Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Meta AnalysisPreoperative Levosimendan in Patients With Severe Left Ventricular Dysfunction Undergoing Isolated Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Controlled Trials.
To verify the impact of preoperative levosimendan on patients with severe left ventricular dysfunction (ejection fraction <35%) undergoing isolated coronary artery bypass grafting. ⋯ Preoperative levosimendan in patients with severe left ventricular dysfunction undergoing isolated coronary artery bypass grafting was associated with reduced all-cause mortality, low-cardiac-output syndrome, acute kidney injury, postoperative atrial fibrillation, and the need for circulatory support without compromising safety.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Review Case ReportsHow Would We Treat Our Own Cystic Fibrosis With Lung Transplantation?
Lung transplantation is the only therapy for patients with end-stage lung disease. In advanced lung diseases such as cystic fibrosis (CF), life expectancy increases, and it is important to recognize extrapulmonary comorbidities. ⋯ Therefore, an optimal anesthesia and surgical management risk evaluation in this high-risk patient population is mandatory, especially concerning the perioperative use of mechanical circulatory support. The use of an index case of an older patient with the diagnosis of cystic fibrosis demonstrates the importance of early risk stratification and strategy planning in a multidisciplinary team approach to guarantee successful lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
ReviewMicrocirculatory Alterations in Cardiac Surgery: A Comprehensive Guide.
Microcirculation is essential for cellular life and its functions. It comprises a complex network of capillaries, arterioles, and venules, which distributes oxygenated blood across and within organs based on regional metabolic demands. Because previous research indicated that organ function is linked to microcirculatory function, it is crucial to maintain sufficient and effective microcirculatory function during major surgery. ⋯ This potentially can lead to better hemodynamic management and outcomes. This review article concentrates on the use of handheld video microscopes for real-time microcirculatory assessment of cardiac surgery patients in the immediate and early postoperative period. Emphasis is placed on integrating microcirculatory monitoring with conventional hemodynamic monitoring in the therapeutic management of patients undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Elevated Renal-Resistive Index as an Indicator of Acute Kidney Injury Associated With Neonatal Extracorporeal Membrane Oxygenation.
The authors aimed to assess the relationship between elevated renal-resistive index (RRI) and acute kidney injury (AKI) related to extracorporeal membrane oxygenation (ECMO) in neonatal patients. ⋯ The elevation of the RRI demonstrated a strong correlation with the onset of neonatal ECMO-related AKI, which may offer valuable support for diagnosing neonatal ECMO-related AKI.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Case ReportsA Case of Abnormal Right Ventricular Color-Flow Doppler Jet.
Transthoracic echocardiography is used routinely during the follow-up after heart transplant surgery to screen possible complications and adverse events such as rejection. It often results in incidental findings that bring diagnostic challenges for sonographers. This E-challenge shows a Doppler flow abnormality associated with a rare cardiovascular diagnosis. Its physiopathology and its association with echocardiography findings are reviewed.