Annals of Cardiac Anaesthesia最新文献

{"title":"Metaflammation and Cardiovascular-Kidney-Metabolic Syndrome: A Unifying Framework for the Cardiac Anesthesiologists.","authors":"Rohan Magoon, Jes Jose, Bhargava V Devarakonda","doi":"10.4103/aca.aca_67_26","DOIUrl":"10.4103/aca.aca_67_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"393-396"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434848","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":"Intraoperative Ventilatory Collapse from Negative Pleural Suction in a Ruptured Pulmonary Hydatid Cyst.","authors":"Sharek Abdul Nazir, Subrata Kumar Singha, Ananya Rao","doi":"10.4103/aca.aca_331_25","DOIUrl":"10.4103/aca.aca_331_25","url":null,"abstract":"<p><strong>Abstract: </strong>A 52-year-old male with a ruptured right hydatid cyst underwent thoracotomy and cyst excision. After repair of diffuse parenchymal air leaks, application of negative pleural suction caused sudden ventilatory collapse with refractory hypotension, unresponsive to tube exchange or vasopressors. Lung-protective ventilation failed until clamping the drain immediately restored tidal volumes, confirming suction-mediated negative-pressure failure. Ultrasound showed good re-expansion without pneumothorax; subsequent pink frothy secretions suggested re-expansion/negative-pressure pulmonary oedema. Switching to a water-seal drain, optimizing ventilation, and diuretics led to rapid recovery. Negative pleural suction can be hazardous after parenchymal leak repair.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"438-441"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434876","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":"Commentary on Peripheral Nerve Blocks for Enhanced Recovery in Cardiac Surgery: A Retrospective Observational Study.","authors":"Sohaib Raza, Muhammad S Arshad, Muhammad Hamas Kashif, Muhammad Rehman Gul, Muhammad Adnan","doi":"10.4103/aca.aca_310_25","DOIUrl":"10.4103/aca.aca_310_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"445-446"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434591","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":"Incidence and Associated Factors of ST-Segment Changes in Noncardiac Surgery Under General Anesthesia.","authors":"Mehryar Taghavi Gilani, Nabiolah Mafi, Leila Mashhadi, Samaneh S Asadi Kakhki","doi":"10.4103/aca.aca_243_25","DOIUrl":"10.4103/aca.aca_243_25","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative cardiac complications may result from an imbalance between myocardial oxygen supply and demand or from plaque rupture. Electrocardiographic (ECG) alterations in the ST-segment observed during surgery or anesthesia can serve as indicators of myocardial ischemia. Numerous factors influence ST-segment variability. This study aimed to investigate the incidence of ST-segment changes and the factors associated with their occurrence.</p><p><strong>Methods: </strong>This prospective observational study enrolled adult patients (aged ≥ 20 years) undergoing noncardiac surgery under general anesthesia. Intraoperative ST-segment monitoring was performed using a five-electrode system. Predisposing factors for ischemia, including hemodynamic parameters, coexisting diseases, and surgical characteristics, were evaluated. A P -value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 102 patients were evaluated, with a mean age of 46.75 ± 16.30 years, comprising 46 males (45.1%). Postinduction ST-segment depression was greater than preinduction (-0.030 to - 0.055 vs. 0.010 to 0.060, respectively) ( P = 0.0 01). ST-segment values were significantly more depressed in patients with underlying conditions, particularly hypertension and diabetes mellitus ( P = 0.001). Also, the variations in ST-segment alteration were considerable among minor and major surgeries ( P = 0.041). Overall, 20 patients (19.6%) exhibited prominent ST-segment changes (greater than 0.1 mV) during surgery; however, the changes were predominantly transient and managed successfully with initial clinical interventions (e.g., fluid administration). While postinduction blood pressure showed a significant drop, no statistical association was observed between the magnitude of blood pressure changes and the occurrence of ST-segment changes ( P = 0.10). No significant relationship was identified between ST-segment changes and other evaluated factors.</p><p><strong>Conclusion: </strong>The intraoperative ST-segment changes occurred following anesthetic induction and are significantly correlated with predisposing factors, specifically hypertension, diabetes mellitus, and major vs. minor surgeries. Despite significant hemodynamic alterations during the procedure, a direct correlation with prominent ST-segment changes could not be statistically established. Given the transient nature of most alterations, further studies incorporating postoperative troponin measurement and long-term follow-up are warranted to clarify the clinical significance of these intraoperative findings.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"352-358"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760337","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":"An Observation of Mitral Lateral Tissue Doppler Biphasic E' Waveform Due to Increased Left Ventricular Anterolateral Wall Myocardial Strain.","authors":"V Krishna Narayanan Nayanar, Ms Saravana Babu, Nithin Krishna Vikraman, Nandhu Subramonian","doi":"10.4103/aca.aca_303_25","DOIUrl":"10.4103/aca.aca_303_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"451-452"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434899","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":"Reply to the comments on The Effect of Continuous Magnesium Infusion to Prevent Post -Operative Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.","authors":"Robin George, Nisha Rajmohan, Rolita Prathima Lobo, Suresh Gangadharan Nair, J Lekshmipriya Govind, Lakshmi Priya Menon","doi":"10.4103/aca.aca_297_25","DOIUrl":"10.4103/aca.aca_297_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"444-445"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434825","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":"Intraoperative Echocardiography as a Cornerstone in Anesthetic Care for Mayo Level IV Clear Cell Renal Cell Carcinoma with Cavoatrial Invasion in a Patient with Sickle Cell Trait.","authors":"Avinash Chauhan, Madan M Maddali, Swaroopa Ghatnatti, Is'haq Al Aamri","doi":"10.4103/aca.aca_215_25","DOIUrl":"10.4103/aca.aca_215_25","url":null,"abstract":"<p><strong>Abstract: </strong>This case report describes the successful perioperative anesthetic management of a 60-year-old woman with Mayo Level IV clear cell renal cell carcinoma and sickle cell trait who underwent radical nephrectomy, inferior vena cava thrombectomy, and right atrial thrombus excision under cardiopulmonary bypass. The anesthetic challenges included a large intracardiac mass with a high probability of producing mechanical obstruction across the right ventricular inflow and embolization, risk of massive hemorrhage, and perioperative concerns related to sickle cell trait. Intraoperative transesophageal echocardiography helped in thrombus surveillance, vascular access, cannulation guidance, and tumor clearance verification. Surrogate markers identified a subclinical hemolytic event.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"402-407"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434707","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":"Another Marker of Inflammation and Oxidative Stress and Its Impact on Myocardial Function, Arterial Elastance, and Vasoactive-Inotropic Score After Coronary Revascularization Surgery: A Prospective Cohort Study.","authors":"Teuku A Husain, Johanes N E Putranto, Philia Setiawan, Nancy M Rehatta, Fajar Perdhana, Yos Kowara","doi":"10.4103/aca.aca_34_26","DOIUrl":"10.4103/aca.aca_34_26","url":null,"abstract":"<p><strong>Context: </strong>Inflammatory and oxidative stress responses are markedly amplified following cardiopulmonary bypass (CPB), contributing to myocardial injury, vascular dysregulation, and potential multiorgan dysfunction.</p><p><strong>Aims: </strong>This study aimed to define how inflammatory, oxidative, and cellular stress responses quantified by tumor necrosis factor-alpha (TNF-α), hydroxyl (OH-) radical scavenging capacity, and heat shock protein-70 (HSP-70) relate to early postoperative myocardial contractility, arterial tone, and vasoactive-inotropic requirements after CPB.</p><p><strong>Settings and design: </strong>A prospective cohort study was conducted in patients undergoing coronary artery bypass grafting (CABG) with preserved preoperative ejection fraction (EF).</p><p><strong>Methods and materials: </strong>Postoperative biomarker levels and perioperative changes in TNF-α, OH- scavenging capacity, and HSP-70 with early myocardial contractility maximum rate of rise of left ventricular pressure (dP/dtmax), arterial elastance, and vasoactive-inotropic score were assessed.</p><p><strong>Statistical analysis used: </strong>Correlation analyses were performed using Pearson's or Spearman's correlation coefficients as appropriate.</p><p><strong>Results: </strong>A total of 52 patients were included in the study. Higher postoperative HSP-70 levels were associated with reduced early myocardial contractility (r = -0.315; P = 0.025) and increased vasoactive-inotropic requirements (ρ =0.341; P = 0.014). No significant associations were observed among postoperative biomarker variables, and changes in TNF-α or OH- scavenging capacity were not related to early postoperative hemodynamic outcomes (all P > 0.05).</p><p><strong>Conclusions: </strong>Early post-CPB myocardial dysfunction appears more closely associated with cellular stress (HSP-70) than with inflammatory or oxidative responses. Elevated HSP-70 levels in the early postoperative CABG may act as damage-associated molecular patterns associated with transient myocardial depression and higher vasoactive-inotropic requirements, whereas early inflammatory and oxidative changes showed no direct hemodynamic correlation.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"359-366"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434894","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":"Failed Ventrain Device! Spontaneous Bag-Mask Ventilation Revisited as a Rescue Procedure in a Case of Recurrent Tracheal Stenosis with Dilated Cardiomyopathy.","authors":"Sanjula Virmani, Soumya Gupta, Ravi Meher, Rachna Wadhwa, Harpreet Singh","doi":"10.4103/aca.aca_209_25","DOIUrl":"10.4103/aca.aca_209_25","url":null,"abstract":"<p><strong>Abstract: </strong>This case report discusses the anesthetic management of a 47-year-old female with recurrent adenocystic carcinoma of the trachea and dilated cardiomyopathy (DCMP) undergoing tracheal tumor debulking and stenting. The patient experienced hemodynamic collapse due to failed expiration during ventilation using a Ventrain device, necessitating a return to spontaneous bag-mask ventilation and an urgent tracheostomy to maintain the airway.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"434-437"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434788","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":"Chronic Preoperative B-blocker Therapy and Postoperative Atrial Fibrillation after Elective Ascending Aortic Surgery.","authors":"Foteini Ampatzidou, Rafail Ioannidis, Maria Nastou, Eleftheria Dalampini, Theodora Asteri, Georgios Drossos, Despoina Sarridou","doi":"10.4103/aca.aca_41_26","DOIUrl":"10.4103/aca.aca_41_26","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a frequent complication following cardiac surgery and is associated with increased morbidity and mortality. Although b-blockers are commonly used for POAF prevention, their efficacy in patients undergoing elective surgery of the ascending aorta remains unclear.</p><p><strong>Aims: </strong>We aimed to evaluate the impact of chronic preoperative b-blocker therapy on the occurrence of POAF in patients undergoing elective ascending thoracic aortic surgery.</p><p><strong>Settings and design: </strong>This single-center, retrospective observational study included adult patients who underwent elective surgical aneurysm repair of the ascending aorta between 2012 and 2021.</p><p><strong>Materials and methods: </strong>Patients with a documented history of paroxysmal, persistent, or permanent atrial fibrillation were excluded. Acute aortic dissection cases were also excluded.</p><p><strong>Statistical analysis: </strong>Associations between preoperative b-blockers therapy and POAF, as well as postoperative clinical outcomes, were assessed using Chi-square tests and independent-samples t -tests.</p><p><strong>Results: </strong>A total of 214 patients were included in the analysis. POAF occurred in 46% of patients. Chronic preoperative b-blocker therapy was not significantly associated with the development of POAF ( P = 0.058). Among postoperative outcomes, stroke was significantly more frequent in patients who developed POAF ( P = 0.026), whereas no significant associations were observed with acute kidney injury, renal replacement therapy, reintubation, or in-hospital mortality.</p><p><strong>Conclusions: </strong>In patients undergoing elective ascending aortic surgery, chronic preoperative b-blocker therapy was not significantly associated with a reduced incidence of POAF. These findings suggest that POAF risk in aortic surgery may be influenced by factors beyond conventional pharmacological prophylaxis.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"372-377"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760346","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}