Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Life-Threatening Iatrogenic Pulmonary Hemorrhage Managed with Salvage Anticoagulation-Free Venovenous Extracorporeal Membrane Oxygenation.","authors":"Aurélien Gonze, Thomas Neff, Sebahat Ocak, Benoit Robaye, Benoit Rondelet, Martial Gillet, Pierre Bulpa, Isabelle Michaux, Arnaud Robert","doi":"10.1053/j.jvca.2025.05.009","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.009","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199230","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":"Clinical Implications of Pharmacogenomics of β₁-Adrenoceptor for Anesthesia.","authors":"Huw Garland, Graham Ladds","doi":"10.1053/j.jvca.2025.05.006","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.006","url":null,"abstract":"<p><p>Genetic polymorphisms within the β₁-adrenoceptor are common within the population. Although not directly causative of disease, accumulating evidence supports that they have significant molecular and clinical effects, including altering the response to inotropes and β-blockers, as well as altering exercise capacity. Here, we summarize current evidence as relevant to anesthetists who treat patients with heart failure.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528064","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 Outpouchings Following Acute Anterior Myocardial Infarction: A Diagnostic Dilemma.","authors":"Cynthia Karam, Nancy Abou Nafeh, Marie T Aouad, Sahar Siddik-Sayyid, Roland Kaddoum, Kelly Merheb, Maher El Shami, Amro Khalili, Carine Zeeni","doi":"10.1053/j.jvca.2025.05.008","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.008","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179977","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)00286-1","DOIUrl":"10.1053/S1053-0770(25)00286-1","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 6","pages":"Page xiv"},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912885","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":"Rescue Transesophageal Echocardiography Matrix for In-hospital Hemodynamic Instability and Cardiac Arrest Imaging.","authors":"Andrew Peev, Alexander Fischman, Audrey Elizabeth Spelde, Emily Gordon, Samantha Stein, John G Augoustides, Stuart J Weiss, William J Vernick, Jacob T Gutsche, Asad Ali Usman","doi":"10.1053/j.jvca.2025.04.040","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.040","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248008","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":"Venoarterial Extracorporeal Membrane Oxygenation: A Better Pressor.","authors":"Edith Elianna Rodríguez Aparicio, Isabel Londono, Gabriel Sanchez, Camilo Pizarro, Leonardo Salazar, Marc Dickstein, Akram Zaaqoq, Michael Mazzeffi, Bryan E Marchant, Rohesh J Fernando","doi":"10.1053/j.jvca.2025.04.038","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.038","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142690","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":"Enhancing Transesophageal Echocardiography Training in Cardiac Anesthesia Fellows Using Wearable Eye-Tracking Technology.","authors":"Benjamin Gorbaty, Enrique Vergara Escuardo, Alexander Gherciuc, Serjey Gherciuc, Tjorvi E Perry","doi":"10.1053/j.jvca.2025.04.039","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.039","url":null,"abstract":"<p><p>The training of Adult Cardiothoracic Anesthesiology (ACTA) fellows in transesophageal echocardiography (TEE) is essential for their development, but assessing technical proficiency remains challenging. While hands-on experience is the cornerstone of learning, traditional evaluation methods primarily focus on image interpretation, neglecting the assessment of image acquisition techniques and visual attention. We describe our experience using wearable eye-tracking technology to objectively assess the TEE skills of ACTA fellows. Since 2023, our ACTA fellows have been equipped with Tobii Pro Glasses 3 (Tobii Pro, Danderyd, Sweden) during weekly preoperative TEE examinations. These glasses record video and track gaze patterns in real-time, allowing for the analysis of fellows' focus and performance over time. The gaze data is processed using Tobii Pro Lab Analyzer, creating heat maps and measuring the time spent on specific TEE views. One attending physician, considered an expert, also participates to provide a benchmark for comparison. Our initial experience suggests that eye-tracking technology can provide valuable insights into the fellows' gaze patterns, enabling objective measurement of their focus during TEE procedures. While limitations such as scheduling conflicts, case type, and variable imaging windows were noted, our experience demonstrates the feasibility of this technology in evaluating technical skills. This approach offers a promising method for refining TEE education and feedback in cardiac anesthesia fellowship. Further research is needed to explore additional metrics such as gaze efficiency and time to image acquisition to enhance TEE training for fellows.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142724","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":"Organ Donation Potential from Patients Receiving Mechanical Circulatory Support in the United Kingdom: A Single-Center Experience.","authors":"Antonio Rubino, Aileen Tan, Thomas Edmiston, Marian Ryan, George Thundiyl Joseph, Antonella Cagnes, Corinna Dunzendorfer, Jo-Anne Fowles, Andrew Hadley-Brown, Kiran Salaunkey, Alex Manara","doi":"10.1053/j.jvca.2025.04.035","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.035","url":null,"abstract":"<p><p>Mechanical circulatory support (MCS), including extracorporeal membrane oxygenation and ventricular assist devices, is increasingly being used to manage critically ill patients with cardiac or respiratory failure. Despite advancements in MCS, many patients do not survive, raising the question of their potential contribution to deceased organ donation. This study evaluated the organ donation potential and outcomes of organ transplantation in patients receiving MCS at a UK regional cardiothoracic and transplant center. Data for all patients who died while receiving MCS in the ICU of a tertiary cardiothoracic referral center in the United Kingdom between January 2012 and November 2021 were analyzed retrospectively. These data included demographics, MCS type, cause of death, organ donation referrals, donation outcomes and recipient follow-up. Donors were categorized as a donor after brain death (DBD) or donor after circulatory determination of death (DCD). Reasons for nonreferral and nonacceptance were assessed, and outcomes of transplanted organs were followed. Of the 376 patients who died while on MCS, 208 were referred for organ donation. Sixteen patients became donors (14 DCD, 2 DBD), donating 30 organs. The most commonly donated organs are kidneys, followed by liver, pancreas, lungs, and heart. Recipients had excellent outcomes, with a median follow-up of 1,196 days and a 93% survival rate. Neurologic complications were the most frequent cause of death associated with donation. Despite concerns about donor organ quality, organ utilization rates and recipient outcomes were comparable to those of donors not on MCS. This study highlights that organ donation is feasible in patients receiving MCS, with outcomes similar to those not on MCS. Emerging technologies, such as ex situ organ perfusion, may further increase the acceptance and utilization of these organs. Patients on MCS represent an underused source of organs for transplantation. Consistent referral criteria and advancements in organ preservation technologies could enhance the potential of this donor population, providing high-quality organs and improving transplant outcomes.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266322","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":"Perioperative Considerations for a Patient with Alpha-Gal Syndrome Undergoing Cardiac Surgery.","authors":"Cole Douglas Rinehart, Kelvin Wang, Carolyn LoBue, John G Augoustides, Saumil Jayant Patel, Patrick Monette, Jessica Zvara, Liliane R Ernst, Rohesh J Fernando","doi":"10.1053/j.jvca.2025.04.037","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.037","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142728","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":"Optimizing Tranexamic Acid Use in Adult Cardiac Surgery: From Rationale to Clinical Practice.","authors":"Luigi La Via, Giuseppe Cuttone, Costantino Terranova, Massimiliano Sorbello, Gennaro Martucci, Federico Pappalardo","doi":"10.1053/j.jvca.2025.04.034","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.04.034","url":null,"abstract":"<p><p>Tranexamic acid (TXA) has emerged as a cornerstone in blood conservation strategies for cardiac surgery. This comprehensive review synthesizes current evidence on TXA's efficacy, safety, and optimal use in various cardiac surgical procedures. We examine the pharmacological properties of TXA, its historical development as an antifibrinolytic agent, and its evolution in cardiac surgical practice. The review critically evaluates key clinical trials and meta-analyses demonstrating TXA's efficacy in reducing blood loss and transfusion requirements across a spectrum of cardiac surgeries, including coronary artery bypass grafting, valve procedures, and aortic surgery. Special consideration is given to its use in pediatric cardiac surgery. We address ongoing debates surrounding optimal dosing strategies, timing of administration, and integration with other hemostatic interventions. The safety profile of TXA is thoroughly examined, with particular focus on the risk of seizures and thromboembolic events. The review also explores practical aspects of TXA implementation in clinical practice, including its role in comprehensive blood management protocols and potential cost-effectiveness. Emerging research areas, such as pharmacokinetic-guided dosing and topical TXA application, are discussed. Finally, we outline future directions and research priorities, including the need for long-term outcome studies and refinement of patient-specific protocols. This review provides a balanced assessment of TXA's role in modern cardiac surgery, offering clinicians and researchers a comprehensive resource for optimizing its use to improve patient outcomes while minimizing potential risks.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119756","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}