Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
Modified Tricuspid Annular Plane Systolic Excursion Using Transesophageal Echocardiography and Its Utility to Predict Postoperative Course in Heart Transplantation and Left Ventricular Assist Device Implantation.
Perioperative right ventricular (RV) function is important for determining the postoperative course in heart transplantation (HT) and left ventricular assist device (LVAD) implantation. The authors describe a modified tricuspid annular plane systolic excursion (m-TAPSE) using transesophageal echocardiography and assessed its clinical utility in HT and LVAD. ⋯ m-TAPSE validated a good correlation to RV systolic function as reflected by RV FAC for both HT and LVAD. For HT, m-TAPSE was helpful for predicting postoperative NO use; whereas for LVAD, m-TAPSE was helpful for predicting postoperative NO use and RV assist device implantation. m-TAPSE should be considered as a useful parameter to decide postoperative management for these cases.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
Observational StudyBleeding Complications Associated With Percutaneous Tracheostomy Insertion in Patients Supported With Venovenous Extracorporeal Membrane Oxygen Support: A 10-Year Institutional Experience.
To evaluate the bleeding complications associated with percutaneous tracheostomy while a patient is receiving venovenous extracorporeal membrane oxygen (VV ECMO) support. ⋯ Bleeding is associated with percutaneous tracheostomy and is self-limiting in the majority of patients.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
ReviewAdvances in Left Ventricular Assist Devices and Mechanical Circulatory Support.
Recent technologic advances have resulted in the availability of percutaneous and minimally invasive surgical devices for temporary mechanical circulatory support. These may be deployed rapidly without the requirement for sternotomy or cardiopulmonary bypass. In addition, third generation implantable left ventricular assist devices have been compared with second generation devices in 2 recent randomized controlled trials. The aim of this article is to provide a current review of the recent literature relating to left ventricular assist devices and mechanical circulatory support.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
ReviewUltra-Short-Acting β-Blockers (Esmolol and Landiolol) in the Perioperative Period and in Critically Ill Patients.
β-Blockers are useful drugs in several clinical cardiologic scenarios. Their use in the perioperative period and in critically ill patients is increasing, but their effect on clinically relevant outcomes remains controversial. ⋯ The authors describe the possible clinical uses of ultra-short-acting β-blockers (esmolol and landiolol) in the perioperative period and in critically ill patients because these drugs have the beneficial effects of β-blockers, but do not have the detrimental effects of long-acting agents. This narrative review focuses on ultra-short-acting β-blockers in the following clinical settings: prevention and treatment of arrhythmias and myocardial ischemia in noncardiac and cardiac surgery, usage as cardioplegia adjuvants or to test the reversibility of systolic anterior motion of the mitral valve in cardiac surgery, medical treatment of aortic dissection before surgery, improvement of microcirculation and oxygenation in critically ill patients experiencing sepsis or undergoing extracorporeal membrane oxygenation, anesthesia induction, and coronary computed tomography angiography.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
ReviewPerioperative Information Systems: Opportunities to Improve Delivery of Care and Clinical Outcomes in Cardiac and Vascular Surgery.
A variety of existing perioperative informatics tools offer clinicians and researchers the opportunity to improve the delivery of care and clinical outcomes for patients undergoing cardiac and vascular surgery. Many of these tools can be used to improve the reliability of the care delivery process through the application of clinical decision support tools and/or quality improvement methodologies at a number of junctures. In this review, the authors will offer a concise overview of the existing perioperative informatics literature, with a focus on tools considered to be of utility in confronting the unique challenges inherent to cardiac and vascular surgery. The authors also highlight areas that they believe are of interest for future targeted inquiry.