Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Review Meta AnalysisEffects of Adding Statins Before Surgery on Mortality and Major Morbidity: A Meta-analysis.
To re-evaluate the effects of adding a statin before surgery on mortality at 30 days and at 1 year and on major morbidity at 0-30 days. ⋯ Adding a statin before a high risk cardiac procedure reduces the 0-30 days' risk of myocardial infarction.
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
ReviewIncidental Moderate Mitral Regurgitation in Patients Undergoing Aortic Valve Replacement for Aortic Stenosis: Review of Guidelines and Current Evidence.
Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Randomized Controlled TrialIndividualized Heparin and Protamine Management Improves Rotational Thromboelastometric Parameters and Postoperative Hemostasis in Valve Surgery.
This study investigated whether a tailored approach to heparin and protamine management improved thromboelastometric parameters after cardiopulmonary bypass and reduced postoperative blood loss compared with activated coagulation time (ACT)-based fixed target heparin and protamine management. ⋯ Individualized heparin and protamine management decreased the protamine-to-heparin ratio, improved postbypass thromboelastometric hemostatic parameters, and reduced the incidence of severe blood loss compared with an ACT-based strategy, supporting the added value of this approach for hemostatic optimization during cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Randomized Controlled Trial Comparative StudyHypothermic Versus Normothermic Cardiopulmonary Bypass in Patients With Valvular Heart Disease.
The aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease. ⋯ Normothermic CPB in patients with valvular heart disease was as effective as hypothermic perfusion in terms of myocardial protection after the surgery assessed by cTnI release. The short ventilation duration in patients who underwent hypothermic CPB needs to be confirmed in a future investigation.