Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Observational StudyPredictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.
The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) data, the EUROMACS-RHF, and the modified postoperative EUROMACS-RHF. The authors assessed the performance characteristics of these 2 risk score formulations in a continuous-flow LVAD cohort at their institution. ⋯ In the authors' single-center retrospective analysis, the EUROMACS-RHF risk score did not predict early RHF. An optimized risk score for the prediction of RHF after LVAD implantation remains an urgent unmet need.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
ReviewTranscatheter Mitral Valve Interventions for Mitral Regurgitation: A Review of Mitral Annuloplasty, Valve Replacement, and Chordal Repair Devices.
Significant mitral regurgitation (MR) is the most common valvular disease in the United States in patients older than 75. However, many patients with severe MR are at a high risk for surgical repair due to other significant comorbidities. Over the past decade, many transcatheter mitral valve devices have been studied that address the different mechanisms of MR, but only a few have received a Conformité Européene (CE) mark or United States Food and Drug Administration (FDA) approval. ⋯ Finally, the NeoChord DS 1000 received a CE mark for transcatheter chordal repair. Each of these devices is reviewed in detail, including device indications, performance in clinical trials, anesthetic management, intraprocedural imaging guidance, and postprocedural complications. Although percutaneous devices will appear and disappear from use, understanding the procedural considerations remains highly relevant, as these key principles will apply to the next generation of transcatheter valve interventions.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Randomized Controlled TrialThe effect of melatonin on cardiac biomarkers after coronary artery bypass graft surgery: A double-blind, randomized pilot study.
Melatonin has emerged as an anti-inflammatory agent, potent direct free-radical scavenger, and an indirect antioxidant in preventing ischemia-reperfusion injury. This study aimed to evaluate melatonin's effect on cardiac biomarkers after coronary artery bypass grafting (CABG). ⋯ Melatonin reduced the postoperative level of CPK-MB and the length of hospitalization in the ICU in patients who underwent cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
ReviewDonation After Circulatory Death: Expanding Heart Transplants.
Heart failure affects 6.2 million adults in the United States (US), resulting in a decrease in quality of life. Limited options exist for the treatment of end-stage heart failure. Mechanical circulatory support and transplantation are considered when no further optimization can be obtained with medical management. ⋯ Heart transplants using organs from donation after circulatory death (DCD) have blossomed globally since 2014; whereas, in the US, this method has had a slower implementation. Today, the realization of the need to increase the number of donor hearts has reinvigorated the interest in heart transplantation using DCD organs. The authors review the process and discuss the unique opportunities anesthesiologists have to impact the future success of DCD heart transplantation as it continues to expand.