Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Meta AnalysisAmino Acid Infusion for Perioperative Functional Renal Protection: A Meta-analysis.
Acute kidney injury (AKI) is a common perioperative complication. To date, no single intervention has been proven effective for AKI prevention in this setting. However, intravenous amino acids (AA) administration may recruit renal functional reserve and, thereby, attenuate the perioperative loss of the glomerular filtration rate. ⋯ This meta-analysis suggests that AA administration likely decreased the perioperative incidence of AKI.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Outflow Graft Tamponade: An Underrecognized Cause of Obstruction.
Left ventricular assist device (LVAD) outflow graft obstruction can result in severe clinical deterioration. Underlying mechanisms may vary depending on the location. Outflow graft tamponade due to external compression can be under recognized. Management of this complication varies across institutions and a uniform approach has yet to be elucidated. ⋯ Conclusions: Outflow graft tamponade is a form outflow graft obstruction with a variable presentation that can result in significant hemodynamic compromise. It is amenable to both surgical and percutaneous interventions that restore LVAD function.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Randomized Controlled Trial Multicenter Study Comparative StudyThe Effects of Angiotensin II versus Norepinephrine on Pulmonary Vascular Resistance in Cardiac Surgery: Post Hoc Analysis of a Randomized Controlled Trial.
To assess whether angiotensin II infusion increases pulmonary vascular resistance (PVR) relative to norepinephrine. ⋯ The results of this study suggest that in cardiac surgery patients and at doses used in the prior feasibility study, angiotensin II did not have significant effects on the pulmonary vasculature compared with norepinephrine. Moreover, at doses used in this study, neither drug appeared to have a substantial effect on the pulmonary circulation relative to surgical and patient factors.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Observational StudyAssociation Between Red Cell Distribution Width and Liver Injury after Cardiac and Aortic Aneurysm Surgery with Cardiopulmonary Bypass.
This study aimed to investigate the association between preoperative red blood cell distribution width (RDW) levels and liver injury (LI) after cardiac surgery, to highlight RDW's usefulness in the early identification and intervention for patients at high risk of LI. ⋯ Preoperative RDW levels are significantly associated with postoperative LI. RDW could serve as a significant useful marker for early detection and intervention in patients at high risk of LI, thereby potentially improving patient outcomes.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Review Case ReportsHow We Would Treat Our Own Congenital Cardiac Catheterization Laboratory Patient.
The field of congenital cardiac catheterization (CCC) has changed dramatically since it began 8 decades ago. New techniques and devices have expanded the indications for interventional catheterization. Heart teams who care for patients in the pediatric and congenital cardiac catheterization laboratory are confronted with a growing number of patients presenting for a wide range of increasingly technically challenging cases. ⋯ We reviewed risk stratification strategies for CCC and describe our institution's comprehensive, multidisciplinary approach to the periprocedural management of patients with congenital heart disease undergoing cardiac catheterization, using the index case of a 6-year-old patient with multiple heart defects. We concluded that risk stratification and a comprehensive, multidisciplinary team approach that begins when a procedure is booked is essential to inform management and optimize outcomes. Clinical decision-making should be informed by expert guidelines and evolving risk stratification research.