Annals of Cardiac Anaesthesia最新文献

{"title":"Utility of transesophageal echocardiography during orthotopic liver transplantation: A narrative review.","authors":"Christopher Hansebout, Tejal V Desai, Achal Dhir","doi":"10.4103/aca.aca_186_22","DOIUrl":"10.4103/aca.aca_186_22","url":null,"abstract":"<p><p>Orthotopic liver transplantation (OLT) is the standard of care for patients suffering from end stage liver disease (ESLD). This is a high-risk procedure with the potential for hemorrhage, large shifts in preload and afterload, and release of vasoactive mediators that can have profound effects on hemodynamic equilibrium. In addition, patients with ESLD can have preexisting coronary artery disease, cirrhotic cardiomyopathy, porto-pulomary hypertension and imbalanced coagulation. As cardiovascular involvement is invariable and patient are at an appreciable risk of intraoperative cardiac arrest, Trans esophageal echocardiography (TEE) is increasingly becoming a routinely utilized monitor during OLT in patients without contraindications to its use. A comprehensive TEE assessment performed by trained operators provides a wealth of information on baseline cardiac function, while a focused study specific for the ESLD patients can help in prompt diagnosis and treatment of critical events. Future studies utilizing TEE will eventually optimize examination safety, quality, permit patient risk stratification, provide intraoperative guidance, and allow for evaluation of graft vasculature.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"367-379"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673635","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 acute right ventricular support in thyrotoxicosis.","authors":"Marc O Maybauer, Joseph M Brewer","doi":"10.4103/aca.aca_26_23","DOIUrl":"10.4103/aca.aca_26_23","url":null,"abstract":"<p><p>A 25-year-old female was presented with acute right heart failure (aRHF) and cardiogenic shock secondary to thyrotoxicosis with concomitant acute respiratory failure. A ProtekDuo cannula was placed to provide temporary percutaneous right ventricular assistance and extracorporeal membrane oxygenation (ECMO) in venopulmonary (V-P) configuration, which provided both decompression of the right ventricle (RV) and oxygenation. With treatment of the underlying thyrotoxicosis, the RV function improved and respiratory failure resolved. She was discharged home in good condition. This case details alternative ECMO management with ProtekDuo compared to the gold standard of venoarterial (V-A) ECMO.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"464-467"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673633","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":"A new indication of ultrasound-guided modified thoracoabdominal nerves block through perichondrial approach for thoracotomy in pediatric patients.","authors":"Swati Singh, Swati Singh, Neha Pandey","doi":"10.4103/aca.aca_42_23","DOIUrl":"10.4103/aca.aca_42_23","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"471-472"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673609","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":"Absent right superior vena cava and persistent left superior vena cava: An incidental finding.","authors":"Swati Joshi, Ajmer Singh","doi":"10.4103/aca.aca_91_23","DOIUrl":"10.4103/aca.aca_91_23","url":null,"abstract":"<p><p>A patient with Marfan syndrome undergoing Bentall operation was found to have an absent right superior vena cava and persistent left superior vena cava. The dilation of coronary sinus raised the suspicion of persistent left superior vena cava. The diagnosis was confirmed by agitated saline contrast echocardiography and computed tomography of the chest.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"433-434"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673611","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":"Comment on \"use of pre-operative haemoglobin a1c to predict early post-operative renal failure and infection risks in patients who are not diabetics and undergoing elective off pump coronary artery bypass graft surgery\".","authors":"Rohan Magoon, Arindam Choudhury","doi":"10.4103/aca.aca_57_23","DOIUrl":"10.4103/aca.aca_57_23","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"475-476"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673618","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: Anomalies of systemic veins: A topic of interest to the anesthesiologist.","authors":"Madan M Maddali, Robert H Anderson","doi":"10.4103/aca.aca_120_23","DOIUrl":"10.4103/aca.aca_120_23","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"435-437"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673619","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 intravenous levosimendan or milrinone on left atrial pressure in patients undergoing off-pump coronary artery bypass grafting-A prospective double-blind, randomized controlled trial.","authors":"Abhinandan Mondal, Kakali Ghosh, Sandeep Kumar Kar, Pavan Kumar Dammalapati, Chaitali S Dasgupta","doi":"10.4103/aca.aca_51_23","DOIUrl":"10.4103/aca.aca_51_23","url":null,"abstract":"<p><strong>Background: </strong>Maintaining a low left atrial pressure (LAP) in off-pump coronary artery bypass grafting (OPCAB) is desirable. This study was done to compare the effects of intravenous levosimendan or milrinone on LAP at different stages of OPCAB.</p><p><strong>Materials and methods: </strong>After institutional ethics committee clearance, this two-arm double-blind randomized control trial was done in 44 adult patients with triple vessel coronary artery disease undergoing OPCAB at cardiac OT of IPGME&R, Kolkata. The patients were randomly allocated into two groups receiving intraoperative either levosimendan or milrinone. Pulmonary capillary wedge pressure (PCWP) was compared as the primary outcome parameter, whereas other echocardiographic and hemodynamic parameters were also assessed during six stages of OPCAB, that is, after sternotomy, proximal(s), left anterior descending artery (LAD), obtuse marginal (OM), posterior descending artery (PDA) grafting, and before sternal closure. Numerical parameters were compared using Student's unpaired two-tailed t-test.</p><p><strong>Results: </strong>PCWP was found to be significantly lower (P < 0.05) in the levosimendan group during proximal (P = 0.047), LAD (P = 0.018), OM (P < 0.0001), PDA grafting (P = 0.028), and before sternal closure (P = 0.015). Other parameters indicate LAP, that is, from mitral early diastolic inflow velocity to mitral annular early diastolic velocity ratio (E/e'), which indicated significantly lower LAP in levosimendan group during LAD, OM, and PDA grafting and before sternal closure. Conclusion: Levosimendan may be used as a primary inotrope in terms of better reduction in left atrial pressure during different stages of OPCAB, translating to a decrease in left ventricular end-diastolic pressure, therefore maintaining optimum coronary perfusion pressure, which is the primary goal of the surgery.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"411-417"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673623","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 on tracheal perfusion pressure and ventilatory parameters in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass: A prospective observational study.","authors":"Abhishek Verma, Guriqbal Singh, Visharad Trivedi, K S Ramkiran, Mittapalli Jeevan Babu, Himani Pandya, Jigisha Pujara","doi":"10.4103/aca.aca_19_23","DOIUrl":"10.4103/aca.aca_19_23","url":null,"abstract":"<p><strong>Background: </strong>Overinflation of cuffed endotracheal tubes and transesophageal echocardiography (TEE) probe causes increased intracuff pressure (CP) compromising tracheal perfusion pressure (TPP). Primary objective of the study was to assess CP, TPP on TEE probe insertion and examination during pediatric cardiac surgeries. Secondary objectives were to evaluate the effect of the probe on peak airway pressures (P_peak), mean airway pressures (P_mean) and to monitor CP, TPP on cardiopulmonary bypass (CPB).</p><p><strong>Materials and methods: </strong>This prospective observational study included fifty patients, aged 1-5 years undergoing cardiac surgeries using CPB. Following induction, TEE probe was introduced. CP, TPP, P_peak, P_mean were measured before insertion of TEE probe (T₁), during probe insertion (T₂) and examination at mid-esophageal (T₃), transgastric level (T₄), and on removing probe (T₆). CP, TPP were monitored on CPB (T₅). Statistical analysis was done using paired t-test.</p><p><strong>Results: </strong>CP, P_peak and P_mean increased significantly, while TPP decreased significantly from T₁ to T₂, T₃, T₄ (P < 0.001). CP, TPP decreased significantly at T₅ in comparison to T₆ (P < 0.001). In 48% of the patients CP increased above 30 cm H₂O at T₂.</p><p><strong>Conclusion: </strong>TEE probe causes an increase in CP and decreases TPP. Constant monitoring and maintaining CP, TPP in optimum range is recommended.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"393-398"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673624","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":"Alternative approaches to central venous cannulation in cardiac surgery.","authors":"Mukul C Kapoor","doi":"10.4103/aca.aca_123_23","DOIUrl":"10.4103/aca.aca_123_23","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"365-366"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673613","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":"Anesthetic considerations in an adult congenital rubella syndrome-patent ductus arteriosus ligation in a resource-limited setting.","authors":"Gegal Pruthi, Mayank Gupta, Brijesh Garg, Anju Grewal","doi":"10.4103/aca.aca_46_23","DOIUrl":"10.4103/aca.aca_46_23","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"26 4","pages":"469-471"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673615","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}