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    [Preoperative risk factors analysis of pulmonary hypertension crisis during perioperative period for caesarean section of woman with severe pulmonary hypertension].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 May;29(5):431-435
    Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. Corresponding author: Ma Jun, Email:
    Objective: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value.

    Methods: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. Read More

    Surgery after drug-eluting stent implantation: it's not all doom and gloom!
    J Thorac Dis 2017 Apr;9(4):E373-E377
    Cardio-Thoraco-Vascular Department, University Hospital of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
    Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. Read More

    Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes.
    Vasc Health Risk Manag 2017 8;13:161-168. Epub 2017 May 8.
    Division of Vascular and Endovascular Surgery, School of Medicine, Boston University Boston, MA, USA.
    Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Read More

    A Structured Transfer of Care Process Reduces Perioperative Complications in Cardiac Surgery Patients.
    Anesth Analg 2017 May 11. Epub 2017 May 11.
    From the *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; and †Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon.
    Introduction: Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. Read More

    Effect of high-dose sodium selenite in cardiac surgery patients: A randomized controlled bi-center trial.
    Clin Nutr 2017 May 2. Epub 2017 May 2.
    Department for Anesthesia, Intensive Care Medicine and Rescue Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland; Department of Anesthesiology and Intensive Care Medicine, Hirslanden Clinic, Zürich, Switzerland. Electronic address:
    Background & Aims: Cardiac surgery is accompanied by oxidative stress and systemic inflammatory response, which may be associated with organ dysfunction and increased mortality. Selenium and selenoenzymes are important constituents of anti-oxidative defense. We hypothesized that high-dose sodium selenite supplementation can attenuate the postoperative inflammation and might, therefore, improve clinical outcome. Read More

    Results of a multimodal approach for the management of aortic coarctation and its complications in adults.
    Interact Cardiovasc Thorac Surg 2017 May 11. Epub 2017 May 11.
    Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
    Objectives: We aimed to assess the results of various tailored management strategies for adults with coarctation in our centre.

    Methods: : We reviewed all adults patients treated for aortic caorctation between January 2000 and December 2015 in our institution. The primary end point was a composite of death, perioperative stroke, paraplegia, need for unplanned reoperation or occurrence of pseudoaneurysm during the follow-up. Read More

    Transthoracic Echocardiography for Diagnosing Pulmonary Embolism: A Systematic Review and Meta-Analysis.
    J Am Soc Echocardiogr 2017 May 9. Epub 2017 May 9.
    Lister Hill Library, Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
    Objective: Pulmonary embolism (PE) is a common diagnosis with significant mortality if not appropriately treated. The use of transthoracic echocardiography in patients with PE is common; however, its diagnostic capabilities in this use are unclear. With the increased use of ultrasonography in medical settings, it is important to understand the strengths and limitations of echocardiography for the diagnosis of PE. Read More

    Perioperative bleeding and thrombotic risks in patients with Von Willebrand disease.
    J Thromb Thrombolysis 2017 May 9. Epub 2017 May 9.
    Division of Cardiology, Department of Medicine, Venous Thromboembolic Center, Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY, 10016, USA.
    Von Willebrand disease (VWD) is an inherited bleeding disorder that often manifests clinically with hemorrhage after invasive procedures. We investigated the association between a diagnosis of VWD and bleeding and thrombotic outcomes following major non-cardiac surgery in a large national database from the United States. Patients age ≥45 years requiring major non-cardiac surgery were identified from Healthcare Cost and Utilization Project's National Inpatient Sample data. Read More

    Severe hyperkalaemia complicating parathyroidectomy in patients with end-stage renal disease.
    Anaesth Intensive Care 2017 May;45(3):365-368
    Consultant, Department of Renal Medicine, The Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria.
    We evaluated the incidence of perioperative hyperkalaemia in end-stage renal disease (ESRD) patients undergoing parathyroidectomy and investigated possible contributors to this phenomenon. This was a retrospective cohort study looking at patients who had undergone parathyroidectomy for chronic kidney disease-associated mineral bone disease (CKD-MBD) at The Alfred Hospital, Melbourne, since 2001. Baseline demographics including age, gender, aetiology of renal failure and mode of renal replacement therapy as well as anaesthetic technique and duration of surgery were studied as possible contributors. Read More

    Fluid Overload and Cumulative Thoracostomy Output Are Associated With Surgical Site Infection After Pediatric Cardiothoracic Surgery.
    Pediatr Crit Care Med 2017 May 8. Epub 2017 May 8.
    1Division of Critical Care Medicine, Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL. 2The George Washington University, School of Medicine and Health Sciences, Washington, D.C. 3Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA. 4Division of Critical Care Medicine, Department of Pediatrics, Children's National Health System, Washington, DC. 5Division of Infectious Disease, Department of Pediatrics, Children's National Health System, Washington, DC. 6Division of Cardiology, Department of Pediatrics, Children's National Health System, Washington, DC. 7Division of Anesthesiology, Department of Pediatrics, Children's National Health System, Washington, DC.
    Objectives: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery.

    Design: A single-center, nested, retrospective, matched case-control study.

    Setting: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. Read More

    Contemporary Approaches to Perioperative IV Fluid Therapy.
    World J Surg 2017 May 8. Epub 2017 May 8.
    Smiths Medical Professor of Anaesthesia and Critical Care, National Institute of Health Research Biomedical Research Centre, University College London Hospitals, London, UK.
    Background: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management.

    Method: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. Read More

    Influence of anaemia and red blood cell transfusion on mortality in high cardiac risk patients undergoing major non-cardiac surgery: a retrospective cohort study.
    Br J Anaesth 2017 May 7. Epub 2017 May 7.
    Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto ON, M5G 2C4 Canada.
    Background.: Perioperative anaemia is common. Physicians believe that patients at increased cardiac risk do not tolerate anaemia and, consequently, these patients receive transfusions earlier and more often. Read More

    Preoperative Cognitive Performance and Postoperative Delirium Are independently Associated With Future Dementia in Older People Who Have Undergone Cardiac Surgery: A Longitudinal Cohort Study.
    Crit Care Med 2017 May 5. Epub 2017 May 5.
    1Department of Nursing and Department of Surgical and Perioperative Science, Umeå University, Umeå, Sweden. 2Department of Nursing, Umeå University, Umeå, Sweden. 3Department of Public Health and Clinical Medicine, Epidemiology and Global Health and Department of Statistics, USBE, Umeå University, Umeå, Sweden. 4Department of Surgical and Perioperative Science, Umeå University, Umeå, Sweden. 5Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Objective: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery.

    Design: Longitudinal cohort study.

    Setting: Cardiothoracic Division, Umeå University Hospital, Sweden. Read More

    Cardiac Evaluation and Monitoring of Patients Undergoing Noncardiac Surgery.
    Health Serv Insights 2017 20;9:1178632916686074. Epub 2017 Feb 20.
    Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, USA.
    Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Read More

    Perioperative Management of Cardiac Transplant Recipients Undergoing Noncardiac Surgery: Unique Challenges Created by Advancements in Care.
    Semin Cardiothorac Vasc Anesth 2017 May 1:1089253217706164. Epub 2017 May 1.
    4 School of Medicine, Division of Cardiology, University of Colorado, Aurora Colorado, USA.
    Advancements in postcardiac transplant care have resulted in significant reductions in morbidity and increased life expectancy for cardiac transplant recipients. Consequently, many cardiac transplant recipients are living long enough to require subsequent noncardiac surgery. The perioperative care of heart transplant recipients presents a unique challenge as many of the common preoperative risk assessments do not apply to a transplanted heart, immunosuppressive medications have side effects and potential for drug-drug interactions, and the denervated heart results in an altered autonomic physiology and response to medications. Read More

    Transpulmonary Thermodilution: Its Role in Assessment of Lung Water and Pulmonary Edema.
    J Cardiothorac Vasc Anesth 2017 Feb 4. Epub 2017 Feb 4.
    Cardiothoracic Anesthesia Service, VA Connecticut Healthcare System, West Haven, CT; Yale University School of Medicine, New Haven, CT.
    Tissue edema, in particular pulmonary edema, increasingly is recognized as a perioperative complication affecting outcome. Management strategies directed at avoiding excessive fluid administration, reducing inflammatory response, and decreasing capillary permeability commonly are advocated in perioperative care protocols. In this review, transpulmonary thermodilution (TPTD) as a bedside tool to quantitatively monitor lung water accumulation and optimize fluid therapy is examined. Read More

    Anesthesia and perioperative pain management during cardiac electronic device implantation.
    J Pain Res 2017 19;10:927-932. Epub 2017 Apr 19.
    Laboratory for Pain Research, University of Split School of Medicine.
    Background: The degree of pain caused by the implantation of cardiac electronic devices (CEDs) and the type of anesthesia or perioperative pain management used with the procedure have been insufficiently studied. The aim of this study was to analyze perioperative pain management, as well as intensity and location of pain among patients undergoing implantation of CED, and to compare the practice with published guidelines.

    Patients And Methods: This was a combined retrospective and prospective study conducted at the tertiary hospital, University Hospital Split, Croatia. Read More

    Outcomes in adult Fontan patients with atrial tachyarrhythmias.
    Am Heart J 2017 Apr 2;186:12-20. Epub 2017 Jan 2.
    Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
    Background: The optimal management strategy for atrial tachyarrhythmia in the Fontan population is unknown.

    Methods: Retrospective review of 264 adult Fontan patients with atrial tachyarrhythmia evaluating 3 clinically adopted scenarios: antiarrhythmic drug (AAD) therapy, catheter ablation (CA), and Fontan conversion (FC). These patients were followed up at Mayo Clinic from 1994 to 2014. Read More

    Attrition in patients with single ventricle and trisomy 21: outcomes after a total cavopulmonary connection.
    Interact Cardiovasc Thorac Surg 2017 May;24(5):747-754
    Division of Pediatric Cardiovascular Surgery, Advocate Children's Hospital, Oak Lawn, IL, USA.
    Objectives: Data are limited regarding the management of children with trisomy 21 (T21) syndrome and a functional single ventricle (FSV). We evaluated patients with T21 and a FSV who had a total cavopulmonary connection (TCPC).

    Methods: From September 1999 to August 2012, 139 patients with a FSV underwent a TCPC. Read More

    Anesthetic consideration for neuromuscular diseases.
    Curr Opin Anaesthesiol 2017 Jun;30(3):435-440
    Northshore University Health System, University of Chicago, Pritzker School of Medicine, Illinois, USA.
    Purpose Of Review: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients. Read More

    Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association.
    Circulation 2017 Apr 26. Epub 2017 Apr 26.
    Background And Purpose: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. Read More

    Reactive Rather than Proactive Diabetes Management in the Perioperative Period.
    Horm Metab Res 2017 Apr 24. Epub 2017 Apr 24.
    Department of General Internal Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
    As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care. Read More

    Aortic stenosis and non-cardiac surgery: A systematic review and meta-analysis.
    Int J Cardiol 2017 Apr 12. Epub 2017 Apr 12.
    Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK.
    Background: Aortic stenosis (AS) poses a perioperative management dilemma to physicians looking after patients who require non-cardiac surgery. The objective of this review is to investigate mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery.

    Methods: We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery. Read More

    Causes of interruptions in postoperative enteral nutrition in children with congenital heart disease.
    Asia Pac J Clin Nutr 2017 May;26(3):402-405
    Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Email:
    Background And Objectives: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. Read More

    Clinical Practice Guidelines Decrease Unnecessary Echocardiograms Before Hip Fracture Surgery.
    J Bone Joint Surg Am 2017 Apr;99(8):676-680
    1Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina.
    Background: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease.

    Methods: A retrospective review of data on 100 geriatric patients with a hip fracture who had undergone preoperative TTE was performed. Read More

    The esophageal cooling device: A new temperature control tool in the intensivist's arsenal.
    Heart Lung 2017 Apr 11. Epub 2017 Apr 11.
    Critical Care & Neuro-Critical Care Medicine, Program in Critical Care, Department of Medicine, London Health Sciences Centre, University of Western Ontario, LHSC-UC, 339 Windermere Road, London, Ontario N6A 5A5, Canada.
    Background: Therapeutic hypothermia has been demonstrated to improve neurological outcome in comatose survivors of cardiac arrest. Current temperature control modalities however, have several limitations. Exploring innovative methods of temperature management has become a necessity. Read More

    Early predictors of poor outcome after out-of-hospital cardiac arrest.
    Crit Care 2017 Apr 13;21(1):96. Epub 2017 Apr 13.
    Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-413 45, Gothenburg, Sweden.
    Background: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA.

    Methods: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up. Read More

    Direct sternal administration of Vancomycin and Gentamicin during closure prevents wound infection†.
    Interact Cardiovasc Thorac Surg 2017 Apr 10. Epub 2017 Apr 10.
    Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
    Objectives: Deep sternal wound infection is still a major complication in patients undergoing cardiac surgery. We previously identified mammary artery harvesting as a risk factor for decreased antibiotic tissue penetration. In addition, other risk factors including diabetes may inhibit sufficient tissue penetration of perioperative antibiotic prophylaxis. Read More

    Volatile anaesthetics added to cardiopulmonary bypass are associated with reduced cardiac troponin.
    Perfusion 2017 Mar 1:267659117701562. Epub 2017 Mar 1.
    1 Anaesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
    Background: Every year, over 1 million cardiac surgical procedures are performed all over the world. Reducing myocardial necrosis could have strong implications in postoperative clinical outcomes. Volatile anaesthetics have cardiac protective properties in the perioperative period of cardiac surgery. Read More

    Neuropsychological and Psychiatric Outcomes in Dextro-Transposition of the Great Arteries across the Lifespan: A State-of-the-Art Review.
    Front Pediatr 2017 24;5:59. Epub 2017 Mar 24.
    Department of Psychiatry, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA.
    Advances in prenatal diagnosis, perioperative management, and postoperative care have dramatically increased the population of survivors of neonatal and infant heart surgery. The high survival rate of these patients into adulthood has exposed the alarming prevalence of long-term neuropsychological and psychiatric morbidities. Dextro-transposition of the great arteries (d-TGA) is one of the most extensively studied cyanotic congenital heart defect (CHD) with regard to neurodevelopmental outcomes. Read More

    Contemporary outcomes of surgical revascularization of the lower extremity in patients on dialysis.
    J Vasc Surg 2017 Apr 5. Epub 2017 Apr 5.
    Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:
    Objective: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE. Read More

    New-onset postoperative atrial fibrillation after aortic valve replacement: Effect on long-term survival.
    J Thorac Cardiovasc Surg 2017 Mar 12. Epub 2017 Mar 12.
    Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
    Objective: There is a paucity of data on long-term survival of new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Also, mean follow-up in previous studies is confined to a maximum of one decade. This retrospective, longitudinal cohort study was performed to determine the effect on long-term survival of new-onset POAF after aortic valve replacement (AVR) over a mean follow-up of almost 2 decades. Read More

    Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery.
    Semin Cardiothorac Vasc Anesth 2017 Apr 1:1089253217702747. Epub 2017 Apr 1.
    1 University of Maryland Medical System, Baltimore, MD, USA.
    Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. Read More

    Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel.
    Neurosurgery 2017 Apr 7. Epub 2017 Apr 7.
    Department of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.
    Background: Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies.

    Objective: To develop guidelines for CCM management.

    Methods: The Angioma Alliance ( www. Read More

    Mortality, rehospitalizations and costs in children undergoing a cardiac procedure in their first year of life in New South Wales, Australia.
    Int J Cardiol 2017 Mar 27. Epub 2017 Mar 27.
    Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.
    Background: Cardiac procedures are part of management for many children with congenital heart disease (CHD). Using population health data, this study explores health outcomes of children undergoing a cardiac procedure in the first year of life to better understand the impact of CHD on children, families and health services.

    Methods And Results: A population-based record-linkage cohort study was undertaken. Read More

    Peri-procedural risk stratification and management of patients with Williams syndrome.
    Congenit Heart Dis 2017 Mar;12(2):133-142
    Department of Anesthesiology, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
    Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Read More

    Twenty Years of Anesthetic and Perioperative Management of Patients With Tetralogy of Fallot With Absent Pulmonary Valve.
    J Cardiothorac Vasc Anesth 2017 Feb 4. Epub 2017 Feb 4.
    Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiac Anesthesia, Boston Children's Hospital, Boston, MA. Electronic address:
    Objective: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve.

    Design: Retrospective chart review.

    Setting: Large academic children's hospital. Read More

    Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe.
    Lancet Respir Med 2017 May 28;5(5):412-425. Epub 2017 Mar 28.
    Département d'Anesthésie-Réanimation pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, Lille, France.
    Background: Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors.

    Methods: The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Read More

    Perioperative cardiac arrest in the operating room environment: a review of the literature.
    Minerva Anestesiol 2017 Mar 28. Epub 2017 Mar 28.
    Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Napoli, Italy.
    Cardiac arrest in the operating room (OR) environment is a rare but potentially catastrophic event with mortality rates of more than 50%. Cardiac arrest during anaesthesia and the immediate postoperative period is distinct from non-operative settings or other in-hospital cardiac arrests since it is almost always witnessed and often anticipated. Contributing factors are known, and the event is generally rapidly recognized, as patients are usually under full monitoring. Read More

    [Prognostic factors for in-hospital mortality in patients with acute kidney injury requiring continuous renal replacement therapy undergoing surgery for acute Stanford type A aortic dissection].
    Zhonghua Wai Ke Za Zhi 2017 Apr;55(4):270-273
    Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing 100029, China.
    Objective: To evaluate prognostic factors for in-hospital mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) undergoing surgery for acute Stanford type A aortic dissection. Methods: Retrospective analysis were conducted for 60 patients diagnosed with AKI requiring CRRT undergoing surgery for acute Stanford type A aortic dissection at Beijing Anzhen Hospital, Capital Medical University from March 2015 to September 2016. There were 43 male and 17 female patients with an mean age of (50±14) years. Read More

    [Progress and challenge of Stanford type A aortic dissection in China].
    Zhonghua Wai Ke Za Zhi 2017 Apr;55(4):241-244
    Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
    In recent 20 years, the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects: (1) the refined classification of aortic dissection based on Stanford classification, (2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection, and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection. However, there are still many problems in the diagnosis and treatment of aortic dissection in China, such as: (1) unstandardized, lack of comprehensive guidelines of aortic dissection, (2) immature, perioperative organ protection and intraoperative blood protection technology remains a big flaw, and (3) it takes a long time to get patient prepared for surgery. In conclusion, as to the issue of the management of acute Stanford type A aortic dissection, there will be a long way for Chinese doctors to go. Read More

    Comparison of 20% mannitol and 3% hypertonic saline on intracranial pressure and systemic hemodynamics.
    J Clin Neurosci 2017 Mar 22. Epub 2017 Mar 22.
    Department of Anaesthesiology and Pain Management, Fortis Hospital, Gurgaon, India.
    Mannitol and hypertonic saline (HS) are most commonly used hyperosmotic agents for intraoperative brain relaxation. We compared the changes in ICP and systemic hemodynamics after infusion of equiosmolar solutions of both agents in patients undergoing craniotomy for supratentorial tumors. Forty enrolled adults underwent a standard anesthetic induction. Read More

    Cardiac Function After Tetralogy of Fallot/Complete Atrioventricular Canal Repair.
    World J Pediatr Congenit Heart Surg 2017 Mar;8(2):189-195
    1 Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center, New York, NY, USA.
    Background: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention.

    Methods: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014). Read More

    Mechanical Support With Impella During Malignant Arrhythmia Ablation: A Case Report on the Growing Trend in the Electrophysiology Laboratory.
    A A Case Rep 2017 Mar 17. Epub 2017 Mar 17.
    From the *Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; and †The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
    Congenitally corrected transposition of the great arteries is a rare form of congenital heart disease in which the persistence of the right ventricle as the systemic ventricle leads to heart failure, tricuspid valve insufficiency, and arrhythmia. Supraventricular arrhythmias are especially common in these patients. We discuss the anesthetic management of a 33-year-old patient with congenitally corrected transposition of the great arteries who required a ventricular assist device to maintain cardiac output during ablation of supraventricular tachyarrythmia. Read More

    The effect of an electronic cognitive aid on the management of ST-elevation myocardial infarction during caesarean section: a prospective randomised simulation study.
    BMC Anesthesiol 2017 Mar 20;17(1):46. Epub 2017 Mar 20.
    Anästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
    Background: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g. Read More

    The role of new oral anticoagulants in orthopaedics: an update of recent evidence.
    Eur J Orthop Surg Traumatol 2017 Mar 17. Epub 2017 Mar 17.
    Department of Οrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece.
    Rivaroxaban, dabigatran, apixaban and edoxaban are the four available new oral anticoagulants (NOAC) which are currently approved for venous thromboembolism prophylaxis after total hip and knee replacement. Large phase 3 and phase 4 studies comparing NOAC with low molecular weight heparins have shown similar results regarding the efficacy and safety of these two categories of anticoagulants. Management of bleeding complications is a matter of great significance. Read More

    Standard donor lung procurement with normothermic ex vivo lung perfusion: A prospective randomized clinical trial.
    J Heart Lung Transplant 2017 Feb 20. Epub 2017 Feb 20.
    Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria; Department of Thoracic Surgery and Surgical Endoscopy, Ruhrlandklinik-University Clinic Essen, Essen, Germany. Electronic address:
    Background: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. Read More

    Anesthesia in adults with congenital heart disease.
    Curr Opin Anaesthesiol 2017 Jun;30(3):418-425
    Department of Anesthesiology and Intensive Care, University Hospital Bonn, Bonn, Germany.
    Purpose Of Review: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients.

    Recent Findings: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers. Read More

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