Seminars in Cardiothoracic and Vascular Anesthesia最新文献

Navigating Complexity: Innovation, Recovery, and Adaptation in Cardiothoracic Anesthesia. 导航复杂性：心胸麻醉的创新、恢复和适应。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-10-20 DOI: 10.1177/10892532261495694

Simon Anthony Martin, Benjamin Aaron Abrams, Miklos David Kertai

引用次数: 0

Preoperative Physical Fitness and Short-Term Postoperative Outcomes in Patients Undergoing Elective Cardiac Surgery: A Retrospective Cohort Study. 择期心脏手术患者术前体能与术后短期预后：一项回顾性队列研究

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-02-21 DOI: 10.1177/10892532261427827

Zoe van der Hoofd, Hanneke C van Dijk-Huisman, Bart C Bongers, Bart Scheenstra, Jos Maessen, Antoine F Lenssen

{"title":"Preoperative Physical Fitness and Short-Term Postoperative Outcomes in Patients Undergoing Elective Cardiac Surgery: A Retrospective Cohort Study.","authors":"Zoe van der Hoofd, Hanneke C van Dijk-Huisman, Bart C Bongers, Bart Scheenstra, Jos Maessen, Antoine F Lenssen","doi":"10.1177/10892532261427827","DOIUrl":"10.1177/10892532261427827","url":null,"abstract":"Preoperative cardiorespiratory fitness, muscle strength, and frailty influence outcomes after cardiac surgery, but these modifiable physical factors are often not routinely incorporated into standardized risk assessments. This study examined the association between preoperative physical fitness and adverse postoperative outcomes across different elective cardiac surgery procedures. Logistic regression analyses were used to assess the association between preoperative cardiorespiratory fitness, muscle strength, functional mobility, frailty, and quality of life and delayed postoperative recovery of physical functioning (Modified Iowa Level of Assistance Scale), in-hospital complications, and postoperative atrial fibrillation in patients undergoing cardiac surgery via sternotomy, mini-thoracotomy, and transfemoral incision (transcatheter aortic valve implantation). Results showed that higher patient-reported preoperative cardiorespiratory fitness, functional mobility, frailty, and physical health-related quality of life were significantly associated with faster recovery of physical functioning and fewer postoperative complications in patients undergoing sternotomy. In patients undergoing mini-thoracotomy, preoperative cardiorespiratory fitness and functional mobility were significantly associated with in-hospital complications. No significant associations were found in patients undergoing transfemoral incision (transcatheter aortic valve implantation). Conclusively, preoperative physical fitness is associated with postoperative outcomes in patients undergoing sternotomy. These findings highlight the importance of incorporating physical fitness assessments into standard preoperative care to facilitate preoperative shared decision-making and optimize modifiable preoperative risk factors.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"160-171"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Intraoperative Discovery of Bioprosthetic Mitral Valve Thrombus on TEE During HeartMate 3 Implantation: Implications for Anesthetic Management and Surgical Planning. 心脏伴侣3号植入术中发现TEE生物假体二尖瓣血栓：麻醉管理和手术计划的意义。

IF 1.1

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-01-05 DOI: 10.1177/10892532251414559

Jenny Huang, Lida Shaygan

{"title":"Intraoperative Discovery of Bioprosthetic Mitral Valve Thrombus on TEE During HeartMate 3 Implantation: Implications for Anesthetic Management and Surgical Planning.","authors":"Jenny Huang, Lida Shaygan","doi":"10.1177/10892532251414559","DOIUrl":"10.1177/10892532251414559","url":null,"abstract":"We present the case of a 73-year-old female with chemotherapy-induced cardiomyopathy, severe mitral regurgitation status post bioprosthetic mitral valve (MV) replacement one year prior, and atrial fibrillation, admitted for evaluation for left ventricular assist device (LVAD) implantation. While her preoperative transthoracic echocardiogram (TTE) did not reveal a discrete mass, it showed a mean mitral gradient of 7 mmHg; intraoperative transesophageal echocardiography (TEE) identified a 2 cm × 1.2 cm thrombus on the bioprosthetic MV. Given these findings, the surgical team decided to replace the mitral valve concurrently with LVAD implantation. Although this approach is not routine, the goal was to improve her quality of life and reduce postoperative complications. Post-procedure TEE showed an improved MV mean gradient of 3 mmHg with no evidence of paravalvular leak. The patient was subsequently discharged home in stable condition without any thromboembolic events. This case highlights the challenges of managing complex valvular pathology in patients undergoing LVAD placement.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"207-212"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraoperative 3D Transesophageal Echocardiography for Early Detection of Pulmonary Vascular Complications in Lung Transplantation: A Case-Based Teaching Series. 术中三维经食管超声心动图对肺移植中肺血管并发症的早期检测：一个以病例为基础的教学系列。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-04-13 DOI: 10.1177/10892532261442795

Ashley Virginia Fritz, Faiz R Saleem, Wesley L Allen, Emily Paige Stephenson, Archer Kilbourne Martin

{"title":"Intraoperative 3D Transesophageal Echocardiography for Early Detection of Pulmonary Vascular Complications in Lung Transplantation: A Case-Based Teaching Series.","authors":"Ashley Virginia Fritz, Faiz R Saleem, Wesley L Allen, Emily Paige Stephenson, Archer Kilbourne Martin","doi":"10.1177/10892532261442795","DOIUrl":"10.1177/10892532261442795","url":null,"abstract":"Lung transplantation presents numerous intraoperative challenges, particularly related to pulmonary artery and vein anastomotic integrity and hemodynamic stability. We present 3 cases where intraoperative transesophageal echocardiography (TEE) provided real-time diagnostic insights that directly altered surgical decision-making. Case 1 highlights pulmonary vein flow acceleration initially concerning for ostial stenosis, ultimately diagnosed as external compression from a retractor. Case 2 demonstrates true right pulmonary vein stenosis requiring immediate revision. Case 3 illustrates severe right pulmonary artery narrowing, detected by TEE and corrected intraoperatively to prevent early graft dysfunction. These cases underscore the critical role of intraoperative TEE in detecting subtle anastomotic abnormalities, distinguishing functional from structural stenosis, and guiding timely surgical correction. Incorporating comprehensive 2D and 3D TEE evaluation into routine lung transplant protocols enhances diagnostic accuracy, reduces postoperative complications, and contributes to improved long-term allograft function. Intraoperative 3D TEE should be considered an essential imaging modality in cardiothoracic transplantation and an invaluable educational tool for perioperative teams.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"191-198"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677672","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}

引用次数: 0

Net Atrioventricular Compliance: A Determinant of Pulmonary Artery Pressure in Patients Undergoing Mitral Valve Replacement for Severe Mitral Stenosis. 净房室顺应性：严重二尖瓣狭窄患者行二尖瓣置换术时肺动脉压的决定因素。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-02-10 DOI: 10.1177/10892532261425015

Nischitha Gowda, Sunder Lal Negi, Goverdhan Dutt Puri, Rupesh Kumar, Prashant Panda

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Alpha-Gal Syndrome-A Case Series of Successful Transcatheter Mammalian-Derived Aortic Valve Replacements. α - gal综合征-经导管哺乳动物源性主动脉瓣置换术的成功案例系列。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-06-30 DOI: 10.1177/10892532261460727

Kian Lari, Shahzeb Leghari, Alan M Smeltz, Dillon Patel, Emily G Teeter

{"title":"Alpha-Gal Syndrome-A Case Series of Successful Transcatheter Mammalian-Derived Aortic Valve Replacements.","authors":"Kian Lari, Shahzeb Leghari, Alan M Smeltz, Dillon Patel, Emily G Teeter","doi":"10.1177/10892532261460727","DOIUrl":"10.1177/10892532261460727","url":null,"abstract":"Alpha-gal syndrome (AGS) is an IgE-mediated hypersensitivity to galactose-α-1,3-galactose, an oligosaccharide found in mammalian tissues, including bovine or porcine-derived bioprosthetic valves and heparin. Concerns exist regarding perioperative hypersensitivity reactions in patients with AGS undergoing cardiac surgery involving xenogeneic materials. We present three patients with documented AGS who underwent transcatheter aortic valve replacement (TAVR) using bovine or porcine-derived bioprostheses. All patients underwent a preoperative evaluation by allergists, and two received no pharmacological pre-treatment. Intraoperative heparin administration was without adverse reactions in all cases. Postoperative courses were uncomplicated, with no evidence of immediate or delayed allergic responses. Follow-up periods ranged from 4 to 6 years without structural valve deterioration attributable to AGS. These cases demonstrate that patients with AGS can safely undergo TAVR with bovine or porcine-derived valves and heparin, provided they are appropriately evaluated and monitored. Despite theoretical concerns, perioperative hypersensitivity appears to be rare in this population, supporting the feasibility of xenogeneic valve use in AGS patients.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"216-220"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Advancing Risk Stratification, Imaging, and Perioperative Decision-Making in Cardiothoracic and Vascular Anesthesia. 在心胸和血管麻醉中推进风险分层、成像和围手术期决策。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 DOI: 10.1177/10892532261477978

Kevin Maar, Andrea Szekely, Benjamin Abrams, Miklos D Kertai

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Effect of Stellate Ganglion Block on Internal Mammary Artery Dynamics: A Randomized Controlled Clinical Trial. 星形神经节阻滞对乳腺内动脉动力学的影响：一项随机对照临床试验。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-02-19 DOI: 10.1177/10892532261428565

Diaaeldin Badr Aboelnile, Mahmoud AbdAlaziz Ghallab, Ehab Hamed Abdelsalam Attia, Amira Yousry Hawas, Farouk Kamal Eldin

{"title":"Effect of Stellate Ganglion Block on Internal Mammary Artery Dynamics: A Randomized Controlled Clinical Trial.","authors":"Diaaeldin Badr Aboelnile, Mahmoud AbdAlaziz Ghallab, Ehab Hamed Abdelsalam Attia, Amira Yousry Hawas, Farouk Kamal Eldin","doi":"10.1177/10892532261428565","DOIUrl":"10.1177/10892532261428565","url":null,"abstract":"The left internal mammary artery (LIMA) is commonly selected as the graft of choice for coronary artery bypass procedures. Various pharmacological agents have been used to enhance LIMA blood flow. Left stellate ganglion block (LSGB) has been utilized to achieve sympathetic blockade, promote vasodilation in the upper extremities, and manage refractory angina. This randomized controlled clinical trial aimed to evaluate the effect of preoperative LSGB on LIMA blood flow in patients undergoing elective coronary artery bypass grafting (CABG). Seventy patients (aged 18-80 years, of both genders) scheduled for elective CABG were equally divided into two groups: the LSGB group and the control group. Patients in the intervention group received an ultrasound-guided LSGB using 8 mL of 0.25% bupivacaine. Both groups received topical nitroglycerin during LIMA harvesting. LIMA diameter was measured at baseline and again after an equal time interval before the induction of anaesthesia. Additionally, LIMA free flow after harvesting and mean graft flow were measured using a transit time flow metre (TTFM). LIMA free blood flow was significantly increased in the LSGB group (50.57 ± 5.79 mL/min) compared to the control group (46.86 ± 8.32 mL/min), with a P-value = 0.034. Similarly, the LIMA diameter was significantly greater in the LSGB group (2.38 ± 0.17 mm) than in the control group (2.31 ± 0.14 mm), with a P-value = 0.04, suggesting that preoperative LSGB significantly enhances LIMA blood flow and diameter in patients undergoing CABG.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"172-182"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221026","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}

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Letter to the Editor: A Scalable Alternative to In Vitro Contracture Testing for Incidentally Discovered Genetic Variants for Malignant Hyperthermia. 致编辑的信：对偶然发现的恶性高热基因变异进行体外挛缩测试的可扩展替代方法。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-05-04 DOI: 10.1177/10892532261446853

Miklos D Kertai, Lisa A Bastarache, David A Roberts

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Statistics for the Clinician II: The T-test, Its Versions, and Its Alternatives. 临床医生统计学II: t检验，它的版本，和它的替代品。

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Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2026-09-01 Epub Date: 2026-04-20 DOI: 10.1177/10892532261446150

Sherwin Thiyagarajan, Paul Abboud, Reza Ehsanian, Ross Hanson, Timothy R Petersen

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