Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Review Comparative StudyManagement of Arterial Hypertension: 2018 ACC/AHA Versus ESC Guidelines and Perioperative Implications.
Hypertension is the most prevalent cardiovascular risk factor worldwide and the leading cause of death and premature morbidity. Despite its prevalence, evaluation and management are nonuniform despite multiple society guidelines worldwide. ⋯ In addition, several expert-based recommendations are provided in these documents, a situation that can lead to confusion. The scope of this manuscript is to briefly compare the recent updated guidelines for the management of arterial hypertension from the American College of Cardiology/American Heart Association and the European Society of Cardiology/European Society of Hypertension and their relevant differences, which are important to the practicing clinician.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Review Historical ArticleFifteen Years of Transesophageal Echocardiography in Cardiac Anesthesia in Russia.
Transesophageal echocardiography was first introduced in Russia as a component of anesthesiology monitoring in 2003 following its successful implementation in the practice of cardiac anesthesia in the United States and Western Europe. This novel opportunity for perioperative hemodynamic evaluation was enthusiastically adopted at several cardiac surgical clinics despite the presence of critical barriers. ⋯ Both the technical conditions and professional mentality of anesthesiologists need to be changed substantially for successful further development of intraoperative echocardiography. This review aims to highlight the milestones, successes, and challenges in the implementation of intraoperative echocardiography in the practice of cardiac anesthesiology in Russia, which may be interesting to a wide range of cardiac anesthesiologists.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Observational StudyPostoperative Cardiac Troponin I Thresholds Associated With 1-Year Cardiac Mortality After Adult Cardiac Surgery: An Attempt to Link Risk Stratification With Management Stratification in an Observational Study.
Cardiac troponin (cTn) concentrations are measured routinely in some centers after cardiac surgery as part of risk stratification, but there are no data on how increased cTn concentrations could change patients' management. The aim of this study was to estimate relevant cTnI thresholds and identify potential interventions (additional monitoring/therapeutic interventions) that could be part of management changes of patients with cTnI greater than relevant thresholds. ⋯ In an attempt to evolve from risk to management stratification, this study's results identified a subgroup of patients with mild cardiac dysfunction and a cTnI concentration greater than the threshold who could be the target for interventions in future validation studies concerning changes in patient management.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Perioperative Factors Associated With Changes in Troponin T During Coronary Artery Bypass Grafting.
Investigate important clinical and operative variables associated with increases in cardiac troponin T (cTnT) as indicators of myocardial injury after coronary artery bypass grafting (CABG). ⋯ Left ventricular ejection fraction, New York Heart Association classification, kidney function, inflammation status, duration of cardiopulmonary bypass, body surface area, and preoperative MI were associated with the cTnT rise-and-fall pattern related to myocardial injury after CABG. Information regarding these variables may be valuable when using cTnT in the diagnostic workup of postoperative MI.