Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Microvascular Alterations During Cardiac Surgery Using a Heparin or Phosphorylcholine-Coated Circuit.
Heparin biocompatible coating frequently is used to reduce inflammation and blood coagulation during cardiopulmonary bypass (CPB) in cardiac surgery. Whether heparin coating is protective or damaging to the vascular endothelium is unclear. The authors investigated whether heparin-coated (HC) circuits are associated with better preservation of microcirculatory perfusion and glycocalyx dimensions compared with nonheparin phosphorylcholine-coated (PC) circuits. ⋯ The use of an HC circuit is associated with better preservation of the endothelial glycocalyx compared with PC circuits, whereas microcirculatory perfusion was disturbed equally in both groups. Hence, CPB-induced microcirculatory perfusion disturbances seem to be coating independent.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Clinical Analysis of the Effects of Different Anesthesia and Analgesia Methods on Chronic Postsurgical Pain in Patients With Uniportal Video-Assisted Lung Surgery.
To understand whether different anesthesia and analgesia methods affected the incidence of chronic postsurgical pain (CPSP) in patients who underwent uniportal video-assisted lung surgery and to explore the influence factors of CPSP. ⋯ CPSP accounted for a specific proportion of patients after uniportal video-assisted lung surgery; however, it was significantly lower than that of patients with conventional thoracotomy. The incidence did not differ significantly among anesthesia and analgesia methods. Active and effective control of acute postsurgical pain might reduce the incidence of CPSP.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Retrosternal Clots After Fontan Surgery by Systematic Evaluation With Transthoracic Ultrasound.
Bleeding is a common, serious, and often subtle complication after total cavopulmonary connection surgery. The aim of the present study was to assess the incidence of retrosternal clots after surgery, which were searched for systematically with transthoracic ultrasound. ⋯ With thoracic ultrasound diagnosis, existence of retrosternal clots was found to be very common after total cavopulmonary connection. Most clots were small or moderate with no clinical effect; however, large clots that required redo surgery also were detected.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
ABO Blood Group and Transfusions In the Intraoperative and Postoperative Period After LVAD Implantation.
To assess whether blood group O patients undergoing left ventricular assist device (LVAD) insertion have higher perioperative transfusion requirements, postoperative chest tube output, and postoperative changes in hematocrit. ⋯ O blood group is not a significant predictor of transfusion requirements in the combined intraoperative and postoperative period up to 90 days after LVAD implantation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Single-Shot Cold Histidine-Tryptophan-Ketoglutarate Cardioplegia for Long Aortic Cross-Clamping Durations in Neonates.
More than 30% of European pediatric cardiac surgery centers use single-dose cold histidine-tryptophan-ketoglutarate cardioplegia (Custodiol; Dr Franz Köhler Chemie GmbH, Bensheim, Germany). In neonates with transposition of the great arteries, arterial switch surgery (ASO) implies aortic division, and it is unknown whether repeated ostial cannulation causes intimal insult and affects long-term results, and therefore, single-dose Custodiol is appealing. The present study investigated the association among myocardial no-flow duration, postoperative troponins, and postoperative outcomes in neonates undergoing ASO with Custodiol cardioplegia. ⋯ Single-dose Custodiol may be inadequate for prolonged cross-clamping durations without myocardial perfusion in neonates.