The Egyptian Journal of Cardiothoracic Anesthesia最新文献

{"title":"Experience with cardiac surgery in a private tertiary hospital in Chennai, India","authors":"O. Adekola, E. Ogunleye, Juriel Kurien, A. Olusegun-Joseph, O. Ajayi, O. Ojo, S. Cherian","doi":"10.4103/1687-9090.183172","DOIUrl":"https://doi.org/10.4103/1687-9090.183172","url":null,"abstract":"Background Major perioperative complications are not uncommon during cardiac surgery, which has been attributed to an increase in patients scheduled for complex and urgent cardiac surgeries on account of a surge of patients at the extremes of age. Patients and methods This was a cohort study of patients anesthetized for open heart surgery from March 2012 to May 2012 at the Frontier Lifeline Hospital, Chennai, India. Primary outcome measures were the pattern of presentation and complications following cardiac surgery. Secondary outcome measure was the 30-day perioperative mortality associated with cardiac surgery. Results A total of 291 patients underwent cardiac surgery. Their mean age was 34.71 ΁ 26.25 years (range 8.4 months to 81 years). Of them, 63.57% were adults and 66.32% were male. The most common indication for cardiac surgery was coronary artery disease [135 (46.39%) patients], followed by septal defect [60 (20.62%)] and valvular defect [40 (13.75%)]. In patients with coronary artery disease, triple-vessel disease occurred in 39.26% and double-vessel disease in 32.59%. Three patients underwent coronary artery bypass grafting plus mitral or aortic valve replacement, whereas off-pump coronary artery bypass grafting was performed in three (2.22%) patients. Sixty-three complications were observed in 291 patients (21.64%); the most common complication was significant pleural effusion in 13 patients (4.47%), followed by deep sternal wound infection in 10 (3.44%) and respiratory failure in seven patients (2.41%). Thirty days′ perioperative mortality was seen in 17 patients (5.84%). Conclusion We have demonstrated that major complications are not uncommon after cardiac surgery. However; prompt and appropriate intervention reduces mortality.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115587453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic evaluation and comparison of the effects of sevoflurane and desflurane on left ventricular relaxation indices in patients with diastolic dysfunction scheduled for coronary artery bypass grafting surgery","authors":"Mahmoud M. Amer, Hosam El Ashmawi, A. El-Shaarawy, Wael Hassen","doi":"10.4103/1687-9090.137225","DOIUrl":"https://doi.org/10.4103/1687-9090.137225","url":null,"abstract":"Background Effect of inhalational anesthetics on diastolic function in humans is still controversial, although inhalational anesthetics have been shown to have negative lusitropic action in experimental studies, which were explained by interference of inhalational anesthetics with calcium homeostasis. Aim This prospective randomized study aims to evaluate and compare the effects of sevoflurane and desflurane on left ventricular (LV) diastolic function in patients with impaired LV relaxation due to ischemic heart disease using transesophageal Doppler echocardiography. Patients and methods After approval from the local ethics committee and informed consent, 24 patients scheduled for coronary artery bypass grafting surgery were enrolled in the study. Patients were selected by a preoperative transthoracic echocardiographic diagnosis of impaired relaxation or grade 1 diastolic dysfunction. Anesthetic induction was standardized in both groups. Patients randomly received 1 MAC of sevoflurane (n = 12) or desflurane (n = 12) for maintenance of anesthesia. Hemodynamic parameters and transesophageal echocardiography (TEE) derived ventricular diastolic relaxation indices before and after the study drug administration were compared. LV filling pressures were kept within normal range throughout the study period to exclude the effect of the loading conditions on diastolic function. Results The two study drugs significantly reduced the systemic vascular resistance index with a significant increase in the cardiac index. Hemodynamic changes measured by invasive arterial line and pulmonary artery catheter were comparable between the two groups. In terms of LV relaxation indices, the two agents led to a significant improvement in diastolic function. Transmitral and tissue Doppler E/A and Em/Am ratios improved significantly accompanied by a significant decrease in deceleration time and isovolumetric relaxation time. The effect of the two agents on diastolic relaxation parameters was comparable. Conclusion Sevoflurane and desflurane appear to improve LV relaxation. This can be explained by a significant reduction in afterload produced by these vapors. The positive effect of these inhalational agents on LV relaxation can have a beneficial effect on the anesthetic management of patients with diastolic dysfunction.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124730524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullying in the hospital environment: an issue for us and our patients","authors":"S. Jaggar","doi":"10.4103/ejca.ejca_2_18","DOIUrl":"https://doi.org/10.4103/ejca.ejca_2_18","url":null,"abstract":"An individual’s behaviour affects others in both positive and negative ways. This article discusses different types of negative behaviour patterns and how this may impact on our patients.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125064000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden onset of coma with anisocoria in a patient with type A aortic dissection: dilemma in management?","authors":"Srinath Damodaran, K. Gourav, Sunita Kajal, Kamal Kajal","doi":"10.4103/ejca.ejca_7_19","DOIUrl":"https://doi.org/10.4103/ejca.ejca_7_19","url":null,"abstract":"creations are licensed under the identical terms. Coma or stroke as a part of the clinical presentation of acute aortic dissection is generally considered to be a major contraindication for emergency surgery. Occasionally, clinical symptoms and signs may mislead us to an incorrect diagnosis or undue delay in management, which may cause a catastrophe in critically ill patients. In this study, we describe the abrupt onset of anisocoria and coma in a patient with aortic dissection that imparts a dilemma in subsequent management.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123730350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repair of ascending aortic aneurysm following resection of subaortic membrane in a 4-year-old child","authors":"M. Madkour","doi":"10.4103/ejca.ejca_12_17","DOIUrl":"https://doi.org/10.4103/ejca.ejca_12_17","url":null,"abstract":"Clinical findings of infective endocarditis in children may be nonspecific in the form of prolonged low-grade fever, weakness, and weight loss, all of which require careful investigations for infective endocarditis. Transoesphageal echocardiography was helpful in management of intraoperative repair of ascending aortic aneurysm as a complication of infective endocarditis in this child.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131514304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of bronchial dehiscence immediately following video-assisted thoracoscopic lobectomy","authors":"M. Eladawy, L. Pardeshi","doi":"10.4103/1687-9090.153414","DOIUrl":"https://doi.org/10.4103/1687-9090.153414","url":null,"abstract":"This is a case report that highlights an acute presentation of bronchial dehiscence following video-assisted thoracoscopic right upper lobectomy for squamous cell carcinoma. Immediately after extubation, the patient developed bilateral surgical emphysema accompanied with a decrease in arterial oxygen saturation to 60%. Breathing was laboured and there was tachypnoea and chest crackles. Endotracheal reintubation and resumption of assisted mechanical ventilation were reinstated.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133162761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous ventricular septal defect closure causing acute aortic regurgitation","authors":"S. Negi, Alok Kumar, S. Podder, A. Mishra","doi":"10.4103/ejca.ejca_20_17","DOIUrl":"https://doi.org/10.4103/ejca.ejca_20_17","url":null,"abstract":"Intravascular hemolysis and aortic regurgitation (AR) are rare complications of transcatheter closure of perimembranous ventricular septal defects. The current study reports a case of an acute AR, which resulted from acute right coronary cusp perforation by the ventricular septal defect occluder. The current manuscript discusses the possible causes of early cusp erosion owing to occluder, advantages of early operation in such cases, and role of thorough perioperative transesophageal echocardiography in identifying acute AR.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124463336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet therapy and the anaesthetist","authors":"S. Jaggar","doi":"10.4103/ejca.ejca_18_18","DOIUrl":"https://doi.org/10.4103/ejca.ejca_18_18","url":null,"abstract":"Increasing numbers of patients internationally are taking dual antiplatelet therapy (DAPT). Both continuing and stopping this treatment may be risky for the patient. It is vital to consider the competing thrombotic and bleeding risks in the perioperative period. It is incumbent upon anaesthetists to maintain their knowledge base in this rapidly developing area. This article provides information to support practice as.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"1119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116069913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective randomized comparative study between Macintosh and GlideScope in adult patients undergoing cardiac surgery","authors":"R. Soliman, M. Mofeed, Osama Alamoudy, A. Farouk","doi":"10.4103/1687-9090.160326","DOIUrl":"https://doi.org/10.4103/1687-9090.160326","url":null,"abstract":"Context The GlideScope laryngoscope is a new device for intubation that provides an improved view of the larynx. Aim The aim of the study was to compare the hemodynamic effect of Macintosh laryngoscope with GlideScope during intubation in adult cardiac surgery. Setting and design This was a prospective, randomized, comparative study conducted in Madinah Cardiac Center, Saudi Arabia. Materials and methods The study included 100 patients classified into two groups (n = 50), The patients were intubated either by Macintosh laryngoscope or by GlideScope. The following parameters were monitored: heart rate, mean arterial blood pressure, catecholamine level, intubation time, number of intubation trials, and the complications. Statistical analysis used Data were statistically described in terms of mean ΁ SD or frequencies. Measurements and main results The intubation time was longer in GlideScope than in Macintosh (P < 0.001), and the number of intubation trials was higher in GlideScope than in Macintosh (P < 0.001). The heart rate increased significantly in patients of the GlideScope group compared with the Macintosh group at first minute (P < 0.001), third minute (P < 0.001), and at fifth minute (P = 0.034). The mean arterial blood pressure increased significantly in patients of the GlideScope group compared with the Macintosh group at first minute (P < 0.001), third minute (P = 0.003), and at fifth minute (P = 0.029). The epinephrine level was higher with GlideScope at first and fifth minute (P = 0.032 and 0.036, respectively). The norepinephrine was higher in the GlideScope group at first and fifth minute (P = 0.043 and 0.033, respectively). The incidence of oral trauma and bleeding was higher with GlideScope than Macintosh (P = 0.003). Conclusion The intubation by GlideScope is associated with increased heart rate, blood pressure, catecholamine level, number of intubation trials, and oral complications compared with Macintosh laryngoscope.","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123709582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous sildenafil for perioperative management of patients with pulmonary artery hypertension in congenital heart surgery − a prospective randomized study","authors":"Jigisha Pujara, Sunny Kesvani, Pragya Sachan, Bhavik Champaneri, Garima Harbola, Ryan Vachaparamil, Tanya Chhauda, Deepika Gehlot","doi":"10.4103/ejca.ejca_6_21","DOIUrl":"https://doi.org/10.4103/ejca.ejca_6_21","url":null,"abstract":"","PeriodicalId":289218,"journal":{"name":"The Egyptian Journal of Cardiothoracic Anesthesia","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131566048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}