Annals of Cardiac Anaesthesia最新文献

{"title":"Innovative Use of Pulmonary Artery (PA) Catheter for Lung Isolation in a Pediatric Patient: A Case Report.","authors":"Vijaya Kumara","doi":"10.4103/aca.aca_191_24","DOIUrl":"https://doi.org/10.4103/aca.aca_191_24","url":null,"abstract":"<p><strong>Abstract: </strong>Lung isolation is essential for optimal surgical exposure and prevents contamination of normal lung. It is challenging in pediatric patients due to the anatomical and physiological differences. The most common methods of achieving lung isolation include the use of double-lumen endotracheal tubes (DLTs) or bronchial blockers (BBs). However, in pediatric patients, the size of the airways often restricts the use of DLTs, and in some cases, specific BBs may not be available or feasible due to the anatomy. Here, we report a case of right lower lobectomy in a two-and-half-year-old child using a pulmonary artery (PA) catheter to isolate the lung.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"176-178"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972923","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}

{"title":"Effect of Transesophageal Echocardiography Probe Insertion on Endotracheal Tube Cuff Pressure in Patients Undergoing Coronary Artery Bypass Graft (CABG) Surgery. A Prospective Randomized Control Trial.","authors":"A Kireeti, Ravikanth Pula, T Nagarjuna, T Rabbani, R Gopinath","doi":"10.4103/aca.aca_175_24","DOIUrl":"https://doi.org/10.4103/aca.aca_175_24","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated endotracheal tube (ETT) cuff pressures during surgery can lead to tracheal ischemia and airway complications, including postoperative sore throat, subglottic edema, and tracheal stenosis. The insertion of a transesophageal echocardiography (TEE) probe, commonly used in cardiac surgeries, may increase ETT cuff pressure due to its proximity to the trachea. This study assesses the impact of TEE probe insertion on ETT cuff pressures and related postoperative airway complications in patients undergoing coronary artery bypass graft (CABG) surgery.</p><p><strong>Methods: </strong>In this prospective, randomized controlled trial, 40 patients undergoing CABG were assigned to either a control group (Group C, n = 20) or an intervention group (Group T, n = 20). Cuff pressures were monitored at baseline (T1), during TEE probe manipulation (T2), after initial examination (T3), and during recovery (T4). In Group T, cuff pressures were adjusted to 20-30 cmH2O if they exceeded 30 cmH2O during T2 and T3. Postoperative complications, including sore throat, hoarseness, and cough, were assessed using standardized scales.</p><p><strong>Results: </strong>TEE probe manipulation significantly increased ETT cuff pressures in both groups, with lower pressures consistently observed in Group T (P < 0.05). At T3, the mean cuff pressure in Group C was 41.00 cmH2O versus 33.30 cmH2O in Group T (P < 0.001). The control group experienced more severe postoperative airway complications, while Group T had a significantly reduced risk of severe complications (odds ratio < 0.2).</p><p><strong>Conclusion: </strong>TEE probe manipulation significantly increases ETT cuff pressures, but cuff deflation during manipulation effectively reduces these pressures and lowers the risk of postoperative airway complications.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"143-148"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969515","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}

{"title":"The Mechanisms and Pathophysiology of Mitral Regurgitation: A Narrative Review.","authors":"Praveen Kumar Neema, Nagarjuna Panidapu","doi":"10.4103/aca.aca_221_24","DOIUrl":"https://doi.org/10.4103/aca.aca_221_24","url":null,"abstract":"<p><strong>Abstract: </strong>Mitral valve closure is a complex process and requires coordinated actions of all its interrelated anatomical components: the left atrium, the mitral annulus, the valve leaflets, the tendinous chordae, and the papillary muscles with its surrounding left ventricular wall for an effective mitral valve closure. Research of last three-decades has shown that the mitral annulus starts contracting during atrial systole which significantly prevent early mitral regurgitation (MR). MR can be acute or chronic, and primary, or secondary or mixed; their etiologies, mechanisms and natural progression are very different and have clinical implications. A leaflet perforation, a rupture of chorda tendinea or papillary muscle and a torn leaflet after balloon mitral valvotomy can result in acute severe MR. The patients of acute severe MR present in pulmonary edema and cardiogenic shock and often need urgent surgical intervention. Primary MR is a disease of the mitral valve apparatus and secondary to valve degeneration, whereas secondary MR is a disease of the left ventricle secondary to coronary artery disease and dilated cardiomyopathy. The other causes of secondary MR include mitral annular dilation secondary to atrial fibrillation and restrictive cardiomyopathy, dys-synchrony due to bundle branch block, right ventricular pacing and hypertrophic cardiomyopathy. The treatment strategy differs for primary and various subsets of secondary MR; hence, a thorough knowledge of the etiology, mechanisms and pathogenesis of MR is necessary to select appropriate management strategy and to decide when to intervene. The review discusses the mechanisms, and pathophysiology in acute, chronic, primary and secondary MR.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"109-118"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952516","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}

{"title":"Communication Between Vascular Catheter Lumens: Safety Implications.","authors":"Gegal Pruthi, Ankita Dey, Dilraj Dhindsa","doi":"10.4103/aca.aca_203_24","DOIUrl":"https://doi.org/10.4103/aca.aca_203_24","url":null,"abstract":"<p><strong>Abstract: </strong>In this case, we report a rare manufacturing defect in a multi-lumen central venous catheter, where communication between lumens was discovered during a pre-use flush check. This defect raises significant safety concerns, including potential medication interference and inaccurate CVP readings. Vigilant pre-use testing and heightened awareness of such anomalies are crucial to preventing life-threatening complications.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"179-180"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956825","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}

{"title":"Crack in Drainage Cannula During Minimally Invasive ASD Repair Surgery- Troubleshooting of an Unforeseen Complication.","authors":"Kumara Vijaya, Rai D Guruprasad, R Sumanth","doi":"10.4103/aca.aca_177_24","DOIUrl":"10.4103/aca.aca_177_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"206-207"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662112","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}

{"title":"The ProtekDuo Cannula for Venopulmonary ECMO as Bridge to Lung Transplantation: A Single Center Case Series.","authors":"Yuriy Stukov, Mindaugas Rackauskas, Marc O Maybauer","doi":"10.4103/aca.aca_194_24","DOIUrl":"10.4103/aca.aca_194_24","url":null,"abstract":"<p><strong>Abstract: </strong>Venovenous extracorporeal membrane oxygenation is the most commonly used mode of support in pre-lung transplant recipients. In patients who experience right ventricular dysfunction, venopulmonary ECMO is an excellent option to preserve RV function. We retrospectively reviewed patients who were supported with venopulmonary ECMO. Descriptive analysis, patient characteristics, ECMO outcomes, and survival were assessed. The primary outcome was mortality. Mean age was 45.5 ± 15.63, mean ECMO hours 1391.75 ± 1239.01. 4 patients had right ventricular dysfunction. All patients received bilateral orthotopic lung transplant. One-year survival was 100% for all patients. Venopulmonary extracorporeal membrane oxygenation can be safely used to bridge patients with end-stage lung disease to lung transplantation.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"190-192"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662115","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}

{"title":"Acute Normovolemic Hemodilution Significantly Reduces RBC Transfusion and Lactic Acidosis Following Cardiac Surgery-A Propensity-Matched Study.","authors":"Vala Sebt, Shahnaz Sharifi, Alipasha Meysamie, Kianoush Saberi","doi":"10.4103/aca.aca_192_24","DOIUrl":"https://doi.org/10.4103/aca.aca_192_24","url":null,"abstract":"<p><strong>Background: </strong>Bleeding represents a major complication in heart surgeries. However, even small amounts of allogeneic blood are associated with reduced long-term survival and short-term complications. Acute normovolemic hemodilution (ANH) serves as a viable alternative, but its effectiveness and safety remain controversial.</p><p><strong>Objective: </strong>We aimed to clarify the effects of mild-volume ANH on blood transfusions and short-term complications following heart surgeries.</p><p><strong>Methods: </strong>This was a quasi-experimental study in a referral center on 2271 patients. We performed an extensive propensity-score matching to mitigate the lack of random assignment and potential selection bias. This resulted in 778 patients with no significant differences in 28 variables, including clinical, paraclinical, and operative features.</p><p><strong>Results: </strong>ANH significantly reduced the rate of RBC transfusion by 16% (50.9% vs. 60.9%; RR: 0.84; P = 0.006) and the number of transfused RBCs by 0.24 units (0.96 ± 1.32 vs. 1.20 ± 1.39; P = 0.013) but did not affect the transfusion of FFP or platelets. Furthermore, ANH significantly lowered the incidence of lactic acidosis by 53% (6.8 vs. 11.3%; RR: 0.47; P < 0.001) but had no notable impact on other short-term outcomes following heart surgery, including mortality, re-intubation, re-exploration, delayed sternal closure, length of ICU stay, or duration of mechanical ventilation.</p><p><strong>Conclusion: </strong>Mild-volume ANH significantly reduced the rate and amount of perioperative RBC transfusions, as well as the incidence of lactic acidosis following heart surgery. ANH did not affect the incidence of other complications during hospitalization.</p><p><strong>Implication: </strong>This suggests that ANH could be a safe and beneficial blood conservation technique. Further randomized clinical trials are needed to evaluate its effects.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"136-142"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960147","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}

{"title":"Aortoesophageal Fistula Following Thoracic Endovascular Aortic Repair.","authors":"Ajmer Singh, Chinmaya Nanda, Vishakha P Konalli, Firdoos Ahmad Mir","doi":"10.4103/aca.aca_220_24","DOIUrl":"https://doi.org/10.4103/aca.aca_220_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"211-212"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958169","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}

{"title":"Navigating the Impact of Artificial Intelligence on Medical Writing.","authors":"Mukul Chandra Kapoor","doi":"10.4103/aca.aca_14_25","DOIUrl":"https://doi.org/10.4103/aca.aca_14_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"105-106"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961228","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}

{"title":"Microbiological Surveillance of Air Quality in Cardiac Operation Theatres: Comparison of the Conventional Settle Plate Technique vs Use of an Air Sampling Device.","authors":"Alok Kumar, Prashant Patil, Abhinay Ankur, Nihar Ameta, Monika Aggarwal","doi":"10.4103/aca.aca_200_24","DOIUrl":"https://doi.org/10.4103/aca.aca_200_24","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSIs) after cardiac surgery poses a serious challenge. The foremost reason for contamination in operating rooms (OR) is airborne. Effective surveillance by air sampling or settle techniques is crucial in maintenance of air quality in cardiac OR.</p><p><strong>Methodology: </strong>The air quality of two different cardiac OR (adult and pediatric) with laminar air flow system and HEPA filters in place was studied with an aim to compare the plate and air sampling technique. Sampling was done both passive and actively using a Surface Air System air sampler. Muller Hinton Agar plates incubated at 36 °C were used, and total viable count assessment was calculated using Koch's sedimentation method.</p><p><strong>Results: </strong>Colony-forming unit (CFU) counts showed significant differences at various time points in both adult and pediatric OR. The settle plate as compared to the air sampling device correlated but showed lesser CFUs across pre, mid, and postsurgical periods (P < 0.05). The adult cardiac OR had significantly higher bioload than pediatric OR (P < 0.05). The results suggested that both the technique was good for air quality monitoring in OR.</p><p><strong>Conclusion: </strong>The study compares the two-sampling technique in adult and pediatric cardiac OR, finding higher levels of bioload in adult ORs possibly due to more personnel and longer surgeries. Although settle plates offer basic contamination assessment, air samplers detect specific events efficiently. Using either air sampler or settle plate technique for microbial surveillance in cardiac ORs is suggested for monitoring and prevention of SSI.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 2","pages":"156-160"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962051","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}