Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Preoperative Cardiac Assessment for Coronary Artery Disease: From Symptoms to Angiography.
Although cardiovascular anesthesiologists play a role in the multidisciplinary heart team, they are generally not involved prior to the diagnosis of coronary artery disease. This work was designed to broadly cover the factors influencing decision-making when proceeding with coronary angiography in a patient with suspected coronary artery disease. The authors cover the principles, rationale, benefits, and downsides of common tests involved.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Combined Short-Long Axis Versus Medial Oblique Axis for Internal Jugular Vein Cannulation: A Prospective Single-Blinded Randomized Clinical Trial.
Previous literature suggested the advantage of combined short-long axis (CSLA) technique to avoid posterior wall puncture during internal jugular vein (IJV) cannulation. The purpose of this study is to define the best ultrasound-guided IJV cannulation technique regarding the success rate in the first trial of insertion, time to successful central line placement, number of attempts, procedural complications, and operator satisfaction. ⋯ This study demonstrated the medial oblique axis approach was superior to the CSLA approach regarding first-trial success rate, time to successful line placement, number of attempts, and operator satisfaction when used during elective cannulation of the IJV. However, regarding the incidence of complications, there was no advantage of one approach over the other. Further research is needed to confirm these results among specific groups of operators, with awake patients and in emergent situations.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Preoperative Hematocrit Is Not Associated With Stroke After Surgery for Acute Type A Aortic Dissection.
To determine the impact of hematocrit on adverse neurologic events after acute type A aortic dissection (ATAAD) repair under deep hypothermic circulatory arrest. ⋯ Preoperative hematocrit was not associated with stroke or mortality after ATAAD repair. The rheologic effect of hematocrit on cerebral perfusion under deep hypothermia may be minimal.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Entrapment of Pulmonary Artery Catheters in Cardiac Surgery: A Structured Literature Review and Analysis of Published Case Reports.
This systematic review aims to tabulate and analyze the published literature regarding pulmonary artery catheter (PAC) entrapment during cardiac surgery. ⋯ Although PAC entrapment during cardiac surgery is rare, an entrapped PAC increases patient morbidity, delays recovery, and increases hospital length of stay. Surgeons and anesthesiologists are encouraged to be attentive to PAC entrapment before chest closure.