Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Cardiac and Renal Transplantation in Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Symptoms: Anesthetic Challenges and Considerations.","authors":"Erik Anderson, Sudarshan Setty, Mariah Dahmen, Matthew M Townsley, John G Augoustides, Rohesh J Fernando","doi":"10.1053/j.jvca.2024.09.138","DOIUrl":"10.1053/j.jvca.2024.09.138","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":"301-308"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466269","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":"Twists and Turns in Arterial Pathways.","authors":"Madan Mohan Maddali, Abdullah Mohammed Al Farqani","doi":"10.1053/j.jvca.2024.10.023","DOIUrl":"10.1053/j.jvca.2024.10.023","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":"317-320"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621101","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":"Epidemiology and Triggers of Severe Perioperative Anaphylaxis: Comment.","authors":"Nils Vlaeminck, Didier G Ebo","doi":"10.1053/j.jvca.2024.10.038","DOIUrl":"10.1053/j.jvca.2024.10.038","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":"329-330"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644309","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":"Comprehensive Dynamic 3-Dimensional Analysis of the Tricuspid Valve in Functional Tricuspid Regurgitation: Implications for Prophylactic Tricuspid Valve Intervention.","authors":"Sankalp Sehgal, Shou Liu, Feroze Mahmood, Andrew Maslow, Andaleeb A Ahmed, Ziyad O Knio, Robina Matyal, Louis Chu, David C Liu, Venkatachalam Senthilnathan, Kamal R Khabbaz","doi":"10.1053/j.jvca.2024.09.144","DOIUrl":"10.1053/j.jvca.2024.09.144","url":null,"abstract":"<p><strong>Objectives: </strong>To track and measure changes in the tricuspid annulus (TA) using 3-dimensional (3D) echocardiography during a complete cardiac cycle in patients with functional tricuspid regurgitation (TR) compared to patients without TR, and to compare tricuspid annular plane systolic excursion (TAPSE) derived from 2-dimensional (2D) and 3D coordinates as a measure of right ventricular (RV) function to the standard method of 2D fractional area change (FAC).</p><p><strong>Design: </strong>Intraoperative 3D echocardiography data were collected prospectively, followed by postprocessing software analysis to track and reconstruct changes throughout the cardiac cycle.</p><p><strong>Setting: </strong>Data were collected from 108 patients undergoing left-sided heart surgery at 2 large academic centers-Beth Israel Deaconess Medical Center in Boston, MA and Rhode Island Hospital, Providence, RI-between November 2018 and April 2020.</p><p><strong>Participants: </strong>The final dataset (n = 92) included 2 groups: the no significant functional TR (NTR) group (n = 74), defined as ≤ mild TR and TA <35 mm, and the significant functional TR (FTR) group (n = 18), defined as ≥ moderate TR.</p><p><strong>Interventions: </strong>3D TEE datasets were analyzed, and the motion of TA coordinates was tracked during complete cardiac cycle in 2D and 3D planes using postprocessing and software analysis. Computational modeling of TA motion was performed using computer-aided design. In further analysis, reconstructed and 3D printed models of TV were developed for the 2 groups.</p><p><strong>Measurements and main results: </strong>`Patients in FTR group had larger TA size during the cardiac cycle, with less overall excursion and reduced annular dynamism. The 3D motion of TA for lateral, anterolateral, and posterolateral coordinates was lower in the FTR group compared to the NTR group [18 ± 6.8 vs 13.6 ± 8.5( p = 0.02); 15.2 ± 5.5 vs 11.3 ± 6.0 (p = 0.009); and 17.6 ± 6.6 vs 12.3 ± 5.2 (p = 0.002), respectively]. TAPSE derived from 3D planes was more accurate for RV function assessment when comapred with 2D FAC (area under the curve [AUC], 0.704; p = 0.011) than 2D TAPSE (AUC, 0.625; p = 0.129). Finally, in the FTR group, the anteroseptal-posterolateral diameter was consistently larger during all phases of the cardiac cycle compared to the conventionally measured septolateral diameter.</p><p><strong>Conclusions: </strong>3D echocardiographic assessment of TA helps better understand its geometry and dynamism in functional TR and is more accurate than 2D measurements for RV function assessment.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":"49-60"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568621","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":"Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients.","authors":"Danial Ahmad, Michel Pompeu Sá, James A Brown, Sarah Yousef, Yisi Wang, Derek Serna-Gallegos, David West, Pyongsoo Yoon, David Kaczorowski, Johannes Bonatti, Danny Chu, Francis D Ferdinand, Julie Phillippi, Ibrahim Sultan","doi":"10.1053/j.jvca.2024.10.039","DOIUrl":"10.1053/j.jvca.2024.10.039","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association of hospital teaching status with outcomes of patients presenting with type B aortic dissection (TBAD).</p><p><strong>Design: </strong>Retrospective cross-sectional study of the National Readmissions Database (NRD), from 2016 to 2020.</p><p><strong>Setting: </strong>Hospitals across the United States stratified by teaching status.</p><p><strong>Participants: </strong>TBAD patients.</p><p><strong>Interventions: </strong>Surgical repair, thoracic endovascular aortic repair (TEVAR), and conservative medical management.</p><p><strong>Measurements and main results: </strong>A total of 44,981 TBAD patients were included, of whom 5421 (12%) were managed at a nonteaching (NT) hospital and 39,470 (88%) were treated at a teaching (T) hospital. Propensity score matching (1:1) yielded 4676 matched pairs. In-hospital mortality (12.9% for NT vs 12.5% for T; p = 0.58) and 30-day readmission (23.3% for NT vs 21.8% for T; p = 0.12) outcomes were not statistically significantly different between the groups. On multivariable regression, teaching status was not associated with higher odds of in-hospital mortality (odds ratio [OR], 0.943; 95% confidence interval [CI, 0.841-1.057; p = 0.31) or 30-day readmission (OR, 0.965; 95% CI, 0.88-1.058; p = 0.44). At teaching hospitals, TEVAR was associated with higher odds of in-hospital mortality (OR, 1.898; 95% CI, 1.596-2.257; p < .01), while hospital volume was associated with higher odds of 30-day readmission (quartile 3: OR, 1.488; 95% CI, 1.106-2.002; quartile 4: OR, 1.684; 95% CI, 1.256-2.257; p < 0.01).</p><p><strong>Conclusions: </strong>Hospital teaching status alone was not associated with in-hospital mortality or 30-day readmission in TBAD patients. At teaching hospitals, management by TEVAR and greater hospital volume were associated with in-hospital mortality and 30-day readmission outcome, respectively.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":"88-94"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621119","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":"Routine Left Ventricular Unloading During Venoarterial Extracorporeal Membrane Oxygenation-A Therapeutic Conundrum.","authors":"Alice Bottussi, Jacopo D'Andria Ursoleo, Enrica Piazza, Edoardo Mongardini, Fabrizio Monaco","doi":"10.1053/j.jvca.2024.12.040","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.040","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949346","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":"Severe Reversible Pulmonary Hypertension in a Patient with Shone Complex Presenting for Heart Transplantation.","authors":"Nicholas Flores-Conner, Molly Brazil, Maggie Whittle, Ashish Shah, Christina Jelly","doi":"10.1053/j.jvca.2024.12.037","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.037","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970868","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":"Deep Serratus Anterior Plane Block for Multimodal Analgesia in Minimally Invasive Mitral Valve Surgery Performed via Right Anterior Mini-Thoracotomy.","authors":"Daniele Marianello, Cesare Biuzzi, Filippo Sanfilippo, Riccardo Marcucci, Francesco Ginetti, Alessandra Cartocci, Matilde Milani, Francesco Lorenzo De Matteis, Antonella Puddu, Martina Rizzo, Gianfranco Montesi, Fabio Silvio Taccone, Sabino Scolletta, Federico Franchi","doi":"10.1053/j.jvca.2024.12.024","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.024","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated if the serratus anterior plane block (SAPB) within a multimodal analgesia scheme would reduce acute post-operative pain and intravenous opioid consumption in patients admitted to the intensive care unit after isolated minimally invasive mitral valve surgery.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Patients were admitted to the intensive care unit (ICU) of the University Hospital of Siena (Italy).</p><p><strong>Interventions: </strong>Patients treated with intravenous opioids (OP-G) as a postoperative analgesic regimen were compared to those managed with an opioid-sparing protocol consisting of a single-shot SAPB with 0.5% ropivacaine plus 4 mg dexamethasone administered 1 hour before the extubation (SAPB-G). The behavioral pain scale (BPS) for intubated (I) or non-intubated patients (NI) and the Richmond Agitation Sedation Scale (RASS) scores were collected at ICU admission and every 8 hours during the initial 24 postoperative hours.</p><p><strong>Measurements and main results: </strong>One hundred five patients (50 SAPB-G; 55 OP-G) were enrolled (median age 67 [60-70]; male 67 [64%]). RASS score at 8 hours after ICU admission was higher in the SAPB-G (0 [0, 0] v OP-G -2 [-3, 0], p < 0.001). At 24 hours after ICU admission, the number of patients with a BPS/BPS-NI score >4 was lower in the SAPB-G (4.0% v 18.2% OP-G, p = 0.048). SAPB-G received a lower number of opioid rescue doses during the first 24 hours (20% v 84% OP-G, p < 0.001).</p><p><strong>Conclusions: </strong>The SAPB may be effective in reducing the postoperative use of opioids in patients undergoing minimally invasive mitral valve surgery. Prospective randomized studies are warranted.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005915","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 Kidney and Lung Injuries After Elective Ascending Aortic Surgery.","authors":"Sahar Abdallah, Amine Fikani, Alessandro Piccardo, Romain Chauvet, Slah Smairi, Franck Pihan, Jérémy Tricard, David Vandroux","doi":"10.1053/j.jvca.2024.12.038","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.038","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970865","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 Role of Fluoroscopic Guidance in Spinal Drain Placement for Thoracoabdominal Aneurysm Repair Patients: A Retrospective Study.","authors":"Amna Shaikh, Alyssa Martin, Syed-Muhammad Waqar, Dragos Galusca","doi":"10.1053/j.jvca.2024.12.039","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.039","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate outcomes after implementation of a preoperative protocol requiring fluoroscopic guidance in patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair identified as being at risk for spinal drain placement complications.</p><p><strong>Design: </strong>This retrospective analysis included patients who underwent spinal drain placement for TAAA repair between November 2013 and November 2018. Patient outcomes were assessed before (control) and after (study) protocol implementation.</p><p><strong>Setting: </strong>Single tertiary care hospital.</p><p><strong>Participants: </strong>A total of 58 patient records were analyzed.</p><p><strong>Intervention: </strong>The protocol was implemented in November 2015 to identify at-risk patients for difficult spinal drain placement undergoing TAAA repair who would benefit from placement under fluoroscopic guidance.</p><p><strong>Measurement and main results: </strong>The mean operating room arrival time to drain placement was lower in the study group than in the control group (44.9 ± 12.7 minutes v 80.5 ± 55.8 minutes; p = 0.03). The mean time to incision was lower in the study group than in the control group (114.9 ± 38.1 minutes v 172.4 ± 32.0 minutes; p < 0.001), and fewer drain placement attempts were done in the study group than in the control group (mean, 1.3 ± 0.7 attempts v 2.7 ± 2.5 attempts; p = 0.006). The mean length of stay was lower in the study group (9.5 ± 6.7 days v 18.7 ± 22.7 days; p = 0.04).</p><p><strong>Conclusions: </strong>Preoperative identification of at-risk patients before TAAA repair may reduce operating room arrival to the incision time, operating room to spinal drain placement time, number of spinal drain placement attempts, length of hospital stay, and complications associated with spinal drain placement.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005919","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}