Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Articles to Appear in Future Issues","authors":"","doi":"10.1053/S1053-0770(25)00229-0","DOIUrl":"10.1053/S1053-0770(25)00229-0","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 5","pages":"Page xii"},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Articles to Appear in Future Issues","authors":"","doi":"10.1053/S1053-0770(25)00153-3","DOIUrl":"10.1053/S1053-0770(25)00153-3","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 4","pages":"Page xii"},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Cardiovascular Pharmacotherapy. II. Ivabradine, an Inhibitor of the Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel.","authors":"Paul S Pagel, Dustin Hang, Julie K Freed, George J Crystal","doi":"10.1053/j.jvca.2025.03.029","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.029","url":null,"abstract":"<p><p>Ivabradine selectively reduces heart rate by inhibiting the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in the sinoatrial node. Unlike other medications that produce negative chronotropic effects [beta-blockers, calcium channel blockers], ivabradine does not affect systemic, pulmonary, and coronary hemodynamics. Despite several proof-of-concept clinical studies suggesting that ivabradine may exert anti-ischemic effects, two large randomized trials did not support its use in patients with chronic stable angina. Preliminary data also did not support the use of ivabradine in patients with acute ST-segment elevation myocardial infarction or acutely decompensated heart failure. However, ivabradine improved outcome in patients with heart failure with reduced ejection fraction (HFrEF), leading to its approval by the Food and Drug Administration, but the drug failed to do so in those with heart failure with preserved ejection fraction (HFpEF). Ivabradine may also be useful in cardiac electrophysiology disorders characterized by tachycardia (e.g., inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome), but it has not yet gained wide acceptance for these indications. In this article, the authors briefly review the structure and function of the cardiac HCN channel; discuss the development and actions of drugs, including ivabradine, that modulate the channel's activity; describe in detail the potential clinical applications of ivabradine in patients with coronary artery disease, HFrEF and HFpEF, and cardiac electrophysiology; comment on the adverse effects of ivabradine therapy; and finally, consider the potential anesthetic implications of ivabradine in patients undergoing noncardiac and cardiac surgery.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Spread and Effect of Local Anesthetic Administered Using Thoracic Muscle Plane Block on Internal Thoracic Artery Grafts.","authors":"Tomohiro Yamamoto, Nobuko Ohashi, Takehito Mishima, Shuichi Shiraishi","doi":"10.1053/j.jvca.2025.03.027","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.027","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the spread and effect of local anesthetic administered using transverse thoracic muscle plane block (TTPB) in the tissue surrounding the internal thoracic artery (ITA) during ITA graft harvesting.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Single hospital.</p><p><strong>Participants: </strong>This study included 60 adult patients undergoing cardiac surgery with a median sternotomy.</p><p><strong>Interventions: </strong>The change in peri-ITA tissue properties before and after TTPB with 20 mL local anesthetics on each side at the T4-T5 intercostal level was evaluated using transthoracic echocardiography in 47 patients. The peri-ITA tissue properties were evaluated from the internal side of sternum using a T-shaped ultrasound probe at the T4-T5 intercostal level after median sternotomy and the dissection of the sternal back side tissue to the ITA region in 30 patients. Seventeen patients underwent both evaluations.</p><p><strong>Measurements and main results: </strong>The ITA identifying rate using transthoracic echocardiography was 90.4%. A weak correlation was observed between the distance from the sternum to ITA and patient height. The 20 mL local anesthetics administered using TTPB spread laterally to the ITA area in all identified ITAs. However, the evaluation from the internal side of the sternum using a T-shaped ultrasound probe revealed that the property changes in the peri-ITA tissue had completely disappeared in all cases. The minimum time from TTPB implementation to this observation was 50 minutes.</p><p><strong>Conclusions: </strong>TTPB can be performed safely on patients undergoing coronary artery bypass grafting using ITAs without affecting the ITA graft properties and patency.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights and Perioperative Implications from the 2024 European Society of Cardiology Guidelines for the Management of Peripheral Arterial and Aortic Diseases.","authors":"Perin Kothari, Natalie J Bodmer, Matthew W Vanneman, Quoc-Sy Nguyen, Larissa Miyachi Kiwakyou","doi":"10.1053/j.jvca.2025.03.022","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.022","url":null,"abstract":"<p><p>As aortic and peripheral arterial disease continue to affect millions of people worldwide, experts have made considerable efforts to advance our understanding of these diseases and develop novel treatment paradigms to improve the quality of life for these patients. In late 2024, the European Society of Cardiology published guidelines for the management of peripheral arterial and aortic diseases. This document consolidates and updates previous guidelines to reflect new evidence for physicians caring for these patients. The purpose of this review is to highlight essential recommendations that are especially relevant to the perioperative physician.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and Reliability Evaluation of Sternal Notch Sagittal Ultrasound Imaging for Endotracheal Tube Positioning in Neonates Under General Anesthesia: A Prospective Study Comparing Electronic Bronchoscopy.","authors":"Yuzhu Cai, Lingli Zhang, Xinghui Liu, Yingying Sun","doi":"10.1053/j.jvca.2025.03.014","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.014","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy and reliability of sternal notch sagittal ultrasound imaging for neonatal endotracheal tube positioning by comparing the ultrasound-measured distance from the endotracheal tube tip to the right pulmonary artery with the electronic bronchoscopy-measured distance from the endotracheal tube tip to the carina.</p><p><strong>Design: </strong>A prospective, single-center, observational study using a self-controlled design.</p><p><strong>Setting: </strong>Department of Anesthesiology and Perioperative Medicine at Anhui Provincial Children's Hospital, Hefei, China.</p><p><strong>Participants: </strong>Neonates undergoing endotracheal intubation under general anesthesia for both elective and urgent surgeries were included, with all intubations performed in the operating room.</p><p><strong>Interventions: </strong>Neonates were evaluated for endotracheal tube position using both electronic bronchoscopy and ultrasound in the median sagittal plane at the sternal notch.</p><p><strong>Measurements and main results: </strong>The distance from the endotracheal tube tip to the right pulmonary artery was measured using ultrasound imaging. The distance from the endotracheal tube tip to the carina was measured using electronic bronchoscopy. A high linear correlation was found between the two methods (r = 0.899, p < 0.001). The internal consistency of the three ultrasound measurements was high (Cronbach alpha = 0.985, ICC = 0.985). The precision of ultrasound measurements varied with endotracheal tube size, showing improved consistency with larger tube diameters. The mean absolute deviation (MAD) was 0.18 mm for the 2.5-mm ETT, 0.14 mm for the 3.0-mm ETT, and 0.12 mm for the 3.5-mm ETT, with corresponding coefficient of variation values of 5.60%, 4.50%, and 4.20%, respectively. No adverse events were observed during the ultrasound examination, whereas the incidence of hypoxemia during the electronic bronchoscopy examination was 18.4% (p < 0.001). In terms of operation time, the electronic bronchoscopy examination took (15.43 ± 4.34) seconds, while the ultrasound examination took (10.25 ± 4.27) seconds, with a significant difference between the two methods (p < 0.001).</p><p><strong>Conclusion: </strong>Sternal notch sagittal ultrasound imaging shows highly consistent measurement results with electronic bronchoscopy for assessing the position of the endotracheal tube in neonates. Additionally, sternal notch sagittal ultrasound is safer and non-invasive, making it a viable alternative method for endotracheal tube positioning in neonates under general anesthesia, with significant clinical application value.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia for Irreversible Electroporation in Patients with a Pacemaker.","authors":"Guilherme Freitas Araújo, Marcelo Froeder Arcuri, Veronica Neves Fialho Queiroz, Guilherme Moratti Gilberto, Priscila Mina Falsarella, Guilherme Cayres Mariotti, Rodrigo Gobbo Garcia","doi":"10.1053/j.jvca.2025.03.025","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.025","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pro: Use of Sterile Technique for Ultrasound-guided Noncentral Line Vascular Access Procedures.","authors":"Marc Ghabach, Yuriy S Bronshteyn","doi":"10.1053/j.jvca.2025.03.018","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.018","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Inflow Obstruction in Neonatal Total Anomalous Pulmonary Venous Drainage.","authors":"Madan Mohan Maddali, Salim Nasser Al-Maskari, Khaled Mohamed Ali, Tuqa Al Lawati, Abdullah Mohammed Al Farqani, Hamood Nasar Al Kindi","doi":"10.1053/j.jvca.2025.03.021","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.021","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of High-Sensitivity Cardiac Troponin Monitoring in Thoracic Surgery for Predicting Severe Postoperative Complications.","authors":"Javier J Mateos, Elena De la Fuente, Pablo Valero, David Martínez, Francisco De la Gala, Jose M Bellón, Patricia Duque, Patricia Piñeiro, Alberto Calvo, Almudena Reyes, Carlos Simón, Francisco J Hortal, Ignacio Garutti","doi":"10.1053/j.jvca.2025.03.023","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.03.023","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the utility of high-sensitivity cardiac troponin (hs-cTn) monitoring in thoracic surgery to predict severe postoperative complications (sPOCs) according to the Clavien-Dindo classification.</p><p><strong>Design: </strong>Retrospective, observational cohort study.</p><p><strong>Setting: </strong>Tertiary-level hospital involving multiple departments.</p><p><strong>Participants: </strong>A total of 220 patients who underwent lung resection surgery between November 2018 and October 2021, with preoperative and postoperative troponin measurements.</p><p><strong>Interventions: </strong>hs-cTnI levels (Abbott Alinity) were measured before surgery and within the first 24 hours postoperatively. Myocardial injury (MI) was defined as hs-cTnI greater than 26.2 ng/L postoperatively. In addition, the impact of a postoperative cTnI elevation greater than 20% or a preoperative value below 1.6 ng/L on the occurrence of sPOCs is analyzed. Postoperative complications were recorded for the first 30 days and classified using the Clavien-Dindo classification.</p><p><strong>Main measurements and results: </strong>Patients with sPOCs had higher pre- and postoperative hs-cTnI levels compared to those without complications. Patients with MI had a higher incidence of POCs than those without MI. Additionally, undetectable preoperative hs-cTnI levels were associated with better survival.</p><p><strong>Conclusions: </strong>Perioperative troponin elevation is associated with worse short-term postoperative outcomes, including a higher incidence of sPOCs and prolonged hospital stays. Preoperative hs-cTnI levels correlate with preoperative morbidity (frailty) in patients.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}