Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients.
To analyze outcomes and risk factors of cardiovascular events in a metropolitan coronavirus disease 2019 (COVID-19) database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race. ⋯ Cardiovascular events were prevalent and associated with worse outcomes in hospitalized patients with COVID-19. Outcomes of cardiovascular events in African American and white COVID-19 patients were similar after propensity score matching analysis. There were common and unique risk factors for cardiovascular events in African American COVID-19 patients when compared with white patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Case ReportsPercutaneous Mechanical Thrombectomy of Atriocaval Floating Thrombus After Impella RP Removal in a Critically Ill Patient.
The rapid institution of mechanical circulatory support (MCS) during cardiogenic shock secondary to severe biventricular failure is strongly recommended. Despite the introduction of less-invasive devices and adequate anticoagulation protocols, the presence of vascular complications in patients treated with MCS has not yet been eliminated. Here, the authors report a 60-year-old patient treated with the Bi-Pella approach for biventricular failure. ⋯ The procedure was completed without intraoperative complications, and both the completion angiography and transesophageal echocardiography showed complete thrombus removal. No procedure-related complications occurred, but the patient died from progressive worsening of left ventricular failure on the 16th postoperative day. In the case of proximal extensive deep vein thrombosis with an increased risk of pulmonary embolism, the use of percutaneous mechanical thrombectomy could be a therapeutic option, even in critically ill patients, due to its minimally invasive nature and low rates of complications.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
ReviewMesenteric Malperfusion Syndromes in Type A Aortic Dissection: Current Management Strategies.
Acute type A aortic dissection is a surgical emergency associated with high mortality and morbidity. When complicated with mesenteric malperfusion, its management carries a very high mortality. Many innovations in the field of vascular and cardiothoracic surgery in the last two decades have been tried in the continuous efforts to improve on the surgical outcomes. Although some reports have documented better mortality rates with reperfusion-first strategies, there is still room for improvement in the absence of a general consensus on its management.
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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
Multicenter StudyOutcome of Repeat Venoarterial Extracorporeal Membrane Oxygenation in Postcardiotomy Cardiogenic Shock.
Data on patients requiring a second run of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in patients affected by postcardiotomy cardiogenic shock (PCS) are very limited. The authors aimed to investigate the effect of a second run of VA-ECMO on PCS patient survival. ⋯ Repeat VA-ECMO therapy is a valid treatment strategy for PCS patients. Early and late survivals are similar between patients who have undergone a single or second run of VA-ECMO.