Seminars in Thoracic and Cardiovascular Surgery最新文献

{"title":"Contemporary Prevention and Management of Postoperative Delirium in Cardiac Surgery Patients","authors":"Syed M. Ali Hassan MD ,&nbsp;Shubh K. Patel ,&nbsp;Miriam S. Badross ,&nbsp;Nitish K. Dhingra MD ,&nbsp;Raj Verma ,&nbsp;Meena Verma ,&nbsp;Ryuta Seguchi MD, PhD ,&nbsp;Bobby Yanagawa MD, PhD ,&nbsp;Jessica Spence MD, PhD ,&nbsp;C. David Mazer MD ,&nbsp;Ahmad Alli MD, Mmed ,&nbsp;Subodh Verma MD, PhD ,&nbsp;Rakesh C. Arora MD, PhD","doi":"10.1053/j.semtcvs.2025.04.008","DOIUrl":"10.1053/j.semtcvs.2025.04.008","url":null,"abstract":"<div><div><span>This review examines the prevention and management of postoperative delirium<span><span> in cardiac surgery patients, a frequent complication linked with significant mortality, morbidity, prolonged hospitalization, and cognitive decline. The aim was to consolidate current evidence on postoperative delirium </span>pathophysiology, risk factors, </span></span>diagnostic<span><span> approaches, and pharmacologic and non-pharmacologic interventions. A PubMed/MEDLINE database review was conducted through October 2024, identifying studies that evaluated the relationship between cardiac surgery and the occurrence of postoperative delirium. The pathogenesis of postoperative delirium is complex, involving </span>neuroinflammation<span><span><span>, neurotransmitter imbalance, and </span>endothelial dysfunction<span>, compounded by baseline vulnerabilities and perioperative stressors. Early screening using tools like the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and </span></span>Intensive Care Delirium<span> Screening Checklist<span> (ICDSC) aid in timely detection. Prevention emphasizes non-pharmacologic interventions, such as the Hospital Elder Life Program and the ABCDEF bundle, alongside pharmacologic strategies to minimize high-risk sedatives. Emerging technologies, including intraoperative neurophysiologic monitoring modalities and machine learning models, enhance postoperative delirium risk assessment and enable targeted interventions. Effective postoperative delirium management in cardiac surgery requires a balanced approach incorporating non-pharmacologic and pharmacologic methods. Integration of evidence-based practices and innovative technologies into routine care holds promise for improving patient outcomes. Ongoing research is essential to optimize postoperative delirium management and standardize practices in high-risk populations.</span></span></span></span></div></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 3","pages":"Pages 263-274.e3"},"PeriodicalIF":2.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional Strategies for Full Hybrid/Norwood, the Double Intention, Double Intervention (DIDI) Approach.","authors":"Dietmar Schranz, Hakan Akintuerk, Michael Huebler, Jelena Pabst von Ohain, Anoosh Esmaeili, Nora Lang, Rainer Kozlik-Feldmann, Gunter Kerst","doi":"10.1053/j.semtcvs.2025.03.013","DOIUrl":"10.1053/j.semtcvs.2025.03.013","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to Intramural Hematoma in South Korea.","authors":"Joon Chul Jung, Kay-Hyun Park","doi":"10.1053/j.semtcvs.2025.04.006","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.04.006","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Debate: Implications for the Continuous Allocation System for Organ Distribution in the United States: Challenges and Controversies - CON","authors":"Caitlin T. Demarest MD, PhD ,&nbsp;Anil J. Trindade MD","doi":"10.1053/j.semtcvs.2025.04.004","DOIUrl":"10.1053/j.semtcvs.2025.04.004","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 3","pages":"Pages 345-349"},"PeriodicalIF":2.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking to the Right Ventricle After Heart Transplantation: Invited Expert Opinion.","authors":"Lise N Tchouta, Lucy Nam, David A D'Alessandro","doi":"10.1053/j.semtcvs.2025.04.005","DOIUrl":"10.1053/j.semtcvs.2025.04.005","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: The Root of the Argument Is Are We Even Arguing About the Root?","authors":"Anna K Gergen, Thomas Brett Reece","doi":"10.1053/j.semtcvs.2025.03.008","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.03.008","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Commando Operation - For the \"Elite\".","authors":"Tsuyoshi Kaneko, Thierry Carrel","doi":"10.1053/j.semtcvs.2025.04.003","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.04.003","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Anatomy and Physiology of Aortic Root Repair.","authors":"Giulio Folino, Raffaele Scaffa, Andrea Salica, Mario Torre, Ruggero De Paulis","doi":"10.1053/j.semtcvs.2025.03.009","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.03.009","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Inotropic Support Strategy in Low Cardiac Output Syndrome.","authors":"Travis J Miles, Kyle W Blackburn, Marc R Moon, Subhasis Chatterjee","doi":"10.1053/j.semtcvs.2025.04.002","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.04.002","url":null,"abstract":"<p><p>Low cardiac output syndrome (LCOS), a form of cardiogenic shock that occurs after cardiac surgery, is associated with an elevated risk of morbidity and mortality. Generally, LCOS is managed medically with inotropes and vasopressors to optimize hemodynamics. However, randomized data comparing the efficacy of individual inotropes in treating LCOS are limited. Consequently, there is little consensus regarding the optimal inotrope strategy, and practice patterns vary widely. This review synthesizes current evidence on pharmacologic, non-mechanical circulatory support strategies for managing LCOS, advocating for a personalized approach tailored to the individual patient's hemodynamic profile and inotropic requirements. Currently available vasoactive agents are discussed, and guidance is provided on their use across specific clinical contexts to support individualized treatment.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Redo Aortic Arch Repair Post Type A Dissection in the Modern Era.","authors":"Suguru Ohira, Sooyun Caroline Tavolacci, Corazon de la Pena, David Spielvogel","doi":"10.1053/j.semtcvs.2025.03.006","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.03.006","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}