Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Invasive Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus: Cardiac Anesthesia in Liver Transplant Settings.
Resection of renal cell carcinomas (RCC) with tumor thrombus invasion into the inferior vena cava (IVC) is associated with significant perioperative morbidity and mortality. This study examined the intra- and inter-departmental collaboration among cardiac, liver transplantation, and urologic surgeons and anesthesiologists in caring for these patients. ⋯ Utilization of specialized liver transplantation and cardiac surgical techniques in the resection of RCC with extension into the IVC calls for a close intra-and interdepartmental collaboration between surgeons and anesthesiologists. The transabdominal approach to suprahepatic segments of the IVC allowed avoidance of extracorporeal circulatory support in most of these patients. Perioperative management of these patients reflected the critical importance of TEE-proficient practitioners experienced in liver transplantation and cardiac anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Observational StudyPlasma Vasopressin Levels in Patients with Right-Sided Heart Dysfunction and Chronic Thromboembolic Pulmonary Hypertension (CTEPH).
Patients with left-sided heart dysfunction and volume overload often have associated elevations in vasopressin from neuroendocrine activation. The authors investigated perioperative levels of vasopressin in patients with isolated right-sided heart dysfunction from chronic thromboembolic pulmonary hypertension. ⋯ Vasopressin levels in PTE patients are in the low-to-normal range at baseline and may be a clinically relevant issue in the hemodynamic management of PTE.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Observational StudyExtubation in the Operating Room After Cardiac Surgery in Children: A Prospective Observational Study With Multidisciplinary Coordinated Approach.
This prospective observational study was undertaken to determine the feasibility of extubation of children in the operating room after cardiac surgery. ⋯ Extubation in the operating room was successful in 87.1% of the patients without any increase in mortality and morbidity, but with a decrease in ICU length of stay and less use of hospital resources.