Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Nov 2021
Review Meta AnalysisRight Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis.
This systematic review and meta-analysis aimed to describe the features of right ventricular impairment and pulmonary hypertension in coronavirus disease (COVID-19) and assess their effect on mortality. ⋯ Mortality in patients with COVID-19 requiring respiratory support and with a diagnosis of right ventricular dysfunction, dilatation, or pulmonary hypertension is high. Future studies should highlight the mechanisms of right ventricular derangement in COVID-19, and early detection of right ventricular impairment using ultrasound might be important to individualize therapies and improve outcomes.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2021
ReviewRisk Stratification and Optimization to Prevent Right Heart Failure During Left Ventricular Assist Device Implantation.
Left ventricular assist device (LVAD) implantation results in superior survival rates compared with optimal medical therapy in patients with end-stage heart failure. However, a potential complication of LVAD implantation is right heart failure (RHF), which can be devastating. ⋯ This review focuses on methods of assessing the risk factors for RHF before surgery, including evaluation of biomarkers, echocardiography, hemodynamics, risk-scoring systems, and existing conditions of right heart dysfunction. In addition, the review also explores the perioperative strategic approaches to reducing the likelihood of RHF.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2021
ReviewAnesthesia for Combined Heart and Liver Transplantation.
A heart or liver transplantation procedure performed in isolation itself presents multiple challenges for the perioperative team. Accordingly, combining both transplants yields a vastly more complicated surgery, with many unique multisystem and multidisciplinary considerations. Although combined heart and liver transplantations are being performed with increasing frequency, nationwide experience is relatively limited at most institutions. The aim of this review is to discuss the perioperative challenges presented to the anesthesiology teams and provide evidence-based guidance for the management of these daunting procedures.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2021
ReviewThe Evolution and Future of Spinal Drain for Thoracic Aortic Aneurysm Repair: A Review.
For decades, spinal drains for cerebrospinal fluid (CSF) pressure monitoring and drainage have been used as adjuncts to protect against spinal cord injury resulting from thoracic aortic aneurysm repair. There are many different approaches to placement and management of CSF drains, with no true consensus on best practice. Furthermore, the incidence of complications resulting from spinal drains largely has been stagnant. This review describes the history and rationale behind placement of CSF drains, explore various considerations, techniques, and equipment, and discuss potential considerations for developing more comprehensive protocols.