Annals of Cardiac Anaesthesia最新文献

{"title":"Incidence and Predictors of Postoperative Atrial Fibrillation Following Cardiac Surgery: A Systematic Review.","authors":"Jokevin Prasetyadhi, Andi Adil, Hisbullah, Syafri Kamsul Arif","doi":"10.4103/aca.aca_285_25","DOIUrl":"10.4103/aca.aca_285_25","url":null,"abstract":"<p><strong>Abstract: </strong>Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with an incidence ranging from 10% to 65%, and is associated with increased risks of stroke, prolonged hospitalization, and mortality. This systematic review aimed to evaluate the incidence and identify predictors of POAF in adults undergoing cardiac procedures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Europe PMC, and SAGE databases for English-language studies published between January 2020 and June 2025. Eligible studies included observational and experimental designs involving adults (>18 years) undergoing cardiac surgery. Two reviewers independently screened titles/abstracts, assessed full texts, extracted data, and evaluated quality using the Newcastle-Ottawa Scale and Joanna Briggs Institute tools. From 6598 initial records, 52 studies (32 prospective cohorts, 17 retrospective cohorts, and 3 cross-sectional) were included, encompassing diverse geographies, and surgical types (e.g., coronary artery bypass grafting, valve surgery). POAF incidence varied from 7.9% to 60.9%, highest in combined procedures (40%-50%), and valve surgery (30%-40%). Consistent predictors included advanced age (odds ratio 1.05-1.10/year), left atrial enlargement, valve surgery, comorbidities (hypertension, diabetes, renal dysfunction), prolonged cardiopulmonary bypass, inflammation (e.g. C-reactive protein, neutrophil-to-lymphocyte ratio), and oxidative stress markers (e.g. NOX2). Novel biomarkers like MR-proANP and gene panels showed potential. POAF remains multifactorial and burdensome; standardized monitoring and integrated risk models could enhance prediction and prevention, warranting further validation in multicenter trials.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"314-324"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760287","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 Pulmonary Embolism During Right Atrial Mass Excision: A Case Report on Intraoperative Rescue TEE.","authors":"Praveen K Neema, Barsha Sen, Nagarjuna Panidapu","doi":"10.4103/aca.aca_327_25","DOIUrl":"10.4103/aca.aca_327_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"453-455"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434719","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":"Revisiting the Universal Definition of Myocardial Infarction: A Case for Extraluminal Coronary Occlusion as a Distinct Entity.","authors":"Bhargava V Devarakonda, Shrinivas V Gadhinglajkar, Mukul C Kapoor, Prafull Sharma, Markose L Paret","doi":"10.4103/aca.aca_340_25","DOIUrl":"10.4103/aca.aca_340_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"397-401"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434804","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":"Patients' Perception of Information Provision Regarding Complications in Cardiac Surgery: A Thematic Analysis.","authors":"Nick J G Visschers, Maaike S Y Thio, Cindy M A de Bot, Peter G Noordzij, Thijs C D Rettig","doi":"10.4103/aca.aca_69_26","DOIUrl":"10.4103/aca.aca_69_26","url":null,"abstract":"<p><strong>Context: </strong>Patients receive preoperative information about possible postoperative complications, but little is known about how they perceive this information or how they understand the consequences when complications occur.</p><p><strong>Aim: </strong>This study explored how patients who experienced postoperative complications perceived preoperative information and how they understood the potential impact of those complications on their well-being.</p><p><strong>Materials and methods: </strong>A qualitative study was conducted with patients who had undergone elective coronary artery bypass grafting or valve surgery and experienced a postoperative complication (Clavien-Dindo ≥≥3B). A qualitative researcher conducted semi-structured telephone interviews. Thematic analysis was used to identify recurring themes.</p><p><strong>Results: </strong>Eight patients were interviewed. The most common complication was postoperative hemorrhage requiring rethoracotomy (n = 7). Six themes were identified: (1) Negative perceptions of risk communication, (2) Need for personalized aftercare, (3) Inadequate validation of emotional experiences, (4) Unawareness of perioperative information, (5) Diversity in patients' functioning and impact of complications, and (6) Discontinuity of care. Patients need a comprehensive explanation of complications that occurred, partly because they did not fully understand the consequences. Patients and family members needed emotional support during the perioperative period. Patients preferred follow-up care by the same physician within the same hospital.</p><p><strong>Conclusion: </strong>Patients who experienced complications after cardiac surgery expressed a desire for more detailed discussions of complications and their consequences, increased emotional support, and continuity of care. Potential improvements in perioperative care in this specific patient group could include debriefing of complications, providing psychological support, and offering video or phone consultations.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"386-392"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434874","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":"Embolic Stroke of Undetermined Source Following Surgical Atrial Septal Defect Closure with Dacron Patch in a Young Adult without Identifiable Risk Factors.","authors":"Tanachot Rattanakosonsri, Supakorn Srihattapadungkit, Ittichai Sakarunchai, Chusak Nudaeng","doi":"10.4103/aca.aca_339_25","DOIUrl":"10.4103/aca.aca_339_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"452-453"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434733","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":"Giant Right Atrial Appendage Aneurysm with Thrombus Causing Cardiac Compression in Pulmonary Tuberculosis.","authors":"Sharek Abdul Nazir, Subrata Kumar Singha, Gade Sandeep, Anil Gupta, T C Arun","doi":"10.4103/aca.aca_289_25","DOIUrl":"10.4103/aca.aca_289_25","url":null,"abstract":"<p><strong>Abstract: </strong>Right atrial appendage aneurysm (RAAA) is a rare cardiac anomaly, predominantly considered congenital, resulting from dysplasia or localized absence of atrial myocardium leading to thinning and aneurysmal dilation. However, this case highlights the possibility of an acquired mechanism, particularly in the context of chronic infectious and inflammatory conditions such as tuberculosis (TB), which may have contributed to aneurysm formation in this patient. The patient's presentation with the left-sided chest pain and weight loss in the setting of active pulmonary TB raises clinical suspicion of an infectious etiology contributing to atrial wall weakening. Histopathological examination of the excised aneurysmal wall and thrombus was instrumental in confirming the diagnosis and etiopathogenesis. Surgical excision of the aneurysm and thrombus remains the cornerstone of management in symptomatic or complicated RAAA, particularly with chamber compression or thromboembolism risk. In this patient, postoperative recovery was uneventful, and continuation of anti-tubercular therapy was crucial to eradicate residual infection and prevent recurrence. Serial follow-up demonstrated no residual aneurysm or thrombus, stable right atrial and ventricular dimensions, and preserved cardiac function. The patient remained symptom-free without arrhythmias or embolic events, underscoring the importance of vigilant postoperative surveillance. This case not only broadens the differential for RAAA etiology to include infectious causes like TB, but also highlights the integral role of histopathological diagnosis and sustained postoperative monitoring for optimal patient outcomes.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"413-416"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434774","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 Editor: [Acute Normovolemic Hemodilution Significantly Reduces RBC Transfusion and Lactic Acidosis Following Cardiac Surgery-A Propensity-Matched Study].","authors":"Rosa Labanca, Domenico Pontillo, Alessandro Belletti, Alessandro Pruna","doi":"10.4103/aca.aca_286_25","DOIUrl":"10.4103/aca.aca_286_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"455-456"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434897","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":"Early Postoperative Complications and Risk Assessment in Cardiac Surgery: A Cohort Study.","authors":"Jarvin M R Velásquez, Beatriz Deras","doi":"10.4103/aca.aca_351_25","DOIUrl":"10.4103/aca.aca_351_25","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative complications are major determinants of outcomes after cardiac surgery, particularly in low- and middle-income countries (LMICs), where perioperative data remain limited.</p><p><strong>Aim: </strong>To describe the incidence and spectrum of early postoperative complications within the first 24 hours after cardiac surgery and to characterize preoperative risk profiles using cardiac anesthesia risk evaluation (CARE) and European system for cardiac operative risk evaluation (EuroSCORE) II.</p><p><strong>Settings and design: </strong>Retrospective, single-center cohort study conducted at a national referral hospital.</p><p><strong>Materials and methods: </strong>A total of 108 adult patients undergoing cardiac surgery with cardiopulmonary bypass between 2017 and 2021 were included. Baseline clinical and surgical variables were collected. Early postoperative complications were recorded by organ system. CARE and EuroSCORE II were calculated preoperatively due to absence of mortality data.</p><p><strong>Statistical analysis used: </strong>Descriptive analysis was performed. The discriminative ability of CARE-predicted morbidity was evaluated using the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals.</p><p><strong>Results: </strong>The mean age was 50.1 ± 17.1 years, and 52.8% were women. Early postoperative complications occurred in 47 patients (43.5%), most frequently cardiovascular (42 patients, 38.9%), followed by renal complications requiring renal replacement therapy (11, 10.2%), infectious (9, 8.3%), and respiratory complications (8, 7.4%). CARE-predicted morbidity showed limited to moderate discrimination (AUC 0.67; 95% CI 0.58-0.77). EuroSCORE II was reported descriptively.</p><p><strong>Conclusion: </strong>Early postoperative morbidity is common in this LMIC cohort, with cardiovascular complications predominating. CARE-predicted morbidity showed limited to moderate discrimination, supporting cautious interpretation and highlighting the need for improved perioperative outcome monitoring.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"367-371"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760300","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":"Relationship Between Entropy-Guided Sevoflurane Administration and End Oxygenator Sevoflurane Concentration in Adult Patients Undergoing Cardiopulmonary Bypass Surgery.","authors":"Vijay Kumar, Alok Kumar, Krishna Prasad Gourav, Bhargava Devarakonda","doi":"10.4103/aca.aca_21_26","DOIUrl":"10.4103/aca.aca_21_26","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary bypass (CPB) during cardiac surgery poses physiological challenges such as altered drug pharmacokinetics. Sevoflurane, a commonly used volatile agent, provides favorable myocardial protection; however, precise dosing during CPB remains difficult. Entropy monitoring, which assesses cerebral and electromyographic activity, offers real-time guidance on anesthetic depth. This study aimed to investigate entropy-guided sevoflurane administration relation with end-oxygenator sevoflurane concentrations, in patients undergoing elective on-pump cardiac surgery.</p><p><strong>Materials and methods: </strong>A prospective, randomized controlled trial was conducted in a single tertiary care center affiliated with a teaching hospital, enrolling 74 adult patients scheduled for elective on-pump cardiac surgeries. Participants were randomized into two groups: fixed sevoflurane concentration (1.5% v/v) and entropy-guided sevoflurane titration. Depth of anesthesia was monitored with state entropy (SE) and response entropy (RE), end-oxygenator sevoflurane concentrations, and clinical parameters.</p><p><strong>Results: </strong>Compared to the fixed-dose group, the entropy-guided group exhibited lower SE and RE values intraoperatively, indicating tighter control of anesthetic depth. Higher sevoflurane dial settings were used initially in the entropy group, resulting in higher end-oxygenator concentrations. Although mean arterial pressure and arterial blood gas parameters remained within acceptable ranges in both groups, VIS was higher in the entropy-guided group, suggesting an increased requirement for vasoactive and inotropic support. There was no statistically significant variation in postoperative mechanical ventilation duration or intensive care unit stay between the two groups.</p><p><strong>Conclusion: </strong>Overall, entropy monitoring facilitated a precise titration of sevoflurane without adversely affecting immediate postoperative outcomes.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"378-385"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434840","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":"ProtekDuo Cannulation via Right External Jugular Vein: A First in Man Method Description.","authors":"Yuriy Stukov, Mohammad Aladaileh, Mindaugas Rackauskas, Marc O Maybauer","doi":"10.4103/aca.aca_279_25","DOIUrl":"10.4103/aca.aca_279_25","url":null,"abstract":"<p><strong>Abstract: </strong>Individuals requiring transplantation represent the sickest cohort of patients with end-stage lung failure. Commonly, they have multiple comorbidities that carry significant risk for post-transplant recovery. Clinical circumstances, such as widespread clots and vascular thrombosis, require novel approaches in attempt to provide extracorporeal life support. We present a patient, who developed respiratory failure during recovery from bilateral lung transplantation, complicated by internal jugular vein thrombosis and an inferior vena cava filter in situ. She was cannulated with a ProtekDuo via the right external jugular vein due to lack of other patent vessels, representing a first in man method description.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"427-429"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434863","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}