Annals of Cardiac Anaesthesia最新文献

{"title":"Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic and Mitral Valve).","authors":"K S Ram Kiran, Visharad Trivedi, Venuthurupalli S P Rajesh, Manisha Sharma, Maruti Haranal, Himani Pandya","doi":"10.4103/aca.aca_66_24","DOIUrl":"10.4103/aca.aca_66_24","url":null,"abstract":"<p><strong>Aims and objectives: </strong>The incidence of postoperative liver dysfunction is high in patients undergoing double-valve replacement - mitral and aortic valve replacement (DVR). This study aims to evaluate N-acetylcysteine's free radical scavenging property (NAC) to prevent postoperative liver dysfunction in these patients, thus affecting overall clinical outcomes.</p><p><strong>Methods: </strong>A single-center, prospective, randomized, double-blinded interventional study of 60 patients divided into two groups of 30 each. Group N received prophylactic intravenous NAC, and Group C received volume-matched 5% dextrose. Data comprised demographics, liver function tests (LFT), renal function tests (RFT), vasoactive-inotropic scores (VIS) score, and C-reactive protein (CRP) at various time intervals. Postoperative parameters such as ventilation duration, length of stay in ICU (LOS-ICU), length of hospital stay (LOHS), atrial fibrillation (AF), acute kidney injury (AKI) requiring hemodialysis, and mortality were noted. Statistical analysis was performed with the Student's t-test and Chi-square test (SPSS 22 software).</p><p><strong>Results: </strong>All postoperative LFT parameters (total bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), and alkaline phosphatase (ALP)) were significantly lower (P < 0.05) at 24, 48, and 72 hours in Group N compared to Group C. RFT and VIS scores were lower in Group N; however, were not statistically significant except for Serum Creatinine at 48 hours (P = 0.0478). Ventilation duration (P = 0.0465) and LOS-ICU (P = 0.0431) were significantly lower in Group N. Other outcomes like AF, LOHS, and mortality were lower in Group N but were not statistically significant.</p><p><strong>Conclusion: </strong>Our study showed that prophylactic administration of NAC in patients undergoing DVR is associated with a reduction in the incidence of postoperative liver dysfunction with a positive impact on postoperative outcomes.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"27 4","pages":"324-329"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370808","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 Successful Awake Fiberoptic Bronchoscopy Intubation of a Cardiomorbid Patient: A Case Report.","authors":"Qusai A Alsalah, Peter R Bael, Arein A M Abufara, Mohammad I Alsahouri, Yousef Abu Asbeh, Majde Hamamdh","doi":"10.4103/aca.aca_13_24","DOIUrl":"10.4103/aca.aca_13_24","url":null,"abstract":"<p><strong>Abstract: </strong>Bronchoscopy is a widely used technique for diagnostic and therapeutic purposes. Though it requires anesthesia, many options are available, depending on the patient's health status, the purpose of the procedure, and the type of bronchoscope used. One such health status is heart failure, a leading cause of death, and a common challenge of anesthesiology. We report a 60-year-old male patient who is a known case of heart failure with an ejection fraction of 15%, and an implanted cardioverter defibrillator, along with concurrent ischemic heart disease, diabetes mellitus, and hypertension, who presented complaining of dysphagia. This highly morbid patient was able to successfully undergo a bronchoscopic biopsy with nerve block anesthesia considering his inadequacy for conventional methods. This report aims to shed light on these challenging cases and alert anesthesiologists on how to manage such situations in patients with cardiac morbidities.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"352-356"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103724","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":"Maintaining a Bloodless Field for HeartMate 3 Placement: Splicing an RVAD Outflow Cannula into the CPB Venous Reservoir for Complete LV Emptying.","authors":"Justin W Walker, S Michael Roberts","doi":"10.4103/aca.aca_18_24","DOIUrl":"10.4103/aca.aca_18_24","url":null,"abstract":"<p><strong>Abstract: </strong>Over the previous 20 years, the use of extracorporeal membranous oxygenation (ECMO) as a bridge to durable left ventricular assist device (dLVAD) increased significantly. Additionally, emerging literature has demonstrated a protective effect of biventricular decompression while on ECMO, with one such strategy including a temporary LVAD and right ventricular assist device (RVAD). The complexity of these operations is increased by the frequency of re-sternotomies, which result in adhesions and difficult access to traditional cannulation sites. In this case report, we present a patient presenting for a re-sternotomy for dLVAD on biventricular support in whom the RVAD outflow cannula was spliced into the cardiopulmonary bypass venous reservoir by the cardiac anesthesiologist. This innovative cannulation strategy allowed for continuation of RVAD flows to prevent thrombosis and active venting of the pulmonary artery to facilitate a bloodless surgical field.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"349-351"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103727","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":"Re-Expansion Pulmonary Edema Following Minimally Invasive Cardiac Surgery: A Case Report.","authors":"Stephanus A Prakasa, Anas Alatas","doi":"10.4103/aca.aca_30_24","DOIUrl":"10.4103/aca.aca_30_24","url":null,"abstract":"<p><strong>Abstract: </strong>Re-expansion pulmonary edema (RPE) is a rare complication of minimally invasive cardiac surgery (MICS). We present a case of RPE following atrial septal defect (ASD) closure using a thoracotomy approach and cardiopulmonary bypass (CPB). REP contributes to significant morbidity and extends the length of stays in the intensive care unit. Understanding the pathophysiology and risk factors of RPE allows us to prevent or minimize the incidence.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"27 4","pages":"361-363"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370806","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":"Ibrutinib-Induced Ventricular Electrical Storm Successfully Managed with Veno-Arterial ECMO and Intralipid Administration: A Rare Case Report.","authors":"Debora E Torre, Carla Stecco, Andrea Porzionato, Domenico Mangino, Veronica Macchi, Raffaele De Caro, Carmelo Pirri","doi":"10.4103/aca.aca_4_24","DOIUrl":"10.4103/aca.aca_4_24","url":null,"abstract":"<p><strong>Abstract: </strong>We report a 55-year-old men patient with a primitive central nervous system non-Hodgkin lymphoma B cell (LNH PNSLC), treated with chemotherapy rituximab, methotrexate, and ibrutinib (first treatment) who developed a refractory ventricular arrhythmic storm two hours after the ibrutinib intake. Indeed, ibrutinib could be associated with severe and occasionally fatal cardiac events. The swift emergence of a ventricular electrical storm with cardiac arrest demanded the prompt initiation of veno-arterial extracorporeal membrane oxygenation to effectively navigate this critically ill patient toward recovery. This intervention was deemed imperative, given the absence of any available antidote for the effects of ibrutinib. Veno-arterial extracorporeal membrane oxygenation proved successful in rescuing this patient, resulting in a complete neurological recovery. Consequently, he was able to resume his chemotherapy treatment.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"344-348"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103725","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":"Perioperative Management of Lower Limb Surgery in a Patient with Asymptomatic Left Ventricular Systolic Dysfunction: A Case Report.","authors":"Saranya Nagalingam, Arunkumaar Srinivasan, Antony John Charles, V R Hemanth Kumar","doi":"10.4103/aca.aca_21_24","DOIUrl":"10.4103/aca.aca_21_24","url":null,"abstract":"<p><strong>Abstract: </strong>Heart failure poses significant challenges in perioperative settings, with an increasing prevalence in India. While much attention has been given to the management of symptomatic heart failure, there is a dearth of literature on asymptomatic left ventricular systolic dysfunction (ALVSD). In this case report, we present the successful perioperative management of a 35-year-old male with ALVSD and a low ejection fraction undergoing lower limb surgery under combined spinal epidural anesthesia. Our approach aimed to maintain hemodynamic stability, minimize myocardial overload, and mitigate the adverse effects of neuraxial blockade.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"27 4","pages":"357-360"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370803","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":"N-acetyl Cysteine to Mitigate Liver Damage in Patients with Deranged Liver Function Undergoing Surgery on Cardiopulmonary Bypass.","authors":"Mukul Chandra Kapoor","doi":"10.4103/aca.aca_156_24","DOIUrl":"10.4103/aca.aca_156_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"27 4","pages":"299-300"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370802","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":"Dwelling on the Utility of Transesophageal Echocardiography (TEE) in the Operating Room: Is It Time to Integrate Training in TEE into the Anesthesia Postgraduate Curriculum?","authors":"Gegal Pruthi, Ankita Dey, R Shwaetha, Rajiv Kumar","doi":"10.4103/aca.aca_96_24","DOIUrl":"10.4103/aca.aca_96_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"27 4","pages":"384-386"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370799","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":"Internal Jugular Vein Valve Dysfunction and Venous Dissection-Complications of Central Venous Catheterization.","authors":"Miho Ogawa, Jun Honda, Keisuke Yoshida, Tatsumi Yakushiji, Satoki Inoue","doi":"10.4103/aca.aca_65_24","DOIUrl":"10.4103/aca.aca_65_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"383-384"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103726","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 Shared Airway: Tracheal Mass Excision.","authors":"Amruta Shringarpure, Surendhar Saba, Sanjeeta Umbarkar, Manjula Sarkar","doi":"10.4103/aca.aca_47_24","DOIUrl":"10.4103/aca.aca_47_24","url":null,"abstract":"<p><strong>Abstract: </strong>We report a case of successful airway management of a 26-year-old male patient who was posted for tracheal mass excision. The main challenge in such a case is to formulate a plan to provide maximum surgical access to the trachea for mass excision through an intraoral approach while ensuring adequate oxygenation and airway management. The patient presented with acute respiratory distress in the emergency ward. On computed tomography (CT), the patient was diagnosed with a polypoidal tracheal tumor occluding more than 90% of the tracheal lumen and 5.8 cm away from the carina. The case was successfully managed using a peripheral bypass for airway management. After the removal of the tumor, a tracheostomy tube was placed through the tracheotomy hole used for tumor excision. The whole process was uneventful.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"379-382"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103630","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}