594 results match your criteria Seminars in Cardiothoracic and Vascular Anesthesia[Journal]


Anesthesiological Management in Transcatheter Mitral Valve Repair With MitraClip: Beyond the EVEREST Criteria.

Semin Cardiothorac Vasc Anesth 2019 Apr 17:1089253219842650. Epub 2019 Apr 17.

1 AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy.

Percutaneous mitral valve repair with the MitraClip system recently emerged as a viable and less invasive therapeutic option in patients with severe mitral regurgitation deemed to be high-risk surgical candidates. Mitral valve morphology and geometry features are key elements for MitraClip eligibility. In the setting of functional mitral regurgitation, the presence of a leaflet coaptation gap due to advanced left ventricle remodeling can be a potential exclusion criterion for MitraClip therapy. Read More

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http://journals.sagepub.com/doi/10.1177/1089253219842650
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http://dx.doi.org/10.1177/1089253219842650DOI Listing
April 2019
1 Read

Noteworthy Literature in 2018 for Cardiovascular Anesthesiologists and Intensivists.

Semin Cardiothorac Vasc Anesth 2019 Apr 15:1089253219842659. Epub 2019 Apr 15.

2 Weill Cornell Medical College, New York, NY, USA.

In this article, we present the annual review of the literature relevant for the practice of cardiovascular critical care. Read More

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http://dx.doi.org/10.1177/1089253219842659DOI Listing

Noteworthy Literature Published in 2018 for Cardiothoracic Anesthesiologists.

Semin Cardiothorac Vasc Anesth 2019 Apr 15:1089253219842651. Epub 2019 Apr 15.

1 Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.

The year 2018 was marked by high-quality, impactful articles spanning the basic, translational, and clinical spectrum in the field of cardiothoracic anesthesia. In this article, we present several hand-picked articles from the past year that we feel were the most significant in shaping our specialty. Large multicenter, randomized controlled trials presenting clinical outcome data dominated the publishing arena: is a restrictive red blood cell transfusion strategy superior to a liberal red blood cell transfusion strategy during cardiopulmonary bypass? Does a low mean arterial blood pressure strategy during cardiopulmonary bypass increase stroke incidence? Does the obesity paradox apply to cardiac surgery? Advancing technology continues to revolutionize our field: can the MitraClip be used to effectively treat secondary mitral regurgitation? Can stem cells improve cardiac function in patients with left ventricular assist devices? These studies allow us to shape our practice in an evidence-based manner, so that we may evolve as a specialty and deliver the best care to our patients. Read More

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http://dx.doi.org/10.1177/1089253219842651DOI Listing
April 2019
1 Read

Unexpected Complication of Hydroxocobalamin Administration for Refractory Vasoplegia in Orthotopic Liver Transplant: A Case Report.

Semin Cardiothorac Vasc Anesth 2019 Apr 15:1089253219842662. Epub 2019 Apr 15.

1 University of Colorado Hospital, Aurora, CO, USA.

A 40-year-old male with alcoholic cirrhosis and end-stage renal disease presented for simultaneous liver and kidney transplantation. Hemodialysis was utilized intraoperatively during liver transplantation. During the procedure, the patient developed refractory hypotension and ultimately received hydroxocobalamin for vasoplegia. Read More

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http://dx.doi.org/10.1177/1089253219842662DOI Listing

Difficult TEE Probe Placement: The Evidence, Troubleshooting Techniques, and a Guide to Alternative Monitoring Options for Intraoperative Physicians.

Semin Cardiothorac Vasc Anesth 2019 Apr 4:1089253219842836. Epub 2019 Apr 4.

1 University of Virginia, Charlottesville, VA, USA.

Transesophageal echocardiography (TEE) imaging has become an essential component of many open and interventional cardiac procedures and has increasing use in monitoring for noncardiac procedures, partly because of an aging population. Whether expected or not, encountering difficulty when inserting the TEE probe presents the anesthesiologist with a conundrum. Repeated insertion attempts increase the risk of a serious complication; however, proceeding without TEE may be unacceptable to the proceduralist or surgeon. Read More

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http://dx.doi.org/10.1177/1089253219842836DOI Listing
April 2019
1 Read

A Rare Case of Stenosis at the Inferior Vena Cava to Right Atrium Anastomosis After Bicaval Orthotopic Heart Transplantation.

Semin Cardiothorac Vasc Anesth 2019 Feb 27:1089253219832608. Epub 2019 Feb 27.

1 University of Colorado, Aurora, CO, USA.

Stenosis at either the superior or inferior caval anastomosis is a rare complication of orthotopic heart transplantation (OHT) and is unique to the bicaval surgical technique. The severity of stenosis dictates the degree of clinical significance, varying from asymptomatic to congestive end-organ injury and hemodynamic instability from impaired preload. Due to differences in the anatomic location of organ congestion, the clinical presentation also depends on which of the 2 anastomoses is involved. Read More

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http://dx.doi.org/10.1177/1089253219832608DOI Listing
February 2019
1 Read

Intrathecal Morphine Administration Does Not Affect Survival After Liver Resection for Hepatocellular Carcinoma.

Semin Cardiothorac Vasc Anesth 2019 Feb 24:1089253219832647. Epub 2019 Feb 24.

1 Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Introduction: Opioids may influence tumor recurrence and cancer-free survival in hepatocellular carcinoma (HCC). The relationship between intrathecal morphine administration, tumor recurrence, and patient survival after hepatectomy for HCC is unknown.

Patients And Methods: This single-center, retrospective study included 1837 liver resections between July 2002 and December 2012; 410 cases were incorporated in the final univariate and multivariate analysis. Read More

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http://dx.doi.org/10.1177/1089253219832647DOI Listing
February 2019
3 Reads

Repair, Replace, or Watchful Waiting: A Contemporary Management of Mitral Valve Disease and Its Related Conditions.

Semin Cardiothorac Vasc Anesth 2019 Mar;23(1):5-10

3 Vanderbilt University Medical Center, Nashville, TN, USA.

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http://dx.doi.org/10.1177/1089253218817856DOI Listing

Adding Value by Going Beyond.

Semin Cardiothorac Vasc Anesth 2018 12;22(4):341-344

4 Vanderbilt University Medical Center, Nashville, TN, USA.

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http://dx.doi.org/10.1177/1089253218807796DOI Listing
December 2018

Tracheal Injury Prior to Sternotomy: A Cautionary Tale.

Semin Cardiothorac Vasc Anesth 2019 Feb 1:1089253218825443. Epub 2019 Feb 1.

2 University of North Carolina at Chapel Hill, NC, USA.

Tracheal laceration during cardiac surgery is a rarely reported form of iatrogenic tracheal injury. During dissection prior to sternotomy, the interclavicular ligament must be divided. This structure overlies the proximal trachea, predisposing the trachea to injury at this location. Read More

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http://dx.doi.org/10.1177/1089253218825443DOI Listing
February 2019

Major Cardiac Events in Patients Admitted to Intensive Care After Vascular Noncardiac Surgery: A Retrospective Cohort.

Semin Cardiothorac Vasc Anesth 2019 Jan 25:1089253218825442. Epub 2019 Jan 25.

1 São João Hospital Centre, Porto, Portugal.

Introduction: Patients proposed to vascular noncardiac surgery (VS) have several comorbidities associated with major adverse cardiac events (MACE). We evaluated incidence, predictors, and outcomes, and compared different scores to predict MACE after VS.

Methods: We included all patients admitted from 2006 to 2013. Read More

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http://dx.doi.org/10.1177/1089253218825442DOI Listing
January 2019
6 Reads

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
22 Reads

Risk Factors for Mitral Valve Surgery: Atrial Fibrillation and Pulmonary Hypertension.

Semin Cardiothorac Vasc Anesth 2019 Mar 4;23(1):57-69. Epub 2019 Jan 4.

1 Vanderbilt University Medical Center, Nashville, TN, USA.

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http://dx.doi.org/10.1177/1089253218821694DOI Listing
March 2019
13 Reads

Common Arterial Trunk: Physiology, Imaging, and Management.

Semin Cardiothorac Vasc Anesth 2018 Dec 29:1089253218821382. Epub 2018 Dec 29.

3 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Common arterial trunk (CAT), or truncus arteriosus, is a rare form of cyanotic congenital heart disease and is highly associated with DiGeorge syndrome (microdeletion 22q11.2). Prenatal diagnosis is highly feasible, allowing proper delivery planning and postnatal management. Read More

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http://journals.sagepub.com/doi/10.1177/1089253218821382
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http://dx.doi.org/10.1177/1089253218821382DOI Listing
December 2018
29 Reads

Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies.

Semin Cardiothorac Vasc Anesth 2018 Dec 27:1089253218819782. Epub 2018 Dec 27.

2 Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia.

Complications and critical events during cardiopulmonary bypass (CPB) are very challenging, difficult to manage, and in some instances have the potential to lead to fatal outcomes. Massive cerebral air embolism is undoubtedly a feared complication during CPB. If not diagnosed and managed early, its effects are devastating and even fatal. Read More

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http://dx.doi.org/10.1177/1089253218819782DOI Listing
December 2018
2 Reads

Surgical Techniques for Mitral Valve Repair: A Pathoanatomic Grading System.

Semin Cardiothorac Vasc Anesth 2019 Mar 5;23(1):20-25. Epub 2018 Dec 5.

1 Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.

Mitral valve surgery has evolved over 4 decades from one based on the principles of prosthetic replacement to a subspecialty with a foundation based on the principles of repair. This review will attempt to enumerate the contemporary techniques of mitral valve repair and a pathoanatomically directed approach with which to apply them by focusing on degenerative disease and associated complexities. Read More

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http://dx.doi.org/10.1177/1089253218815465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415492PMC
March 2019
18 Reads

Percutaneous Techniques, Limitations and Challenges for the Failed Surgical Mitral Intervention.

Semin Cardiothorac Vasc Anesth 2019 Mar 8;23(1):48-56. Epub 2018 Nov 8.

1 Brigham and Women's Hospital, Boston, MA, USA.

The advent of percutaneous therapies has significantly altered therapeutic options for patients with valvular heart disease. Building on the success of transcatheter aortic valve replacement, both expanded indications and purpose-built devices are now being used to address percutaneous approaches for mitral valve pathology. While surgical mitral valve repair remains the gold standard for addressing significant mitral valve pathology, there has been a progressive increase in the utilization of bioprosthetic valves despite their limited lifespan. Read More

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http://dx.doi.org/10.1177/1089253218812425DOI Listing
March 2019
4 Reads

Functional Tricuspid Regurgitation in Mitral Valve Disease.

Semin Cardiothorac Vasc Anesth 2019 Mar 1;23(1):108-122. Epub 2018 Nov 1.

1 Department of Anesthesiology, Duke University, Durham, NC, USA.

Functional tricuspid regurgitation is a common finding in patients with left-sided heart disease. If left untreated, it may reduce survival, limit functional capacity and cause end-organ dysfunction. Annulus dilation and leaflet tethering due to right ventricle remodeling are 2 major pathophysiologic mechanisms in functional tricuspid regurgitation. Read More

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http://dx.doi.org/10.1177/1089253218807922DOI Listing
March 2019
3 Reads

A Systematic Review of Caudal Anesthesia and Postoperative Outcomes in Pediatric Cardiac Surgery Patients.

Semin Cardiothorac Vasc Anesth 2018 Sep 28:1089253218801966. Epub 2018 Sep 28.

1 Hospital for Sick Children, Toronto, Ontario, Canada.

Objectives: In pediatric cardiac surgery, does caudal anesthesia promote early extubation, reduce pain scores, reduce stress responses, and length of stay (LOS)?

Design: A systematic review.

Participants: Inclusion criteria included cardiac surgical procedures (with or without cardiopulmonary bypass) in any subject between the ages of full-term newborn and 18 years receiving caudal anesthesia of any medication combination. Searches were conducted with assistance of an Academic librarian from 1947 to July 2017. Read More

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http://dx.doi.org/10.1177/1089253218801966DOI Listing
September 2018
1 Read

Right Ventricular Function in Left Heart Disease.

Semin Cardiothorac Vasc Anesth 2019 Mar 19;23(1):88-107. Epub 2018 Sep 19.

1 Divisions of Cardiothoracic Anesthesiology & Critical Care Medicine, Department of Anesthesiology, Duke University School of Medicine / Duke University Medical Center, Durham, NC, USA.

Right ventricular (RV) function is an independent prognostic factor for short- and long-term outcomes in cardiac surgical patients. Patients with mitral valve (MV) disease are at increased risk of RV dysfunction before and after MV operations. Yet RV function is not part of criteria for decision making or risk stratification in this setting. Read More

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http://dx.doi.org/10.1177/1089253218799345DOI Listing
March 2019
4 Reads

Ischemic Mitral Regurgitation: Repair, Replacement or Nothing.

Semin Cardiothorac Vasc Anesth 2019 Mar 13;23(1):11-19. Epub 2018 Aug 13.

1 University of Texas Southwestern Medical Center, Dallas, TX, USA.

The treatment strategy for ischemic mitral regurgitation (MR) continues to evolve with the completion of multicenter trials and the advancement of surgical and percutaneous interventional techniques. This review defines ischemic MR, outlines key clinical trials that assess surgical and interventional approaches, and reports the main elements of recent national guidelines for decision making in treatment of ischemic MR. New findings in percutaneous mitral valve repair and replacement for ischemic MR will also be described. Read More

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http://dx.doi.org/10.1177/1089253218792921DOI Listing
March 2019
23 Reads

Management and Anesthetic Considerations for Patients With Anomalous Aortic Origin of a Coronary Artery.

Semin Cardiothorac Vasc Anesth 2018 Dec 10;22(4):383-394. Epub 2018 Aug 10.

1 Masonic Children's Hospital, University of Minnesota, Minneapolis, MN, USA.

The term "coronary artery anomalies" encompasses a large and heterogeneous group of disorders that may affect origin, intrinsic anatomy, course, location, and termination of the coronary arteries. With these different anatomies, presentation, symptoms, and outcomes are heterogeneous as well. While significant efforts are directed toward improving diagnosis and risk-stratification, best evidence-guided practices remain in evolution. Read More

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http://journals.sagepub.com/doi/10.1177/1089253218793888
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http://dx.doi.org/10.1177/1089253218793888DOI Listing
December 2018
5 Reads

Thomas Bevill Peacock and the First Descriptions of Congenital Heart Disease.

Semin Cardiothorac Vasc Anesth 2018 09;22(3):241-244

1 University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

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http://dx.doi.org/10.1177/1089253218788914DOI Listing
September 2018
1 Read

Combined Use of a Fiberscope and Fuji Uniblocker for Removal of Retained Bronchial Tissue Glue After Repair of a Disrupted Left Main Bronchus.

Semin Cardiothorac Vasc Anesth 2018 Jul 30:1089253218792056. Epub 2018 Jul 30.

1 Imam Abdulrahman Bin Faisal University, King Fahd Hospital, Dammam, Saudi Arabia.

We describe the novel combined use of a fiberoptic bronchoscope and a Fuji Uniblocker placed outside the endotracheal tube (ETT) for removal of a retained BioGlue polymerized tissue fragment (2.8 × 0.8 cm) from the right main bronchus (RMB). Read More

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http://dx.doi.org/10.1177/1089253218792056DOI Listing
July 2018
29 Reads

Elevated Renal Oxygen Extraction During Open Abdominal Aortic Aneurysm Repair Is Related to Postoperative Renal Dysfunction.

Semin Cardiothorac Vasc Anesth 2018 Dec 26;22(4):369-375. Epub 2018 Jul 26.

1 Rigshospitalet, Copenhagen, Denmark.

Background: Open abdominal aortic aneurysm repair is often followed by elevated plasma creatinine, likely due to impaired renal blood flow. We evaluated whether postoperative elevation in creatinine relates to renal oxygen extraction during surgery as an index of renal blood flow and also monitored frontal lobe oxygenation.

Methods: For 19 patients (66 ± 10 years; mean ± SD) undergoing open infrarenal abdominal aortic aneurysm repair, renal oxygen extraction was determined by arterial and renal vein catheterization. Read More

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http://dx.doi.org/10.1177/1089253218790270DOI Listing
December 2018
1 Read

Surgical Echocardiography of the MV: Focus on 3D.

Semin Cardiothorac Vasc Anesth 2019 Mar 18;23(1):26-36. Epub 2018 Jul 18.

1 University of North Carolina, Chapel Hill, NC, USA.

The mitral valve remains a complex structure where multiple forms of pathology can be seen. Mitral regurgitation continues to be one of the most common valvular diseases in the industrialized world. While intraoperative 2-dimensional transesophageal echocardiography has been commonplace for some time, 3-dimensional technology has emerged and has shown great benefit for diagnosis and guidance during mitral valve surgery. Read More

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http://dx.doi.org/10.1177/1089253218789409DOI Listing
March 2019
3 Reads

The Left Atrial Appendage, Including LAA Occlusion Devices Line Watchman, Amulet, and Lariat.

Semin Cardiothorac Vasc Anesth 2019 Mar 18;23(1):70-87. Epub 2018 Jul 18.

1 Vanderbilt University Medical Center, Nashville, TN, USA.

Atrial fibrillation is a very common arrhythmia whose prevalence is expected to increase significantly as the population ages. The associated stroke risk is a major cause of morbidity and mortality. Stroke prevention by anticoagulation carries its own risks, leading to the search for alternative strategies. Read More

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http://dx.doi.org/10.1177/1089253218789159DOI Listing
March 2019
4 Reads

Mitral Intervention with LVAD: Preparing for Recovery.

Semin Cardiothorac Vasc Anesth 2019 Mar 17;23(1):134-139. Epub 2018 Jul 17.

2 Medical University of South Carolina, Charleston, SC, USA.

Left ventricular assist device (LVAD) insertion is an increasingly common treatment of advanced heart failure. Insertion guidelines suggest regurgitant lesions of the mitral valve should not be addressed. However, recent evidence suggests that mitral regurgitation may not necessarily improve with LVAD insertion, and such patients may have worse outcomes. Read More

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http://dx.doi.org/10.1177/1089253218788081DOI Listing
March 2019
6 Reads

Risk Factors and Outcomes Associated With Sepsis After Coronary Artery Bypass and Open Heart Valve Surgeries.

Semin Cardiothorac Vasc Anesth 2018 Dec 11;22(4):359-368. Epub 2018 Jul 11.

1 Brigham and Women's Hospital, Boston, MA, USA.

Purpose: Sepsis causes significant morbidity and mortality after cardiac surgery and carries a significant burden on health care costs. There is a general association of increased risk of post-cardiac surgery sepsis in patients with postoperative complications. We sought to investigate significant patient and procedural risk factors and outcomes associated with sepsis after cardiac surgery. Read More

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http://dx.doi.org/10.1177/1089253218785362DOI Listing
December 2018
10 Reads

Future Technology.

Semin Cardiothorac Vasc Anesth 2019 Mar 13;23(1):123-133. Epub 2018 Jun 13.

1 Vanderbilt University Medical Center, Nashville, TN, USA.

Mitral regurgitation is the most common valvular disease and significant (moderate/severe) mitral regurgitation is found in 2.3% of the population older than 65 years. New transcatheter minimally invasive technologies are being developed to address mitral valve disease in patients deemed too high a risk for conventional open-heart surgery. Read More

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http://dx.doi.org/10.1177/1089253218779787DOI Listing
March 2019
1 Read

Interventional Echocardiography of the MV: What the Interventionalist Wants to Know.

Semin Cardiothorac Vasc Anesth 2019 Mar 13;23(1):37-47. Epub 2018 Jun 13.

1 Cooper University Hospital, Camden, NJ, USA.

The past 2 decades have seen a proliferation of transcatheter mitral valve (MV) therapies, which are less invasive and distinct from surgical MV repair or replacement. The commonly used MV transcatheter therapies include (1) percutaneous mitral balloon commissurotomy (PMBC) for rheumatic mitral stenosis; (2) edge-to-edge repair with the MitraClip for mitral regurgitation; (3) valve-in-valve implantation in bioprosthetic MV, native MV, or mitral ring; and (4) closure of paravalvular leaks (PVLs). This article will focus on the use of echocardiography in the diagnosis, patient selection, procedural guidance, and postprocedural follow-up for PMBC, with notes on the role of transesophageal echocardiography in transcatheter interventions for prosthetic valve degeneration and PVL closure. Read More

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http://dx.doi.org/10.1177/1089253218778822DOI Listing
March 2019
4 Reads

Transcatheter Aortic Valve Replacements: Current Trends and Future Directions.

Semin Cardiothorac Vasc Anesth 2018 Jun 1:1089253218779389. Epub 2018 Jun 1.

1 Johns Hopkins School of Medicine, Baltimore, MD, USA.

Since the 1960s when the first aortic surgical aortic valve replacement (SAVR) was performed, continuous growth in the field of valvular technology has occurred. Although SAVR remains a lifesaving procedure, minimally invasive transcatheter aortic valve replacement has revolutionized and expanded aortic valve replacement to patients who were not previously SAVR candidates, increasing their quality of life and survival. Since its introduction in the United States in 2011, the technology and practice have rapidly expanded. Read More

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http://dx.doi.org/10.1177/1089253218779389DOI Listing
June 2018
4 Reads

A Patient With Remote Heparin-Induced Thrombocytopenia and Antiphospholipid Syndrome Requiring Cardiopulmonary Bypass: Do Current Guidelines Apply?

Semin Cardiothorac Vasc Anesth 2018 Jun 1:1089253218779081. Epub 2018 Jun 1.

1 The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Anticoagulation for cardiopulmonary bypass (CPB) is required to prevent acute disseminated intravascular coagulation and clot formation within the bypass circuit. Unfractionated heparin is the standard anticoagulant for CPB due to its many advantages and long history of successful use. However, heparin has the unique drawback of triggering Heparin-PF4 (PF4) antibodies potentially leading to heparin-induced thrombocytopenia (HIT). Read More

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http://journals.sagepub.com/doi/10.1177/1089253218779081
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http://dx.doi.org/10.1177/1089253218779081DOI Listing
June 2018
7 Reads

Perioperative and Anesthetic Considerations in Truncus Arteriosus.

Semin Cardiothorac Vasc Anesth 2018 Sep 29;22(3):285-293. Epub 2018 May 29.

2 University of Washington, Seattle, WA, USA.

Truncus arteriosus is a congenital cardiac lesion in which failure of embryonic truncal septation results in a single semilunar valve and single arterial trunk providing both pulmonary and systemic circulations. Most patients with this lesion are symptomatic in the neonatal period with cyanosis and/or congestive heart failure and undergo complete repair in the first weeks of life. This review will focus on the anatomy, physiology, and perioperative anesthetic management of patients with truncus arteriosus. Read More

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http://dx.doi.org/10.1177/1089253218778826DOI Listing
September 2018
2 Reads

Improved Cost-Effectiveness and Blood Product Utilization From Instituting a Blood Ordering Algorithm for Cardiac Surgical Cases.

Semin Cardiothorac Vasc Anesth 2018 Dec 23;22(4):353-358. Epub 2018 May 23.

1 Ochsner Health System, New Orleans, LA, USA.

Background: Results of a previous study revealed an over-ordering of blood products for cardiac surgery and led to the creation of a new blood ordering algorithm. This follow-up study has been conducted to evaluate improvement in ordering practices.

Methods: Retrospective data were collected for 171 patients who underwent coronary artery bypass grafting or valve surgery from March 2015 to March 2016 to determine the crossmatch-to-transfusion ratio (C:tx) and potential cost savings. Read More

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http://dx.doi.org/10.1177/1089253218778602DOI Listing
December 2018
1 Read

Surgical Considerations in Interrupted Aortic Arch.

Semin Cardiothorac Vasc Anesth 2018 Sep 18;22(3):278-284. Epub 2018 May 18.

2 Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.

Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era. Read More

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http://journals.sagepub.com/doi/10.1177/1089253218776664
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http://dx.doi.org/10.1177/1089253218776664DOI Listing
September 2018
13 Reads

Perioperative and Anesthetic Considerations in Interrupted Aortic Arch.

Semin Cardiothorac Vasc Anesth 2018 Sep 10;22(3):270-277. Epub 2018 May 10.

1 Boston Children's Hospital, Boston, MA, USA.

Interrupted aortic arch (IAA) is defined as the loss of luminal continuity between the ascending and descending aorta and is classified based on the anatomic level of interruption. IAA is associated with a number of intracardiac anomalies with the most common being patent ductus arteriosus, ventricular septal defect, and left ventricular outflow obstruction. There is also a strong association between type B interruption and 22q11 deletion syndrome. Read More

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http://dx.doi.org/10.1177/1089253218775954DOI Listing
September 2018
6 Reads

Risk Factors Associated With the Development of Acquired Airway Disease After Congenital Heart Surgery: A Retrospective Cohort Study.

Semin Cardiothorac Vasc Anesth 2018 Sep 2;22(3):294-299. Epub 2018 May 2.

1 George Washington University School of Medicine, Washington, DC, USA.

Objective: In this single-center, retrospective review, we sought to determine the risk factors associated with the development of severe acquired airway disease (AAD; vocal cord paralysis [VCP] or subglottic stenosis [SGS]) in pediatric patients who had undergone surgery for congenital heart disease (CHD) with cardiopulmonary bypass. All patients who required surgical treatment for CHD using cardiopulmonary bypass at our institution between 2010 and 2015 were reviewed. We defined severe AAD as either clinically significant VCP, SGS, or both, requiring consultation with the otolaryngology (ENT) service for evaluation. Read More

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http://dx.doi.org/10.1177/1089253218772848DOI Listing
September 2018
9 Reads

An Update in Abdominal Organ Transplantation Anesthesia in 2018: Society for the Advancement of Transplant Anesthesia (SATA).

Semin Cardiothorac Vasc Anesth 2018 06;22(2):109-110

4 University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

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http://dx.doi.org/10.1177/1089253218768558DOI Listing
June 2018
4 Reads

Opiate-Free Tricuspid Valve Replacement: Case Report.

Semin Cardiothorac Vasc Anesth 2018 Dec 20;22(4):407-413. Epub 2018 Apr 20.

1 Ochsner Health System, New Orleans, LA, USA.

The utility of opioid pain medications for perioperative analgesia is well described. However, opioids have many dangerous side effects including respiratory depression, acute tolerance, hyperalgesia, and chronic opioid dependence. Multimodal approaches continue to be used in more invasive and complex surgical procedures for enhanced recovery and decreased postoperative complications from opioid administration. Read More

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http://dx.doi.org/10.1177/1089253218771342DOI Listing
December 2018
3 Reads

Preoperative Physiology, Imaging, and Management of Interrupted Aortic Arch.

Authors:
Kevin Friedman

Semin Cardiothorac Vasc Anesth 2018 Sep 12;22(3):265-269. Epub 2018 Apr 12.

1 Boston Children's Hospital, Boston, MA, USA.

Interrupted aortic arch (IAA) is a rare form of critical neonatal heart disease in which there is lack of continuity between the ascending aorta and the descending thoracic aorta. In the absence of prenatal diagnosis, patients with IAA present in shock when the patent ductus arteriosus closes. Diagnosis can generally be made by echocardiography, and initiation of prostaglandin E1 infusion allows for adequate lower body perfusion prior to surgical repair. Read More

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http://dx.doi.org/10.1177/1089253218770198DOI Listing
September 2018
8 Reads

Enteral Guanfacine to Treat Severe Anxiety and Agitation Complicating Critical Care After Cardiac Surgery.

Semin Cardiothorac Vasc Anesth 2018 Dec 5;22(4):403-406. Epub 2018 Apr 5.

1 University of Kentucky, Lexington, KY, USA.

This article is the first reported case describing the off-label use of enteral immediate-release guanfacine, a long-acting α-2 adrenergic agonist most commonly used in the treatment of attention-deficit hyperactivity disorder, for sedation in a patient with severe anxiety and agitation limiting mechanical ventilation weaning several days after cardiac surgery. In this case, after several days of unsuccessful attempts to control his agitation and anxiety with conventional therapies, guanfacine therapy was initiated, and the patient was rapidly weaned from all other sedatives and mechanical ventilation shortly thereafter. The patient was weaned from guanfacine therapy without evidence of bradycardia, hypotension, or rebound syndrome. Read More

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http://dx.doi.org/10.1177/1089253218768537DOI Listing
December 2018
12 Reads

Ethics of Liver Transplantation: The Role of the Anesthesiologist.

Authors:
James M West

Semin Cardiothorac Vasc Anesth 2018 Jun 14;22(2):229-236. Epub 2018 Mar 14.

1 Methodist-LeBonheur Healthcare, Memphis, TN, USA.

Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Read More

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http://dx.doi.org/10.1177/1089253218763815DOI Listing
June 2018
5 Reads

Perioperative Surgical Home Reduces Rapid Response Calls to a Postoperative Surgical Ward: How Anesthesiologists Are Improving the Inpatient Safety Net.

Semin Cardiothorac Vasc Anesth 2018 Dec 7;22(4):345-352. Epub 2018 Mar 7.

1 VA Palo Alto Health Care System, Palo Alto, CA, USA.

Background: The Perioperative Surgical Home (PSH) is an anesthesiologist-led, coordinated care model that may improve patient experience and safety. We hypothesized that PSH will decrease activation of the rapid response system for surgical inpatients.

Methods: This retrospective study was performed at an academic Veterans Affairs hospital with a PSH. Read More

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http://dx.doi.org/10.1177/1089253218761813DOI Listing
December 2018
43 Reads

Critical Importance of Low-Dose Tissue Plasminogen Activator Policy for Treating Intraoperative Pulmonary Thromboembolism During Liver Transplantation.

Semin Cardiothorac Vasc Anesth 2018 Dec 28;22(4):376-382. Epub 2018 Feb 28.

1 Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Tissue plasminogen activator (tPA) has been reported to treat intraoperative pulmonary thromboembolism (PTE) during liver transplantation (LT). However, tPA administration is often delayed due to fear of uncontrolled bleeding and storage in a refrigerator outside of operating rooms. Various dosages of tPA were used. Read More

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http://dx.doi.org/10.1177/1089253218760221DOI Listing
December 2018
15 Reads

Rapid Recovery of Liver Transplantation Recipients by Implementation of Fast-Track Care Steps: What Is Holding Us Back?

Semin Cardiothorac Vasc Anesth 2018 Jun 28;22(2):191-196. Epub 2018 Feb 28.

3 University of Colorado, Aurora, CO, USA.

A body of scientific studies has shown that early extubation is safe and cost-effective in a large number of liver transplant (LT) recipients including pediatric patients. However, fast-track practices are not universally accepted, and debate still lingers about whether these interventions are safe and serve the patients' best interest. In this article, we focus on reasons why physicians still have a persistent, although diminishing, reluctance to adopt fast-track protocols. Read More

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http://dx.doi.org/10.1177/1089253218761124DOI Listing
June 2018
7 Reads

Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement.

Semin Cardiothorac Vasc Anesth 2018 Feb 1:1089253218758463. Epub 2018 Feb 1.

1 University of Pittsburgh, Pittsburgh, PA, USA.

In this report, we provided details of periprocedural echocardiographic guidance for patients undergoing Amplatzer-Amulet device left atrial closure. Familiarity with left atrial appendage (LAA) occlusion devices and the required left atrial examination and measurements are key before device placement. Device placement is assisted by transesophageal echocardiography (TEE) and fluoroscopy, but TEE will be the main guide for patients with renal insufficiency in whom contrast dye use needs to be minimal. Read More

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http://dx.doi.org/10.1177/1089253218758463DOI Listing
February 2018
24 Reads

Comparative Effectiveness and Harms of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery: A Systematic Review.

Semin Cardiothorac Vasc Anesth 2018 Jun 14;22(2):122-136. Epub 2018 Feb 14.

5 School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Read More

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http://dx.doi.org/10.1177/1089253218756756DOI Listing
June 2018
11 Reads

Intraoperative Transesophageal Echocardiogram During Orthotopic Liver Transplantation: TEE to the Rescue!

Semin Cardiothorac Vasc Anesth 2018 Jun 9;22(2):146-149. Epub 2018 Feb 9.

1 MedStar Georgetown University Hospital, Washington, DC, USA.

Supported by a growing number of studies and case reports in the literature, perioperative use of TEE in non-cardiac cases has significantly increased the past two decades. The utility of TEE in monitoring hemodynamic, and diagnosing causes of hypotension refractory to conventional therapy, have made it an almost indispensible tool during major surgeries, such liver transplantation. Despite this fact, compared to the adult population, there is a lack of an equivalent amount of literature on the perioperative use of TEE in pediatric cases. Read More

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http://dx.doi.org/10.1177/1089253218757032DOI Listing
June 2018
7 Reads

Pulmonary Atresia With an Intact Ventricular Septum: Preoperative Physiology, Imaging, and Management.

Semin Cardiothorac Vasc Anesth 2018 Sep 7;22(3):245-255. Epub 2018 Feb 7.

2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare complex cyanotic congenital heart disease with heterogeneous morphological variation. Prenatal diagnosis allows for developing a safe plan for delivery and postnatal management. While transthoracic echocardiography allows for detailed delineation of the cardiac anatomy, additional imaging modalities such as computed tomography, magnetic resonance imaging, and catheterization may be necessary to further outline features of the cardiac anatomy, specifically coronary artery anatomy. Read More

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http://dx.doi.org/10.1177/1089253218756757DOI Listing
September 2018
11 Reads