6,781 results match your criteria Perioperative Cardiac Management


Pheochromocytoma-related cardiomyopathy presenting as broken heart syndrome: Case report and literature review.

Int J Surg Case Rep 2019 Jan 9;55:7-10. Epub 2019 Jan 9.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, United States.

Introduction: Pheochromocytoma are neuroendocrine tumors that arise from sympathetic chromaffin cells within the adrenal medulla. They principally secrete catecholamines, potentially causing life-threatening cardiovascular complications. A myriad of symptomatology and clinical findings are associated with pheochromocytoma, including a catecholamine-induced dilated cardiomyopathy. Read More

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http://dx.doi.org/10.1016/j.ijscr.2018.12.003DOI Listing
January 2019

Maternal Mirror Syndrome Masquerading as Congestive Heart Failure: A Case Report.

A A Pract 2019 Jan 10. Epub 2019 Jan 10.

Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania.

Mirror syndrome is a rare pregnancy complication, life-threatening to mother and fetus. Increasing survival rates of congenital heart disease into reproductive age mean that complications like Mirror syndrome in this population may be more challenging to diagnose, given overlapping signs of edema in cases of heart failure exacerbation. We report a case of a pregnant woman with a history of unspecified congenital heart disease, presenting with swelling and distension, with diagnostic findings not consistent with preeclampsia. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000965DOI Listing
January 2019

Perioperative impact of sleep apnea in a high-volume specialty practice with a strong focus on regional anesthesia: a database analysis.

Reg Anesth Pain Med 2019 Jan 11. Epub 2019 Jan 11.

Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA

Background And Objectives: Obstructive sleep apnea (OSA) is a risk factor for adverse postoperative outcome and perioperative professional societies recommend the use of regional anesthesia to minimize perioperative detriment. We studied the impact of OSA on postoperative complications in a high-volume orthopedic surgery practice, with a strong focus on regional anesthesia.

Methods: After Institutional Review Board approval, 41 766 cases of primary total hip and knee arthroplasties (THAs/TKAs) from 2005 to 2014 were extracted from institutional data of the Hospital for Special Surgery (approximately 5000 THAs and 5000 TKAs annually, of which around 90% under neuraxial anesthesia). Read More

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http://dx.doi.org/10.1136/rapm-2018-000038DOI Listing
January 2019

Effects of Dezocine-Remifentanil Intravenous Anaesthesia on Perioperative Signs, Serum TNF-&aipha; and IL-6 in Liver Cancer Patients undergoing Radiofrequency Ablation.

J Coll Physicians Surg Pak 2019 Jan;29(1):4-7

Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.

Objective: To analyse the impact of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum tumour necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in liver cancer patients undergoing radiofrequency ablation (RFA).

Study Design: An experimental study.

Place And Duration Of Study: Renmin Hospital of Wuhan University, Wuhan, China, from January 2017 to February 2018. Read More

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http://dx.doi.org/10.29271/jcpsp.2019.01.4DOI Listing
January 2019
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Management of antiplatelet therapy for non-elective invasive procedures or bleeding complications: Proposals from the French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Thrombosis and Haemostasis (GFHT), in collaboration with the French Society for Anaesthesia and Intensive Care (SFAR).

Arch Cardiovasc Dis 2019 Jan 5. Epub 2019 Jan 5.

Service d'angiologie et d'hémostase, département de spécialités de médecine, hôpitaux universitaires de Genève, 1205 Genève, Switzerland; Geneva Platelet Group, faculté de médecine, université de Genève, 1205 Genève, Switzerland.

The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT), in collaboration with the French Society for Anaesthesia and Intensive Care (SFAR), drafted up-to-date proposals on the management of antiplatelet therapy for non-elective invasive procedures or bleeding complications. The proposals were discussed and validated by a vote; all proposals could be assigned with a high strength. Management of oral antiplatelet agents in emergency settings requires knowledge of their pharmacokinetic and pharmacodynamic parameters, evaluation of the degree of alteration of haemostatic competence and the associated bleeding risk. Read More

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http://dx.doi.org/10.1016/j.acvd.2018.10.004DOI Listing
January 2019

A 71-year-old woman with an asymptomatic postoperative troponin elevation.

CMAJ 2019 Jan;191(1):E11-E14

Department of Medicine (Ruzycki, Kachra); W21C Research and Innovation Centre (Kachra), Cumming School of Medicine; Division of Cardiology (Lyons), Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alta.

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http://dx.doi.org/10.1503/cmaj.181085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312517PMC
January 2019

Perioperative and Anesthetic Management of Coarctation of the Aorta.

Semin Cardiothorac Vasc Anesth 2019 Jan 7:1089253218821953. Epub 2019 Jan 7.

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

Isolated coarctation of the aorta is a relatively common form of congenital heart disease that is characterized by variable degrees of obstruction to aortic outflow. The clinical presentation varies from asymptomatic arterial hypertension to cardiogenic shock. The treatment options include surgical repair or interventional therapy with aortic balloon dilation and stent placement. Read More

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http://dx.doi.org/10.1177/1089253218821953DOI Listing
January 2019
2 Reads

Nutrition of neonates with congenital heart disease: existing evidence, conflicts and concerns.

J Matern Fetal Neonatal Med 2019 Jan 4:1-6. Epub 2019 Jan 4.

a Department of Pediatrics , NICU, University of Patras Medical School , Patras , Greece.

Introduction: Congenital heart disease is one of the most of the groups of congenital anomalies with an incidence of about 1 per 100 live births. Almost one-third of these infants require some type of intervention, usually in the first year of life and increasingly often in the neonatal period. Innovative reparative and palliative surgical procedures and advanced medical support in the Neonatal Intensive Care Unit have significantly reduced the mortality related to congenital heart disease. Read More

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http://dx.doi.org/10.1080/14767058.2018.1548602DOI Listing
January 2019
2 Reads

The Disparate Effects of Epinephrine and Norepinephrine on Hyperglycemia in Cardiovascular Surgery.

Heart Surg Forum 2018 Dec 19;21(6):E522-E526. Epub 2018 Dec 19.

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.

Hyperglycemia is a metabolic derangement that frequently develops after cardiovascular surgery. The perioperative administration of inotropic and vasoactive agents, such as epinephrine and norepinephrine, are common in the management of cardiac surgery patients and are known to contribute to the development of postoperative hyperglycemia. We hypothesized that hemodynamic support with epinephrine exacerbates postoperative hyperglycemia to a greater degree than does treatment with norepinephrine. Read More

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http://dx.doi.org/10.1532/hsf.2008DOI Listing
December 2018
1 Read

Electromagnetic Interference with Protocolized Electrosurgery Dispersive Electrode Positioning in Patients with Implantable Cardioverter Defibrillators.

Anesthesiology 2018 Dec 28. Epub 2018 Dec 28.

From the Department of Anesthesiology and Perioperative Medicine (P.M.S., M.M.T., M.J.M., V.S., I.H., R.B.A., A.B., N.A.) the Knight Cardiovascular Institute (C.A.H., P.M.J., T.A.D., E.C.S.) Oregon Health and Science University, Portland, Oregon; the School of Public Health, Oregon Health and Science University and Portland State University, Portland, Oregon (N.D.Y.) Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (E.K.).

What We Already Know About This Topic: Electromagnetic interference from monopolar electrosurgery may disrupt implantable cardioverter defibrillators.Current management recommendations by the American Society of Anesthesiologists and Heart Rhythm Society are based on expert clinical opinion since there is a paucity of data regarding the risk of electromagnetic interference to implantable cardioverter defibrillators during surgery.

What This Article Tells Us That Is New: With protocolized electrosurgery dispersive electrode positioning in patients with implantable cardioverter defibrillators, the risk of clinically meaningful electromagnetic interference was 7% in above-the-umbilicus noncardiac surgery and 0% in below-the-umbilicus surgery. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002571DOI Listing
December 2018
1 Read

Systematic review and meta-analysis of acute type B thoracic aortic dissection, open, or endovascular repair.

J Vasc Surg 2018 Dec 28. Epub 2018 Dec 28.

Department of Aortovascular Surgery, Manchester Royal Infirmary, Manchester, United Kingdom.

Objective: The purpose of this study was to compare perioperative and mortality outcomes of endovascular aortic repair against open repair in acute type B thoracic aortic dissection.

Methods: A comprehensive search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all published data comparing open vs endovascular repair in management of acute type B aortic dissection. Databases where evaluated and assessed to July 2017. Read More

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http://dx.doi.org/10.1016/j.jvs.2018.08.187DOI Listing
December 2018

Medical therapy for atherosclerotic cardiovascular disease in patients with myocardial injury after non-cardiac surgery.

Int J Cardiol 2018 Dec 12. Epub 2018 Dec 12.

Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University Langone Medical Center, New York, NY, United States of America.

Background: Myocardial injury after non-cardiac surgery (MINS) is a common post-operative cardiovascular complication and is associated with short and long-term mortality. The objective of this study was to describe the contemporary management of patients with and without MINS after total joint and spine orthopedic surgery at a large urban health system in the United States.

Methods: Adults admitted for total joint and major spine surgery from January 2013 through December 2015 with ≥1 cardiac troponin (cTn) measurement during their hospitalization were identified. Read More

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http://dx.doi.org/10.1016/j.ijcard.2018.12.032DOI Listing
December 2018

The Right Ventricle During Selective Lung Ventilation for Thoracic Surgery.

J Cardiothorac Vasc Anesth 2018 Nov 22. Epub 2018 Nov 22.

University Hospitals Birmingham National Health Service Foundation Trust, Department of Critical Care Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, Centre of Translational Inflammation Research, University of Birmingham, Birmingham, UK.

The right ventricle (RV) has been an area of evolving interest after decades of being ignored and considered less important than the left ventricle. Right ventricular dysfunction/failure is an independent predictor of mortality and morbidity in cardiac surgery; however, very little is known about the incidence or impact of RV dysfunction/failure in thoracic surgery. The pathophysiology of RV dysfunction/failure has been studied in the context of acute respiratory distress syndrome (ARDS), cardiac surgery, pulmonary hypertension, and left ventricular failure, but limited data exist in literature addressing the issue of RV dysfunction/failure in the context of thoracic surgery and one-lung ventilation (OLV). Read More

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http://dx.doi.org/10.1053/j.jvca.2018.11.030DOI Listing
November 2018
1 Read

Impact of Age on Perioperative Outcomes at Radical Prostatectomy: A Population-Based Study.

Eur Urol Focus 2018 Dec 26. Epub 2018 Dec 26.

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Québec, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada.

Background: Radical prostatectomy (RP) represents one standard of care for patients with localized prostate cancer and is associated with several established postoperative complications.

Objective: We tested the relationship between RP early postoperative outcomes and age within a population-based data repository.

Design, Setting, And Participants: Within the National Inpatient Sample database (2008-2013), we identified patients who underwent robotically assisted or open RP. Read More

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http://dx.doi.org/10.1016/j.euf.2018.12.006DOI Listing
December 2018
1 Read

Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anaesthetists Practice Advisory for the Management of Perioperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

J Cardiothorac Vasc Anesth 2019 Jan;33(1):12-26

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.

Postoperative atrial fibrillation (poAF) is the most common adverse event after cardiac surgery and is associated with increased morbidity, mortality, and increased hospital and intensive care unit length of stay. Despite progressive improvements in overall cardiac surgical operative mortality and postoperative morbidity, the incidence of poAF has remained unchanged at 30% to 50%. A number of evidence-based recommendations regarding the perioperative management of atrial fibrillation (AF) have been released from leading cardiovascular societies in recent years; however, it is unknown how closely these guidelines are being followed by medical practitioners. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10530770183092
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http://dx.doi.org/10.1053/j.jvca.2018.09.039DOI Listing
January 2019
8 Reads

Mean arterial pressure during targeted temperature management and renal function after out-of-hospital cardiac arrest.

J Crit Care 2018 Dec 18;50:234-241. Epub 2018 Dec 18.

Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.

Purpose: This study investigates the association between mean arterial pressure (MAP) and renal function after out-of-hospital cardiac arrest (OHCA).

Materials And Methods: Post-hoc analysis of 851 comatose OHCA-patients surviving >48 h included in the targeted temperature management (TTM)-trial.

Results: Patients were stratified by mean MAP during TTM in the following groups; <70 mmHg (22%), 70-80 mmHg (43%), and > 80 mmHg (35%). Read More

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http://dx.doi.org/10.1016/j.jcrc.2018.12.009DOI Listing
December 2018
1 Read

Is Conventional Bypass for Coronary Artery Bypass Graft Surgery a Misnomer?

J Extra Corpor Technol 2018 Dec;50(4):225-230

Green Lane Perfusion, Auckland City Hospital, Auckland, New Zealand.

Although recent trials comparing on vs. off-pump revascularization techniques describe cardiopulmonary bypass (CPB) as "conventional," inadequate description and evaluation of how CPB is managed often exist in the peer-reviewed literature. We identify and subsequently describe regional and center-level differences in the techniques and equipment used for conducting CPB in the setting of coronary artery bypass grafting (CABG) surgery. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296447PMC
December 2018
7 Reads

Anesthesiologic Management of Patients Undergoing Cardiac Transapical Procedures: Which Challenges in the Modern Era?

J Cardiothorac Vasc Anesth 2018 Oct 28. Epub 2018 Oct 28.

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address:

Objective: Patients undergoing transapical cardiac procedure are a minority of cardiac surgery patients but represent a challenge for cardiac anesthesiologists because they generally are older and have more comorbidities than do open heart cardiac surgery patients. The aims of this study were to describe the anesthetic experience with transapical procedures in a single high-volume center and to analyze the most critical aspects for anesthetic management.

Design: Retrospective study. Read More

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http://dx.doi.org/10.1053/j.jvca.2018.10.039DOI Listing
October 2018
1 Read

High-flow humidified nasal preoxygenation in pregnant women: a prospective observational study.

Br J Anaesth 2019 Jan 3;122(1):86-91. Epub 2018 Oct 3.

Department of Anaesthesia, The Royal Women's Hospital, Parkville, Victoria, Australia; Departments of Obstetrics and Gynaecology, Pharmacology, and Medicine and Radiology (Anaesthesia, Perioperative and Pain Medicine Unit), University of Melbourne, Parkville, Victoria, Australia. Electronic address:

Background: Obstetric airway guidelines recommend preoxygenation in preparation for general anaesthesia to achieve end-tidal oxygen concentrations (etO) of ≥90%, and mention the potential use of high-flow humidified nasal oxygen (HFNO). We investigated the new HFNO technique (Optiflow™) in term pregnant women.

Methods: Seventy-three term participants underwent a 3 min HFNO protocol (30 L min for 30 s, and then 50 L min for 150 s). Read More

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http://dx.doi.org/10.1016/j.bja.2018.08.015DOI Listing
January 2019

Perioperative management of patients who are receiving antiplatelet therapy: a case-based, evidence-informed approach.

Pol Arch Intern Med 2018 Dec 21;128(12):771-778. Epub 2018 Dec 21.

Addressing the optimal management approach for patients who are receiving single or dual antiplatelet therapy is a common and sometimes challenging clinical problem, especially for patients with coronary stents who are receiving dual antiplatelet therapy with acetylsalicylic acid (ASA) combined with a P2Y12 inhibitor. Using a case-based format, we summarize the findings of recent clinical trials and key observational studies which help inform best practices for the perioperative antiplatelet management of noncardiac surgery and coronary artery bypass graft surgery. In this review, we explore the evidence to address 3 key questions: What is the minimum duration that a surgery should be delayed after coronary stent implantation? In patients who are receiving single antiplatelet therapy with ASA, how to manage patients who require noncardiac and cardiac surgery? In patients who are receiving dual antiplatelet therapy for a coronary stent, how to manage patients who require noncardiac and cardiac surgery? Read More

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http://dx.doi.org/10.20452/pamw.4403DOI Listing
December 2018
1 Read

Research priorities in single-ventricle heart conditions: a United Kingdom national study.

Cardiol Young 2018 Dec 21:1-7. Epub 2018 Dec 21.

2Institute of Cardiovascular Sciences,University of Birmingham,Birmingham,UK.

Objective: To bring together stakeholders in the United Kingdom to establish national priorities for research in single-ventricle heart conditions.

Methods: This study comprised two surveys and a workshop. The initial public online survey asked respondents up to three questions they would like answered for research. Read More

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http://dx.doi.org/10.1017/S104795111800224XDOI Listing
December 2018
1 Read

Clinical observation of tongue coating of perioperative patients: factors related to the number of bacteria on the tongue before and after surgery.

BMC Oral Health 2018 Dec 20;18(1):223. Epub 2018 Dec 20.

Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.

Background: Increased amount of tongue coating has been reported to be associated with increased bacteria count in the saliva and aspiration pneumonia in elderly people. However, the implications of tongue coating for prevention of postoperative complications in patients undergoing major oncologic or cardiac surgery has not been well documented. The purpose of this study is to investigate the number of bacteria on the tongue before and after surgery and factors affecting it. Read More

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http://dx.doi.org/10.1186/s12903-018-0689-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302525PMC
December 2018

Next generation viscoelasticity assays in cardiothoracic surgery: Feasibility of the TEG6s system.

PLoS One 2018 20;13(12):e0209360. Epub 2018 Dec 20.

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Background: Viscoelastic near-patient assays of global hemostasis have been found useful and cost-effective in perioperative settings. Shortcomings of current systems include substantial laboratory intensity, user-dependent reproducibility, relatively large sample volumes, sensitivity to ambient vibration and limited comparability between techniques and devices. The aim of this study was to assess feasibility of a new, resonance-based viscoelastic whole blood methodology (TEG6s) in cardiac surgery with cardiopulmonary bypass (CPB) and to compare the parameters this system produces with the ROTEM delta system and standard coagulation tests. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209360PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301661PMC
December 2018

Postoperative Complications Associated With Spine Surgery in Patients Older Than 90 Years: A Multicenter Retrospective Study.

Global Spine J 2018 Dec 19;8(8):887-891. Epub 2018 Apr 19.

Nagoya University Graduate School of Medicine, Nagoya, Japan.

Study Design: A review of a prospective database.

Objectives: Surgery for elderly patients is increasing yearly due to aging of society and the desire for higher quality of life. The goal of the study was to examine perioperative complications in spine surgery in such patients. Read More

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http://dx.doi.org/10.1177/2192568218767430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293421PMC
December 2018
1 Read

Postoperative Pain Management Strategies and Delirium After Transapical Aortic Valve Replacement: A Randomized Controlled Trial.

J Cardiothorac Vasc Anesth 2018 Nov 14. Epub 2018 Nov 14.

Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Canada. Electronic address:

Objective(s): This study was designed to compare 2 different perioperative analgesia strategies with respect to the incidence of postoperative delirium after a transapical approach for transcatheter aortic valve replacement (TAVR). The authors hypothesized that perioperative thoracic paravertebral analgesia with a local anesthetic would decrease opioid consumption and in turn reduce the incidence of postoperative delirium when compared with systemic opioid-based analgesia after a transapical TAVR procedure.

Design: Prospective, randomized controlled clinical trial. Read More

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http://dx.doi.org/10.1053/j.jvca.2018.11.010DOI Listing
November 2018
1 Read

Perioperative risk assessment with Euroscore and Euroscore II in patients with coronary artery or valvular disease.

Medicine (Baltimore) 2018 Dec;97(50):e13572

Department of Cardiac Surgery.

Nowadays, both the European System for Cardiac Operative Risk Evaluation (EuroSCORE) logistic (ESL) and EuroSCORE II (ESII) models are used worldwide in predicting in-hospital mortality after cardiac operation. However, these scales are based on different populations and represent different medical approaches. The aim of the study was to assess the effectiveness of the ESL and the ESII risk scores in predicting in-hospital death and prolonged hospitalization in intensive care unit (ICU) after coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve replacement (MVR) by comparison of an estimated risk and a real-life observation at a reference cardiac surgery unit. Read More

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http://dx.doi.org/10.1097/MD.0000000000013572DOI Listing
December 2018
1 Read

Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses.

BMJ Open 2018 Dec 14;8(12):e024086. Epub 2018 Dec 14.

Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Objective: This systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).

Design: Systematic review and meta-analysis.

Data Sources: PubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303633PMC
December 2018
1 Read
2.063 Impact Factor

Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anaesthetists Practice Advisory for the Management of Perioperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

Anesth Analg 2019 Jan;128(1):33-42

Department of Perioperative Medicine, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.

Postoperative atrial fibrillation (poAF) is the most common adverse event after cardiac surgery and is associated with increased morbidity, mortality, and hospital and intensive care unit length of stay. Despite progressive improvements in overall cardiac surgical operative mortality and postoperative morbidity, the incidence of poAF has remained unchanged at 30%-50%. A number of evidence-based recommendations regarding the perioperative management of atrial fibrillation (AF) have been released from leading cardiovascular societies in recent years; however, it is unknown how closely these guidelines are being followed by medical practitioners. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003865DOI Listing
January 2019
3 Reads

Minimally Invasive Periareolar Approach to Cor Triatriatum Repair.

Innovations (Phila) 2018 Nov/Dec;13(6):445-447

From the Division of Cardiac Surgery.

Cor triatriatum sinister is an uncommon cardiac abnormality characterized by a membrane that divides the left atrium into two chambers. Definitive management requires surgical resection, traditionally through sternotomy. Minimally invasive reparative techniques are associated with reduced blood loss, shorter hospitalization, faster recovery time, and improved cosmesis with excellent patient satisfaction. Read More

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http://dx.doi.org/10.1097/IMI.0000000000000565DOI Listing
December 2018

Pulse pressure and perioperative stroke.

Curr Opin Anaesthesiol 2019 Feb;32(1):57-63

Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Purpose Of Review: Central pulse pressure (PP), a marker of vascular stiffness, is a novel indicator of risk for perioperative morbidity including ischemic stroke. Appreciation for the mechanism by which vascular stiffness leads to organ dysfunction along with understanding its clinical detection may lead to improved patient management.

Recent Findings: Vascular stiffness is associated with increased mortality and neurologic, cardiac, and renal injury in nonsurgical and surgical patients. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310080PMC
February 2019

Agnostic Pathway/Gene Set Analysis of Genome-Wide Association Data Identifies Associations for Pancreatic Cancer.

Authors:
Naomi Walsh Han Zhang Paula L Hyland Qi Yang Evelina Mocci Mingfeng Zhang Erica J Childs Irene Collins Zhaoming Wang Alan A Arslan Laura Beane-Freeman Paige M Bracci Paul Brennan Federico Canzian Eric J Duell Steven Gallinger Graham G Giles Michael Goggins Gary E Goodman Phyllis J Goodman Rayjean J Hung Charles Kooperberg Robert C Kurtz Núria Malats Loic LeMarchand Rachel E Neale Sara H Olson Ghislaine Scelo Xiao O Shu Stephen K Van Den Eeden Kala Visvanathan Emily White Wei Zheng Demetrius Albanes Gabriella Andreotti Ana Babic William R Bamlet Sonja I Berndt Ayelet Borgida Marie-Christine Boutron-Ruault Lauren Brais Paul Brennan Bas Bueno-de-Mesquita Julie Buring Kari G Chaffee Stephen Chanock Sean Cleary Michelle Cotterchio Lenka Foretova Charles Fuchs J Michael M Gaziano Edward Giovannucci Michael Goggins Thilo Hackert Christopher Haiman Patricia Hartge Manal Hasan Kathy J Helzlsouer Joseph Herman Ivana Holcatova Elizabeth A Holly Robert Hoover Rayjean J Hung Vladimir Janout Eric A Klein Robert C Kurtz Daniel Laheru I-Min Lee Lingeng Lu Núria Malats Satu Mannisto Roger L Milne Ann L Oberg Irene Orlow Alpa V Patel Ulrike Peters Miquel Porta Francisco X Real Nathaniel Rothman Howard D Sesso Gianluca Severi Debra Silverman Oliver Strobel Malin Sund Mark D Thornquist Geoffrey S Tobias Jean Wactawski-Wende Nick Wareham Elisabete Weiderpass Nicolas Wentzensen William Wheeler Herbert Yu Anne Zeleniuch-Jacquotte Peter Kraft Donghui Li Eric J Jacobs Gloria M Petersen Brian M Wolpin Harvey A Risch Laufey T Amundadottir Kai Yu Alison P Klein Rachael Z Stolzenberg-Solomon

J Natl Cancer Inst 2018 Dec 12. Epub 2018 Dec 12.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Background: Genome-wide association studies (GWAS) identify associations of individual single-nucleotide polymorphisms (SNPs) with cancer risk but usually only explain a fraction of the inherited variability. Pathway analysis of genetic variants is a powerful tool to identify networks of susceptibility genes.

Methods: We conducted a large agnostic pathway-based meta-analysis of GWAS data using the summary-based adaptive rank truncated product method to identify gene sets and pathways associated with pancreatic ductal adenocarcinoma (PDAC) in 9040 cases and 12 496 controls. Read More

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https://academic.oup.com/jnci/advance-article/doi/10.1093/jn
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http://dx.doi.org/10.1093/jnci/djy155DOI Listing
December 2018
3 Reads
12.583 Impact Factor

Risk of Clinically Relevant Pericardial Effusion After Pediatric Cardiac Surgery.

Pediatr Cardiol 2018 Dec 11. Epub 2018 Dec 11.

Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, PO Box 9600, 2300RC, Leiden, The Netherlands.

Pericardial effusion (PE) after pediatric cardiac surgery is common. Because of the lack of a uniform classification of the presence and severity of PE, we evaluated PE altering clinical management: clinically relevant PE. Risk factors for clinically relevant PE were studied. Read More

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http://link.springer.com/10.1007/s00246-018-2031-4
Publisher Site
http://dx.doi.org/10.1007/s00246-018-2031-4DOI Listing
December 2018
4 Reads

Literature review of apheresis procedures performed perioperatively in cardiac surgery for ASFA category indications.

J Clin Apher 2018 Dec 8. Epub 2018 Dec 8.

Department of Clinical Hematology - Blood Bank and Hemostasis, Onassis Cardiac Surgery Center, Kallithea, Greece.

Background: Perioperative therapeutic plasma exchange in patients with cardiovascular diseases poses several challenges, including alterations in intravascular volume, serum electrolytes, the coagulation cascade, and drug pharmacokinetics.

Methods: This review article summarizes different indications of plasma exchange for patients requiring cardiac surgery based on reported case reports and case series.

Results: The most common reported indication is plasma exchange for the management of allosensitized cardiac transplant candidate patients in combination with immunosuppressive regimens, which increases the likelihood of obtaining a cross-match-negative allograft, improving post-transplant clinical outcome. Read More

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http://dx.doi.org/10.1002/jca.21676DOI Listing
December 2018
1 Read

Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.

J Am Geriatr Soc 2018 Dec 7. Epub 2018 Dec 7.

Cardiovascular Division, Department of Internal Medicine, Washington University, St. Louis, Missouri.

Objectives: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD).

Design: Consensus meeting.

Setting: Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6-7, 2017. Read More

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http://dx.doi.org/10.1111/jgs.15634DOI Listing
December 2018
2 Reads

Sodium-glucose cotransporter-2 inhibitors: an overview and perioperative implications.

Curr Opin Anaesthesiol 2019 Feb;32(1):80-85

Department of Anesthesiology, Yale School of Medicine.

Purpose Of Review: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new class of drugs used in the management of diabetes mellitus. This review will highlight key pharmacologic characteristics of this class of drugs; discuss their potential role in management of patients with cardiac disease; and raise several perioperative concerns for anesthesiologists caring for patients on SGLT-2 inhibitors.

Recent Findings: Recent trials have shown a strong mortality benefit in diabetic patients on SGLT 2 inhibitors especially in patients with a high cardiovascular burden. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000674DOI Listing
February 2019
1 Read

Role of anesthesiologists in managing perioperative anemia.

Curr Opin Anaesthesiol 2019 Feb;32(1):64-71

Department of Anesthesia, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Muenster, Germany.

Purpose Of Review: Anemia can contribute negatively to a patient's morbidity and mortality. Which treatment options do exist and what role do anesthesiologists play in management of perioperative anemia treatment? This review gives an overview about recent findings.

Recent Findings: Patient Blood Management and standards for the management and treatment of anemia have been established worldwide. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000671DOI Listing
February 2019
1 Read

Regional Techniques for Cardiac and Cardiac-Related Procedures.

J Cardiothorac Vasc Anesth 2019 02 13;33(2):532-546. Epub 2018 Sep 13.

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

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http://dx.doi.org/10.1053/j.jvca.2018.09.017DOI Listing
February 2019

Renin-angiotensin-aldosterone system antagonists: perioperative management.

Br J Hosp Med (Lond) 2018 Dec;79(12):717

Consultant Cardiac Anaesthetist, Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Manchester.

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http://dx.doi.org/10.12968/hmed.2018.79.12.717DOI Listing
December 2018

Acute Pulmonary Edema in a Pregnant Patient with Undiagnosed Levo-Transposition of the Great Arteries.

Am J Case Rep 2018 Dec 6;19:1445-1448. Epub 2018 Dec 6.

Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

BACKGROUND Levo-transposition of the great arteries (L-TGA) is a rare form of congenital heart disease that may go unrecognized until adulthood. Parturient women with L-TGA have a high likelihood of developing acute pulmonary edema and cardiac dysrhythmias during the peri-partum period. CASE REPORT We present the case of a 32-year-old primigravida patient with previously unknown diagnosis of L-TGA, presenting with preeclampsia, whose peri-partum course was complicated by the development of acute pulmonary edema, complete heart block, and acute hypoxic respiratory failure. Read More

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http://dx.doi.org/10.12659/AJCR.912168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293864PMC
December 2018
1 Read

Implementing a thoracic enhanced recovery with ambulation after surgery program: key aspects and challenges.

J Thorac Dis 2018 Nov;10(Suppl 32):S3809-S3814

Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.

Enhanced recovery after surgery (ERAS) protocols aim to improve operative outcomes by focusing on perioperative care, including early mobilization, limitation of narcotics, and maintenance of fluid balance. We implemented a T-ERAS (Thoracic-Early Recovery with Ambulation After Surgery) protocol which focused on early ambulation, with the rationale that a patient's mobility may be a reproducible and measurable metric for their overall status-pain control, respiratory function, cardiac function, and patient satisfaction. We set a benchmark distance of 250 feet for our early ambulation goal and redefined "early" as within the first hour post extubation. Read More

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http://dx.doi.org/10.21037/jtd.2018.10.106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258653PMC
November 2018

A review and analysis of strategies for prediction, prevention and management of post-operative atrial fibrillation after non-cardiac thoracic surgery.

J Thorac Dis 2018 Nov;10(Suppl 32):S3799-S3808

Division of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Atrial fibrillation (AF) is the most common sustained arrhythmia after non-cardiac thoracic surgery and is associated with a significant increase in perioperative morbidity, intensive care unit (ICU) admission, and mortality. Practical guidance is needed to assist clinicians in managing this critical issue and direct further research. Here we aim to provide a synoptic review and analysis of the literature to distil practical recommendations for prediction, prevention and management of post-operative atrial fibrillation (POAF) suitable for clinical application and further evaluation. Read More

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http://dx.doi.org/10.21037/jtd.2018.09.144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258651PMC
November 2018
1 Read

Sedation versus general anesthesia for transcatheter aortic valve replacement.

J Thorac Dis 2018 Nov;10(Suppl 30):S3588-S3594

Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, ON, Canada.

There is currently significant controversy regarding the best anesthesia management for patients undergoing transcatheter aortic valve replacement (TAVR). Some institutions primarily use general anesthesia (GA) but many institutions primarily use moderate sedation. Much of the controversy is due to the limited evidence base available to inform this decision and the strong feelings and pre-conceived notions about the optimal anesthesia technique which exist amongst anesthesiologists, cardiologists, and cardiac surgeons. Read More

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http://dx.doi.org/10.21037/jtd.2018.08.89DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242923PMC
November 2018

Risk Factors Analysis of Postoperative Pleural Effusion after Liver Resection.

Dig Surg 2018 Dec 5:1-8. Epub 2018 Dec 5.

Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City,

Background: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes.

Methods: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively. Read More

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http://dx.doi.org/10.1159/000494218DOI Listing
December 2018
9 Reads

The Effects of Radiofrequency Neurotomy Using a Strip-Lesioning Device on Patients with Sacroiliac Joint Pain: Results from a Single-Center, Randomized, Sham-Controlled Trial.

Pain Physician 2018 Nov;21(6):607-618

Pain and Anaesthesia Research Centre, St. Bartholomew's Hospital, United Kingdom.

Background: Radiofrequency neurotomy (RFN) is a therapy aimed at providing lasting back pain relief for sacroiliac joint (SIJ) pain. A recent advancement in RFN is a strip lesioning technique that involves placement of a single curved electrode and a 3-pole design that facilitates the creation of 5 overlapping lesions. These lesions form one long strip lesion accessible through a single entry point, without the need for multiple punctures. Read More

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November 2018
1 Read

Endovascular Management of Acute Traumatic Aortic Injury.

Tech Vasc Interv Radiol 2018 Sep 14;21(3):131-136. Epub 2018 Jun 14.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, 1500 East Medical Center Drive, Ann Arbor, MI.

Acute traumatic injury of the thoracic aorta is a highly lethal condition, with many afflicted patients expiring before hospital arrival. While previously these conditions were managed with open surgery, endovascular repair has rapidly evolved and is now considered the standard of care for certain patterns of aortic injury at centers with appropriate expertise. The development of newer branched devices has allowed these techniques to be utilized further and further proximally into the aorta. Read More

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http://dx.doi.org/10.1053/j.tvir.2018.06.002DOI Listing
September 2018

Evaluation of Strategies in the Management of Infective Aortic Valve Endocarditis at German Cardiac Surgical Departments.

Thorac Cardiovasc Surg 2018 Nov 28. Epub 2018 Nov 28.

Department of Cardiac Surgery, Heart Centre, University of Leipzig, Leipzig, Germany.

Background:  Surgical treatment of infective aortic valve endocarditis (AVE) remains a therapeutic challenge, necessitating interdisciplinary approach to limit morbidity and mortality in this high-risk cohort. With a considerable spectrum of available laboratory testings, imaging techniques, as well as operative strategies developed in recent years, there is a lack of standardization across cardiac surgical departments in Germany. Thus, the optimal treatment strategy of AVE has yet to be defined. Read More

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http://dx.doi.org/10.1055/s-0038-1673634DOI Listing
November 2018
1 Read

Out-of-hospital cardiac arrest at place of residence is associated with worse outcomes in patients admitted to intensive care: a post-hoc analysis of the Targeted Temperature Management trial.

Minerva Anestesiol 2018 Nov 22. Epub 2018 Nov 22.

Department of Clinical Sciences, Center for Cardiac Arrest, Faculty of Medicine, Lund University, Lund, Sweden.

Background: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place residence, which is associated with worse outcomes in unselected prehospital populations. Our aim was to investigate whether location of arrest was associated with outcome in a selected group of initial survivors admitted to intensive care.

Methods: This is a post-hoc analysis of the Targeted Temperature Management after cardiac arrest trial (TTM trial), a multicenter controlled trial, randomizing 950 OHCA patients to an intervention of 33°C or 36°C. Read More

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http://dx.doi.org/10.23736/S0375-9393.18.12878-1DOI Listing
November 2018
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Adverse side effects of dexamethasone in surgical patients.

Cochrane Database Syst Rev 2018 11 23;11:CD011940. Epub 2018 Nov 23.

Department of Anaesthesiology, Academic Medical Center (AMC) University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands, 1105 AZ.

Background: In the perioperative period, dexamethasone is widely and effectively used for prophylaxis of postoperative nausea and vomiting (PONV), for pain management, and to facilitate early discharge after ambulatory surgery.Long-term treatment with steroids has many side effects, such as adrenal insufficiency, increased infection risk, hyperglycaemia, high blood pressure, osteoporosis, and development of diabetes mellitus. However, whether a single steroid load during surgery has negative effects during the postoperative period has not yet been studied. Read More

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http://dx.doi.org/10.1002/14651858.CD011940.pub3DOI Listing
November 2018
8 Reads

Prothrombin Complex Concentrates for Warfarin Reversal Prior to Heart Transplantation.

Ann Thorac Surg 2018 Nov 23. Epub 2018 Nov 23.

Department of Cardiothoracic Surgery, New York University Langone Health.

Background: Anticoagulation with warfarin is common prior to heart transplantation and complicates perioperative management.

Methods: This single-center, non-interventional, retrospective cohort study evaluated heart transplants before and after institution of a PCC-based preoperative warfarin reversal protocol for heart transplantation. Patients with international normalized ratio (INR) > 1. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2018.10.032DOI Listing
November 2018
3 Reads

Therapeutic Hypothermia and Targeted Temperature Management for Traumatic Arrest and Surgical Patients.

Ther Hypothermia Temp Manag 2018 Nov 22. Epub 2018 Nov 22.

1 Department of Trauma Surgery, Allegheny General Hospital , Pittsburgh, Pennsylvania.

Therapeutic hypothermia (TH) and targeted temperature management (TTM) have been shown to improve outcomes in survivors of cardiac arrest, but prior research has excluded trauma and postoperative patients. We sought to determine whether TH/TTM is safe in trauma and surgical patients. A retrospective cohort study was conducted at a single level I trauma center reviewing adults presenting as a traumatic arrest or cardiac arrest in the postoperative period with a Glasgow Coma Scale <8 after return of circulation who were treated with either TH or TTM. Read More

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https://www.liebertpub.com/doi/10.1089/ther.2018.0022
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http://dx.doi.org/10.1089/ther.2018.0022DOI Listing
November 2018
7 Reads