Annals of Cardiac Anaesthesia最新文献

{"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":"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":"In Response to 'Intraoperative Atrial Fibrillation: An Anesthetic Challenge - A Safe Outcome Saves the Day'.","authors":"Praveen Kumar Neema, Nagarjuna Panidapu","doi":"10.4103/aca.aca_319_25","DOIUrl":"10.4103/aca.aca_319_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"449-450"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434721","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}

{"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":"Revascularization and Risk Prediction in CAD Patients Undergoing Carotid Endarterectomy: Interpreting Associations with Caution.","authors":"Bhargava V Devarakonda, Sri Sumanth Pelluru, K Vishnu","doi":"10.4103/aca.aca_341_25","DOIUrl":"10.4103/aca.aca_341_25","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"456-457"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434819","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":"Rare Right Lung Tumor with Intracardiac Extension: A Case of Successful Multidisciplinary Management.","authors":"Lava K Penumaka, Chitra Rajeswari Thangaswamy, Hemachandren Munuswamy, Sindhu Kashetty","doi":"10.4103/aca.aca_197_25","DOIUrl":"10.4103/aca.aca_197_25","url":null,"abstract":"<p><strong>Abstract: </strong>We present a challenging case of a high-grade spindle cell sarcoma originating in the right lung with intracardiac extension to the left atrium and left ventricle via the pulmonary veins, complicated by aorto-iliac thromboembolism. An 18-year-old male presented with sudden-onset bilateral lower limb weakness, low-grade fever, cough, and breathlessness. Computed tomography imaging revealed a large mediastinal mass with intracardiac extension and an infrarenal aortic thrombus. A multidisciplinary team performed a successful single-stage procedure involving excision of the intracardiac tumor via median sternotomy under cardiopulmonary bypass, right pneumonectomy under total circulatory arrest, and bilateral transfemoral embolectomy. Histopathology confirmed a high-grade spindle cell sarcoma with negative surgical margins. This case highlights the importance of a collaborative team approach, vigilant intraoperative monitoring, and the strategic use of circulatory arrest in managing complex thoracic tumors with intravascular extension.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"408-412"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434869","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":"Albumin in Cardiac Surgery-Associated Acute Kidney Injury: Therapeutic Target or Epiphenomenon?","authors":"Mukul C Kapoor","doi":"10.4103/aca.aca_164_26","DOIUrl":"10.4103/aca.aca_164_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"311-313"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434885","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":"Harbinger of Difficult Weaning from Cardiopulmonary Bypass in Aortic Valve Replacement Surgery: A Case Report.","authors":"Allan Deepak, Balaji Kuppuswamy, Kirubakaran Davis, Shalom S Andugala","doi":"10.4103/aca.aca_290_25","DOIUrl":"10.4103/aca.aca_290_25","url":null,"abstract":"<p><strong>Abstract: </strong>Failure to wean from cardiopulmonary bypass (CPB) is a rare but critical intraoperative challenge. Common causes include residual structural defects (causing intracardiac shunting, prosthetic valve leaks), left ventricle outflow tract obstruction, ventricular dysfunction, or vasoplegic syndrome. We present the case of a 56-year-old man with severe aortic stenosis who underwent surgical aortic valve replacement. Separation from CPB failed repeatedly due to acute right ventricular dysfunction detected on transesophageal echo. The patient was found to have a congenital anomalous high origin of the right coronary artery (RCA), likely compromised during surgery. Timely recognition and surgical revascularization of the RCA with a saphenous vein graft restored right ventricular function and facilitated successful weaning. This case highlights the importance of intraoperative echocardiography, awareness of anomalous coronary anatomy, and prompt multidisciplinary decision-making in managing difficult separation from CPB.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"430-433"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434702","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 Obstruction of Centrifugal Pump, in Patient on Extracorporeal Circulatory Support.","authors":"Johannes Bladt Andersen, Henrik Frederiksen Højgaard, Claus Andersen","doi":"10.4103/aca.aca_259_25","DOIUrl":"10.4103/aca.aca_259_25","url":null,"abstract":"<p><strong>Abstract: </strong>This case report tells the story of a 36-year-old overweight male with suspected myocarditis, who goes into cardiac arrest, and is subsequently transported to a heart center for extracorporeal membrane oxygenation. Mechanical support was established and running until distal limb perfusion was attempted. It is suspected that an aspired guidewire of a central venous catheter placed with the Seldinger technique was aspired and eventually obstructed the impeller of the centrifugal pump.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 3","pages":"421-423"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434744","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}