Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · May 2019
ReviewUse of 3-Dimensional Printing to Create Patient-Specific Abdominal Aortic Aneurysm Models for Preoperative Planning.
Fenestrated endovascular aortic repair (FEVAR) stent grafting is a minimally invasive procedure and an alternative to open surgical repair for abdominal aortic aneurysm repair, particularly with unideal neck anatomy. Planning and implementing a custom FEVAR graft is complicated, requiring advanced training and years of practice. ⋯ The model can be used to help physicians create custom FEVAR grafts, thus eliminating the currently used difficult and technical method for creating custom grafts. It also can assist physicians in visualizing and practicing their surgical approach for a specific patient.
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J. Cardiothorac. Vasc. Anesth. · May 2019
Comparative StudyOff-Pump Versus On-Pump: Long-Term Outcomes After Coronary Artery Bypass in a Veteran Population.
The authors sought to investigate long-term outcomes after revascularization with and without use of cardiopulmonary bypass and hypothesized that off-pump would be comparable with on-pump. The primary outcome of interest was survival, and secondary outcomes were need for reintervention for revascularization or new diagnosis of myocardial infarction occurring any time after surgery during the 8- to 12-year follow-up period. ⋯ The present study's data did not show differences in key long-term outcomes between patients who underwent revascularization with or without cardiopulmonary bypass, supporting the idea that both methods achieve similar late results regarding overall survival, need for reintervention, and postoperative myocardial infarction.
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J. Cardiothorac. Vasc. Anesth. · May 2019
Impact of Sex on the Outcome of Isolated Aortic Valve Replacement and the Role of Different Preoperative Profiles.
The aim of this study was to compare the patient profiles and outcomes of men and women undergoing isolated aortic valve replacement. ⋯ Although women undergoing aortic valve replacement have relatively more risk factors than do men, early mortality in women is not significantly higher than in men. Overall survival is worse in women than in men; however, after adjustment for preoperative risk factors, there is no difference in overall survival between women and men.
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J. Cardiothorac. Vasc. Anesth. · May 2019
A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Reducing Mortality.
The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians' opinions and routine practices to understand the clinicians' response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. ⋯ The concordance between agreement and use (a positive answer both to "do you agree" and "do you use") showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location.