Annals of Cardiac Anaesthesia最新文献

{"title":"Anesthetic Challenges in Interarterial Right Coronary Artery Anomaly from the Left Sinus of Valsalva: A Case Report.","authors":"Izabela S Coelho, Luiz F C Lopes, Marina A Delgado","doi":"10.4103/aca.aca_323_25","DOIUrl":"10.4103/aca.aca_323_25","url":null,"abstract":"<p><strong>Abstract: </strong>Coronary artery anomalies are rare but clinically significant malformations, particularly when involving an interarterial course, which predisposes to ischemia and sudden cardiac death. We report the case of a previously healthy 22-year-old man who suffered out-of-hospital cardiac arrest associated with recreational inhalant use. Imaging revealed an anomalous right coronary artery originating from the left sinus of Valsalva with interarterial trajectory. Surgical reimplantation was performed under tailored anesthetic management emphasizing hemodynamic stability. The patient recovered uneventfully. This case discusses and highlights anesthetic priorities and the potential role of external triggers in vulnerable coronary anatomy.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"605-609"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comments on Comparison of Analgesic Efficacy of Intrathecal Morphine and Ultrasound - Guided Bilateral Erector Spinae Plane Block in Patients Undergoing Open Heart Surgery with Midline Sternotomy: An Open Label Randomized Control Trial.","authors":"Visalatchi Karuppiah, Rakesh Kumar, Sadik Mohammed, Anita Chouan, Swati Chhabra, Manoj Kamal, Alok Sharma","doi":"10.4103/aca.aca_182_26","DOIUrl":"10.4103/aca.aca_182_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"661-662"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to \"Intravenous Levosimendan versus Milrinone: Coronary Sinus Lactate and PA Catheter Derived Parameters in Patients with Pulmonary Hypertension Undergoing Elective Mitral Valve Replacement\".","authors":"Ankita Singh, Mohit Prakash, Suruchi Hasija, Neeti Makhija","doi":"10.4103/aca.aca_4_26","DOIUrl":"10.4103/aca.aca_4_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"663-664"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Characterization of a Circular Shunt After Arterial Switch in a Neonate to Guide Management Strategy.","authors":"Mohan Madan Maddali, Salim Nasser Al Maskari, Abdullah Mohammed Al Farqani, Sarah Abdelsalam Elmetwally, Maziar Gholampour Dehaki, Hamood Nasar Al-Kindi","doi":"10.4103/aca.aca_29_26","DOIUrl":"10.4103/aca.aca_29_26","url":null,"abstract":"<p><strong>Abstract: </strong>A circular shunt is a complex and often critical condition in neonates after cardiac surgery. We report a case of a newborn with refractory hypoxemia and a circular shunt following an arterial switch operation. Cardiac catheterization provided a precise hemodynamic characterization and guided intervention. A trial balloon occlusion confirmed that closure would resolve the shunt, leading to successful device deployment and resolution of the patient's condition. Hemodynamic changes due to inadvertent partial pressure of arterial carbon dioxide (PaCO2) accumulation suggest that, in addition to focusing on inspired oxygen concentrations during shunt calculations, one needs to pay heed to PaCO2 levels as well. This case highlights the indispensable role of catheterization for detailed hemodynamic assessment and guiding interventional strategies when non-invasive imaging is insufficient.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"650-656"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metaflammation and Cardiovascular-Kidney-Metabolic Syndrome: A Unifying Framework for the Cardiac Anesthesiologists.","authors":"Rohan Magoon, Jes Jose, Bhargava V Devarakonda","doi":"10.4103/aca.aca_67_26","DOIUrl":"10.4103/aca.aca_67_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"393-396"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434848","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 Ventilatory Collapse from Negative Pleural Suction in a Ruptured Pulmonary Hydatid Cyst.","authors":"Sharek Abdul Nazir, Subrata Kumar Singha, Ananya Rao","doi":"10.4103/aca.aca_331_25","DOIUrl":"10.4103/aca.aca_331_25","url":null,"abstract":"<p><strong>Abstract: </strong>A 52-year-old male with a ruptured right hydatid cyst underwent thoracotomy and cyst excision. After repair of diffuse parenchymal air leaks, application of negative pleural suction caused sudden ventilatory collapse with refractory hypotension, unresponsive to tube exchange or vasopressors. Lung-protective ventilation failed until clamping the drain immediately restored tidal volumes, confirming suction-mediated negative-pressure failure. Ultrasound showed good re-expansion without pneumothorax; subsequent pink frothy secretions suggested re-expansion/negative-pressure pulmonary oedema. Switching to a water-seal drain, optimizing ventilation, and diuretics led to rapid recovery. Negative pleural suction can be hazardous after parenchymal leak repair.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"438-441"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434876","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 on Peripheral Nerve Blocks for Enhanced Recovery in Cardiac Surgery: A Retrospective Observational Study.","authors":"Sohaib Raza, Muhammad S Arshad, Muhammad Hamas Kashif, Muhammad Rehman Gul, Muhammad Adnan","doi":"10.4103/aca.aca_310_25","DOIUrl":"10.4103/aca.aca_310_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"445-446"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434591","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":"Incidence and Associated Factors of ST-Segment Changes in Noncardiac Surgery Under General Anesthesia.","authors":"Mehryar Taghavi Gilani, Nabiolah Mafi, Leila Mashhadi, Samaneh S Asadi Kakhki","doi":"10.4103/aca.aca_243_25","DOIUrl":"10.4103/aca.aca_243_25","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative cardiac complications may result from an imbalance between myocardial oxygen supply and demand or from plaque rupture. Electrocardiographic (ECG) alterations in the ST-segment observed during surgery or anesthesia can serve as indicators of myocardial ischemia. Numerous factors influence ST-segment variability. This study aimed to investigate the incidence of ST-segment changes and the factors associated with their occurrence.</p><p><strong>Methods: </strong>This prospective observational study enrolled adult patients (aged ≥ 20 years) undergoing noncardiac surgery under general anesthesia. Intraoperative ST-segment monitoring was performed using a five-electrode system. Predisposing factors for ischemia, including hemodynamic parameters, coexisting diseases, and surgical characteristics, were evaluated. A P -value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 102 patients were evaluated, with a mean age of 46.75 ± 16.30 years, comprising 46 males (45.1%). Postinduction ST-segment depression was greater than preinduction (-0.030 to - 0.055 vs. 0.010 to 0.060, respectively) ( P = 0.0 01). ST-segment values were significantly more depressed in patients with underlying conditions, particularly hypertension and diabetes mellitus ( P = 0.001). Also, the variations in ST-segment alteration were considerable among minor and major surgeries ( P = 0.041). Overall, 20 patients (19.6%) exhibited prominent ST-segment changes (greater than 0.1 mV) during surgery; however, the changes were predominantly transient and managed successfully with initial clinical interventions (e.g., fluid administration). While postinduction blood pressure showed a significant drop, no statistical association was observed between the magnitude of blood pressure changes and the occurrence of ST-segment changes ( P = 0.10). No significant relationship was identified between ST-segment changes and other evaluated factors.</p><p><strong>Conclusion: </strong>The intraoperative ST-segment changes occurred following anesthetic induction and are significantly correlated with predisposing factors, specifically hypertension, diabetes mellitus, and major vs. minor surgeries. Despite significant hemodynamic alterations during the procedure, a direct correlation with prominent ST-segment changes could not be statistically established. Given the transient nature of most alterations, further studies incorporating postoperative troponin measurement and long-term follow-up are warranted to clarify the clinical significance of these intraoperative findings.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":" ","pages":"352-358"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760337","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 Observation of Mitral Lateral Tissue Doppler Biphasic E' Waveform Due to Increased Left Ventricular Anterolateral Wall Myocardial Strain.","authors":"V Krishna Narayanan Nayanar, Ms Saravana Babu, Nithin Krishna Vikraman, Nandhu Subramonian","doi":"10.4103/aca.aca_303_25","DOIUrl":"10.4103/aca.aca_303_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"451-452"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434899","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":"Another Marker of Inflammation and Oxidative Stress and Its Impact on Myocardial Function, Arterial Elastance, and Vasoactive-Inotropic Score After Coronary Revascularization Surgery: A Prospective Cohort Study.","authors":"Teuku A Husain, Johanes N E Putranto, Philia Setiawan, Nancy M Rehatta, Fajar Perdhana, Yos Kowara","doi":"10.4103/aca.aca_34_26","DOIUrl":"10.4103/aca.aca_34_26","url":null,"abstract":"<p><strong>Context: </strong>Inflammatory and oxidative stress responses are markedly amplified following cardiopulmonary bypass (CPB), contributing to myocardial injury, vascular dysregulation, and potential multiorgan dysfunction.</p><p><strong>Aims: </strong>This study aimed to define how inflammatory, oxidative, and cellular stress responses quantified by tumor necrosis factor-alpha (TNF-α), hydroxyl (OH-) radical scavenging capacity, and heat shock protein-70 (HSP-70) relate to early postoperative myocardial contractility, arterial tone, and vasoactive-inotropic requirements after CPB.</p><p><strong>Settings and design: </strong>A prospective cohort study was conducted in patients undergoing coronary artery bypass grafting (CABG) with preserved preoperative ejection fraction (EF).</p><p><strong>Methods and materials: </strong>Postoperative biomarker levels and perioperative changes in TNF-α, OH- scavenging capacity, and HSP-70 with early myocardial contractility maximum rate of rise of left ventricular pressure (dP/dtmax), arterial elastance, and vasoactive-inotropic score were assessed.</p><p><strong>Statistical analysis used: </strong>Correlation analyses were performed using Pearson's or Spearman's correlation coefficients as appropriate.</p><p><strong>Results: </strong>A total of 52 patients were included in the study. Higher postoperative HSP-70 levels were associated with reduced early myocardial contractility (r = -0.315; P = 0.025) and increased vasoactive-inotropic requirements (ρ =0.341; P = 0.014). No significant associations were observed among postoperative biomarker variables, and changes in TNF-α or OH- scavenging capacity were not related to early postoperative hemodynamic outcomes (all P > 0.05).</p><p><strong>Conclusions: </strong>Early post-CPB myocardial dysfunction appears more closely associated with cellular stress (HSP-70) than with inflammatory or oxidative responses. Elevated HSP-70 levels in the early postoperative CABG may act as damage-associated molecular patterns associated with transient myocardial depression and higher vasoactive-inotropic requirements, whereas early inflammatory and oxidative changes showed no direct hemodynamic correlation.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"359-366"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434894","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}