Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2020
Review Meta AnalysisGeneral Anesthesia Versus Local Anesthesia in Carotid Endarterectomy: A Systematic Review and Meta-Analysis.
The choice of anesthetic technique in carotid endarterectomy (CEA) has been controversial. This study compared the outcomes of general anesthesia (GA) and local anesthesia (LA) in CEA. ⋯ The results from this study showed no inferiority of using LA to GA in patients undergoing CEA. Future investigations should be reported more systematically, preferably with randomization or propensity-matched analysis, and thus registries will facilitate investigation of this subject. Anesthetic choice in CEA should be individualized and encouraged where applicable.
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J. Cardiothorac. Vasc. Anesth. · Jan 2020
ReviewStrategies for Left Ventricular Decompression During Venoarterial Extracorporeal Membrane Oxygenation - A Narrative Review.
Extracorporeal cardiopulmonary resuscitation involves the application of venoarterial extracorporeal membrane oxygenation for patients in cardiac arrest who have received good quality conventional cardiopulmonary resuscitation, and who are deemed to have a reversible cause and no contraindications. Systemic perfusion is maintained by the extracorporeal life support, allowing time for the underlying cause to be treated and the heart to recover. Specific considerations to promote cardiac recovery are discussed, including the maintenance of sinus rhythm, promotion of cardiac ejection, management of pulmonary hypertension, management of intravascular volume, and prevention of ventricular distention. Advanced strategies for ventricular decompression including atrial septostomy and percutaneous ventricular assist devices are discussed.
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J. Cardiothorac. Vasc. Anesth. · Jan 2020
Observational StudyRadiological Incidence of Unilateral Pulmonary Edema After Minimally Invasive Cardiac Surgery.
The authors aimed to define the incidence of unilateral pulmonary edema (UPE) within the first 24 hours after minimally invasive cardiac surgery without one lung ventilation techniques based on assessment of chest x-rays. ⋯ This study showed an incidence of 1.6% of radiologic evident UPE after minimally invasive cardiac surgery. Future prospective studies are needed to validate the effect of the independent risk factors.