Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Randomized Controlled Trial Comparative StudyComparison Between Histidine-Tryptophan-Ketoglutarate Cardioplegia and Cold Blood Cardioplegia for Myocardial Protection in Tetralogy of Fallot Patients Undergoing Surgical Repair: A Randomized Clinical Trial.
This study was conducted to compare the efficacy of histidine-tryptophan-ketoglutarate (HTK) cardioplegia and cold blood cardioplegia (CBC), especially for postoperative right ventricular (RV) function after tetralogy of Fallot repair. ⋯ HTK cardioplegia may offer better cardiac protection to pediatric patients undergoing tetralogy of Fallot repair than our institutional standard CBC with better recovery for the hypertrophic RV.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Observational StudyLeft Atrial Strain to Predict Postoperative Atrial Fibrillation in Patients Undergoing Off-pump Coronary Artery Bypass Graft.
Postoperative atrial fibrillation (POAF) is associated with increased morbidity, mortality, and length of hospital stay. The objective of this study was to assess the utility of left atrial strain (LAS) to predict POAF in patients undergoing off-pump coronary artery bypass grafting (OPCABG). ⋯ LAS R is a significant predictor of POAF, and its use can be recommended for screening of OPCABG patients at high risk of POAF.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Randomized Controlled Trial Comparative StudyEffect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A Randomized Controlled Trial.
To assess the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) on the time to extubation in patients who had undergone cardiac surgery through a midline sternotomy. ⋯ Among adult patients undergoing cardiac surgery through a midline sternotomy, the extubation time was halved in patients who received single-shot bilateral ESPB compared to patients who received fentanyl infusion.
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Galactose-alpha-1,3-galactose (alpha-gal) is a carbohydrate expressed by all mammals except for humans and certain old-world primates. It can be found in a plethora of products derived from mammals, including milk, organs, skeletal muscle and gelatin, in addition to products prepared with mammalian cells or constituents. In the late 2000s, an association between tick bites and the development of immunoglobulin E antibodies to the alpha-gal carbohydrate was discovered. ⋯ Bioprosthetic valves have similar origins and risks. Awareness of AGS in cardiac surgery patients can lead to decreased risk preoperatively and inform management perioperatively and postoperatively. In this narrative review, we have reviewed the published literature relevant to AGS in patients undergoing cardiac surgery and shared our treatment approach.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Comparative StudyPreoperative Modified Frailty Index-11 versus EuroSCORE II in Predicting Postoperative Mortality and Complications in Elderly Patients Who Underwent Elective Open Cardiac Surgery: A Retrospective Cohort Study.
To compare sensitivity, specificity, receiver operating characteristic (ROC), and area under the curve (AUC) values using the modified Frailty Index 11 (mFI-11), EuroSCORE II, and combined mFI-11 and EuroSCORE II to predict in-hospital mortality and composite morbidities. ⋯ The mFI-11 and EuroSCORE II demonstrated good discrimination in ROC analysis, with EuroSCORE II showing superior predictive accuracy for in-hospital mortality in elderly elective cardiac surgery patients. However, neither score independently predicted mortality in multiple logistic regression, nor did combining them enhance predictive power significantly. Furthermore, both scores were less effective in predicting postoperative complications.