Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
ReviewAnesthetic Techniques in Transcatheter Aortic Valve Replacement and the Evolving Role of the Anesthesiologist.
The development of transcatheter aortic valve replacement (TAVR) has transformed the treatment of patients with aortic valve disease. This procedure now is used widely for patients at high and intermediate risk for surgical aortic valve replacement. The rapid acceptance and popularity of TAVR most clearly was enabled by advancements in device technology and procedural experience. ⋯ Anesthesiologists have witnessed this movement first hand, and while improved anesthetic techniques have contributed to the success of the procedure, in return these improved outcomes likely will result in further changes to perioperative anesthetic management. In this review the authors sought to evaluate the role and responsibility of the cardiac anesthesiologist in the development of TAVR. Future advancements in device technology and considerations of how the anesthetic technique for TAVR may continue to evolve in future years are discussed.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Preincision Initiation of Dexmedetomidine Maximally Reduces the Risk of Junctional Ectopic Tachycardia in Children Undergoing Ventricular Septal Defect Repairs.
To evaluate whether initiation of dexmedetomidine (DEX) infusion before surgical incision and cardiopulmonary bypass (CPB) versus initiation after CPB had an impact on the incidence of junctional ectopic tachycardia (JET). ⋯ Preincision initiation of DEX and its continued use during the immediate postoperative period are significantly associated with reduced risk of JET after congenital heart surgeries involving repair of ventricular septal defect.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Observational StudyIndependent Predictors of the Duration and Overall Burden of Postoperative Delirium After Cardiac Surgery in Adults: An Observational Cohort Study.
Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. ⋯ Known risk factors for the development of POD after cardiac surgery also are predictive of prolonged duration and high overall burden of POD.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
ReviewImpact of the Zika Virus for Anesthesiologists: A Review of Current Literature and Practices.
Zika virus disease is of growing concern to all clinicians. There is a growing concern with regards to the neurologic sequela of the virus, particularly for infants born to women infected while pregnant. ⋯ This article addresses some of the key issues that pertain to anesthesiologists with regards to the Zika virus including the risks of perioperative management of patients with Zika virus. A discussion of the risks of transfusion and current blood management practices also is included in this review.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Randomized Controlled TrialSevoflurane Relieves Lung Function Deterioration After Cardiopulmonary Bypass.
To investigate sevoflurane's potential to alleviate the detrimental pulmonary changes after cardiopulmonary bypass (CPB). ⋯ Sevoflurane can alleviate CPB-induced bronchoconstriction, compromised lung tissue mechanics, and enhanced intrapulmonary shunt. This benefit has particular importance in patients with severe CPB-induced lung function deterioration.