Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Observational StudyPotential Role of Transfontanelle Ultrasound for Infants Undergoing Modified Blalock-Taussig Shunt.
Transfontanelle ultrasound is a noninvasive method for assessing cerebral blood flow in neonates and infants. The authors applied this technique as a point-of-care tool, before and after modified Blalock-Taussig shunt procedure, to evaluate cerebral perfusion. ⋯ Transfontanelle ultrasound is a feasible tool for assessing the pattern of shunt flow and cerebral perfusion before and after the modified Blalock-Taussig shunt procedure. The transfontanelle ultrasound examinations may have potential role in assessing "over-shunting," but it needs more studies.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Pediatric Patients with High Pulmonary Arterial Pressure in Congenital Heart Disease Have Increased Tracheal Diameters Measured by Computed Tomography.
Determination of the appropriate tracheal tube size using formulas based on age or height often is inaccurate in pediatric patients with congenital heart disease (CHD), particularly in those with high pulmonary arterial pressure (PAP). Here, the authors compared tracheal diameters between pediatric patients with CHD with high PAP and low PAP. ⋯ Pediatric patients with high PAP had larger tracheal diameters than those with low PAP and required larger tracheal tubes compared with the size predicted using formulas based on age or height.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Carotid Artery Disease as a Predictor of In-Hospital Postoperative Stroke After Coronary Artery Bypass Grafting From 1999 to 2011.
In this study, the risk factors for stroke after coronary artery bypass grafting (CABG) were examined. In particular, the role of asymptomatic carotid artery stenosis (both unilateral and bilateral) as a predictor of in-hospital postoperative stroke was investigated. Finally, the trends surrounding in-hospital postoperative stroke from 1999 to 2011 also were examined. The purpose of the study was to appropriately identify patients at high risk for stroke after CABG and spark discussion about the perioperative management of such patients. ⋯ This study examined risk factors for stroke after CABG in a large, longitudinal, and population-based database. The study found that both unilateral and bilateral asymptomatic carotid stenoses are indeed risk factors for in-hospital postoperative stroke. In addition, a number of other predictors were identified. These results can be used to identify patients at high risk for perioperative stroke and hopefully decrease the rate of a devastating complication of CABG.