Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Observational StudyPredictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients.
To determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). ⋯ PNX/PMD occurs frequently in COVID-19 patients with ARDS requiring mechanical ventilation, and is associated with increased mortality. Development of PNX/PMD seems to occur despite use of protective mechanical ventilation and has a radiologic predictor sign.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Case ReportsSubaortic Membrane-A Savior in Large Perimembranous Ventricular Septal Defect.
Ventricular septal defects (VSD) are the most common congenital cardiac defect. Patients with large VSDs present early due to an increase in the volume load on the left ventricle and pressure load on the right ventricle. Few of them present late even without surgical intervention, due to partial restriction of perimembranous (PM) VSD, either by the septal leaflet of the tricuspid valve or by aortic valve cusp prolapse into the VSD. The authors observed a novel structure (ie, subaortic membrane in this case) restricting the large PM VSD in a 15-year-old child.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Usefulness of Right Ventricular Longitudinal Shortening Fraction to Detect Right Ventricular Dysfunction in Acute Cor Pulmonale Related to COVID-19.
To compare two-dimensional-speckle tracking echocardiographic parameters (2D-STE) and classic echocardiographic parameters of right ventricular (RV) systolic function in patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (CARDS) complicated or not by acute cor pulmonale (ACP). ⋯ Classic RV function parameters were not altered by ACP in patients with CARDS, contrary to 2D-STE parameters. RV-LSF seems to be a valuable parameter to detect early RV systolic dysfunction in CARDS patients with ACP.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Prior Statin Therapy and Mortality After Extracorporeal Membrane Oxygenation Therapy: A Retrospective, Population-Based, Cohort Study.
To investigate whether prior statin therapy is associated with an improvement in mortality among patients who undergo extracorporeal membrane oxygenation (ECMO) therapy. ⋯ Among patients who underwent ECMO in South Korea, prior statin therapy was found to be associated with lower 90-day mortality rates after ECMO therapy. However, because this study had a retrospective design, future prospective trials are needed to confirm the findings.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Airway Surgery for Laryngotracheal Stenosis During the COVID-19 Pandemic: Institutional Guidelines.
The management of laryngotracheal stenosis is challenging, as patients usually require in-time interventions. The current coronavirus disease 2019 (COVID-19) pandemic has added unique challenges to this procedure. The presence of the virus in high concentrations in the aerodigestive tract and the need for an open airway during surgery can increase the risk of aerosolization of the virus and subsequent infection of the surgical, anesthetic, and operating room (OR) personnel. ⋯ Surgical and bronchoscopic management of laryngotracheal stenosis presents a unique challenge during the COVID-19 pandemic, requiring careful consideration of patient triage and the development of protocols that minimize risk to patients and healthcare professionals. Close collaboration between thoracic surgeons and anesthesiology teams is essential to safely navigate and handle these threatened airways while mitigating the risk of viral aerosolization.