Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Apr 2018
Multicenter StudyHospital Outcome and Risk Indices of Mortality after redo-mitral valve surgery in Potential Candidates for Transcatheter Procedures: Results From a European Registry.
Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. ⋯ High EuroSCORE II and STS scores, advanced age at surgery, LVEF <30%, previous CABG, severe pulmonary hypertension or preoperative dialysis might represent in the future preferred indications for TM-VIVoR in the redo-mitral surgery scenario.
-
J. Cardiothorac. Vasc. Anesth. · Apr 2018
ReviewNoninvasive Ventilation During Endoscopic Procedures: Rationale, Clinical Use, and Devices.
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself. ⋯ Ventilatory support has been delivered during prolonged transesophageal cardiac examinations and interventions, broncoscopic maneuvers, and in difficult airway scenarios. Furthermore, the availability of innovative dedicated devices has allowed for some interventional procedures that require endoscopy to be peformed with the patient under sedation and on ventilatory support with noninvasive ventilation instead of general anesthesia. These approaches might be further expanded in the future and possibly reduce costs, organizational requirements, and complications compared using standard management with general anesthesia.