Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Review Meta AnalysisLocal Versus General Anesthesia in Nonemergency Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis.
The purpose of this systematic review was to assess the perioperative clinical outcomes in using local/regional anesthesia (LA/RA) or general anesthesia (GA) in patients undergoing endovascular abdominal aortic aneurysm repair. A comprehensive electronic literature search was undertaken from inception to September 2018, identifying all randomized and nonrandomized studies comparing LA/RA versus GA in patients with abdominal aortic aneurysm who underwent endovascular repair. A total of 12,024 patients (n = 1,664 LA/RA, n = 10,360 GA) were analyzed from 12 observational studies included in this analysis. ⋯ Thirty-day morality was not different between the 2 cohorts (2% v 1.7%; p = 0.97). Use of LA/RA in selective endovascular abdominal aortic aneurysm repair procedures provides satisfactory and comparable perioperative outcomes with those of GA, with the advantage of a shorter hospital stay. A large randomized controlled trial or multicenter study is required to confirm the present study's findings.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Observational StudyThe Effects of Positioning on the Volume/Location of the Internal Jugular Vein Using 2-Dimensional Tracked Ultrasound.
To investigate the effects of different positioning on the volume/location of the internal jugular vein (IJV) using 2-dimensional (2D) tracked ultrasound. ⋯ Trendelenburg position significantly increased the CSA of the IJV, thus facilitating IJV cannulation. This new 3D reconstruction method permits the creation of a 3D volume through a tracked 2D ultrasound scanning system with image acquisition and integration and may prove useful in providing the user with a "road map" of the vascular anatomy of a patient's neck or other anatomic structures.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Sex Differences in Long-Term Outcomes After Surgical Aortic Valve Replacement: A Nationwide Propensity-matched Study.
Women are considered to have poorer prognoses after cardiac surgery, although evidence is scarce. The authors studied sex differences and long-term outcomes after surgical aortic valve replacement (SAVR). ⋯ Baseline-matched long-term survival after SAVR is similar between sexes. Men had increased risk of bleeding, early re-surgery after SAVR, and infective endocarditis when using biological prosthesis.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Fifty Percent Effective Dose of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children With Cyanotic and Acyanotic Congenital Heart Disease.
To determine the 50% and 95% effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in children with cyanotic and acyanotic congenital heart disease. ⋯ The 50% (95% confidence intervals) effective doses of intranasal dexmedetomidine sedation for transthoracic echocardiography were 3.2 (2.78-3.55) μg/kg and 1.9 (1.69-2.06) μg/kg in children with cyanotic and acyanotic congenital heart disease, respectively.