Annals of Cardiac Anaesthesia最新文献

{"title":"A Challenging Distinction Between the Elongated Eustachian Valve and the Interatrial Septum.","authors":"Mostafa Yahyazadeh, Ali Hosseinsabet, Homa Ghaderian","doi":"10.4103/aca.aca_138_24","DOIUrl":"10.4103/aca.aca_138_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"101-102"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031867","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":"Massive Hemothorax due to a Rare Entity: Dilemma of ICD Insertion!! A Case Report.","authors":"Prabhav Chhaperwal, Masti Nagendra Rao Vijai, Gurbinder Singh Suri, Uma Shankar Garg, Kiran Kumar Parate, Suraj Kapoor","doi":"10.4103/aca.aca_135_24","DOIUrl":"10.4103/aca.aca_135_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intercostal artery aneurysms are a type of vascular abnormality that poses a potential risk of rupture, which could lead to life-threatening hemothorax. This case report presents a young male who experienced a rupture of an intercostal artery aneurysm and subsequently suffered from a massive hemothorax after engaging in strenuous physical activity. The current case study sheds light on the difficulties and lessons learned in managing such cases in peripheral settings, including the dilemma of whether to insert an intercostal chest drain (ICD). The patient was ultimately diagnosed with a rare clinical entity known as rupture of right posterior intercostal artery aneurysm with massive hemothorax.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"76-79"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032056","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":"Role of Intraoperative Left Ventricular Global Longitudinal Strain in Hemodynamic and Cognitive Outcomes in On-Pump Coronary Artery Bypass Surgery: A Prospective Observational Study.","authors":"Eric B Lineburger, Rajesh C Arya, Celso G Junior, Fernanda S Lima, Eduardo M Búrigo, Gabriel Simoni R Fermo","doi":"10.4103/aca.aca_74_24","DOIUrl":"10.4103/aca.aca_74_24","url":null,"abstract":"<p><strong>Background: </strong>The role of left ventricular global longitudinal strain (LVGLS) in coronary artery bypass grafting (CABG) and outcomes such as low cardiac output syndrome (LCOS) is not well established. The authors investigated the relationship between LVGLS before and after induction of anesthesia, their differences, and their relationship with LCOS and other outcomes.</p><p><strong>Methodology: </strong>A prospective observational study was conducted in a public/private hospital with 50 adult patients scheduled for on-pump CABG with normal left ventricular ejection fraction (LVEF). Acoustic windows necessary to obtain the 2D-LVGLS were acquired with transthoracic echocardiography (TTE) before induction of anesthesia (LVGLSBI) and after with mechanical ventilation (LVGLSAI) using transesophageal echocardiography (TEE). LCOS was defined as the use of epinephrine, dobutamine, and/or milrinone at minimum IV doses of 1 μg/min-1, 2.5 μg/kg-1/min-1, and 0.375 μg/kg-1/min-1, respectively, for a minimum of 24 h after cardiopulmonary bypass.</p><p><strong>Results: </strong>A dedicated workstation (EchoPAC Software v203, GE) was used for offline calculation of LVGLS. LVGLSBI did not have a significant correlation with LCOS (mean difference, 1.66; 95% CI, --3.63 to 3.05; P = 0.862), nevertheless, it was an independent risk factor of in-hospital mortality (OR, 0.74; 95% CI, 0.57-0.95; P = 0.02), 3-month mortality (OR, 0.80; 95% CI, 0.64-0.99; P = 0.05), and delirium (OR, 0.65; 95% CI, 0.43-0.97; P = 0.03) in the multivariate analysis. LVGLSAI was also an independent risk factor for 3-month mortality (OR, 0.78; 95% CI, 0.62-0.99; P = 0.04).</p><p><strong>Conclusions: </strong>In CABG surgeries, LVGLS was a predictor of adverse outcomes in both awake and anesthetized patients with normal LVEF.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"25-32"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031603","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":"Anticipated Difficult Airway and Thoracic Surgery: A Conflictive Marriage.","authors":"Carolina García-Albares, Anna Ureña, Marc Giménez-Milà","doi":"10.4103/aca.aca_155_24","DOIUrl":"10.4103/aca.aca_155_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"89-90"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031818","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":"Continuous Positive Airway Pressure versus Differential Lung Ventilation during One Lung Ventilation for Thoracic Surgery.","authors":"Bhakti R Patil, Nagarjuna Panidapu, Praveen K Neema","doi":"10.4103/aca.aca_151_24","DOIUrl":"10.4103/aca.aca_151_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"95-96"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031887","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":"Comparison of Transesophageal Echocardiography Probe as Surface Probe with Vascular Probe During Right Internal Jugular Vein Catheterization in Cardiac Surgeries.","authors":"G Annushha Gayathri, Soundarya Kalligudd, Nagarjuna Panidapu, Praveen K Neema","doi":"10.4103/aca.aca_160_24","DOIUrl":"10.4103/aca.aca_160_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"98-99"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031884","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_139_24","DOIUrl":"10.4103/aca.aca_139_24","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to assess right ventricular function in patients undergoing mitral valve repair using trans-esophageal echocardiography, focusing on the predictive value of right ventricular longitudinal strain compared to other echocardiographic measures.</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>Toronto General Hospital.</p><p><strong>Participants: </strong>Thirty elective patients undergoing mitral valve repair.</p><p><strong>Interventions: </strong>Quantitative assessment of right ventricular function using transesophageal echocardiography images pre- and post-mitral valve repair, including right ventricular longitudinal strain, fractional area change, tricuspid annular plane systolic excursion, and systolic peak velocity (S').</p><p><strong>Measurements and main results: </strong>3 patterns of RV strain were identified with right ventricular longitudinal strain emerging as the most significant discriminator among right ventricular functional subgroups, with 43% of cases showing worsening, 20% showing no change, and 37% showing improvement. No correlation was found between right ventricular performance parameters and the need for vasopressors post-cardiopulmonary bypass. There was also no association between initial right ventricular longitudinal strain and difficulty in weaning off bypass or increased demand for pressors. Changes in tricuspid annular plane systolic excursion across all cases warrant further investigation with a larger cohort.</p><p><strong>Conclusions: </strong>Right ventricular longitudinal strain is a valuable tool for assessing right ventricular function post-mitral valve repair, offering insights into immediate postoperative outcomes and long-term right ventricular remodeling. Despite limitations like single-surgeon experience and institution-specific choice of pressors, our study provides useful insights into right ventricular function post-mitral repair surgery, paving the way for future research in larger patient populations.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"46-52"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031943","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":"Succinylcholine use in Patients 8 Years and Younger is NOT Zero While Midazolam use in Patients 65 Years and Older is NOT Decreasing Anymore: A 14-Year Census Report from a Tertiary Care Medical Center in the United States.","authors":"Deepak Gupta, Maria M Zestos","doi":"10.4103/aca.aca_112_24","DOIUrl":"10.4103/aca.aca_112_24","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"84-88"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942929","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":"Effectiveness of Three-dimensional Cardiac Computed Tomography Scan in Congenital Heart Surgery-An Impact on Diagnostic Performance and Surgical Management.","authors":"Alok Kumar, Monalisha Ganguly, B Dhanalakshmi, Ritwik Chakrabarti, Arvind Mishra, Nikhil Tiwari","doi":"10.4103/aca.aca_102_24","DOIUrl":"10.4103/aca.aca_102_24","url":null,"abstract":"<p><strong>Background: </strong>Recent advances in gated cardiac contrast-enhanced computed tomography (CECT) with anesthesia support, enhance the imaging performance in congenital heart disease (CHD). 3D reconstruction of the CECT image is a novel modality that could help manage pediatric cardiac patients.</p><p><strong>Methods: </strong>A retrospective study of children diagnosed with CHD presenting for surgical intervention (n = 139) was carried out at our cardiac surgical center. Primary diagnosis was established by transthoracic echocardiography. Analysis of all data and reports including echocardiography, cardiac CECT, operative notes, and medical documents were performed to determine the impact of cardiac 3D CECT concerning the following: supporting the primary diagnosis, providing relevant diagnostic information, prompting management changes, cardiac catheterization or interventions.</p><p><strong>Results: </strong>Forty-eight children underwent cardiac CECT scans and 3D reconstruction of the images over one year. The indications of 3D CECT included suspicion of extracardiac shunt, delineation of vascular anatomy, and intracardiac structure extent identification. With cardiac 3D CECT, every patient's primary diagnostic question was answered with ease. Moreover, the accuracy of the diagnosis gave increased confidence among surgeons in the procedures they performed. 3D Cardiac CECT brought a change in the surgical management in 35.4% of scans, there was percutaneous intervention in 12.55% and surgery was abandoned and changed to medical management in 48%.</p><p><strong>Conclusions: </strong>For children reported with complex CHD, it was evident that cardiac 3D CECT in selected patients was accurate, supported the primary diagnostic questions in almost all cases, and aided in optimization that further had an impact on surgical intervention and management.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"17-24"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942926","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":"Our Experience of Managing Central Airway Tumors: Anesthesia Perspectives.","authors":"Thushara Madathil, Devika Poduval, Tony Jose, Nagarjuna Panidapu, Don Jose, Tinku Joseph, Praveen Kumar Neema","doi":"10.4103/aca.aca_118_24","DOIUrl":"10.4103/aca.aca_118_24","url":null,"abstract":"<p><strong>Abstract: </strong>Adult patients with central airway tumors commonly present with dyspnea on exertion. These patients may remain asymptomatic until more than half of the airway diameter is obliterated. Anesthesia for debulking a central airway tumor is challenging. Anesthetic management should include a strategy for oxygenation and ventilation, a plan for the same if tumor bleeding aggravates airway obstruction and a plan to deal with acute emergencies like pneumothorax and cardiac arrest. Patients with airway tumors occupying < 50% airway diameter and comfortable during routine activities can be managed using relaxant anesthesia and rigid bronchoscopy for debulking. Airway tumors with >75% airway lumen compromise are the sickest and may present in respiratory failure. We found that in these patients, maintaining spontaneous ventilation, avoidance of general anesthesia, and muscle relaxation are the keys to management. General anesthesia and muscle relaxants decreases / abolishes negative intrapleural pressure, which may result in dynamic hyperinflation and pneumothorax in presence of airway obstruction. In this subset, we routinely use i-gel (sizes 4 and 5) as an airway conduit for debulking. We prefer i-gel® (Intersurgical Ltd, UK) over rigid bronchoscopy as it requires less sedation. To allow this, it is prudent to ensure excellent airway anesthesia prior to i-gel placement using airway blocks, topical anesthetics, and titrated doses of sedation. We manage 20-30 cases of central airway tumors for debulking or stenting every year and share our experience of managing four cases depicting a spectrum of airway and review the literature on anesthetic management of central airway tumors.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"28 1","pages":"3-9"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031567","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}