Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
ReviewIatrogenic Aortic Dissection Associated With Cardiac Surgery: A Narrative Review.
Iatrogenic aortic dissection (iAD) is a relatively rare but a life-threatening complication associated with cardiac surgery. All members of the team caring for cardiac surgical patients (surgeons, perfusionists, and anesthesiologists) must be familiar with this complication to minimize its incidence and improve outcome. The present narrative review focuses on iAD occurring intraoperatively and during the early postoperative period (within 1 month) of cardiac surgery. ⋯ Other common sites are the aortic cross-clamp or partial occlusion clamp (∼29%) and the proximal saphenous vein anastomosis site (14%). Sixty percent of cases occur during coronary artery bypass graft (CABG) surgery and 17% during aortic valve surgery with or without CABG. iAD may be somewhat less common in off-pump versus on-pump CABG but is still not very rare. Risk factors, presentation, diagnosis, and management are reviewed in detail as is the key role of the use of echocardiography in the early diagnosis of iAD and for guiding its management.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Randomized Controlled TrialSerratus Anterior Plane Block and Erector Spinae Plane Block Versus Thoracic Epidural Analgesia for Perioperative Thoracotomy Pain Control: A Randomized Controlled Study.
This study was designed to evaluate the safety and efficacy of erector spinae plane block and serratus anterior plane block versus thoracic epidural in perioperative pain control for patients with cancer undergoing lung surgeries. ⋯ Erector spinae plane block can be used as an effective and safe alternative to thoracic epidural analgesia and shows superior analgesic profile to serratus anterior plane block for patients with lung cancer undergoing posterolateral thoracotomy.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Randomized Controlled TrialEffect of High-Flow Nasal Cannula Oxygen Therapy on Pediatric Patients With Congenital Heart Disease in Procedural Sedation: A Prospective, Randomized Trial.
The study was conducted to compare the outcome of high-flow nasal cannula (HFNC) oxygen therapy with conventional oxygen therapy through a simple oxygen mask for pediatric patients with congenital heart disease during percutaneous intervention while under procedural sedation. ⋯ When compared with simple mask oxygenation, HFNC could reduce the incidence of desaturation, the need for airway assisted ventilation and risk of carbon dioxide retention without causing hemodynamic instability or gastric distention. It is effective for pediatric patients with non-cyanotic congenital heart disease who require procedural sedation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
ReviewThe Year in Thoracic Anesthesia: Selected Highlights From 2020.
Selected highlights in thoracic anesthesia in 2020 include updates in the preoperative assessment and prehabilitation of patients undergoing thoracic surgery; updates in one-lung ventilation (OLV) pertaining to the devices used for OLV; the use of dexmedetomidine for lung protection during OLV and protective ventilation, recommendations for the care of thoracic surgical patients with coronavirus disease 2019; a review of recent meta-analyses comparing truncal blocks with paravertebral and thoracic epidural blocks; and a review of outcomes after initiating the enhanced recovery after surgery guidelines for lung and esophageal surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
ReviewSelected 2020 Highlights in Congenital Cardiac Anesthesia.
This article is a review of the highlights of pertinent literature published during the 12 months of 2020 that are of interest to the congenital cardiac anesthesiologist. After a search of the US National Library of Medicine's PubMed database, several topics emerged for which significant contributions were made in 2020. The authors of the present article considered the following topics noteworthy to be included in this review: pediatric cardiac care in the coronavirus disease 2019 era, the use of mechanical circulatory support in coronavirus disease 2019-related multisystem inflammatory syndrome in children, transfusion and coagulation management in children undergoing congenital heart surgery, and pulmonary vein stenosis.