Annals of Cardiac Anaesthesia最新文献

{"title":"Identification of Right-sided Aortic Arch Using TEE and its Impact on Cardiac Surgical Planning.","authors":"Matea Malinovic, Basil Jouryyeh, Michael Beshara","doi":"10.4103/aca.aca_270_24","DOIUrl":"10.4103/aca.aca_270_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"310-312"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590299","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":"Intravenous Levosimendan versus Milrinone: Coronary Sinus Lactate and PA Catheter Derived Parameters in Patients with Pulmonary Hypertension Undergoing Elective Mitral Valve Replacement.","authors":"Sanjula Virmani, Sukhdev Garg, Indira Malik, Abhas Chandra Dash, Sayyed Ehtesham Hussain Naqvi, Rachna Wadhwa, Harpreet Singh","doi":"10.4103/aca.aca_4_25","DOIUrl":"10.4103/aca.aca_4_25","url":null,"abstract":"<p><strong>Background: </strong>Coronary sinus (CS) lactate level has been shown to corroborate with changes in myocardial metabolism induced by ischaemia and reperfusion, and hence can be used to indicate the effect on myocardial metabolism. In patients with mitral stenosis (MS) undergoing valvuloplasty or valve replacement, presence of severe pulmonary hypertension (PH), indicates advanced disease state and development of right ventricular (RV) failure, an important hallmark of bad prognosis. Levosimendan and milrinone are increasingly being used as inodilators to treat PH and improve RV function to varying degrees, but their effect on myocardial metabolism awaits precise validation.</p><p><strong>Methods: </strong>Thirty patients were randomized into two groups of 15 patients each. Group L (received levosimendan) and Group M (received milrinone). All the patients received fentanyl (8-10 μg/kg), rocuronium bromide 0.8 mg/Kg for induction and maintenance of anaesthesia. In addition to the routine intravenous and invasive arterial access, a Cavafix® (Certo® 257, 45 cm, B Braun Melsungen AG, Germany) was inserted via right IJV and positioned in the right atrium (RA) to be later re-positioned in the CS before coming off cardiopulmonary bypass (CPB), to obtain blood samples for measuring the CS lactate levels postoperatively. At the commencement of rewarming, group L received levosimendan 10 μ/kg bolus over 10 min, followed by an infusion (0.1 μ/kg/min) and group M received 50 μg/kg bolus over 10 min, followed by infusion (0.5 μg/kg/min), till 24 hours post-operatively. CS lactate, heart rate (HR), mean arterial pressure (MAP) and PA catheter derived data [Cardiac index (CI), cardiac output (CO), PA pressure, systemic and pulmonary vascular resistance indices (SVRI/PVRI)] and mixed venous oxygen saturations (SvO2) were recorded at predetermined time points.</p><p><strong>Results: </strong>In both the groups the CS lactate levels increased gradually till 6 hours after surgery followed by a decrease at 24 hours. Comparison of CS lactate between the two groups revealed that the CS lactate levels were significantly lower in group L at various time points till 24 hours after surgery with a P value of < 0.05. HR and MAP were comparable in both the groups at all time points. MAP was significantly lower in the two groups, both after induction of anaesthesia and after CPB. 7 patients in group M (46.7%) developed hypotension (MAP decreased by > 20% of baseline) that was treated with norepinephrine. CO increased significantly in both group M and group L, post CPB 10 min after surgery. Patients in group L had a significantly higher CO and CI, compared to group M, P < 0.05. PAP was significantly reduced compared to baseline values after valve replacement in both the groups being lower in group L compared to group M, but the difference was statistically not significant. After valve replacement, SVRI decreased significantly in both the group the decrease being sig","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"298-304"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590302","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 Role of Acetaminophen Use in Acute Kidney Injury Prevention in Cardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Luis E Ciconini, Victor Perim, Theodoro Beck, Mauren F Carbonar, Mazpa M Ejikem, Ahmed Zaky, Javier Neyra, Andre F Gosling","doi":"10.4103/aca.aca_223_24","DOIUrl":"10.4103/aca.aca_223_24","url":null,"abstract":"<p><strong>Abstract: </strong>Acute kidney injury (AKI) is a common complication following cardiac surgery, often leading to increased morbidity and mortality. Despite its prevalence, the role of acetaminophen in preventing AKI after cardiac surgery remains uncertain. This meta-analysis sought to clarify whether perioperative administration of acetaminophen could reduce the risk of postoperative AKI in adult patients undergoing cardiac procedures. To address this question, a systematic review and meta-analysis were performed by searching the MEDLINE, Cochrane, and Embase databases. Studies comparing the effects of perioperative acetaminophen to those of no acetaminophen in adult cardiac surgery patients were evaluated, with risk of bias assessed for each study. Sensitivity analyses were also conducted to strengthen the reliability of the findings. In total, 13 studies, including nine randomized controlled trials and four observational studies, involving 11,583 patients, were analyzed. The results showed that acetaminophen administration was associated with a lower incidence of AKI [OR 0.62 (95% CI 0.40-0.97), P = 0.04]. Additionally, acetaminophen use was linked to reduced in-hospital mortality, delirium rates, and shorter ICU stays, though it had no significant effect on overall hospital length of stay. These findings suggest that perioperative acetaminophen administration may play a protective role in reducing both AKI incidence and in-hospital mortality in patients undergoing cardiac surgery. Until large multicenter randomized controlled trials confirm these results, acetaminophen may still be considered as a preventive measure for patients both before cardiopulmonary bypass initiation and in the postoperative period.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"238-247"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590314","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 Approach to Intraoperative Accidental Pulmonary Artery Transection and Role of Mid-Point to Transverse Process Interfascial Plane Block.","authors":"Ankita Suri, Swati Jindal, Deepika Gupta, Varna Madhu, Naini Sood","doi":"10.4103/aca.aca_233_24","DOIUrl":"10.4103/aca.aca_233_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"332-333"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590200","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":"Assessment of Right Ventricle Function in Patients with Mitral Repair: Case Series.","authors":"Yannis Amador, Jacobo Moreno Garijo, Azad Mashari, Giovanni Gadotti, Wilma M Hopman, Tirone E David, Massimiliano Meineri","doi":"10.4103/aca.aca_34_25","DOIUrl":"10.4103/aca.aca_34_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"342-344"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590203","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":"Aortic Transvalvular Gradient Mis-Quantification.","authors":"Marco Modestini, Jan A Krikken, Geertje Jansma, Wobbe Bouma, Jayant S Jainandunsing","doi":"10.4103/aca.aca_10_25","DOIUrl":"10.4103/aca.aca_10_25","url":null,"abstract":"<p><strong>Abstract: </strong>Mitral regurgitation (MR) can occasionally mimic aortic stenosis (AS) on echocardiographic Doppler imaging, leading to diagnostic challenges. We present the case of a 55-year-old man undergoing minimally invasive mitral valve surgery for severe MR caused by posterior mitral valve leaflet prolapse. Preoperative transthoracic echocardiography revealed severe MR with no significant aortic valve abnormalities. Intraoperative transesophageal echocardiography (TEE) initially showed a high transvalvular aortic gradient (3 m/s) in the transgastric long-axis view, suggestive of mild-to-moderate AS. However, detailed Doppler analysis revealed a double envelope signal, representing both eccentric MR and true aortic valve flow. The closer evaluation showed the MR signal occurred earlier in the cardiac cycle, aligning with its hemodynamic timing, while the true aortic flow followed isovolumetric contraction. Subsequent three-dimensional TEE confirmed normal aortic valve morphology and function. This case highlights the importance of correlating preoperative findings, Doppler signal timing, and imaging data to avoid misdiagnosis. Systematic echocardiographic evaluation, including signal timing analysis, can differentiate between MR and AS, ensuring accurate intraoperative decision-making and preventing unnecessary interventions.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"329-331"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590202","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":"EVLW by Lung Ultrasound to Predict Short-Term Post Operative Outcomes in Pediatric Cardiac Surgery - A Prospective Observational Study.","authors":"Anitha Diwakar, Pankaj Punetha, Anuradha Kamat, Kolli S Chalam","doi":"10.4103/aca.aca_230_24","DOIUrl":"10.4103/aca.aca_230_24","url":null,"abstract":"<p><strong>Background: </strong>Extravascular lung water (EVLW) in children undergoing cardiac surgery may affect the outcomes after surgery. The study aimed to evaluate if extravascular lung water assessed by ultrasound could serve as a predictor of short-term postoperative outcomes in pediatric cardiac surgery.</p><p><strong>Material and methods: </strong>This is a prospective observational study conducted at a tertiary care facility involving children aged 6 months to 12 years who were scheduled for cardiac surgery. A lung ultrasound assessment was carried out before the operation (T0), immediately after the surgery (T1), 6 to 8 hours after surgery (T2), and 18 to 24 hours postoperatively (T3). A score was assigned based on the presence of extravascular lung water indicated by B lines. Pearson's correlation analysis was performed to examine the relationship between the lung ultrasound score of extravascular lung water and the duration of mechanical ventilation and the length of stay in the intensive care unit, with fluid balance, inotrope score, and oxygenation status being analyzed secondarily.</p><p><strong>Results: </strong>The EVLW score demonstrated a positive relationship with the duration of mechanical ventilation across all time points, with correlation coefficients of r = 0.56 at T0, r = 0.70 at T1, r = 0.40 at T2, and r = 0.52 at T3. The most pronounced correlation occurred at T1, where r = 0.7 was observed. A moderate positive correlation with the duration of ICU stay was noted at the time points T0, T1, and T3. The EVLW score at T1 proved to be significant in linear regression analysis for prediction of both the duration of mechanical ventilation and the length of stay in the ICU.</p><p><strong>Conclusions: </strong>The EVLW score measured at T1, which is immediately after surgery, can serve as an indicator of short-term postoperative outcomes in pediatric cardiac surgery related to the duration of mechanical ventilation.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"305-309"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590209","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":"Novel Application of Ultrasound for Retrieval of Retained Pacing Wire.","authors":"S Keerthy Nath, Udit Khajuria, K P Unnikrishnan, S Renjith","doi":"10.4103/aca.aca_211_24","DOIUrl":"10.4103/aca.aca_211_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"336-337"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590305","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":"Outcome of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients with Milrinone Versus Milrinone and Inhaled Nitric Oxide (INO): A Prospective Randomized Observational Study.","authors":"Saritas Bulent, Unal Koray, Ucar Zeynep","doi":"10.4103/aca.aca_56_24","DOIUrl":"10.4103/aca.aca_56_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"333-334"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590306","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":"Guidewire Misplacement into the Hepatic Vein During Inferior Vena Cava Cannulation via the Femoral Vein: The Role of Transesophageal Echocardiography.","authors":"Motoi Inoue, Shohei Eto, Fumiaki Komaki, Hirotoshi Kitagawa","doi":"10.4103/aca.aca_46_25","DOIUrl":"10.4103/aca.aca_46_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 3","pages":"350"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590298","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}