Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Observational StudyPerioperative Changes of Right Ventricular Function in Cardiac Surgical Patients Assessed by Myocardial Deformation Analysis and 3-Dimensional Echocardiography.
To test the hypothesis that longitudinal strain of the right ventricle (RV) is significantly reduced in patients undergoing cardiac surgery with extracorporeal circulation and cardioplegic cardiac arrest at the end of surgery, whereas RV ejection fraction remains unchanged. ⋯ In patients undergoing coronary artery bypass grafting with cardioplegic cardiac arrest, the longitudinal contraction of the RV lateral and inferior wall, the RV outflow tract, and the interventricular septum is impaired at the end of surgery. This impairment is compensated by an increase in circumferential contraction without changes in RV ejection fraction.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Insurance Status and Socioeconomic Markers Affect Readmission Rates After Cardiac Valve Surgery.
To characterize the effect of insurance status and other socioeconomic markers on readmission rates after cardiac valve surgery. ⋯ Markers of low socioeconomic status, including insurance status, race, and household income, are associated with an increased odds of readmission after cardiac valve surgery. Such findings may point to inequalities in health care; additional investigation is necessary to understand the causal link.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Case ReportsPulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications.
Pulmonary hypertension (PH) results from varied etiologies, leading to progressive symptoms and limiting physical activity and quality of life, with associated morbidity and mortality. External compression of the pulmonary artery (PA) is a rare cause of PH and may give the clinician cause to investigate compression of nearby structures. In this E-Challenge, the authors present a case of PA stenosis in a patient with prior histoplasmosis scheduled for left PA stenting. ⋯ TEE revealed external compression of the pulmonary veins. This case highlights the value of pathophysiologic understanding, preoperative planning, and the effect of echocardiography on clinical management and patient safety. In this case, TEE prevented possible morbidity and mortality.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Observational StudyThe Effect of Sedation on Long-Term Psychological Impairment After Extracorporeal Life Support.
This retrospective study aimed to identify the association between long-term psychological impairment and total sedation received during venovenous extracorporeal life support (VV-ECLS) for acute respiratory failure (ARF). ⋯ This retrospective analysis identified a significant association between the presence of long-term post-VV-ECLS psychiatric symptoms and the total number of days of intravenous sedation.