Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2010
Comparative StudyThe incidence of intraoperative awareness in cardiac surgery fast-track treatment.
To determine the occurrence of intraoperative awareness with recall in cardiac surgery patients undergoing fast-track anesthetic management in a direct-admission postanesthetic care unit. ⋯ Therefore, the authors conclude that, with respect to intraoperative awareness, the "Leipzig Fast-Track Concept" with the use of ultra-short-acting opioids should be considered as a safe method of management of patients undergoing a wide variety of cardiac operations.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2010
ReviewProgress in perioperative medicine: focus on statins.
Beyond cholesterol reduction, statins have multiple beneficial influences on vascular endothelial function, atherosclerotic plaque stability, inflammation, and thrombosis. These favorable pleiotropic effects may be the basis for their perioperative risk reduction in cardiothoracic and vascular procedures. The published evidence suggests that statins offer significant outcome benefits throughout perioperative practice. ⋯ The pleiotropic effects of statins also appear to have therapeutic roles in the progression of valve disease, sepsis, and venous thrombosis. Further trials are required to provide data to drive their safe and comprehensive perioperative application for optimal patient outcome both in the short term and the long term. Because there are multiple randomized trials currently in progress throughout perioperative medicine, it is very likely that the indications for statins will be expanded significantly.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2010
Comparative StudyAscending aortic aneurysms: asymmetrical differences in aortic cross-sectional wall motion detected by epiaortic echocardiography.
To evaluate in vivo cross-sectional conformational changes of ascending aortic wall excursion in patients undergoing resection for aortic aneurysm with those undergoing elective coronary artery bypass grafting (CABG) using epi-aortic echocardiography. ⋯ This in vivo study documented a lack of asymmetric aortic wall motion in ascending aortic aneurysms. In contrast, both the internal and external control groups (aneurysm neck and CABG) demonstrated asymmetric wall motion. The lack of asymmetric wall motion may be an important aspect of aneurysm pathophysiology and key to the development of management strategies for timing of surgical intervention.