Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Vasoplegia After Restrictive Mitral Annuloplasty for Functional Mitral Regurgitation in Patients With Heart Failure.
Patients undergoing heart failure surgery are at risk for developing postoperative vasoplegia. The aim of this study was to determine the incidence, survival, and predictors of vasoplegia in heart failure patients undergoing mitral valve repair for functional mitral regurgitation and to evaluate the effect of ischemic versus non-ischemic etiology. ⋯ Vasoplegia occurs in 19% of heart failure patients undergoing mitral valve repair for functional mitral regurgitation. It is associated with a poor early outcome. Prior hypertension, a higher creatinine clearance, and beta-blocker use were associated with a decreased risk of vasoplegia, whereas anemia and longer procedure times were associated with an increased risk of vasoplegia, independent of heart failure etiology.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Observational StudyIntermittent Cross-Clamp Fibrillation Versus Cardioplegic Arrest During Coronary Surgery in 6,680 Patients: A Contemporary Review of an Historical Technique.
Myocardial management during on-pump coronary artery bypass grafting (CABG) surgery includes aortic cross-clamping followed by fibrillation (XCF) and aortic cross-clamping followed by diastolic cardioplegia (cardioplegia). The authors wished to compare in-hospital and survival outcomes between these procedures. ⋯ This is the largest analysis of XCF. XCF does not adversely affect in-hospital outcomes. Long-term results demonstrate cardioplegic arrest may convey a survival advantage that would preclude routine XCF in the modern era.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Multicenter Study Observational StudyGender Composition and Trends of Journal of Cardiothoracic and Vascular Anesthesia Editorial Board Membership: A 33-Year Analysis, 1987-2019.
Gender disparities in editorial board composition exist in the vast majority of specialties including anesthesiology. If a similar lack of gender parity exists in cardiothoracic anesthesiology is unknown. The authors examined the gender composition and trends of the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) editorial board from the initial year of its publication (1987) to 2019. The authors tested the hypothesis that the proportion of women serving on the JCVA editorial board has steadily increased over the journal's history, but women are underrepresented compared with the percentage of those currently practicing academic cardiothoracic anesthesia in the United States (US). ⋯ The results demonstrate that the proportion of women serving on the JCVA editorial board has steadily increased over the journal's history. Nevertheless, women continue to be underrepresented on the JCVA board compared with the percentage of US female academic cardiothoracic anesthesiologists, and gender gaps between first and last authorship and board composition also persist.
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J. Cardiothorac. Vasc. Anesth. · Dec 2019
Evaluation of Neuromuscular Blockade Reversal on Postoperative Mechanical Ventilation Time in a Cardiovascular Surgery Population.
To report on postoperative outcomes related to the administration of neostigmine for reversal of nondepolarizing neuromuscular blocking agents in cardiovascular surgery patients, with a specific focus on the duration of postoperative mechanical ventilation as the primary endpoint. ⋯ The use of neostigmine was found to have a protective effect on the duration of postoperative mechanical ventilation without increasing the risk of adverse complications.
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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.