Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
Comparative Study Observational StudyComparison of Four Intensive Care Scores in Predicting Outcomes After Venoarterial Extracorporeal Membrane Oxygenation: A Single-center Retrospective Study.
To assess the capability of the Acute Physiology and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA) scores, Cardiac Surgery Score (CASUS), and Survival After VA-ECMO (SAVE) in predicting outcomes among a cohort of patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO). ⋯ The APACHE-II, SOFA, and CASUS, calculated at 24 hours of ICU admission, were significantly higher among nonsurvivors compared with survivors. The APACHE-II demonstrated the highest mortality predictive ability. APACHE-II scores of 27 or above and SOFA scores of 14 or above at 24 hours of ICU admission after ECMO cannulation can predict mortality and assist physicians in decision-making.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
Observational StudyFeasibility of Intraoperative 3-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Aortic Valve Replacement: A Prospective Observational Pilot Study.
To assess the feasibility of intraoperative 3-dimensional speckle-tracking-based myocardial deformation analysis for evaluation of twist, torsion, and strain using speckle tracking, and to investigate the immediate changes in these parameters after aortic valve replacement. ⋯ 3D speckle-tracking-based myocardial deformation analysis from intraoperative TEE datasets is feasible in >60% of patients with aortic valve stenosis. There were no statistically significant differences in GLS, CS, twist, or torsion between the intraoperative examinations.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
Observational StudyReduction in Postoperative Right Ventricular Echocardiographic Indices Predicts Longer Duration of Vasoactive Support After Cardiac Surgery.
To assess perioperative right ventricular (RV) echocardiographic indices and their relationship to vasopressor and inotropic support in cardiac surgical patients. The authors hypothesized that a reduction in echocardiographic parameters of RV function would be associated with a longer duration of vasopressor and inotropic support in the intensive care unit (ICU). ⋯ Patients with post-CPB TAPSE <17 mmHg require a longer duration of inotropic support in the ICU. From all measured RV echocardiographic indices, post-CPB FAC is an independent predictor of vasopressor and inotropic support. A reduction of post-CPB TAPSE and FAC in patients undergoing cardiac surgery is indicative of RV dysfunction requiring a longer use of vasopressor and inotropic support and potentially longer stay in the cardiovascular ICU.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
Case ReportsPulmonary Artery Pseudoaneurysm Due to Pulmonary Artery Catheter Placement: A New Minimally Invasive Approach to Solve a Life-threatening Complication.
This article discusses a pulmonary artery pseudoaneurysm (PAP) formation following pulmonary artery catheter (PAC) placement for cardiac surgery. The patient, an 82-year-old female with a history of hypertension and chronic heart failure, underwent elective mitral and tricuspid valve surgery. After surgery, bleeding was observed in the endotracheal tube, indicating a potential complication. ⋯ While conservative, surgical, and interventional approaches are discussed, the preferred treatment is coil embolization due to its effectiveness and minimal invasiveness. The authors emphasize the importance of rapid diagnosis, multidisciplinary collaboration, and the feasibility of using the pulmonary artery route for embolization to rapidly reach the lesion to stabilize. Overall, the case demonstrates the successful resolution of a life-threatening complication through timely intervention and coordinated teamwork.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
Correlation Between Intraoperative Near-infrared Spectroscopy Values and Neurologic Outcomes in Patients Undergoing Total Aortic Arch Replacement Using the Frozen Elephant Trunk Technique.
To correlate intraoperative near-infrared spectroscopy (NIRS) values with neurologic outcomes in patients undergoing total aortic arch replacement using the frozen elephant trunk (FET) technique. ⋯ NIRS is a reliable tool to monitor intraoperative frontal lobe cerebral oxygen saturation. However, its use to predict postoperative stroke remains limited. Further refinements are needed to develop the technique into a prediction tool.