A A Pract 2020 Jul;14(9):e01255

From the Department of Anesthesiology, Perioperative, and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001255DOI Listing

The impact of atrial fibrillation on outcomes in patients undergoing radical prostatectomy.

World J Urol 2020 Jul 4. Epub 2020 Jul 4.

Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Road, Dongcheng District, Beijing, 100730, China.

Purpose: To assess the role of atrial fibrillation (AF) on complicating inpatient outcomes of radical prostatectomy (RP).

Materials And Methods: We identified patients treated with RP during 2012-2014 within National Inpatient Sample (NIS) database. Length of stay, cost of hospitalization, and in-hospital complications were compared between patients with or without diagnosis of AF. Read More

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http://dx.doi.org/10.1007/s00345-020-03337-2DOI Listing

Tricuspid Regurgitation in Congestive Heart Failure: Management Strategies and Analysis of Outcomes.

J Cardiothorac Vasc Anesth 2020 Jun 12. Epub 2020 Jun 12.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Tricuspid regurgitation is a notable aspect of congestive heart failure and is linked with worse outcomes if untreated. Functional tricuspid regurgitation commonly is seen in patients with heart failure, particularly in patients presenting for surgical management, such as those for mechanical cardiac assist device implantation. This review aims to study the published data related to the surgical management of tricuspid regurgitation in the cardiac surgical population comprehensively. Read More

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http://dx.doi.org/10.1053/j.jvca.2020.06.022DOI Listing

The use of doxazosin before adrenalectomy for pheochromocytoma: is the duration related to intraoperative hemodynamics and postoperative complications?

Int Urol Nephrol 2020 Jul 3. Epub 2020 Jul 3.

Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.

Purpose: No conclusion exists for the optimum duration of preoperative administration of doxazosin (DOX) before adrenalectomy for pheochromocytoma. The purpose of this study is to investigate whether perioperative hemodynamics and postoperative outcomes are related to the duration of DOX administration.

Methods: In total, 132 patients managed preoperatively with single α-receptor blocker DOX were enrolled. Read More

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http://dx.doi.org/10.1007/s11255-020-02539-2DOI Listing

Perioperative care of the newborns with CHDs in the time of COVID-19.

Cardiol Young 2020 Jul 25;30(7):946-954. Epub 2020 Jun 25.

Department of Pediatric Cardiovascular Surgery, Yüksek İhtisas Cardiovascular Hospital of Ankara City Hospital, The Ministry of Health of Turkey, University of Health Sciences of Turkey, Ankara, Turkey.

Coronavirus disease 2019 (COVID-19), caused by a novel betacoronavirus (SARS-CoV-2), has led to an unexpected outbreak affecting people of all ages. The first data showed that COVID-19 could cause severe pulmonary disease, cardiac injury, and death in adults, especially the elderly and those with concomitant diseases. Currently, it was demonstrated that severe COVID-19 may also develop in neonatal age, although rarely. Read More

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http://dx.doi.org/10.1017/S1047951120001845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322211PMC

Surgical Aortic Valve Replacement for Aortic Stenosis in Dialysis Patients - Analysis of Japan Cardiovascular Surgery Database.

Circ J 2020 Jul 1. Epub 2020 Jul 1.

Department of Cardiovascular Surgery, Toho University, Sakura Medical Center.

Background: Perioperative risk during surgical aortic valve replacement (SAVR) is reportedly high in dialysis patients. We aimed to determine the postoperative mortality and morbidity and identify the perioperative risk factors of mortality during SAVR in dialysis-dependent patients.Methods and Results:From the Japan Adult Cardiovascular Surgery Database, we compared 2,875 dialysis-dependent patients with 18,839 non-dialysis patients who all underwent SAVR between January 2013 and December 2016. Read More

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http://dx.doi.org/10.1253/circj.CJ-20-0042DOI Listing

Prospective Study Evaluating a Pain Assessment Tool in a Postoperative Environment: Protocol for Algorithm Testing and Enhancement.

JMIR Res Protoc 2020 Jul 1;9(7):e17783. Epub 2020 Jul 1.

Department of Computer Science, University of California, Irvine, Irvine, CA, United States.

Background: Assessment of pain is critical to its optimal treatment. There is a high demand for accurate objective pain assessment for effectively optimizing pain management interventions. However, pain is a multivalent, dynamic, and ambiguous phenomenon that is difficult to quantify, particularly when the patient's ability to communicate is limited. Read More

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http://dx.doi.org/10.2196/17783DOI Listing

The role of high-sensitive troponin measurement as a biomarker during the postoperative period for the detection of myocardial injury after non-cardiac surgery.

J Perioper Pract 2020 Jul 1:1750458920930993. Epub 2020 Jul 1.

Perioperative Service, Royal Perth Hospital, Perth, Western Australia.

Myocardial injury after non-cardiac surgery is common and defined as myocardial ischaemia within 30 days after non-cardiac surgery. Diagnosis of myocardial injury after non-cardiac surgery is challenging as this could be clinically asymptomatic during the postoperative period due to many other factors. Role of high-sensitive cardiac troponin in diagnosing myocardial injury after non-cardiac surgery had been evaluated in several studies. Read More

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http://dx.doi.org/10.1177/1750458920930993DOI Listing

[Role of preoperative cardiology consultation in patients undergoing cancer surgery].

Ter Arkh 2020 Jan 15;92(1):25-29. Epub 2020 Jan 15.

Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Disease".

Aim: To evaluate the effects of preoperative cardiology consultation on the risk of perioperative cardiac complications in patients undergoing cancer surgery.

Materials And Methods: 74 patients with bronchial, lung, mediastinal and gastrointestinal cancer were referred to the cardiologist as a part of the preoperative management. Patients were assigned either to Group 1 (n=21), who required non - invasive testing or invasive coronary angiography (CAG), or to Group 2 (n=53), who did not have any indications to additional testing. Read More

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http://dx.doi.org/10.26442/00403660.2020.01.000478DOI Listing
January 2020

Severe low cerebral oximetry in difficult cardiopulmonary bypass weaning of low body-weight infant: a case report and literature review.

Authors:
Xuechao Hao Wei Wei

BMC Anesthesiol 2020 Jun 27;20(1):159. Epub 2020 Jun 27.

Department of Anesthesiology, The Research Unit of Perioperative Stress Assessment and Clinical Decision (2018RU012), Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, 610041, Chengdu, People's Republic of China.

Background: For infants undergoing complex cardiac surgery, hemodynamic management after cardiopulmonary bypass (CPB) is challenging because of severe myocardial edema, vasomotor dysfunction and weak tolerance to a change in blood volume. More importantly, the lack of availability of equipment for advanced monitoring, such as transesophageal echocardiography or transthoracic echocardiography, restricts the accurate assessment of hemodynamics.

Case Presentation: This is a case of severe hypotension and non-detectable pulse oxygen saturation (SpO) after CPB in a low-weight infant who had normal blood pressure and oxygen saturation before surgery. Read More

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http://dx.doi.org/10.1186/s12871-020-01071-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320539PMC

[ANESTHESIOLOGY AND CRITICAL CARE, PERIOPERATIVE MEDICINE, PAIN MANAGEMENT, EMERGENCY MEDICINE AND RESUSCITATION].

Authors:
Benjamin Drenger

Harefuah 2020 Jun;159(6):406-409

Hebrew University and Hadassah Faculty of Medicine, Jerusalem, Israel.

Introduction: Anesthesia and intensive care, perioperative medicine and pain management, emergency medicine and resuscitation, all together constitute the field of action of the anesthesiologist. The definition of "anesthesiologist" underestimates the profession, and the lack of anesthesiologists seems understandable when we examine the scope of their activities throughout the hospital. There is little awareness among the public of the extent of the anesthesiologist's activity. Read More

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Interleukin 10 and Heart Fatty Acid-Binding Protein as Early Outcome Predictors in Patients With Traumatic Brain Injury.

Front Neurol 2020 2;11:376. Epub 2020 Jun 2.

Department of Specialities of Internal Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Patients with traumatic brain injury (TBI) exhibit a variable and unpredictable outcome. The proteins interleukin 10 (IL-10) and heart fatty acid-binding protein (H-FABP) have shown predictive values for the presence of intracranial lesions. To evaluate the individual and combined outcome prediction ability of IL-10 and H-FABP, and to compare them to the more studied proteins S100β, glial fibrillary acidic protein (GFAP), and neurofilament light (NF-L), both with and without clinical predictors. Read More

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http://dx.doi.org/10.3389/fneur.2020.00376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280446PMC

[The clinical characteristics and surgical management of ciliated muconodular papillary tumor].

Zhonghua Zhong Liu Za Zhi 2020 Jun;42(6):491-494

Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

To investigate the clinical characteristics and surgical management based on the clinical manifestation, pathological feature and the medical imaging finding of ciliated muconodular papillary tumor (CMPT). The data of clinical manifestation, pathological feature and the medical imaging finding of 15 patients with CMPT who received surgical treatment from January 2017 to April 2019 were collected and retrospectively analyzed. CMPT generally occurred in the elderly people. Read More

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http://dx.doi.org/10.3760/cma.j.cn112152-20190829-00555DOI Listing

Opportune Time of Tooth Extraction in Individuals Requiring Ventricular Assist Device Implantation: A Retrospective Cohort Study.

J Oral Maxillofac Surg 2020 May 19. Epub 2020 May 19.

Professor, Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.

Purpose: Individuals with implantable ventricular assist devices (VADs) are at extremely high risk of bleeding, thromboembolism, and infection after undergoing invasive dental procedures. This study aimed to investigate the systemic and local complications of tooth extraction before and after VAD implantation.

Patients And Methods: This retrospective cohort study was conducted at a single center. Read More

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http://dx.doi.org/10.1016/j.joms.2020.05.019DOI Listing

Ultrasound-guided "hourglass-pattern" fascia iliac block combined with sacral plexus and gluteal epithelial nerve block for an elderly hip fracture patient with organ failure.

Medicine (Baltimore) 2020 Jun;99(25):e19732

Department of Anesthesiology, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu Province, P.R. China.

Introduction: Anesthesia management for high-risk elderly patients with hip fracture is challenging, it is significant to choose a more minimally invasive anesthesia technique for them than using conventional methods, like general anesthesia and neuraxial anesthesia.

Patients Concerns: Herein the patient suffered from the right intertrochanteric fracture, combined with heart failure, renal failure at the stage of uremia and pneumonia in her upper left lung DIAGNOSIS:: Because of right intertrochanteric fracture, internal fixation with proximal femoral intramedullary nail was scheduled for this patient INTERVENTIONS:: Ultrasound-guided "hourglass-pattern" fascia iliac block combined with sacral plexus and gluteal epithelial nerve block were performed to a high-risk elderly patient OUTCOMES:: The surgery in our report was successfully completed with our effective anesthesia technique and no perioperative complication occurred CONCLUSION:: Ultrasound-guided "hourglass-pattern" fascia iliac block combined with gluteal epithelial nerve block and sacral plexus block not only satisfied the anesthesia and provided effective postoperative analgesia of hip operation, but also has minimal invasion to high-risk elderly patients, and contributed to enhancing recovery after surgery. Read More

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http://dx.doi.org/10.1097/MD.0000000000019732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310916PMC

Intraoperative Management of Large Resuscitation-Associated Venous Air Embolism (VAE) for Emergent Neurological Surgery.

Case Rep Anesthesiol 2020 6;2020:8868037. Epub 2020 Jun 6.

Mayo Clinic, Department of Anesthesiology and Perioperative Medicine, Rochester, MN, USA.

Venous air embolism (VAE) is a well-described phenomenon that may have life-threatening cardiopulmonary and neurological consequences. Accidental administration of air during resuscitation while using a rapid infuser is rare. Furthermore, there is a paucity of published data describing the intraoperative management of VAE during emergent nonseated neurological surgery. Read More

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http://dx.doi.org/10.1155/2020/8868037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294353PMC

Impact of Deceased Donor Management on Donor Heart Use and Recipient Graft Survival.

J Am Coll Surg 2020 Jun 17. Epub 2020 Jun 17.

Operative Care Division, Section of Surgical Critical Care, VA Portland Health Care System, Portland, OR; Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, OR. Electronic address:

Background: Current risk-adjusted models used to predict donor heart utilization and cardiac graft survival from organ donors after brain death (DBDs) do not include bedside critical care data. We sought to identify novel independent predictors of heart utilization and graft survival to better understand the relationship between donor management and transplant outcomes.

Study Design: Prospective observational study of DBDs managed from 2008 to 2013 by 10 organ procurement organizations. Read More

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http://dx.doi.org/10.1016/j.jamcollsurg.2020.05.025DOI Listing

Thromboelastometry and a hemostasis management system are most beneficial for guiding hemostatic therapy in cardiac surgery patients with a EuroSCORE II of ≥1.83%: a randomized controlled two-step trial.

J Anesth 2020 Jun 17. Epub 2020 Jun 17.

Department of Anesthesiology and Intensive Care, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, 116-8567, Japan.

Purpose: We evaluated the efficacy of hemostatic therapy based on point-of-care (POC) testing in patients undergoing cardiac surgery.

Methods: This was a single-institution, prospective, randomized, double-blinded study. In step 1, 90 patients scheduled for elective cardiac surgery underwent complete blood count and fibrinogen measurements at baseline, after cardiopulmonary bypass (CPB) initiation (CPB start), just after CPB end, and in the intensive care unit (ICU). Read More

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http://dx.doi.org/10.1007/s00540-020-02810-xDOI Listing

How I treat Anemia in the Perisurgical Setting.

Blood 2020 Jun 18. Epub 2020 Jun 18.

Stanford University, Stanford, California, United States.

Anemia is a common finding in perioperative setting with significant untoward consequences including worsening of outcomes and diminished quality of life as well as increased risk of allogeneic blood transfusions. Here we present three cases that illustrate how anemia can be perioperatively managed in patients undergoing cardiac, orthopedic and oncology surgeries. Timely detection of anemia prior to high-blood loss surgeries can allow clinicians to manage it and optimize hemoglobin level, making patients better prepared for the surgery. Read More

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http://dx.doi.org/10.1182/blood.2019003945DOI Listing

Impact of Hospital Volume on Outcomes of Elective Pneumonectomy in the United States.

Ann Thorac Surg 2020 Jun 15. Epub 2020 Jun 15.

Cardiovascular Outcomes Research Laboratories, University of California, Los Angeles; Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles. Electronic address:

Background: Despite advances in surgical technique and perioperative management, pneumonectomy remains associated with significant morbidity and mortality. The purpose of this study was to examine the impact of annual, institutional volume of anatomic lung resections on outcomes following elective pneumonectomy.

Methods: We evaluated all patients who underwent elective pneumonectomy from 2005 to 2014 in the National Inpatient Sample. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.04.115DOI Listing

Acute hemodynamics of cardiac sympathetic denervation.

Indian Pacing Electrophysiol J 2020 Jun 14. Epub 2020 Jun 14.

Holy Family Hospital, Bandra West, Mumbai, 400050, India.

Introduction: We aimed to study the immediate hemodynamic effects of thoracoscopic bilateral cardiac sympathetic denervation (CSD) for recurrent ventricular tachycardia (VT) or VT storm.

Method: We studied a group of 18 adults who underwent bilateral thoracoscopic CSD; the blood pressure (BP) and Heart Rate (HR) were continuously monitored during the surgery and up to 6 h post-operatively.

Results: Immediately on removal of the sympathetic ganglia, the patients had a drop in both the systolic (110 mm Hg to 95. Read More

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http://dx.doi.org/10.1016/j.ipej.2020.06.006DOI Listing

Haemodynamics and vasopressor support during prolonged targeted temperature management for 48 hours after out-of-hospital cardiac arrest: a post hoc substudy of a randomised clinical trial.

Eur Heart J Acute Cardiovasc Care 2020 Jun 17:2048872620934305. Epub 2020 Jun 17.

Research Center for Emergency Medicine, Aarhus University Hospital and Aarhus University, Denmark.

Background: Comatose patients admitted after out-of-hospital cardiac arrest frequently experience haemodynamic instability and anoxic brain injury. Targeted temperature management is used for neuroprotection; however, targeted temperature management also affects patients' haemodynamic status. This study assessed the haemodynamic status of out-of-hospital cardiac arrest survivors during prolonged (48 hours) targeted temperature management at 33°C. Read More

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http://dx.doi.org/10.1177/2048872620934305DOI Listing

The Impact of Intraoperative Patient Blood Management on Quality Development in Cardiac Surgery.

J Cardiothorac Vasc Anesth 2020 May 15. Epub 2020 May 15.

Department of Hemostaseology and Transfusion Medicine, Heinrich-Heine-University, Düsseldorf, Germany.

Objectives: Patient blood management (PBM) is increasingly introduced into clinical practice. Minimizing effects on transfusion have been proven, but relevance for clinical outcome has been sparsely examined. In regard to this, the authors analyzed the impact of introducing intraoperative PBM to cardiac surgery. Read More

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http://dx.doi.org/10.1053/j.jvca.2020.04.025DOI Listing

How to minimize peri-procedural complications during subcutaneous defibrillator implant?

Expert Rev Cardiovasc Ther 2020 Jul 2:1-8. Epub 2020 Jul 2.

Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center , Columbus, OH, USA.

Introduction: Subcutaneous defibrillator (S-ICD) is the latest development in the clinically available devices for sudden cardiac death prevention. Experience from pivotal trials and post-marketing studies has proven the feasibility and safety of S-ICD. Extra-cardiac location of S-ICD obviates the need for transvenous leads which translates into lower incidence of lead-related complications and systemic infections. Read More

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http://dx.doi.org/10.1080/14779072.2020.1784006DOI Listing

Effect of QT interval prolongation on cardiac arrest following liver transplantation and derivation of a risk index.

Am J Transplant 2020 Jun 12. Epub 2020 Jun 12.

Department of Cardiology, Austin Health, Melbourne, Victoria, Australia.

Liver transplantation (LT) has a 4-fold higher risk of periprocedural cardiac arrest and ventricular arrhythmias (CA/VAs) compared with other noncardiac surgeries. Prolongation of the corrected QT interval (QTc) is common in patients with liver cirrhosis. Whether it is associated with an increased risk of CA/VAs following LT is unclear. Read More

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http://dx.doi.org/10.1111/ajt.16145DOI Listing

Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy.

Can Urol Assoc J 2020 Jun 5. Epub 2020 Jun 5.

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.

Introduction: Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP.

Methods: Hospitalized patients who underwent RALRP from 2008-2014 were identified using the National Inpatient Sample database. Read More

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http://dx.doi.org/10.5489/cuaj.6389DOI Listing

The Impact of Perioperative Use of a Statin-Magnesium Combination on Opioid Consumption in Patients Who Underwent Cardiac Surgery: A Retrospective Study with Propensity-Score Matching.

Chonnam Med J 2020 May 25;56(2):130-135. Epub 2020 May 25.

Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea.

Both statins and magnesium are associated with NMDA receptors and anti-inflammatory effect. Peripheral NMDA receptors are known to be involved in inflammation-induced pain. This study aimed to investigate the impact of perioperative use of a statin-magnesium combination on opioid consumption in patients who underwent cardiac surgery. Read More

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http://dx.doi.org/10.4068/cmj.2020.56.2.130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250675PMC

Post-Discharge Pain Management After Thoracic Surgery - A Patient-Centered Approach.

Ann Thorac Surg 2020 Jun 1. Epub 2020 Jun 1.

Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, U.S.A.; Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, U.S.A.. Electronic address:

Background: Postoperative analgesia is paramount to recovery following thoracic surgery, and opioids play an invaluable role in this process. Yet, current one-size-fits-all prescribing practices produce large quantities of unused opioids, increasing the risk of nonmedical use and overdose. Here, we hypothesized that patient and perioperative characteristics, including 24-hour before discharge opioid intake, could inform more appropriate post-discharge prescriptions after thoracic surgery. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.04.048DOI Listing

A Comprehensive and Contemporary Review on Immunosuppression Therapy for Heart Transplantation.

Curr Pharm Des 2020 Jun 3. Epub 2020 Jun 3.

Heart Transplantation Unit, Cardiology Department, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre. Brazil.

Heart transplantation is the standard of therapy for patients with end-stage heart disease. Since the first human-to-human heart transplantation, performed in 1967, advances in organ donation, surgical techniques, organ preservation, perioperative care, immunologic risk assessment, immunosuppression agents, monitoring of graft function and surveillance of long-term complications have drastically increased recipient survival. However, there are yet many challenges in the modern era of heart transplantation in which immunosuppression may play a key role for further advances in the field. Read More

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http://dx.doi.org/10.2174/1381612826666200603130232DOI Listing

Anaesthesia concerns and perioperative management in a child with DiGeorge syndrome with corrected tetralogy of Fallot with pulmonary atresia posted for laparoscopic orchidopexy: Case report.

Indian J Anaesth 2020 Apr 28;64(4):322-324. Epub 2020 Mar 28.

Department of Anaesthesiology and Paediatric Cardiac Sciences, Sir H. N. Reliance Hospital, Mumbai, Maharashtra, India.

DiGeorge syndrome is afflicted with multiple congenital anomalies such as conotruncal and craniofacial anomaly, immune system dysfunction and hypoplasia/aplasia of parathyroid glands. Laparoscopy is a preferred surgical approach over open orchidopexy due to better visualisation of impalpable testis avoiding long incision, minimal tissue damage and a faster recovery. We report a case of DiGeorge syndrome with corrected tetralogy of Fallot with pulmonary atresia in a 1-year-old male child posted for laparoscopic orchidopexy. Read More

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http://dx.doi.org/10.4103/ija.IJA_770_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259404PMC

Neuromuscular blockade management in the critically Ill patient.

J Intensive Care 2020 24;8:37. Epub 2020 May 24.

3Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN USA.

Neuromuscular blocking agents (NMBAs) can be an effective modality to address challenges that arise daily in the intensive care unit (ICU). These medications are often used to optimize mechanical ventilation, facilitate endotracheal intubation, stop overt shivering during therapeutic hypothermia following cardiac arrest, and may have a role in the management of life-threatening conditions such as elevated intracranial pressure and status asthmaticus (when deep sedation fails or is not tolerated). However, current NMBA use has decreased during the last decade due to concerns of potential adverse effects such as venous thrombosis, patient awareness during paralysis, development of critical illness myopathy, autonomic interactions, and even residual paralysis following cessation of NMBA use. Read More

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http://dx.doi.org/10.1186/s40560-020-00455-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245849PMC

Low Body Weight Predicted Bradycardia and Desaturation in Retinopathy of Prematurity Surgeries: A Retrospective Cohort Study.

Front Pediatr 2020 5;8:226. Epub 2020 May 5.

Department of Anesthesiology, Peking University People's Hospital, Beijing, China.

As a leading cause of childhood blindness, the epidemic of retinopathy of prematurity (ROP) in China is characterized by advanced stage of ROP in more mature infants than those in the West. More advanced stage of disease necessitates more complicated surgical procedures and consequently exposure to general anesthesia. These ex-prematurely born infants are at risk of developing desaturation especially after surgery under general anesthesia. Read More

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http://dx.doi.org/10.3389/fped.2020.00226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232568PMC

Blood Pressure Management Following Large Vessel Occlusion Strokes: A Narrative Review.

Balkan Med J 2020 May 29. Epub 2020 May 29.

Department of Anesthesiology and Perioperative Medicine, Stroke ICU, University of Louisville Hospital Kentucky, USA.

Stroke is one of the leading causes of mortality and morbidity worldwide. Intravenous tissue Plasminogen Activator (tPA) and Mechanical Thrombectomy (MT) comprise the two major treatments for acute ischemic stroke. tPA has been used for more than two decades and guidelines for hemodynamic management following tPA administration are well established. Read More

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http://dx.doi.org/10.4274/balkanmedj.galenos.2020.2020.4.196DOI Listing

Challenging report of cardiopulmonary bypass in 16th week pregnant patient with endoventricular mass.

Heart Lung 2020 May 28. Epub 2020 May 28.

Division of Cardiovascular Emergencies, University of Napoli "Federico II", Italy. Electronic address:

Background: Pregnancy usually represents a risk factor for aortic dissection or thrombotic events, but therapeutic options are very scarce because the foetus limits the common approaches especially in the early stages of pregnancy.

Case Presentation: We present a challenging case of a young woman in her 16th week of gestation with an history of multiple abortions associated with autoimmune thrombophilia. A strictly designed perioperative management protocol was required to remove a huge right endoventricular mass, due to her decision to not terminate the pregnancy. Read More

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http://dx.doi.org/10.1016/j.hrtlng.2020.05.008DOI Listing

Combined Coronary Artery Bypass Grafting, Aortic, and Lung Carcinoma Surgery.

Thorac Cardiovasc Surg Rep 2020 Jan 22;9(1):e21-e23. Epub 2020 May 22.

Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany.

 Patients presenting with several cardiothoracic conditions that need to be addressed surgically require individual decision making as evidence remains inconclusive and combined surgical procedures carry an elevated perioperative risk.  We present the case and management of a 73-year-old male with myocardial infarction due to three-vessel disease and left main stem stenosis, calcified aortic aneurysm, and right-sided non-small cell lung carcinoma.  High-risk combined surgery should be indicated with scrutiny after individual consideration by an experienced heart team. Read More

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http://dx.doi.org/10.1055/s-0040-1710321DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244333PMC
January 2020

Approaches to Minimizing Periprocedural Complications During Subcutaneous Implantable Cardioverter-defibrillator Placement.

J Innov Card Rhythm Manag 2020 May 15;11(5):4100-4105. Epub 2020 May 15.

Division of Cardiovascular Medicine, Wexner Medical Center, Ohio State University Medical Center, Columbus, OH, USA.

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is the latest option among devices clinically available for the prevention of sudden cardiac death, with experience from previous trials and postmarketing studies supporting the feasibility and safety of this kind of system. The extracardiac positioning of the S-ICD obviates the need for transvenous leads, which translates into lower incidence rates of lead-related complications and systemic infections. This review will highlight the results of pertinent studies related to the perioperative management of S-ICDs and review potential approaches to minimizing the risk of complications such as hematoma at the pulse generator location, unsuccessful defibrillation due to suboptimal S-ICD lead and generator positioning, and postoperative pain. Read More

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http://dx.doi.org/10.19102/icrm.2020.110504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244169PMC

Intubation precautions in a pediatric patient with severe COVID-19.

J Pediatr Surg Case Rep 2020 Jul 18;58:101495. Epub 2020 May 18.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA.

We present the case of a child diagnosed with COVID-19 soon after open-heart surgery who required an urgent second surgery. The patient suffered from severe COVID-19 disease. The utility of preoperative COVID-19 testing, determination of recovery by an array of inflammatory markers and perioperative management are described. Read More

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http://dx.doi.org/10.1016/j.epsc.2020.101495DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233244PMC

Effect of Ketamine/Propofol Admixture on Peri-Induction Hemodynamics: A Systematic Review and Meta-Analysis.

Anesthesiol Res Pract 2020 8;2020:9637412. Epub 2020 May 8.

Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.

To evaluate the effectiveness of an admixture of ketamine and propofol on peri-induction hemodynamics during airway manipulation, we searched electronic databases of randomized controlled trials from January 1, 2000, to October 17, 2018. Trial screening, selection, and data extraction were done independently by two reviewers with outcomes pooled across included trials using the random-effects model. We included 10 randomized trials (722 patients, mean age of 53. Read More

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http://dx.doi.org/10.1155/2020/9637412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231081PMC

Tetralogy of Fallot With Pulmonary Atresia: Anatomy, Physiology, Imaging, and Perioperative Management.

Semin Cardiothorac Vasc Anesth 2020 May 26:1089253220920480. Epub 2020 May 26.

Seattle Children's Hospital, Seattle, WA, USA.

Tetralogy of Fallot (ToF) with pulmonary atresia (ToF-PA) is a complex congenital heart defect at the extreme end of the spectrum of ToF, with no antegrade flow into the pulmonary arteries. Patients differ with regard to the sources of pulmonary blood flow. In the milder spectrum of disease, there are confluent branch pulmonary arteries fed by ductus arteriosus. Read More

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http://dx.doi.org/10.1177/1089253220920480DOI Listing

Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study.

J Knee Surg 2020 May 25. Epub 2020 May 25.

Sydney Orthopaedic Research Institute, Chatswood, New South Wales, Australia.

Despite multiple studies, there remains a debate on the safety of bilateral total knee arthroplasty (BTKA) in the average age patient, with a paucity of data on the outcome of BTKA in an elderly population. This study included 89 patients aged 80 years and older undergoing sequential BTKA over 14 years were identified in a prospectively collected database. Two matched comparison groups were created: patients under 80 undergoing sequential BTKA and patients over 80 undergoing unilateral TKA (UTKA). Read More

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http://dx.doi.org/10.1055/s-0040-1712100DOI Listing

Molecular mechanisms by which iNOS uncoupling can induce cardiovascular dysfunction during sepsis: Role of posttranslational modifications (PTMs).

Life Sci 2020 Aug 20;255:117821. Epub 2020 May 20.

Department of Anaesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, Canada; Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Canada.

Human sepsis is the result of a multifaceted pathological process causing marked dysregulation of cardiovascular responses. A more sophisticated understanding of the pathogenesis of sepsis is certainly prerequisite. Evidence from studies provide further insight into the role of inducible nitric oxide synthase (iNOS) isoform. Read More

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http://dx.doi.org/10.1016/j.lfs.2020.117821DOI Listing