Journal of Cardiothoracic and Vascular Anesthesia This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

The use of Pulmonary Artery Catheter and of Echocardiography in the cardiac surgery setting: a nationwide Italian survey.
Wide variations exist in the use of pulmonary artery catheter (PAC) and echocardiography in the field of cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 27, 2024 Category: Anesthesiology Authors: Filippo Sanfilippo, Alberto Noto, Valentina Ajello, Blanca Martinez Lopez de Arroyabe, Tommaso Aloisio, Pietro Bertini, Michele Mondino, Simona Silvetti, Antonio Putaggio, Carlotta Continella, Marco Ranucci, Fabio Sangalli, Sabino Scolletta, Gianluca Pate Source Type: research

Uncommon and Unfavorable: Heparin-Induced Hyperkalemia
Heparin remains an integral part of cardiac and vascular surgery, where it is used to prevent catastrophic thromboembolic events resulting from vascular manipulation and extracorporeal circulation1. Heparin and its many analogs also see extensive and routine use in the prevention and treatment of venous thromboembolism (VTE)1. Despite its ubiquity and long history of use, heparin is known to carry risks of adverse events, perhaps most infamously heparin-induced thrombocytopenia (HIT)2. A less common, yet potentially lethal adverse effect is heparin-induced hyperkalemia (HIH). (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 26, 2024 Category: Anesthesiology Authors: Daniel P. Weigle, Alexis Nielsen, Stefan Braunecker Tags: Case Report Source Type: research

Right ventricular function following sternotomy versus a less-invasive approach for left ventricular assist device implant: Retrospective cohort study
Durable left ventricular assist device (LVAD) implantation is traditionally performed via median sternotomy (MS). Less-invasive implantation may lower the incidence of post-implant right ventricular failure (RVF). Our primary objective was to determine whether less-invasive implantation reduces the odds of severe RVF compared to MS. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 26, 2024 Category: Anesthesiology Authors: Terri Sun, Paul Yen, Defen Peng, Laura Besola, Wynne Chiu, Alana Flexman, Anson Cheung Tags: Original Article Source Type: research

Trends in the Utilization of Multiorgan Support Among Adults Undergoing High-risk Cardiac Surgery in United States
The management of multiorgan dysfunction syndrome (MODS) with multiorgan support (MOS) is a core component of care in intensive care units (ICUs).1 Recipients of MOS can survive after a prolonged stay in the ICU but often have a diminished quality of life after discharge.2,3 MOS after surgery is grounded in a strong sense of responsibility that physicians carry when expected or unexpected complications occur, and patients and their families “buy in” to life-sustaining treatments (LSTs).4 On the other hand, postoperative MOS5 may leave patients dependent on long-term organ support,6,7, and at risk for post-intensive car...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 26, 2024 Category: Anesthesiology Authors: Julien Cobert, Zachary Frere, Pattrapun Wongsripuemtet, Tetsu Ohnuma, Vijay Krishnamoorthy, Matthew Fuller, Allyson C Chapman, Miguel Yaport, Kamrouz Ghadimi, Raquel Bartz, Karthik Raghunathan Tags: Original Article Source Type: research

Minimally Invasive Approach versus Sternotomy for Cardiac Surgery in Jehovah's Witness Patients
Patients who refuse transfusion due to religious beliefs, such as Jehovah's Witnesses (JWs), have been considered high-risk candidates for cardiac surgery. Nevertheless, favorable cardiac surgery outcomes for JW patients have been reported and showed similar results with non-JW patients. However, these studies have comprised the conventional median sternotomy approach. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 25, 2024 Category: Anesthesiology Authors: Heemoon Lee, Jihoon Kim, Jong Hyun Lee, Jae Suk Yoo Tags: Original Article Source Type: research

Anesthetic management during laparoscopic liver resection in a patient with Fontan physiology and high central venous pressure
The Fontan procedure was developed in 1971 for the surgical palliation of patients with single ventricle physiology [1]. In patients with Fontan physiology, pulmonary perfusion depends on pulmonary vascular resistance and systemic venous pressure. Long-term survival after the Fontan procedure has improved [2]. However, chronically high venous pressure may cause liver congestion and lead to the development of hepatocellular carcinoma (HCC) [3]. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 25, 2024 Category: Anesthesiology Authors: Kousuke Kikuchi, Akira Iura, Naohiro Hara, Takeshi Iritakenishi, Daisuke Hiramatsu, Yuji Fujino Tags: Case Report Source Type: research

“Con: Is Minimal Invasive Extracorporeal Circulation Superior to Conventional Cardiopulmonary Bypass in Cardiac Surgery?”
While individualized treatment is one of the pillars of the evolving practice towards a more physiological perfusion approach, further than “the elections of the artists”, decision-making algorithms considering different strategies to reduce blood product requirements (BPR) during Cardiopulmonary Bypass (CPB), should be implemented by Cardiac Surgery teams, considering the adequacy to circumstances and the cost-benefit balance. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 25, 2024 Category: Anesthesiology Authors: Morillo J. Blanco, M Vives Tags: Pro and Con Source Type: research

Analysis of the 2023 European Multidisciplinary (ESC/ESICM/EACTS) Consensus Statement on the Management of Short-term Mechanical Circulatory Support of Cardiogenic Shock in Adults in the Intensive Cardiac Care Unit
Despite medical advancements, mortality in cardiogenic shock (CS) remains unacceptably high.1-3 The decreased cardiac output resulting in impaired oxygen delivery, characteristic of CS, triggers a dismal cascade culminating in tissue hypoperfusion, multiorgan failure, and death if not intervened upon early.4 Given the scarcity of interventions to alleviate this harmful progression, there has been a notable increase in utilization of percutaneous mechanical circulatory support devices aimed at restoring blood flow and oxygen delivery, despite limited evidence supporting their efficacy. (Source: Journal of Cardiothoracic and...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Katrina Joy Augustin, Patrick M. Wieruszewski, Lewis McLean, Eric Leiendecker, Harish Ramakrishna Tags: Expert Review Source Type: research

Towards better anticoagulation monitoring for extracorporeal membrane oxygenation – Taking C-reactive Protein Out of the Equation?
C-reactive protein (CPR) is an acute phase reactant protein, primarily synthesized in the liver.1 It belongs to the Pentraxin family of the innate immune system, serving as a pattern recognition molecule for phosphorylcholine residues abundant in bacterial cell membranes. It also binds to damaged cells and altered self-antigens, making it a valuable marker for inflammation, particularly in conditions such as rheumatoid arthritis and certain types of vasculitis. CRP exhibits a notable affinity for oxidized phosphatidylcholine (lysophosphatidylcholine) expressed on apoptotic cells and in oxidized low-density lipoproteins (LD...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Kenichi A. Tanaka, Kenneth E. Steward, Michael A. Mazzeffi Tags: Editorial Source Type: research

Effect of low-dose ketamine infusion on opioid consumption in children undergoing open cardiac surgery: a randomized controlled double-blind study
Open cardiac surgery in the pediatric population is associated with severe metabolic and neurohumeral responses that adversely affect the cardiorespiratory system, resulting in a high risk of morbidity and mortality. 1,2,3 Up to 75% of patients who underwent cardiac surgery experienced moderate to severe postoperative pain that arises mainly from sternotomy incision and to a lesser extent from the sites of mediastinal drainage tubes. 4 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Mahmoud Abdelfattah, Ibrahim Abdelbaser, Kareem Ali Awad, Ahmed Magdy Atallah, Mohamed Sanad, Mohamed Sayedalahl Tags: Original Article Source Type: research

The Ketogenic Diet and Pediatric Cardiac Surgery A Case Report and Narrative Review
Epilepsy affects approximately 470,000 children in the US(1) and up to 40% of these patients do not achieve adequate control with antiepileptic drugs (AED) alone.(2, 3) The addition of a ketogenic diet, which switches the energy source in the brain from glucose to ketones, can decrease the seizures frequency in some cases by up to 50%.(4, 5) A special high fat and low carbohydrate diet is used to achieve ketosis and metabolic changes otherwise seen during starvation. Unlike fatty acids, ketones can cross the blood brain barrier and are an important alternative energy source for the brain. (Source: Journal of Cardiothoracic...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Mckenna Longacre, Laurence Ohia, Sharon Boyle, Kevin Conner, Aditya Kaza, Annette Schure Tags: Case Report Source Type: research

Implementation of Routine In Situ Simulation in Residency Curriculum Targeting Competency in Technical and Decision-Making Skills
To describe the development and implementation of a comprehensive in situ simulation-based curriculum for anesthesia residents. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Nadav Levy, Shirin Saeed, Peva F Gbagornah, David Benavides Zora, Dario Winterton, Cullen D Jackson, Aidan Sharkey, Lior Levy, Sara Neves, Daniel P Walsh, Robina Matyal Tags: Original Article Source Type: research

Regarding the predictor of perioperative stroke/TIA in carotid endarterectomy patients
We read Monaco's recent study1 with great interest. The authors assessed the relationship between thrombin receptor activator peptide 6 (TRAP), adenosine-5 ′-diphosphate (ADP), and arachidonic acid (ASPI) tests measured using multiple electrode aggregometry and the rate of stroke/transient ischemic attack (TIA) in patients undergoing carotid endarterectomy (CEA). They used a logistic LASSO regression model to identify factors independently associated with stroke/TIA. They concluded that an ADP>72 U and the need for a shunt during CEA were the only 2 variables independently associated with perioperative stroke/TIA. (Sourc...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Ying Zhang, Weiwei Chen Tags: Letter to the Editor Source Type: research

Advancing perioperative medicine with continuous cardiac ultrasound monitoring: a call for multicenter-based effectiveness-implementation hybrid studies
Continuous echocardiography monitoring offers a non-invasive and convenient method for tracking changes in cardiac structure and function over time, enabling early detection of anomalies and intervention. In recent years, significant technological advancements have been made in noninvasive cardiac monitoring methods for perioperative medicine, particularly in acute care settings. While echocardiography has proven especially valuable in this context, existing clinical studies have limitations, including small sample sizes, single study centers, a lack of standardized protocols, and implementation challenges. (Source: Journa...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Mingjing Chen, Ramzi G. Salloum, Haibo Song Tags: Letter to the Editor Source Type: research

Is supraclavicular subclavian venous catheterization superior to the infraclavicular approach? The devil is in the details.
We read with interest the recent work of Gong et al.1 The authors compared the ultrasound-guided supraclavicular and infraclavicular approaches for subclavian vein cannulation in children with congenital heart disease. Compared with the infraclavicular approach, supraclavicular cannulation of the subclavian vein had a higher success rate (90.6% vs. 71.4%), shorter time to access (median difference -4.2 seconds), and less frequent catheter malposition. The study's findings may be at least partially explained by the operators ’ lack of familiarity with the supraclavicular approach. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 24, 2024 Category: Anesthesiology Authors: Evangelia Samara, Mona Momeni, Petros G. Tzimas, Mohamed R. El Tahan Tags: Letter to Editor Source Type: research