Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Heart Failure in 2025: Update With Perioperative Considerations.","authors":"Parry Mendapara, Harish Ramakrishna, Kristin Stawiarski","doi":"10.1053/j.jvca.2025.08.019","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.019","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064429","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)00588-9","DOIUrl":"10.1053/S1053-0770(25)00588-9","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 9","pages":"Page xv"},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814035","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":"The Catalyst, the Question, and the Path Forward: Reflections on Adult Cardiothoracic Fellow Research Program (ACARP).","authors":"Sergey Karamnov, Lauren Cornella, Gabriela Querejeta-Roca, Chinyere Archie, Louisa J Palmer, Stanton K Shernan","doi":"10.1053/j.jvca.2025.08.005","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.005","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015491","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":"Mechanism and Imaging of Anomalous Origin of the Right Coronary Artery Resulting in Myocardial Ischemia in the Left Coronary Artery Territory.","authors":"Juliana Svantner, Alain Deschamps, Nancy Poirier, Philippe L'allier, Stephanie Tan, André Denault, Pierre Couture","doi":"10.1053/j.jvca.2025.08.016","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.016","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053680","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":"Usefulness of the Recruitment-to-Inflation Ratio and Pulmonary Compliance for Assessing Pulmonary Recruitability in Cardiac Surgery Patients: A Prospective Study","authors":"Jenny Carvalho Badas MD,&nbsp;Jaime Guembe MD,&nbsp;Celia Novials MD,&nbsp;Giulia Scandurra MD,&nbsp;Leo Jaubert MD,&nbsp;Denis Schmartz MD,&nbsp;Olivier Duranteau MD, PhD,&nbsp;Tuna Turgay MD, PhD,&nbsp;Laurent Perrin MD","doi":"10.1053/j.jvca.2025.08.014","DOIUrl":"10.1053/j.jvca.2025.08.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate in cardiac surgery patients the potential for alveolar recruitment at 3 perioperative time points—after intubation, after cardiopulmonary bypass (CPB), and on arrival in the intensive care unit (ICU)—by collecting pulmonary compliance values and calculating the recruitment-to-inflation (R/I) ratio.</div></div><div><h3>Design</h3><div>An interventional cohort single-center study conducted in a department of anaesthesiology and critical care and an ICU</div></div><div><h3>Setting</h3><div>This interventional study was conducted in 41 patients undergoing noncomplex cardiac surgery. Ventilatory mechanics, blood gas analysis, and hemodynamic parameters were measured before, during, and after a lung recruitment maneuver (LRM) (3 minutes at a positive end-expiratory pressure [PEEP] of 12 cmH₂O). The R/I ratio was calculated retrospectively at 3 time points.</div></div><div><h3>Participants</h3><div>The study included patients scheduled for elective, nonurgent cardiac surgery requiring cardiopulmonary bypass (CPB), including coronary artery bypass grafting (CABG), valve replacement, and valve repair.</div></div><div><h3>Interventions</h3><div>R/I ratio measurement.</div></div><div><h3>Measurements and Main Results</h3><div>The proportion of recruitable patients (those with an R/I &gt;0.5) decreased over time, from 61% (25 patients) postintubation (IOT), to 29% (12 patients) post-CPB and 17% (7 patients) in the ICU. After recruitment, lung compliance at all 3 time points was significantly higher in recruitable patients (R/I &gt;0.5) compared to nonrecruitable patients (R/I &lt;0.5) (p &lt; 0.01). At all 3 time points, compliance before LRM did not differ significantly between the recruitable and nonrecruitable groups. Of the 123 LRMs performed in 41 patients, 11 (9%) were interrupted because of hemodynamic intolerance (defined as a &gt;20% drop in mean arterial pressure).</div></div><div><h3>Conclusions</h3><div>In this study, an R/I ratio &gt;0.5 identified up to 60% of patients as potentially recruitable. This parameter is particularly valuable given that PaO₂, partial pressure of oxygen in arterial blood (PaO₂), PaO₂:fraction of inspired oxygen ratio, and prerecruitment compliance did not predict a positive recruitment response. Further studies are needed to assess the utility of the R/I ratio in individualizing PEEP settings and reducing pulmonary complications in cardiac surgery patients.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 11","pages":"Pages 2970-2977"},"PeriodicalIF":2.1,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955524","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":"Baseline Amplitude Ratios of Median Nerve Somatosensory Evoked Potentials: Clinical Implications During Carotid Endarterectomy.","authors":"Swantje de Abreu Malchow, Parisa Moll-Khosrawi, Kristen K Thomsen, Hans O Pinnschmidt, Bernd Saugel, Christian Zöllner, Leonie Schulte-Uentrop","doi":"10.1053/j.jvca.2025.08.011","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.011","url":null,"abstract":"<p><strong>Objectives: </strong>To (1) examine associations between the ipsi-to-contralateral median nerve somatosensory evoked potential (mSSEP) baseline amplitude ratio (=IAR) and clinical symptoms, cerebral infarction, or ischemic injury in the ipsilateral middle cerebral artery territory in patients undergoing carotid endarterectomy (CEA); and (2) evaluate the IAR as a predictor of clamp-induced ischemia.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Single-center study, Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.</p><p><strong>Participants: </strong>Patients after CEA with mSSEP monitoring between 2015 and 2019.</p><p><strong>Intervention: </strong>A total of 221 patients were categorized into subgroups (S/I groups): asymptomatic or symptomatic patients without infarction and/or injury (-S/-I and +S/-I, respectively), symptomatic patients with old infarction (+S/+Io), and symptomatic patients with (sub-)acute infarction and/or injury (+S/+Ia). Predictors of clamp-induced ischemia were evaluated in 228 patients.</p><p><strong>Measurements and main results: </strong>The effects of S/I groups, sex, age, and stenosis degrees on the IAR were tested in uni- and multivariable models. A statistically significant effect was found for \"S/I groups.\" The mean IAR differed statistically significantly between the four subgroups (pF < 0.001); -S/-I, +S/-I, and +S/+Io had significantly higher mean IARs than the reference +S/+Ia. The association between predictor variables and a significant amplitude decline during carotid cross-clamping was examined using univariable and multivariable logistic regression models. A total of 16 of 228 patients (7%) experienced a significant amplitude decline. Solely contralateral carotid artery occlusion showed an indicated effect (odds ratio 4.21, 95% confidence interval 0.76-23.38, p = 0.1).</p><p><strong>Conclusions: </strong>In CEA patients, a decreased IAR reflects the acuity of an infarction or injury but does not predict clamp-induced ischemia. Contralateral carotid artery occlusion showed a trend toward predicting clamp-induced ischemia.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992625","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":"Acute Hepatorenal Failure in the Setting of Ruptured Sinus of Valsalva: Concerns and Considerations","authors":"Jordan Holloway MD ,&nbsp;Theodore Dimitrov BS ,&nbsp;Ammu Alvarez MD ,&nbsp;Bryan A. Whitson MD, PhD ,&nbsp;Galina Dimitrova MD","doi":"10.1053/j.jvca.2025.08.007","DOIUrl":"10.1053/j.jvca.2025.08.007","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 11","pages":"Pages 3204-3205"},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955458","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":"Management of Emergency Cardiopulmonary Bypass Failure During Robot-Assisted Mitral Valve Repair: Successful Recovery With Hypothermia and Centrifugal Pump Exchange.","authors":"Hiroshi Osumi, Ryo Kaminaka, Naoko Koh, Kazuyuki Atsumi","doi":"10.1053/j.jvca.2025.08.010","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.010","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955551","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. V. Molecular Targets in Transthyretin Amyloid Cardiomyopathy.","authors":"Paul S Pagel, Dustin Hang, Julie K Freed, George J Crystal","doi":"10.1053/j.jvca.2025.08.006","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.08.006","url":null,"abstract":"<p><p>Transthyretin amyloid cardiomyopathy (ATTR-CM) is an infiltrative disease that occurs when the tetrameric transthyretin complex dissociates into its constituent monomers, which then misfold, aggregate, and accumulate as amyloid fibrils in the myocardial extracellular matrix. The amyloid deposits thicken and stiffen the myocardium, interfering with cardiac function and leading to the development of heart failure. Chronic exposure to cytotoxic circulating amyloid precursors contributes to further myocardial damage. Once considered rare, ATTR-CM is now recognized as the most common form of cardiac amyloidosis, occurring in variant and wild types. Amyloid formation in variant ATTR-CM results from an inherited, defective transthyretin gene that causes an amino acid substitution, which renders the protein more vulnerable to instability, dissociation, and monomer misfolding. Wild type ATTR-CM originates from a normal gene and occurs primarily in the elderly. A comprehensive understanding of the molecular basis of ATTR-CM has led to the development of 3 new classes of drugs that stabilize transthyretin, silence its genetic expression, or act to degrade amyloid fibrils within the myocardium. These groundbreaking advances are transforming ATTR-CM from debilitating, uniformly fatal disease to a manageable chronic condition with extended life-expectancy and preserved quality of life. This review discusses the pathophysiology of ATTR-CM, reviews the clinical trials demonstrating the efficacy of drugs that stabilize transthyretin or silence its expression, describes the preliminary use of monoclonal antibodies to degrade amyloid fibrils and reverse the disease's structural and functional consequences, and lastly, comments on the potential anesthetic implications of these new disease-modifying therapies.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212711","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":"Extracorporeal Life Support and Lung Transplant: A Breath of Fresh Air","authors":"Jamel Ortoleva MD, FASE ,&nbsp;Dominic V. Pisano MD ,&nbsp;Eriberto Michel MD ,&nbsp;Christoph Nabzdyk MD","doi":"10.1053/j.jvca.2025.08.003","DOIUrl":"10.1053/j.jvca.2025.08.003","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 11","pages":"Pages 2922-2924"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955391","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}