MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Cardiothoracic and Vascular Anesthesia' source. Sun, 21 Mar 2010 13:42:16 +0100 http://www.medworm.com/index.php?rid=3205625&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003607%2Fabstract%3Frss%3Dyes 30th Annual Cardiothoracic Surgery Symposium. Newport Beach, CA. March 4-7, 2010. Contact: e-mail: kmorgan@amainc.com, www.amainc.com. 30th International Symposium on Intensive Care and Emergency Medicine. Brussels, Belgium. March 23-26, 2010. Contact: Erasmus University Hospital, Route de Lennik 808, B-1070 Brussels, Belgium, e-mail: veronique.de.vlaeminck@nlb.ac.be. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205625 Tue, 26 Jan 2010 13:42:32 +0100 3205625 http://www.medworm.com/index.php?rid=3205621&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004133%2Fabstract%3Frss%3Dyes See accompanying editorial by Feroze Mahmood and Madhav Swaminathan: “Ordinary Images—Extraordinary Stories: Echo Challenges and Clinical Decisions” on page 5 of this issue. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205621 Tue, 26 Jan 2010 13:42:31 +0100 3205621 http://www.medworm.com/index.php?rid=3205618&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004248%2Fabstract%3Frss%3Dyes THE ADULT POPULATION WITH congenital heart disease (CHD) is increasing due to advances in surgical and medical management, with an estimated 850,000 adults with CHD and more than 20,000 patients with CHD transitioning into adulthood annually. This heterogeneous group includes patients with various modifications of the Fontan procedure; a distinct population of particular complexity who require specialized attention and periodic follow-up with their medical care into adulthood. As the adult population who had the Fontan procedure continues to expand, causes of long-term morbidity, including arrhythmias, cyanosis due to systemic venous collateralization, ventricular failure, protein-losing enteropathy, and thrombotic complications, are recognized with increasing frequency. The authors report... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205618 Tue, 26 Jan 2010 13:42:28 +0100 3205618 http://www.medworm.com/index.php?rid=3205608&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003759%2Fabstract%3Frss%3Dyes Conclusions: St Thomas cardioplegia solution supplemented with emulsified isoflurane enhanced its cardioprotection in an isolated heart ischemia reperfusion injury model in rats. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205608 Tue, 26 Jan 2010 13:42:26 +0100 3205608 http://www.medworm.com/index.php?rid=3205603&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003747%2Fabstract%3Frss%3Dyes Conclusion: Patients with positive heparin antibodies pretreated with heparin prior to surgery developed a type of immune-mediated cardiovascular changes and postoperative thrombocytopenia. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205603 Tue, 26 Jan 2010 13:42:25 +0100 3205603 http://www.medworm.com/index.php?rid=3205594&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004078%2Fabstract%3Frss%3Dyes The hybrid operating room is the venue for transcatheter therapy with the convergence of 3 specialties: cardiac surgery, cardiovascular anesthesiology, and interventional cardiology. Transcatheter aortic valve replacement is proof that cardiac specialists have embraced the endovascular revolution. Because pharmacologic conditioning and ischemic myocardial conditioning are safe and effective, they are currently the focus of multiple trials. Angiotensin blockade, anemia, and endoscopic saphenous vein harvesting worsen outcome after coronary artery bypass graft (CABG) surgery. Although off-pump CABG surgery is equivalent to on-pump CABG surgery, it may improve outcomes in high-risk groups. Although percutaneous coronary intervention (PCI) significantly decreases mortality after myocardial inf... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205594 Tue, 26 Jan 2010 13:42:20 +0100 3205594 http://www.medworm.com/index.php?rid=3205593&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003589%2Fabstract%3Frss%3Dyes TRANSESOPHAGEAL echocardiography (TEE) is fast assuming the role of an essential monitor in cardiac operating rooms (ORs). Its role has evolved from an alternative to epicardial echocardiography during cardiac surgery to be classified as a category I indication during congenital and valve repair cardiac surgery. The diagnostic and therapeutic uses of TEE cross medical disciplines, and the indications are determined by the circumstances of its use (eg, cardiologists commonly use it for the evaluation of intracardiac masses and the placement of percutaneous closure devices and anesthesiologists have traditionally used TEE for intraoperative monitoring during cardiac surgery). Gradually, the use of perioperative TEE is transitioning from being exclusively a monitoring modality during cardiac ... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205593 Tue, 26 Jan 2010 13:42:20 +0100 3205593 http://www.medworm.com/index.php?rid=3205592&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004224%2Fabstract%3Frss%3Dyes THE ANNUAL MEETING is always a highlight of the Chinese Society of Anesthesiologists (CSA). The 2009 annual meeting of the CSA was held on September 4-6, at The Shanghai International Convention Center, which is located in the heart of Lujiazui, Shanghai's financial and trade zone, adjacent to the Oriental Pearl TV Tower and facing the multinational architecture along the Bund across the Huangpu River. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205592 Tue, 26 Jan 2010 13:42:20 +0100 3205592 http://www.medworm.com/index.php?rid=3205591&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004236%2Fabstract%3Frss%3Dyes THE MEMBERS OF the Editorial Board of the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) and the Journal's publisher, Elsevier, Inc, are pleased to announce a new affiliation with the Chinese Society of Cardiovascular and Thoracic Anesthesiologists (CSCVTA) of the Chinese Society of Anesthesiologists (CSA), starting with this issue of the Journal. JCVA is pleased to become the official journal of the CSCVTA at this important time of international growth and collaboration among cardiovascular specialists, educators, and researchers around the world. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205591 Tue, 26 Jan 2010 13:42:20 +0100 3205591 http://www.medworm.com/index.php?rid=3205590&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004674%2Fabstract%3Frss%3Dyes The Journal of Cardiothoracic and Vascular Anesthesia will consider for publication suitable articles on all topics related to anesthesia for cardiac, vascular, and thoracic surgery. The scope of this Journal is broad and seeks to consolidate all material pertinent to cardiothoracic anesthesiology, including topics from critical care medicine, pharmacology, monitoring, perfusion technology, internal medicine, surgery, and transplantation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205590 Tue, 26 Jan 2010 13:42:20 +0100 3205590 http://www.medworm.com/index.php?rid=3205589&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004662%2Fabstract%3Frss%3Dyes Esmolol Reduces Perioperative Ischemia in Noncardiac Surgery: A Meta-analysis of Randomized Controlled Studies G. Landoni, S. Turi, G. Biondi-Zoccai, E. Bignami, V. Testa, I. Belloni, G. Cornero, and A. Zangrillo; Milan, Italy (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205589 Tue, 26 Jan 2010 13:42:20 +0100 3205589 http://www.medworm.com/index.php?rid=3205588&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004650%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205588 Tue, 26 Jan 2010 13:42:20 +0100 3205588 http://www.medworm.com/index.php?rid=3205587&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004649%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205587 Tue, 26 Jan 2010 13:42:20 +0100 3205587 http://www.medworm.com/index.php?rid=3205586&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004637%2Fabstract%3Frss%3Dyes Journal of Cardiothoracic and Vascular Anesthesia (ISSN 1053-0770) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are February, April, June, August, October, and December. Periodicals postage paid at New York, NY and additional mailing offices. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205586 Tue, 26 Jan 2010 13:42:19 +0100 3205586 http://www.medworm.com/index.php?rid=3205624&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003565%2Fabstract%3Frss%3Dyes Significant innovations have defined the approach to the proximal thoracic aorta. Aortic proteolysis predisposes to dissection and aneurysm. Losartan may prevent aortic root dilation in Marfan syndrome. The Loeys-Dietz syndrome mandates early aortic intervention. Because genetic aortopathies have a multicenter registry, further aortic molecular advances are likely. Acute intramural hematoma (IMH) may be due to aortic dissection with unrecognized microintimal tears. Type-A IMH is often a surgical emergency, whereas type-B IMH often requires medical management. Because preoperative ischemia predicts mortality in type-A dissection, it is logical to classify this disease by ischemic presentation. Because advanced age worsens the outcome in type-A dissection, transcatheter interventions should ... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205624 Mon, 14 Dec 2009 00:00:00 +0100 3205624 http://www.medworm.com/index.php?rid=3205620&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003681%2Fabstract%3Frss%3Dyes THE DEVELOPMENT OF novel medical technology is often driven by the desire to improve patient care and outcome. During the 1960s, cardiac surgery experienced an explosive growth, and the demand for monitoring and measuring surgical interventions and cardiac parameters broadened. These demands led to the development of transesophageal echocardiography (TEE). Since its introduction, the uses for TEE have increased significantly, especially in the operating room, because it allows clinicians to continually monitor cardiac performance and evaluate surgical repairs. As TEE functionality advances, it has posed challenges on issues of training, certification, and credentialing among professional organizations, most notably within the field of anesthesia. Conventionally, in a cardiac anesthesia fel... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205620 Mon, 14 Dec 2009 00:00:00 +0100 3205620 http://www.medworm.com/index.php?rid=3205596&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003474%2Fabstract%3Frss%3Dyes Conclusions: B-natriuretic peptide increased after surgical but not after endovascular aortic valve replacement. Furthermore, endovascular aortic valve implantation acutely improved left ventricular diastolic function as documented by increases in mitral flow propagation velocity and mitral annulus early diastolic velocity. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205596 Mon, 30 Nov 2009 00:00:00 +0100 3205596 http://www.medworm.com/index.php?rid=3034832&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004170%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034832 Sat, 28 Nov 2009 13:41:42 +0100 3034832 http://www.medworm.com/index.php?rid=3034831&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009004169%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034831 Sat, 28 Nov 2009 13:41:42 +0100 3034831 http://www.medworm.com/index.php?rid=3034830&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003978%2Fabstract%3Frss%3Dyes The Editor-in-Chief and the members of the Journal's Editorial Board would like to thank the following guest reviewers for their expertise in reviewing manuscripts during the past year. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034830 Sat, 28 Nov 2009 13:41:42 +0100 3034830 http://www.medworm.com/index.php?rid=3034819&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003279%2Fabstract%3Frss%3Dyes THERE HAS BEEN significant progress in the clinical management of mitral disease. The past decade has witnessed a shift away from mitral valve replacement (MVR) toward mitral valve (MV) repair, given that the repair techniques have generalized globally. The success and safety of MV repair has established it as the therapy of choice for severe mitral regurgitation (MR), even if the MR is asymptomatic. Risk models have recently been published for both MVR and MV repair based on extensive multivariate analysis of large adult cardiac surgical datasets. These outcome tools not only allow estimation of postoperative risks for multiple important clinical endpoints besides mortality but are also available as online calculators. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034819 Sat, 28 Nov 2009 13:41:37 +0100 3034819 http://www.medworm.com/index.php?rid=3034815&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003280%2Fabstract%3Frss%3Dyes SINCE THE Leuven Trial in 2001 in which van den Berghe et al reported a head turning 46% reduction in mortality from the application of an intensive insulin treatment (IIT) regimen in critically ill patients, especially surgical patients, reports of subsequent trials have been inconsistent. Despite the profound inconsistencies, both the American Diabetes Association and the American Association of Clinical Endocrinologists have repeatedly published guidelines encouraging IIT regimens. Bellomo and Egi, in a 2005 editorial responding to the runaway express train-like deployment of this therapy, raised the following concerns regarding the Leuvin Trial: (1) it was not blinded; (2) subjects were predominantly cardiac surgery patients; (3) patients were administered the equivalent of 2 to 3 L of... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034815 Sat, 28 Nov 2009 13:41:36 +0100 3034815 http://www.medworm.com/index.php?rid=3034813&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003346%2Fabstract%3Frss%3Dyes THE SURGICAL REPAIR of the descending thoracic aorta presents a myriad of challenges to the anesthesiologist. Operative exposure of the descending aorta often requires a left thoracotomy and institution of one-lung ventilation techniques. One of the major physiologic perturbations produced by the aortic cross-clamp is the abrupt onset of hypertension and afterload mismatch proximal to the aortic occlusion. Reduced blood flow distal to the clamp may lead to significant multiorgan ischemia and subsequent reperfusion injury. The various forms of aortic bypass provide a mechanism for unloading proximal hypertension by diverting flow to a more downstream site and balancing proximal flow with distal perfusion. The surgical approach to aortic repairs can vary from simple cross-clamping to the use... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034813 Sat, 28 Nov 2009 13:41:36 +0100 3034813 http://www.medworm.com/index.php?rid=3034812&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003267%2Fabstract%3Frss%3Dyes EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) is mechanical support of the lungs and/or heart for a period of days to weeks by a modified heart-lung machine. There are 2 basic types of ECMO: venovenous (VV), which provides support for the lungs only, and venoarterial (VA), which provides support for both the heart and the lungs. VV ECMO is primarily used for treating severe but potentially reversible respiratory failure, and VA ECMO is primarily used for treating severe cardiac or cardiorespiratory failure. Because VA ECMO may be used as a bridge to a longer form of mechanical support or to a heart transplant, the underlying cause of the cardiac failure need not necessarily be reversible. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034812 Sat, 28 Nov 2009 13:41:36 +0100 3034812 http://www.medworm.com/index.php?rid=3034790&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003292%2Fabstract%3Frss%3Dyes IN THE CURRENT health care environment, anesthesiologists are acutely aware of the need to contain the costs of the care that they provide; to maximize resource utilization; and, at the same time, to continue to strive for ways to enhance and improve patient safety and outcomes. The peer-reviewed literature describes several studies that address these issues and how anesthesiologists can potentially impact successful patient outcomes. One area in particular that shows how anesthesiologists can positively impact patient outcome is perioperative pain management. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034790 Sat, 28 Nov 2009 13:41:31 +0100 3034790 http://www.medworm.com/index.php?rid=3034789&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003814%2Fabstract%3Frss%3Dyes Aortic Valve Replacement With or Without Coronary Artery Bypass Surgery: The Risk of Surgery in Patients >80 Years Old A. Maslow, P. Casey, A. Poppas, C. Schwartz, and A. Singh; Providence, RI (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034789 Sat, 28 Nov 2009 13:41:31 +0100 3034789 http://www.medworm.com/index.php?rid=3034788&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003802%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034788 Sat, 28 Nov 2009 13:41:31 +0100 3034788 http://www.medworm.com/index.php?rid=3034787&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003796%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034787 Sat, 28 Nov 2009 13:41:31 +0100 3034787 http://www.medworm.com/index.php?rid=3034786&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003784%2Fabstract%3Frss%3Dyes Journal of Cardiothoracic and Vascular Anesthesia (ISSN 1053-0770) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are February, April, June, August, October, and December. Periodicals postage paid at New York, NY and additional mailing offices. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034786 Sat, 28 Nov 2009 13:41:31 +0100 3034786 http://www.medworm.com/index.php?rid=3205619&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003413%2Fabstract%3Frss%3Dyes DESPITE MONITORING OF routine hemodynamic variables, many patients develop complications of cardiovascular origin while undergoing noncardiac surgery. Not only is monitoring of routine hemodynamic variables insufficient to accurately diagnose and treat hemodynamic instability, it does not even ensure maintenance of intravascular volume. Transesophageal echocardiography (TEE) allows multiplane imaging of the myocardium, heart chambers and valves, pericardium, and great vessels and the assessment of blood flow characteristics and the timing of intracardiac events. It is an excellent intraoperative hemodynamic monitor. TEE has aided in the diagnosis of numerous discrete entities and determination of the etiology of hemodynamic instability, hypoxemia, and cardiac arrest. Many published reports... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205619 Fri, 27 Nov 2009 00:00:00 +0100 3205619 http://www.medworm.com/index.php?rid=3205617&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003012%2Fabstract%3Frss%3Dyes IN THIS SECOND OF 2 articles on the use of extracorporeal membrane oxygenation (ECMO) for treating severe cardiac and respiratory failure in adults, the physiology, technical considerations, and complications of this technique are reviewed. Although ECMO remains a technically and logistically demanding undertaking, recent advances in the design of circuit components, particularly the oxygenator, have improved the ease of use and durability of the technique, such that extracorporeal support can be maintained relatively safely for several weeks. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205617 Thu, 29 Oct 2009 00:00:00 +0100 3205617 http://www.medworm.com/index.php?rid=3205614&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002961%2Fabstract%3Frss%3Dyes A VARIETY OF pathologic conditions give rise to a single-ventricle (SV) physiology. This occurs when one of the ventricles is hypoplastic or absent. These patients often require a series of procedures to provide effective palliation. Surgical therapy commits the single ventricle to the delivery of oxygenated blood to the systemic circulation. Deoxygenated blood is directed to the pulmonary circulation bypassing the ventricle. With improved surgical techniques and medical care, SV patients are living longer. However, over time, they can present with a number of comorbidities related to SV physiology. Additionally, many SV patients appear in need of anesthesia for routine general and obstetric procedures. Anesthesiologists, generalists, and subspecialists alike increasingly may encounter the... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205614 Thu, 29 Oct 2009 00:00:00 +0100 3205614 http://www.medworm.com/index.php?rid=3205595&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002882%2Fabstract%3Frss%3Dyes Conclusions: Short- and long-term mortality was low for this group of elderly patients undergoing AVR or AVR/CABG and not significantly different between the 2 surgical groups. Predicted outcomes were worse than that observed, consistent with the hypothesis, and supportive of a more aggressive surgical treatment for aortic valve disease in the elderly patient. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205595 Tue, 13 Oct 2009 00:00:00 +0100 3205595 http://www.medworm.com/index.php?rid=3034820&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002924%2Fabstract%3Frss%3Dyes Sixty-Third Postgraduate Assembly in Anesthesiology, New York State Society of Anesthesiology. New York, NY. December 11-15, 2009. Contact: NYSSA, 85 Fifth Avenue, New York, NY 10003, www.nyssa-pga.org. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034820 Mon, 12 Oct 2009 00:00:00 +0100 3034820 http://www.medworm.com/index.php?rid=3205602&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001128%2Fabstract%3Frss%3Dyes Conclusions: The authors concluded that continuous ultrafiltration reduced postoperative bleeding and blood transfusions, improved liver function, and shortened the hospital stay in cirrhotic patients after valvular heart surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205602 Mon, 05 Oct 2009 00:00:00 +0100 3205602 http://www.medworm.com/index.php?rid=3205597&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002870%2Fabstract%3Frss%3Dyes Conclusions: In patients with severely impaired cardiac function, general anesthesia for the implantation of a biventricular pacing device can be used with justifiable risk. The method of anesthesia did not influence outcome. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205597 Mon, 05 Oct 2009 00:00:00 +0100 3205597 http://www.medworm.com/index.php?rid=3034799&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002663%2Fabstract%3Frss%3Dyes Conclusions: This analysis indicated that spinal analgesia does not improve clinically relevant outcomes in patients undergoing cardiac surgery, discouraging further randomized controlled trials on this topic even if changes in techniques, devices, and drugs could modify the outlook of the comparison between spinal and standard anesthesia in this setting. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034799 Mon, 05 Oct 2009 00:00:00 +0100 3034799 http://www.medworm.com/index.php?rid=2836909&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900264X%2Fabstract%3Frss%3Dyes AS REVIEWED IN THE “Pro” side of this debate, the data are fairly convincing that based on multiple randomized controlled trials (RCTs), the use of ultrasound guidance (USG) as compared with the landmark technique (LT) for central venous cannulation of the internal jugular vein (IJV) is more effective in terms of all outcomes including faster placement, fewer attempts, fewer overall failures and fewer failures on first attempt, and reduction of complications. However, that is not what is being debated. What is being debated is whether the use of USG should be recommended as the standard of care, and this author hopes to convince the reader that it should not. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836909 Mon, 28 Sep 2009 16:09:55 +0100 2836909 http://www.medworm.com/index.php?rid=2836907&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002079%2Fabstract%3Frss%3Dyes LACTIC ACIDOSIS IS A metabolic acidosis that occurs as a result of elevated serum L-lactate levels. It is classified according to the presence or absence of associated tissue hypoxia. In type-A lactic acidosis, impaired tissue oxygenation leads to increased anaerobic metabolism and an excessive production of pyruvate (which is then converted to lactate). Shock, hypoxia, heart failure, and/or hypovolemia are common causes of type-A lactic acidosis. Type-B lactic acidosis is characterized by an absence of overt tissue hypoxia; causes include toxin-induced impairment of cellular metabolism (cyanide, metformin, anti-HIV medications), thiamine deficiency, malignancy, alcoholism, and liver failure. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836907 Mon, 28 Sep 2009 16:09:54 +0100 2836907 http://www.medworm.com/index.php?rid=2836906&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002237%2Fabstract%3Frss%3Dyes CONGESTIVE HEART FAILURE (CHF) has been estimated to affect between 62 and 124 million people worldwide. The incidence (2-3/1,000 population) is predicted to increase proportionally as life expectancy of the world's population rises. In the United States alone, about 6 million people suffer from CHF, and approximately 400,000 new cases are diagnosed each year. In addition to the resulting financial burden, this condition shows a merely 20% to 40% survival rate at 5 years, and for those patients in the terminal phase of systolic heart failure (New York Heart Association IV), mortality rates at 1 year are as high as 50% despite optimal maximized medical therapy. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836906 Mon, 28 Sep 2009 16:09:54 +0100 2836906 http://www.medworm.com/index.php?rid=2836905&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002122%2Fabstract%3Frss%3Dyes This article provides a summary of the current literature, a practical guide to acquiring the images, and a discussion of the potential clinical applications. This article uses standard nomenclature for probe manipulation as described by Shanewise et al. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836905 Mon, 28 Sep 2009 16:09:54 +0100 2836905 http://www.medworm.com/index.php?rid=2836886&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002651%2Fabstract%3Frss%3Dyes IN 1976, Bland and Lowenstein reported that the volatile anesthetic halothane attenuated ST-segment changes caused by brief coronary artery occlusion in dogs. These seminal experiments showed, for the first time, that volatile anesthetics may be capable of exerting important anti-ischemic effects. Since this landmark article was published, the ability of modern volatile agents and the anesthetic noble gas xenon to attenuate reversible and irreversible myocardial ischemic injury have been validated repeatedly in several animal species using a variety of experimental preparations. The alterations in receptor activity, intracellular signaling, and mitochondrial physiology presumed to be responsible for anesthetic-induced cardioprotection have been studied comprehensively, yet many fundamental... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836886 Mon, 28 Sep 2009 16:09:43 +0100 2836886 http://www.medworm.com/index.php?rid=2836885&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003127%2Fabstract%3Frss%3Dyes The Journal of Cardiothoracic and Vascular Anesthesia will consider for publication suitable articles on all topics related to anesthesia for cardiac, vascular, and thoracic surgery. The scope of this Journal is broad and seeks to consolidate all material pertinent to cardiothoracic anesthesiology, including topics from critical care medicine, pharmacology, monitoring, perfusion technology, internal medicine, surgery, and transplantation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836885 Mon, 28 Sep 2009 16:09:43 +0100 2836885 http://www.medworm.com/index.php?rid=2836884&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003115%2Fabstract%3Frss%3Dyes Predictors of Prolonged Postoperative Endotracheal Intubation in Patients Undergoing Thoracotomy for Lung Resection J.B. Cywinski, M. Xu, D.I. Sessler, D. Mason, and C. Gorman Koch; Cleveland, OH (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836884 Mon, 28 Sep 2009 16:09:43 +0100 2836884 http://www.medworm.com/index.php?rid=2836883&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003103%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836883 Mon, 28 Sep 2009 16:09:42 +0100 2836883 http://www.medworm.com/index.php?rid=2836882&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003097%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836882 Mon, 28 Sep 2009 16:09:42 +0100 2836882 http://www.medworm.com/index.php?rid=2836881&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009003085%2Fabstract%3Frss%3Dyes Journal of Cardiothoracic and Vascular Anesthesia (ISSN 1053-0770) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are February, April, June, August, October, and December. Periodicals postage paid at New York, NY and additional mailing offices. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836881 Mon, 28 Sep 2009 16:09:42 +0100 2836881 http://www.medworm.com/index.php?rid=3034795&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002109%2Fabstract%3Frss%3Dyes Conclusion: The authors identified 4 preoperative and intraoperative risk factors for prolonged ICU stay. This is helpful to identify patients with increased risk for prolonged ICU stay, implement specific strategies, and allocate medical resources. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034795 Fri, 04 Sep 2009 00:00:00 +0100 3034795 http://www.medworm.com/index.php?rid=3205604&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002225%2Fabstract%3Frss%3Dyes Conclusions: Aprotinin appeared more effective in reducing blood product use after thoracic aortic surgery in this limited cohort. Aprotinin use also appeared to be associated with postoperative renal dysfunction. The choice of antifibrinolytic appeared to not be associated with cardiac, neurologic, or respiratory outcomes or survival after thoracic aortic surgery requiring DHCA. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205604 Mon, 31 Aug 2009 00:00:00 +0100 3205604 http://www.medworm.com/index.php?rid=3205599&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002262%2Fabstract%3Frss%3Dyes Conclusions: Three-dimensional epicardial echocardiography is feasible, and in the x-plane modality it is quicker than standard epicardial 2-dimensional examination. According to the judgment of independent observers, it provides high-quality and reproducible images, which are particularly valuable for mitral valve repair. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205599 Mon, 31 Aug 2009 00:00:00 +0100 3205599 http://www.medworm.com/index.php?rid=3205600&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002134%2Fabstract%3Frss%3Dyes Conclusions: Levosimendan has cardioprotective effects that could result in a reduced postoperative mortality. A large randomized controlled study is warranted in this setting. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205600 Mon, 24 Aug 2009 00:00:00 +0100 3205600 http://www.medworm.com/index.php?rid=3205598&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002146%2Fabstract%3Frss%3Dyes Conclusion: Feasibility and repeatability of 2DSE is good but affected by image quality. This study shows that 2DSE can be used in a clinical setting. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205598 Mon, 24 Aug 2009 00:00:00 +0100 3205598 http://www.medworm.com/index.php?rid=3034792&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002158%2Fabstract%3Frss%3Dyes Conclusions: In patients undergoing thoracic surgery, the use of PCV compared with VCV during OLV with the same Vt of 8 mL/kg does not affect arterial oxygenation during OLV or early postoperative oxygenation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034792 Mon, 24 Aug 2009 00:00:00 +0100 3034792 http://www.medworm.com/index.php?rid=2836914&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002195%2Fabstract%3Frss%3Dyes American Society of Anesthesiologists Annual Meeting. New Orleans, LA. October 17-21, 2009. Contact: ASA, 520 N Northwest Highway, Park Ridge, IL 60068, ASAhq.org. Twenty-Third European Association of Cardiothoracic Surgery. Vienna, Austria. October 17-21, 2009. Contact: EACTS Secretariat, 3 Park Street, Windsor, Berkshire SL41LM, UK, e-mail: info@eacts.co.uk. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836914 Sun, 16 Aug 2009 23:00:00 +0100 2836914 http://www.medworm.com/index.php?rid=2836913&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002213%2Fabstract%3Frss%3Dyes There has been significant progress in heart failure treatment; its stages are defined as a management platform for cardiovascular specialists. Surgical ventricular restoration adds no outcome advantage in ischemic heart failure over coronary artery bypass surgery alone. Novel medical therapies may include cytokine blockade and the vasodilator, relaxin. Although diastolic failure is prevalent, its clinical significance is unclear. Cardiac resynchronization reduces mortality and hospitalization. Perioperative enoximone facilitates β-blockade for prophylaxis against myocardial ischemia. Heart failure still determines outcome in pulmonary embolism and cardiac surgery. The practice of ventricular assist devices continues to progress. A profile system based on urgency of mechanical support wil... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836913 Sun, 16 Aug 2009 23:00:00 +0100 2836913 http://www.medworm.com/index.php?rid=2836908&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002250%2Fabstract%3Frss%3Dyes THE ROLE OF ULTRASOUND in the conduct of perioperative central venous cannulation (CVC) has been studied extensively in the last 20 years since its phased introduction to anesthetic and critical care practice, both in the adult and pediatric worlds. Multiple randomized controlled trials and high-quality meta-analyses detail the clinical advantages of this technology for this important and common clinical procedure. Despite this, the abundance of high-quality evidence supporting the clinical advantages of ultrasound guidance for central venous cannulation (UG-CVC), the technique remains to gain widespread acceptance in clinical practice. To address this divide between actual practice and the adoption of best practices based on evidence, it is important to examine why UG-CVC should be consid... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836908 Sun, 16 Aug 2009 23:00:00 +0100 2836908 http://www.medworm.com/index.php?rid=3205615&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001906%2Fabstract%3Frss%3Dyes NEUROPROTECTION MAY BE DEFINED AS the “prevention or amelioration of neuronal damage evidenced by abnormalities in cerebral metabolism, histopathology or neurologic function occurring after a hypoxic or an ischemic event.” Thus, the prevention of cerebral ischemia and the recovery of neural tissue that already has sustained an ischemic insult represent essential goals of neuroprotection. Neuroprotection may occur as a consequence of reduced O2 demand, enhanced O2 delivery, or attenuation of pathologic processes that contribute to cellular injury or death. For decades, the dissociative sedative-hypnotic ketamine has been considered to be relatively contraindicated in the presence of ischemic brain injury or an intracerebral mass because the drug increases cerebral metabolic rate for O2 ... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205615 Thu, 30 Jul 2009 00:00:00 +0100 3205615 http://www.medworm.com/index.php?rid=3034800&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002092%2Fabstract%3Frss%3Dyes Conclusions: The authors concluded that the intraoperative assessment of LITA patency with TEE was a markedly useful and powerful tool for anesthesiologists during CABG surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034800 Thu, 30 Jul 2009 00:00:00 +0100 3034800 http://www.medworm.com/index.php?rid=3205631&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001918%2Fabstract%3Frss%3Dyes We report the novel use of a Proseal LMA (PLMA; LMA North America, Inc, San Diego, CA) with the Arndt BB (Cook Critical Care, Bloomington, IN) for lung separation in a patient at aspiration risk in whom a tracheal mass prevented the safe placement of a tracheal tube. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205631 Mon, 27 Jul 2009 00:00:00 +0100 3205631 http://www.medworm.com/index.php?rid=3205613&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001955%2Fabstract%3Frss%3Dyes SEVERAL DEVICES ARE now commercially available to allow for direct ultrasound (US) visualization of vascular structures in order to facilitate central venous cannula (CVC) placement. The authors report a case in which the use of a transesophageal echocardiographic (TEE) probe as a surface probe altered the site of CVC placement. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205613 Mon, 27 Jul 2009 00:00:00 +0100 3205613 http://www.medworm.com/index.php?rid=3205611&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001876%2Fabstract%3Frss%3Dyes BLAND-WHITE-GARLAND SYNDROME, also known as anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA), accounts for 0.26% of all congenital heart defects, with an occurrence of 1 in 300,000 live births. The mortality of this congenital anomaly is approximately 90% without surgical correction in the first years of life. A case of a previously asymptomatic woman with ALCAPA who developed preeclampsia during pregnancy and heart failure is presented. The authors review the natural history and pathophysiology of this rare anomaly and the anesthetic principles in the management of these patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205611 Mon, 27 Jul 2009 00:00:00 +0100 3205611 http://www.medworm.com/index.php?rid=3034809&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001967%2Fabstract%3Frss%3Dyes ABSOLUTE INDICATIONS FOR providing one-lung ventilation (OLV) include the isolation of one lung to avoid the contamination of a contralateral lung from either blood or infectious material or to provide positive-pressure ventilation to one lung in the presence of either a bulla or bronchopleural fistula in the other lung. Additional indications for OLV are to facilitate surgery in cases such as video-assisted thoracoscopy (VAT), lung resections, esophageal surgery, thoracic spine surgery, and open repair of the descending thoracic aorta. Surgeries using VAT, in particular, require OLV because the surgeon has limited ability to otherwise retract and operate on the lung. These indications are summarized in . (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034809 Mon, 27 Jul 2009 00:00:00 +0100 3034809 http://www.medworm.com/index.php?rid=2627714&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001670%2Fabstract%3Frss%3Dyes Sixth Congress of the European Federation of International Associations for the Study of Pain. Lisbon, Portugal. September 9-11, 2009. Contact: Kenes International, 1-3, Rue de Chantepoulet, PO Box 1726, Geneva CH-1211, Switzerland, e-mail: efic2009@kenes.com. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627714 Thu, 23 Jul 2009 10:37:12 +0100 2627714 http://www.medworm.com/index.php?rid=2627709&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001864%2Fabstract%3Frss%3Dyes THE INTRAOPERATIVE ASSESSMENT OF mitral regurgitation (MR) may be one of the most challenging dilemmas facing cardiac anesthesiologists today. The assessment of MR is complex and complicated by the dynamic nature of this valve and is expressed most dramatically in the operating room, where anesthetic induction and inotropic agents can reduce moderate MR to trace amounts, confounding decisions regarding the need for repair. The presence of MR has been identified as an independent predictor of long-term morbidity and mortality; therefore, the ability to diagnose and identify intraoperative MR has become an important matter. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627709 Thu, 23 Jul 2009 10:37:11 +0100 2627709 http://www.medworm.com/index.php?rid=2627708&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001736%2Fabstract%3Frss%3Dyes MITRAL REGURGITATION (MR) is the second most commonly encountered valvular disease. Almost all of the patients who present for nonemergent valvular surgery or coronary artery bypass graft (CABG) surgery have a preoperative transthoracic echocardiogram (TTE) as part of the routine preoperative workup. Intraoperative assessment of MR to judge suitability for mitral valve repair is an integral component of perioperative transesophageal echocardiography (TEE) examination during mitral valve surgery. Intraoperative TEE examination provides an anatomic/functional “road map” of the mitral valve, which has been shown to improve the outcome after mitral valve repair. The mitral valve is supposed to be competent during systole and nonrestrictive during diastole. Anatomic abnormalities of the mit... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627708 Thu, 23 Jul 2009 10:37:11 +0100 2627708 http://www.medworm.com/index.php?rid=2627705&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000755%2Fabstract%3Frss%3Dyes ANESTHESIOLOGISTS cannot concentrate solely on advances made within the specialty, but must also keep up with developments occurring within the field of surgery because the surgical management of the patients partly determines the anesthetic management. Mitral valve disease and its surgical therapy represent a very dynamic area within the field of cardiac surgery. Thanks to better understanding of the anatomy of the mitral valve apparatus, pathophysiology of underlying disease processes, and improvements in surgical technique, a shift has taken place clearly favoring mitral valve repair over mitral valve replacement for regurgitant lesions. Despite this shift in surgical philosophy, as reflected in the 2006 guidelines published by the American Heart Association/American College of Cardiolo... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627705 Thu, 23 Jul 2009 10:37:10 +0100 2627705 http://www.medworm.com/index.php?rid=2627686&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002067%2Fabstract%3Frss%3Dyes IN HIS BOOK, Darwin's Dangerous Idea, philosopher Daniel Dennett introduces an imaginary substance he calls “Universal Acid.” This liquid is so powerful it can eat through any substance—rock, steel, the Earth—ultimately invading everywhere and everything. Dennett draws an analogy between Evolutionary Theory and “Universal Acid,” making the argument that Evolutionary Theory is so powerful a concept that it withstands, even flourishes, as scrutiny increases. People can try to escape or avoid it, but the facts and evidence will persist, ultimately leading to a single conclusion. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627686 Thu, 23 Jul 2009 10:36:58 +0100 2627686 http://www.medworm.com/index.php?rid=2627685&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002390%2Fabstract%3Frss%3Dyes The Journal of Cardiothoracic and Vascular Anesthesia will consider for publication suitable articles on all topics related to anesthesia for cardiac, vascular, and thoracic surgery. The scope of this Journal is broad and seeks to consolidate all material pertinent to cardiothoracic anesthesiology, including topics from critical care medicine, pharmacology, monitoring, perfusion technology, internal medicine, surgery, and transplantation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627685 Thu, 23 Jul 2009 10:36:58 +0100 2627685 http://www.medworm.com/index.php?rid=2627684&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002389%2Fabstract%3Frss%3Dyes Volatile Anesthetics Reduce Mortality in Cardiac Surgery E. Bignami, G. Biondi-Zoccai, G. Landoni, O. Fochi, V. Testa, S. Imad, F. Giunta, and A. Zangrillo; Milan, Italy (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627684 Thu, 23 Jul 2009 10:36:58 +0100 2627684 http://www.medworm.com/index.php?rid=2627683&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002377%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627683 Thu, 23 Jul 2009 10:36:58 +0100 2627683 http://www.medworm.com/index.php?rid=2627682&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002365%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627682 Thu, 23 Jul 2009 10:36:58 +0100 2627682 http://www.medworm.com/index.php?rid=2627681&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009002353%2Fabstract%3Frss%3Dyes Journal of Cardiothoracic and Vascular Anesthesia (ISSN 1053-0770) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are February, April, June, August, October, and December. Business Office: 1600 John F. Kennedy Blvd., Ste. 1800, Philadelphia, PA 19103-2899. Editorial Office: 360 Park Avenue South, New York, NY 10010-1710. Customer Service Office: 11830 Westline Industrial Drive, St. Louis, MO 63146. Periodicals postage paid at New York, NY and additional mailing offices. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627681 Thu, 23 Jul 2009 10:36:57 +0100 2627681 http://www.medworm.com/index.php?rid=3034810&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000986%2Fabstract%3Frss%3Dyes PERIOPERATIVE ECHOCARDIOGRAPHIC assessment of aortic stenosis (AS) is a complicated and challenging undertaking. It becomes even more important to accurately assess the severity of AS in the operating room (OR) when there are discordant data between the preoperative assessments of severity of AS and intraoperative aortic valve area (AVA) measurement. Anesthesiologists may be confronted with a clinical situation when the decision to replace the aortic valve (AV) may potentially be changed based on the intraoperative evaluation of AS. Furthermore, evidence of the flow dependence of AVA and the benefits of expectant management of mild AS over a more aggressive approach make it even more important to accurately calculate the AVA in the OR. Expected improvement in contractility and cardiac outp... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034810 Thu, 09 Jul 2009 00:00:00 +0100 3034810 http://www.medworm.com/index.php?rid=3034811&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001700%2Fabstract%3Frss%3Dyes PROPOFOL IS A COMMONLY USED intravenous anesthetic agent. Chemically, propofol is a lipophilic, sterically hindered alkylated phenol that is a very weak acid. Pharmacokinetic and pharmacodynamic properties make propofol a useful drug in everyday anesthesia with rapid and clear emergence, precise control of the level of sedation, and lack of cumulative effects even after prolonged administration. Although the terminal half-life of propofol is long, recovery is rapid because of the slow mobilization from the highly lipophilic tissue compartment. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034811 Mon, 06 Jul 2009 00:00:00 +0100 3034811 http://www.medworm.com/index.php?rid=3205629&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001396%2Fabstract%3Frss%3Dyes We read with interest the study by Lema et al. In this interesting article, the authors established whether the release of the endothelial vasodilator nitric oxide (NO) or NO products is altered in patients undergoing surgery with cardiopulmonary bypass (CPB) in 3 different clinical conditions. They took samples for NO products (NOx) before and during hypo- and normothermic CPB and 1 hour postoperatively in 30 patients assigned to 3 groups: elective coronary artery surgery, elective coronary artery surgery randomized to 2 hematocrit values during CPB, and pediatric patients undergoing surgical repair of noncyanotic cardiac defects. They found a significant decrease of NO products, which they attributed to the physiologic response to CPB. (Source: Journal of Cardiothoracic and Vascular Anes... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205629 Fri, 26 Jun 2009 00:00:00 +0100 3205629 http://www.medworm.com/index.php?rid=3205606&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001074%2Fabstract%3Frss%3Dyes Conclusions: The results of this study confirm that long-term mortality remains high after endovascular repair of abdominal aortic aneurysms. The Lee index may be a useful tool for stratification of high-risk patients from both a short- and long-term perspective in the setting of endoluminal graft repair. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205606 Fri, 26 Jun 2009 00:00:00 +0100 3205606 http://www.medworm.com/index.php?rid=3034814&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001384%2Fabstract%3Frss%3Dyes IN THE AUTHORS' previous article on tight glucose control and outcome in cardiovascular surgery, the following questions that are clinically important for perioperative glycemic control were outlined: (1) What are the clinical hazards of acute perioperative hyperglycemia? (2) What level of glycemia is dangerous for the surgical patient? and (3) When should treatment be initiated, and what should the target blood glucose concentration be? (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034814 Fri, 26 Jun 2009 00:00:00 +0100 3034814 http://www.medworm.com/index.php?rid=3205630&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001372%2Fabstract%3Frss%3Dyes We thank Dr Palomero Rodríguez and colleagues for their comments and review regarding nitric oxide (NO) changes in the postoperative period of cardiac surgery. We agree that in the context of inflammatory conditions and trauma, changes in NO production may indicate some form of endothelial dysfunction. However, correct interpretations of those changes are still lacking. The correlation between NO changes and postoperative condition is, at the most, speculative. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205630 Thu, 25 Jun 2009 00:00:00 +0100 3205630 http://www.medworm.com/index.php?rid=3205601&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001359%2Fabstract%3Frss%3Dyes Conclusions: In hemodynamically stable cardiac surgery patients with preserved renal function, an infusion of 0.1 μg/kg/min of fenoldopam mesylate has no influence on systemic hemodynamics while increasing renal blood flow. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205601 Thu, 25 Jun 2009 00:00:00 +0100 3205601 http://www.medworm.com/index.php?rid=3034791&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001025%2Fabstract%3Frss%3Dyes Conclusion: Most predictors of delayed postoperative extubation (ie, red blood cell transfusion, higher preoperative serum creatinine, lower preoperative FEV1, and more extensive lung resection) are difficult to modify in the perioperative period and probably represent greater severity of underlying lung disease and more advanced comorbid conditions. However, thoracic epidural anesthesia and analgesia is a modifiable factor that was associated with reduced odds for postoperative ventilatory support. Thus, the use of epidural analgesia may reduce the need for post-thoracotomy mechanical ventilation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034791 Mon, 15 Jun 2009 00:00:00 +0100 3034791 http://www.medworm.com/index.php?rid=2627707&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900113X%2Fabstract%3Frss%3Dyes REEXPANSION PULMONARY EDEMA (REPE) is a well-known but rare complication of lung reinflation after pathologic collapse or intentional deflation. The presentation of REPE may be highly variable, ranging from a clinically asymptomatic, incidental radiologic finding to acute respiratory failure accompanied by severe, life-threatening hypoxemia. Early reviews of REPE reported that fatalities occur in as many as 20% of afflicted patients, but more recent data suggest that the knowledge of major risk factors, early clinical recognition, and improvements in supportive management may substantially limit mortality. The estimated incidence of REPE was reported as 0.9% and 14% in 2 investigations of patients receiving treatment for spontaneous pneumothorax. The true incidence of this disorder is prob... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627707 Sun, 14 Jun 2009 23:00:00 +0100 2627707 http://www.medworm.com/index.php?rid=3034794&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000998%2Fabstract%3Frss%3Dyes Conclusions: Pneumonia is a common complication in the CTICU, and the authors recommend the following: the removal of the endotracheal tube as soon as possible, the minimal use of a bronchoscope and only in cases of bronchial obstruction, and the use of NIMV. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034794 Fri, 05 Jun 2009 00:00:00 +0100 3034794 http://www.medworm.com/index.php?rid=3034793&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001037%2Fabstract%3Frss%3Dyes Conclusion: The present study indicates that the ETCO2 difference between TLV and early OLV has an association with impaired oxygenation later during OLV. This would be a simple and clinically convenient predictor of the lowest PaO2 value likely to be reached during one-lung anesthesia with either propofol or sevoflurane. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034793 Fri, 05 Jun 2009 00:00:00 +0100 3034793 http://www.medworm.com/index.php?rid=2627713&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001001%2Fabstract%3Frss%3Dyes There have been major advances in the management of aortic valve disease. Because bicuspid aortic valve is common and predicts an increased risk of adverse aortic events, these patients merit aortic surveillance and consideration for ascending aortic replacement when its diameter exceeds 4.0 cm. Serial quantitative echocardiographic analysis, as compared with traditional clinical markers, can result in better timing of surgical intervention for aortic regurgitation. Furthermore, echocardiographic analysis of aortic regurgitation can classify the mechanism based on cusp mobility to guide aortic valve repair. In aortic root replacement, aortic valve preservation with reimplantation is a mainstream surgical option in Marfan syndrome to offer freedom from valve-related anticoagulation. Prosthe... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627713 Thu, 04 Jun 2009 23:00:00 +0100 2627713 http://www.medworm.com/index.php?rid=3034802&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000809%2Fabstract%3Frss%3Dyes Conclusions: COud measurements agreed well with COtd. The results of this study indicated that COud might be interchangeable with conventional COtd in perioperative adult patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034802 Mon, 25 May 2009 00:00:00 +0100 3034802 http://www.medworm.com/index.php?rid=2428709&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000974%2Fabstract%3Frss%3Dyes In this report, the authors present 2 off-pump TECAB cases. Both cases show the perioperative concerns unique to robotically assisted TECAB surgery while contrasting 2 quite different perioperative courses. The first report shows a smooth course from the preoperative period all the way through hospital discharge. The second report highlights unique challenges associated with this technique. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428709 Sat, 23 May 2009 01:53:46 +0100 2428709 http://www.medworm.com/index.php?rid=2428708&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000767%2Fabstract%3Frss%3Dyes MONITORING OF cardiac performance is important to either confirm diagnosis or guide therapy in patients undergoing major surgery and critically ill patients in the intensive care unit (ICU). The invasive technique of pulmonary artery catheterization has been used effectively to optimize hemodynamics. However, it is about to lose its role as the tool of first choice since alternative, less invasive devices to measure cardiac output (CO) have become available. Techniques such as transthoracic bioimpedance, pulse dye densitometry, and esophageal Doppler have been developed for assessing CO and have become increasingly accepted in clinical practice. The results of these techniques with regard to validity, practicability, and accuracy are not uniform, and only a few techniques are universally a... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428708 Sat, 23 May 2009 01:53:42 +0100 2428708 http://www.medworm.com/index.php?rid=2428706&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000081%2Fabstract%3Frss%3Dyes Conclusions: Peak transaortic valve velocities and VTI measured with epicardial echocardiography are higher in comparison to measurements via TEE in patients undergoing AVR. The precise role of epicardial echocardiography in the comprehensive echocardiographic examination of patients undergoing aortic valve replacement needs further evaluation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428706 Sat, 23 May 2009 01:53:37 +0100 2428706 http://www.medworm.com/index.php?rid=2428705&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900072X%2Fabstract%3Frss%3Dyes IN NORTH AMERICA, coronary artery stenting has had a huge impact on the volume of coronary artery bypass graft surgery. However, there has been a reasonable expectation that cardiac surgical volumes would stabilize with the aging of the US population. In the United States, the most common adult valvular lesion is aortic stenosis, so it can be predicted that the incidence of aortic stenosis in the population will rise rapidly. The same is true of mitral regurgitation. However, the expectation of increasing surgical treatment of adult-acquired valvular disease may be tempered by advances in interventional cardiology. These cardiologic interventions will directly affect anesthesia practice. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428705 Sat, 23 May 2009 01:53:36 +0100 2428705 http://www.medworm.com/index.php?rid=2428704&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001475%2Fabstract%3Frss%3Dyes The Journal of Cardiothoracic and Vascular Anesthesia will consider for publication suitable articles on all topics related to anesthesia for cardiac, vascular, and thoracic surgery. The scope of this Journal is broad and seeks to consolidate all material pertinent to cardiothoracic anesthesiology, including topics from critical care medicine, pharmacology, monitoring, perfusion technology, internal medicine, surgery, and transplantation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428704 Sat, 23 May 2009 01:53:36 +0100 2428704 http://www.medworm.com/index.php?rid=2428703&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001463%2Fabstract%3Frss%3Dyes Focused Cardiovascular Ultrasound Performed by Anesthesiologists in the Perioperative Period: Feasible and Alters Patient Management B. Cowie; Melbourne, Australia (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428703 Sat, 23 May 2009 01:53:35 +0100 2428703 http://www.medworm.com/index.php?rid=2428702&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001451%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428702 Sat, 23 May 2009 01:53:35 +0100 2428702 http://www.medworm.com/index.php?rid=2428701&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900144X%2Fabstract%3Frss%3Dyes (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428701 Sat, 23 May 2009 01:53:35 +0100 2428701 http://www.medworm.com/index.php?rid=2428700&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009001438%2Fabstract%3Frss%3Dyes Journal of Cardiothoracic and Vascular Anesthesia (ISSN 1053-0770) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are February, April, June, August, October, and December. Business Office: 1600 John F. Kennedy Blvd., Ste. 1800, Philadelphia, PA 19103-2899. Editorial Office: 360 Park Avenue South, New York, NY 10010-1710. Customer Service Office: 11830 Westline Industrial Drive, St. Louis, MO 63146. Periodicals postage paid at New York, NY and additional mailing offices. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428700 Sat, 23 May 2009 01:53:34 +0100 2428700 http://www.medworm.com/index.php?rid=3205616&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000962%2Fabstract%3Frss%3Dyes THE POTENTIAL FOR noble gases to produce anesthesia was initially suggested 70 years ago by Behnke and Yarbrough, who reported the development of progressive “narcosis” in United Stated Navy divers exposed to 80% argon or krypton in 20% oxygen under hyperbaric conditions (≤10 atm). This hypothesis was subsequently verified in mice and human volunteers exposed to xenon in experiments conducted shortly after the end of World War II. However, the ability of these anesthetic and other nonanesthetic (helium and neon) monatomic gases to protect myocardium against reversible and irreversible ischemia-reperfusion injury has only been recognized recently. The majority of research conducted to date has examined the cardioprotective effects of xenon, in large part, because this noble gas, in co... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205616 Thu, 21 May 2009 00:00:00 +0100 3205616 http://www.medworm.com/index.php?rid=3205607&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000792%2Fabstract%3Frss%3Dyes Conclusions: Desflurane induces a first (0.5-2 hours) and second window of preconditioning (24-72 hours) in the rabbit model of acute myocardial infarction. The second window of APC is mediated by nitric oxide. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205607 Thu, 21 May 2009 00:00:00 +0100 3205607 http://www.medworm.com/index.php?rid=3034801&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000858%2Fabstract%3Frss%3Dyes Conclusions: TEG may be a useful tool for predicting response to rFVIIa in the setting of refractory hemorrhage after cardiac surgery. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034801 Thu, 21 May 2009 00:00:00 +0100 3034801 http://www.medworm.com/index.php?rid=2836895&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000779%2Fabstract%3Frss%3Dyes Conclusions: TNF G-308A polymorphism may be associated with excess TNF-α secretion in this study and may not be associated with excess IL-6 secretion and postoperative morbidity after CPB. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836895 Wed, 20 May 2009 23:00:00 +0100 2836895 http://www.medworm.com/index.php?rid=3205612&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000937%2Fabstract%3Frss%3Dyes AORTIC DISSECTION in young patients is primarily associated with trauma, cocaine use, chronic hypertension, bicuspid aortic valve, congenital coarctation of the aorta, or connective tissue disorders such as Marfan, Turner, and Ehrlos-Danlos syndromes. Aortic dissection during pregnancy is rare, and reported cases are associated with underlying risk factors. However, because of the low incidence of aortic dissection in pregnant women, clinical suspicion may remain low, leading to a delayed or missed diagnosis. Furthermore, the management of acute aortic dissection in the presence of fetal distress during late pregnancy is not well described. The authors report a unique case of a pregnant patient mistakenly diagnosed with myocardial infarction (MI) secondary to acute coronary syndrome who pr... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205612 Mon, 18 May 2009 00:00:00 +0100 3205612 http://www.medworm.com/index.php?rid=3034808&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000780%2Fabstract%3Frss%3Dyes ACTIVATED PROTEIN C (APC) is the only medication that has been approved by the Food and Drug Administration for use in severe sepsis. Because of its antithrombotic and profibrinolytic properties, bleeding is a major concern during its administration. APC is used with caution in surgical patients because of the possibility of an uncontrolled hemorrhage. The authors present safe administration of APC after cardiac surgery with an open sternotomy in the immediate postoperative period. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034808 Mon, 18 May 2009 00:00:00 +0100 3034808 http://www.medworm.com/index.php?rid=3034796&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000846%2Fabstract%3Frss%3Dyes Objective: The purpose of this study was to compare the respiratory function of patients operated either with a ministernotomy or with a conventional sternotomy for an aortic valve replacement.Design: A prospective randomized study.Setting: A single-institution university hospital.Participants: Seventy-eight patients scheduled for aortic valve replacement.Interventions: Patients were assigned to have minimal sternotomy access (ministernotomy) or conventional median total sternotomy. Pulmonary function was measured using a mobile respiratory spirometric device preoperatively and after 1 (POD1), 2 (POD2), and 7 days (POD7) postoperatively.Measurements and Main Results: There was no significant difference in any respiratory parameter measured between the 2 groups of patients. Almost all respi... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034796 Mon, 18 May 2009 00:00:00 +0100 3034796 http://www.medworm.com/index.php?rid=2836898&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000949%2Fabstract%3Frss%3Dyes Conclusions: Averaged cerebral and renal rSO2 less than 65% as measured by NIRS predicts hyperlactatemia (>3 mmol/L) in acyanotic children after congenital heart surgery. Hence, this noninvasive, continuous monitoring tool may facilitate the identification of global hypoperfusion caused by low cardiac output syndrome in this population. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836898 Sun, 17 May 2009 23:00:00 +0100 2836898 http://www.medworm.com/index.php?rid=3034797&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000743%2Fabstract%3Frss%3Dyes Conclusions: Cardiac surgery with cardiopulmonary bypass is associated with an increase in endogenous CO production. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034797 Mon, 27 Apr 2009 00:00:00 +0100 3034797 http://www.medworm.com/index.php?rid=3034798&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900038X%2Fabstract%3Frss%3Dyes Conclusions: Epidural anesthesia added to general anesthesia for CABG surgery significantly attenuates NT-proBNP release in elderly patients and reduces the incidence of prolonged intensive care unit stay. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034798 Mon, 20 Apr 2009 00:00:00 +0100 3034798 http://www.medworm.com/index.php?rid=2627694&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000421%2Fabstract%3Frss%3Dyes Conclusion: DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627694 Sun, 19 Apr 2009 23:00:00 +0100 2627694 http://www.medworm.com/index.php?rid=2428712&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900041X%2Fabstract%3Frss%3Dyes Euroanesthesia 2009. Milan, Italy. June 6-9, 2009. Contact: ESA Office, 24 Rue des Comediens, B-100 Brussels, Belgium, registration@euroanesthesia.org. Perioperative Care for the Geriatric Patient. Prague, Czech Republic. June 14-16, 2009. Contact: GUARANT International, Opletalova 22, 11000 Prague 1, Czech Republic, www.geriatric09.cz. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428712 Fri, 17 Apr 2009 04:00:00 +0100 2428712 http://www.medworm.com/index.php?rid=2428711&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000408%2Fabstract%3Frss%3Dyes There have been major advances in perioperative cardiothoracic and vascular medicine. Because of promising data, steroids, statins, and endothelin antagonists are being clinically tested in randomized trials with adult cardiac surgical patients. In vascular surgical patients, recent meta-analysis has revealed that interventions such as β-blockade or endovascular stenting for peripheral vascular lesions may not improve outcome overall. Furthermore, a landmark trial has shown that anesthetic technique does not affect outcome after carotid endarterectomy. The surgical Apgar score may become part of routine clinical care of the vascular surgical patient because it predicts outcome and can be calculated at the bedside. Recent studies confirm that the serious perioperative risks of hyperglycemi... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428711 Fri, 17 Apr 2009 04:00:00 +0100 2428711 http://www.medworm.com/index.php?rid=2428710&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000329%2Fabstract%3Frss%3Dyes SOME ISSUES REMAIN controversial among surgeons concerning aortic arch surgery. One of the most important is the cerebral protection method. Many techniques have been offered including antegrade cerebral perfusion (ACP), deep hypothermic circulatory arrest (DHCA), and retrograde cerebral perfusion (RCP), but which method is the best for cerebral protection remains a dilemma. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428710 Fri, 17 Apr 2009 04:00:00 +0100 2428710 http://www.medworm.com/index.php?rid=3034804&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000299%2Fabstract%3Frss%3Dyes THE AUTHORS REPORT the successful use of high-frequency jet ventilation (HFJV) during single-lung transplantation (SLTx) in a patient with bullous emphysema-induced inability to achieve adequate ventilation with pressure control ventilation. Jet ventilation improved gas exchange on one-lung ventilation (OLV), allowing for the completion of SLTx while avoiding the use of cardiopulmonary bypass (CPB). (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034804 Fri, 17 Apr 2009 00:00:00 +0100 3034804 http://www.medworm.com/index.php?rid=2428707&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000238%2Fabstract%3Frss%3Dyes ALL SURGERY PERFORMED on the heart or on the great vessels will inevitably lead to bleeding of varying magnitude. It is routine practice in cardiac surgery to use different methods to minimize blood loss or to recycle the blood, thereby reducing the volume discarded. The practice of cardiotomy suction was introduced early in cardiac surgery as a means of returning the blood collected in the surgical field to the cardiopulmonary bypass circuit. Apart from this standard procedure, a multitude of pharmacologic, mechanical, and technical approaches exist to reduce blood loss. Despite these technologies, cardiotomy suction is still used in the majority of cases. However, several potentially negative effects have recently been attributed to retransfusion of shed blood by means of cardiotomy suct... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428707 Mon, 13 Apr 2009 04:00:00 +0100 2428707 http://www.medworm.com/index.php?rid=3205609&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000342%2Fabstract%3Frss%3Dyes POLYCYTHEMIA VERA (PV) is a chronic myeloproliferative disorder characterized by an absolute increase in red blood cell mass. In well over 90% of cases, a somatic mutation in hematopoietic precursors (JAK2V617F) is causative. This acquired mutation results in growth factor hypersensitivity and increased proliferation of erythroid, myeloid, and megakaryocyte lineages. The most common presentation is polycythemia with or without thrombocytosis, leukocytosis, splenomegaly, and arterial or venous thrombosis. Symptoms of hyperviscosity including headaches, visual disturbances, dizziness, weakness, and paresthesias can be subtle and easily overlooked. Extreme thrombocytosis (>1,000 × 109/L) also can occur and contributes, paradoxically, to an increased risk of hemorrhagic complications. (Source... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205609 Mon, 13 Apr 2009 00:00:00 +0100 3205609 http://www.medworm.com/index.php?rid=3205605&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000354%2Fabstract%3Frss%3Dyes Objective: To assess the effectiveness of an insulin regimen in divided doses designed to target risk factors of hyperkalemia in patients undergoing liver transplantation.Design: Retrospective comparison of the divided insulin dose regimen with a conventional large-bolus insulin method during liver transplantation.Setting: University-based, academic, tertiary center.Participants: Adult patients whose baseline potassium levels were ≥4.0 mmol/L and received insulin therapy during liver transplantation at the authors' medical center between January 2004 and April 2007.Interventions: Insulin was administered either in divided doses (1-2 units) for each unit of red blood cells transfused or in a large-bolus in patients at high risk for hyperkalemia during liver transplantation.Measurements an... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3205605 Mon, 13 Apr 2009 00:00:00 +0100 3205605 http://www.medworm.com/index.php?rid=3034806&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000366%2Fabstract%3Frss%3Dyes POSTOPERATIVE IPSILATERAL SHOULDER PAIN (ISP) occurs in many patients who have undergone thoracic surgery. Such pain often radiates to the upper arm and the ipsilateral shoulder remote from the incisional area. The source of ISP remains unclear, and, indeed, it has been postulated to have many sources. The authors present a case in which ISP may have resulted from latent cervical spine lesions that were not diagnosed preoperatively. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034806 Mon, 13 Apr 2009 00:00:00 +0100 3034806 http://www.medworm.com/index.php?rid=3034803&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000305%2Fabstract%3Frss%3Dyes Conclusions: These results suggest that a significant proportion of the authors' patients undergoing cardiac electrophysiology laboratory procedures required deep sedation if not general anesthesia, although a non–general anesthetic was planned. The issue of depth of sedation has implications for patient safety, privileging, and regulatory compliance. Based on the present results, the authors believe sedation for these procedures is best given by anesthesia providers; furthermore, caregivers should be aware that these procedures are likely to require deep sedation if not general anesthesia. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=3034803 Mon, 13 Apr 2009 00:00:00 +0100 3034803 http://www.medworm.com/index.php?rid=2836894&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000287%2Fabstract%3Frss%3Dyes Conclusions: Sevoflurane attenuates the pulmonary sequestration of neutrophil and leukocytes and also preserves the pulmonary consumption of cytokines at the time of early pulmonary reperfusion. Sevoflurane attenuates the systemic inflammatory response induced by cardiopulmonary bypass. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836894 Sun, 12 Apr 2009 23:00:00 +0100 2836894 http://www.medworm.com/index.php?rid=2836893&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000433%2Fabstract%3Frss%3Dyes Objective: The aim of this study was to determine whether perioperative statin therapy was associated with a dose-dependent decrease in adverse cardiovascular events after coronary artery bypass graft (CABG) surgery.Design: A prospective observational study.Setting: A cardiovascular anesthesia unit in a university hospital.Participants: Four hundred eighteen consecutive patients undergoing CABG surgery between October 2004 and October 2005.Interventions: Patients were divided in 2 groups depending on whether their preoperative treatment included statins or not. In patients receiving statins, high- and low-dose regimens were respectively defined as a regimen recognized to induce a theoretic reduction of low-density lipoprotein cholesterol level equal to 45% (n = 87) or (Source: Journal of C... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836893 Sun, 12 Apr 2009 23:00:00 +0100 2836893 http://www.medworm.com/index.php?rid=2836890&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000317%2Fabstract%3Frss%3Dyes Conclusion: Combined isoflurane/xenon anesthesia reduced infarct size but not more than isoflurane alone. Ischemic preconditioning was more effective than the anesthetics. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2836890 Sun, 12 Apr 2009 23:00:00 +0100 2836890 http://www.medworm.com/index.php?rid=2627696&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000378%2Fabstract%3Frss%3Dyes Conclusions: There was a trend toward a difference between times to place a bronchial blocker and the DLT. The Cohen blocker is more difficult to position in the left main bronchus than in the right one. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627696 Sun, 12 Apr 2009 23:00:00 +0100 2627696 http://www.medworm.com/index.php?rid=2627693&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000330%2Fabstract%3Frss%3Dyes Conclusion: In this cohort of patients undergoing CABG surgery, preoperative leukocytosis was a significant predictor of AF independent of CRP. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2627693 Sun, 12 Apr 2009 23:00:00 +0100 2627693 http://www.medworm.com/index.php?rid=2354266&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008001110%2Fabstract%3Frss%3Dyes Transesophageal echocardiography (TEE) is an accepted perioperative diagnostic and monitoring tool used by cardiologists and anesthesiologists. In intubated patients, in situ endotracheal tubes impede the subsequent insertion of the TEE probe into the esophagus. Hirabayashi reported the use of the GlideScope (Diagnostic Ultrasound Corp, Bothell, WA) to help with difficult transesophageal echocardiography probe placement. Airway Scope (AWS-S100; Pentax, Tokyo, Japan) is a rigid video laryngoscope used for tracheal intubation. The built-in monitor screen has a wide viewing angle of the larynx including the inlet portion of the esophagus. These features aid the operator in the placement of instruments other than the endotracheal tube. Herein, we describe using the AWS in lieu of the GlideScop... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354266 Wed, 01 Apr 2009 04:00:00 +0100 2354266 http://www.medworm.com/index.php?rid=2354265&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000360%2Fabstract%3Frss%3Dyes We report a rare cause of entrapment of a pulmonary artery catheter (PAC). A 62-year-old, 150-cm, 145-kg woman was brought to the operating room for an on-pump coronary artery bypass grafting procedure. In addition to coronary artery disease and morbid obesity, her past medical history included congestive heart failure, obstructive sleep apnea, and pulmonary hypertension. Preoperative transthoracic echocardiogram was significant for normal left ventricular function, right ventricular enlargement, and right atrial enlargement. The anesthetic plan included placement of an 8F PAC (Swan-Ganz CCOmbo; Edwards Lifescience, Irvine, CA) while awake to follow pulmonary artery pressures during induction. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354265 Wed, 01 Apr 2009 04:00:00 +0100 2354265 http://www.medworm.com/index.php?rid=2354264&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008001729%2Fabstract%3Frss%3Dyes We read with interest the article of Yazigi et al in which they compared the monitoring of central venous oxygen saturation (ScvO2) versus mixed venous oxygen saturation (SvO2) in low cardiac index patients. These authors found that ScvO2 cannot be used as an alternative to SvO2 for the normalization of cardiac index because large differences exist between its individual values. Yazig et al concluded that further studies in specific patient subpopulations are needed to confirm their results. They also suggest that the clinical utility of ScvO2 as a monitor, at least in cardiac surgery, should be elucidated. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354264 Wed, 01 Apr 2009 04:00:00 +0100 2354264 http://www.medworm.com/index.php?rid=2354263&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077007004028%2Fabstract%3Frss%3Dyes Iatrogenic tracheal ruptures are rare and life-threatening complications after endotracheal intubation. Various mechanical and anatomic factors contribute to this problem. We recently experienced 2 iatrogenic tracheal ruptures similar to those reported by Miñambres et al. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354263 Wed, 01 Apr 2009 04:00:00 +0100 2354263 http://www.medworm.com/index.php?rid=2354262&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000244%2Fabstract%3Frss%3Dyes I read with interest the article entitled “Inflation of the Distal Cuff by Saline Reduces the Incidence of Malposition of the Bronchial Tube During Lung Separation in Patients Receiving Nitrous Oxide.” These authors successfully showed a significant reduction in the number of patients requiring repositioning of the double-lumen tube (DLT) when the bronchial cuff of the DLT was filled with saline instead of air. All of the patients in this study were ventilated with a mixture of 50% N2O and 50% oxygen with isoflurane. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354262 Wed, 01 Apr 2009 04:00:00 +0100 2354262 http://www.medworm.com/index.php?rid=2354261&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000384%2Fabstract%3Frss%3Dyes Regarding the case report published in the December 2007 issue of the Journal entitled “Single-Lung Ventilation for Right-Sleeve Pneumonectomy With a Modified Nasal RAE Endotracheal Tube,” the operation that the authors describe in the text and figures is a right pneumonectomy and not a sleeve pneumonectomy. A sleeve pneumonectomy “includes pneumonectomy together with resection of the carina followed by end-to-end anastomosis of the contralateral main bronchus to the trachea.” There was no carinal resection or tracheobronchial anastomosis performed in the case described. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354261 Wed, 01 Apr 2009 04:00:00 +0100 2354261 http://www.medworm.com/index.php?rid=2354260&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002450%2Fabstract%3Frss%3Dyes Tiwari and D'Attellis recently reported on transient takotsubo cardiomyopathy (TCM) during liver transplantation (LT). This was only the second case of this type of ventricular dysfunction ever reported in a LT recipient. The first such reported complication occurred several hours after LT. In 1 case, major complications triggered the event and in the other it developed spontaneously. In both cases, myocardial infarction was assumed; both patients underwent coronary arterial angiography, which excluded coronary artery disease as a cause in both cases. However, in both patients, profound left ventricular dysfunction was shown on echocardiography, and they recovered from the event within a few days with normal cardiac function. We would like to add another case but emphasize the differential... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354260 Wed, 01 Apr 2009 04:00:00 +0100 2354260 http://www.medworm.com/index.php?rid=2354259&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008003844%2Fabstract%3Frss%3Dyes Fifty-Sixth Annual Meeting Association of University Anesthesiologists. Galveston, TX. April 3-5, 2009. Contact: AUA, 520 N Northwest Highway, Park Ridge, IL 60068, e-mail: c.dionne@asahq.org. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354259 Wed, 01 Apr 2009 04:00:00 +0100 2354259 http://www.medworm.com/index.php?rid=2354258&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008004151%2Fabstract%3Frss%3Dyes The recent advances in the multidisciplinary management of coronary artery disease (CAD) have been significant. The assessment of patients before percutaneous coronary intervention is likely to change significantly. National compliance with clinical guidelines in the preprocedural assessment of myocardial ischemia should be encouraged. Multislice computed tomographic coronary angiography continues to improve and is already an excellent screening test for CAD. Coronary stenting has an increasing role in multivessel and left main CAD, although further outcome trials are indicated, especially in the elderly. Although off-pump coronary artery bypass graft (CABG) surgery reduces postoperative atrial fibrillation, further major outcome advantages have not been shown in comprehensive meta-analyse... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354258 Wed, 01 Apr 2009 04:00:00 +0100 2354258 http://www.medworm.com/index.php?rid=2354257&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077007003278%2Fabstract%3Frss%3Dyes A 30-YEAR-OLD, 90-kg, 190-cm man with a history of hypertension and remote repair of an aortic coarctation presented to a community hospital with sudden onset of sharp left-sided chest pain and hemoptysis. The patient described a 1-week history of a sore throat and dry cough without a fever or sputum production but was otherwise healthy before his presenting symptoms began. The aortic coarctation had been repaired by using a Dacron patch aortoplasty when the patient was 7 years old. The remainder of his childhood development was normal. The physical examination showed a respiratory rate of 30 breaths/min and reduced breath sounds on the left side but was otherwise unremarkable. Laboratory analysis was significant for a hemoglobin concentration of 12.4 g/dL and a white blood cell count of 1... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354257 Wed, 01 Apr 2009 04:00:00 +0100 2354257 http://www.medworm.com/index.php?rid=2354256&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700700287X%2Fabstract%3Frss%3Dyes A 41-YEAR-OLD, 71-kg, 188-cm man with a long history of hemodialysis-dependent end-stage renal disease resulting from chronic glomerulonephritis presented to the authors' institution with a 6-month history of mild dyspnea on exertion. He was otherwise asymptomatic. The patient had undergone a cadaveric renal transplant 13 years before the current admission, but the transplanted kidney failed and was explanted 3 years later. He also had undergone a subtotal parathyroidectomy for the treatment of secondary hyperparathyroidism caused by renal failure. The patient was treated with hemodialysis 3 times per week through a left-arm fistula, which was well tolerated. He denied a history of syncope, angina pectoris, orthopnea, or peripheral edema. The physical examination was significant for a hars... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354256 Wed, 01 Apr 2009 04:00:00 +0100 2354256 http://www.medworm.com/index.php?rid=2354255&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000293%2Fabstract%3Frss%3Dyes A 52-YEAR-OLD woman was admitted to the hospital because of progressive dyspnea and fatigue. She had chronic severe mitral regurgitation (MR) because of radiation-induced mitral valve degeneration. Ten years earlier, she had received mediastinal radiation for thoracic non-Hodgkin's lymphoma. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354255 Wed, 01 Apr 2009 04:00:00 +0100 2354255 http://www.medworm.com/index.php?rid=2354254&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS105307700900024X%2Fabstract%3Frss%3Dyes OVER THE PAST 3 DECADES, the field of surgery has been transformed because of significant advances in technology and innovation. Advances in laparoscopy and robotic surgery have led to fewer and less-invasive operations, and the current surgical landscape may not be recognizable to a practitioner who stopped operating even as late as the 1980s. Vascular surgery has also been transformed because of the innovations in the catheter-based technology and therapies. Since the adaptation of endovascular abdominal aortic surgery, first introduced by Parodi in 1995, aortic operations are performed more and more commonly using the endovascular techniques. The adaptation of this has led to a significant decrease in the number of open aneurysm cases performed by the graduating vascular surgery fellows... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354254 Wed, 01 Apr 2009 04:00:00 +0100 2354254 http://www.medworm.com/index.php?rid=2354253&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000275%2Fabstract%3Frss%3Dyes CAROTID ENDARTERECTOMY (CEA) has been considered the gold standard for the treatment of extracranial carotid artery disease since the publication of the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the Asymptomatic Carotid Atherosclerosis Study (ACAS). These trials demonstrated decreased morbidity and mortality in both symptomatic and asymptomatic patients undergoing the procedure versus medical therapy, and often are used as the comparison between CEA and carotid angioplasty and stenting (CAS). (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354253 Wed, 01 Apr 2009 04:00:00 +0100 2354253 http://www.medworm.com/index.php?rid=2354252&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077009000032%2Fabstract%3Frss%3Dyes CONGENITALLY CORRECTED transposition of the great arteries (CC-TGA), defined as a combination of atrioventricular (AV) discordance and transposition of the great arteries (TGA), is a rare congenital anomaly and is even more rare when combined with situs inversus with visceroatrial mirror imaging. Blood flows from the left-sided superior and inferior vena cava to the left-sided morphologic right atrium and, subsequently, through the mitral valve to the morphologic left ventricle located on the left. The left ventricle pumps blood into the pulmonary artery. From the lungs, blood returns to the left atrium located on the right side and, subsequently, goes through the tricuspid valve (TV) to the right ventricle (also located on the right side) to be pumped into the aorta. The authors describe ... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354252 Wed, 01 Apr 2009 04:00:00 +0100 2354252 http://www.medworm.com/index.php?rid=2354251&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008003546%2Fabstract%3Frss%3Dyes THE STANDARD OF CARE in modern medicine is supported by many quality control tools, and intraoperative graft patency testing after coronary artery surgery can be proposed, in this context, as part of the operation documenting the success of the procedure itself. The aim of coronary artery bypass graft (CABG) surgery is to increase blood flow to the ischemic myocardium. This statement makes more of an impact if it is realized that 5% to 20% of all grafts performed fail before discharge from the hospital and up to 30% before 1 year without any objective evidence that these grafts were actually patent in the operating room. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354251 Wed, 01 Apr 2009 04:00:00 +0100 2354251 http://www.medworm.com/index.php?rid=2354250&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002395%2Fabstract%3Frss%3Dyes CARDIOPULMONARY BYPASS (CPB) temporarily replaces the functions of the heart and lungs during cardiac surgery, allowing the heart to be opened and operated on. To achieve this requires 2 key postulates to hold true: the circulation of blood around a patient's vasculature can be maintained by mechanical pumps while the heart is arrested, and venous blood can be artificially “arterialized” in an extracorporeal gaseous exchange device. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354250 Wed, 01 Apr 2009 04:00:00 +0100 2354250 http://www.medworm.com/index.php?rid=2354249&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000955%2Fabstract%3Frss%3Dyes DELAYED EMERGENCE from anesthesia in patients after major operations such as pneumonectomy may occur because of an overdose of anesthetic agents, especially in combination with factors such as age, abnormal drug disposition, and hypothermia. Acute renal failure may occur in postpneumonectomy patients in the week after the operation because of infection and sepsis. Less commonly, tumor embolization may lead to multiple infarctions and diverse clinical presentations. The case of a patient with delayed emergence from anesthesia and acute renal failure because of tumor embolization leading to acute cerebral and renal infarctions is reported. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354249 Wed, 01 Apr 2009 04:00:00 +0100 2354249 http://www.medworm.com/index.php?rid=2354248&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000207%2Fabstract%3Frss%3Dyes CEREBROVASCULAR PRESSURE autoregulation maintains a relatively constant cerebral blood flow (CBF) across a range of arterial blood pressures (ABPs). The study of the relationship between the intracranial pressure (ICP) and ABP waveforms has resulted in a characterization of cerebral vasculature as either pressure passive or pressure reactive. When ABP decreases, the vasculature dilates, or vascular resistance changes, to maintain constant CBF (CBF = ABP − ICP/vascular resistance). Changing vascular resistance (pressure reactivity) protects the brain from alterations in perfusion pressure. This physiologic response increases cerebral blood volume and ICP, and the result is a negative correlation between slow waves of ICP and ABP. Similarly, constriction occurs in pressure-reactive vascula... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354248 Wed, 01 Apr 2009 04:00:00 +0100 2354248 http://www.medworm.com/index.php?rid=2354247&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077007004107%2Fabstract%3Frss%3Dyes ATRIAL MYXOMAS ARE frequently misdiagnosed because of a lack of specific symptoms. An unusual case of a presumably healthy woman who developed acute loss of neurologic function in the lower extremities with subsequent pulmonary edema during exercise is presented here. The cause was an abdominal aortic embolism caused by a previously unrecognized left atrial myxoma. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354247 Wed, 01 Apr 2009 04:00:00 +0100 2354247 http://www.medworm.com/index.php?rid=2354246&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077007003084%2Fabstract%3Frss%3Dyes BODYBUILDING AND RESISTANCE TRAINING are two of the most popular sports in the world. Both involve extreme physical training and lifting heavy weights. This specific training is unique in that it involves transient extreme elevations in blood pressure (up to 480 mmHg) and heart rate. These sudden alterations in the loading conditions and extreme mechanical stresses can cause myocardial and valvular abnormalities. These cardiovascular abnormalities can have implications for the anesthetic management of these patients. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354246 Wed, 01 Apr 2009 04:00:00 +0100 2354246 http://www.medworm.com/index.php?rid=2354245&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008000943%2Fabstract%3Frss%3Dyes MOYAMOYA DISEASE (MMD) is a progressive cerebrovascular occlusive disease of the internal carotid arteries and anterior and middle cerebral arteries that affects children and young adults. The distinctive appearance of these collateral vessels on angiograms gives it the name “moyamoya,” which in Japanese means puff of smoke. MMD is a relatively common cause of ischemic and hemorrhagic strokes in pediatric patients in Asia, especially Korea and Japan. Genetic linkage studies and the study of the factors involved in the pathogenesis have shed new light on this disease. There is some suggestion that the pathogenesis may vary between races. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354245 Wed, 01 Apr 2009 04:00:00 +0100 2354245 http://www.medworm.com/index.php?rid=2354244&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077007003941%2Fabstract%3Frss%3Dyes PRIMARY GRAFT FAILURE in the early postoperative period after heart transplantation is a severe complication, potentially leading to multiorgan failure, presenting with a poor outcome. It seems to be the result of poor donor conditions, acute cellular and humoral rejection, and prolonged ischemia time. Therapeutic options are limited to pharmacologic support with catecholamines and phosphodiesterase inhibitors. Mechanical support with intra-aortic counterpulsation or extracorporeal membrane oxygenation (ECMO) may be necessary in severe cases of primary graft failure. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354244 Wed, 01 Apr 2009 04:00:00 +0100 2354244 http://www.medworm.com/index.php?rid=2354243&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008001857%2Fabstract%3Frss%3Dyes NONCOMPACTION CARDIOMYOPATHY (NCCMP) is a rare congenital cardiomyopathy characterized by multiple prominent trabeculations and recesses in the endo/myocardium of a noncompacted left ventricle. The clinical presentation can be very variable, ranging from an asymptomatic patient to one with symptoms of extreme congestive heart failure, arrhythmias, and/or systemic thromboembolic events. Although the pathogenesis of NCCMP remains the subject of debate, the most likely cause is thought to be arrest during embryologic development of the endocardium and myocardium. NCCMP has recently been the subject of numerous reports and reviews in the cardiology literature but to date has received little attention from anesthesiologists. The authors report a case of NCCMP in a patient who presented with pre... Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354243 Wed, 01 Apr 2009 04:00:00 +0100 2354243 http://www.medworm.com/index.php?rid=2354242&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008003650%2Fabstract%3Frss%3Dyes Conclusions: Urinary NGAL was not different in patients undergoing off-pump and on-pump CABG surgery despite a very good match between the groups with respect to pre- and intraoperative risk factors. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354242 Wed, 01 Apr 2009 04:00:00 +0100 2354242 http://www.medworm.com/index.php?rid=2354241&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002486%2Fabstract%3Frss%3Dyes Conclusions: Cardiac surgery with cardiopulmonary bypass is associated with a significant decrease of NO products. In the absence of kidney damage, decreased NO products could represent a physiologic response to cardiopulmonary bypass; however, endothelial dysfunction cannot be excluded. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354241 Wed, 01 Apr 2009 04:00:00 +0100 2354241 http://www.medworm.com/index.php?rid=2354240&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002498%2Fabstract%3Frss%3Dyes Conclusions: The pharmacokinetic model used markedly underestimated propofol plasma levels in the patient group studied. The large variability among patients suggests that BIS monitoring is not suitable for indicating an exact endpoint corresponding to deep sedation. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354240 Wed, 01 Apr 2009 04:00:00 +0100 2354240 http://www.medworm.com/index.php?rid=2354239&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002978%2Fabstract%3Frss%3Dyes Conclusions: Explicit and implicit memory were not detectable in patients anesthetized with an effect-site target-controlled infusion of propofol and remifentanil with bispectral index monitoring. These results suggest that there is no memory processing under anesthesia in the surgical setting. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354239 Wed, 01 Apr 2009 04:00:00 +0100 2354239 http://www.medworm.com/index.php?rid=2354238&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008002188%2Fabstract%3Frss%3Dyes Conclusion: There was no difference in patient satisfaction between the 2 groups. On the basis of the reduction of pain scores (with cough and movement) at 1 or 2 postoperative time points, PCA-remifentanil infusion is a better analgesic technique; overall, both PCA techniques provided for effective pain scores ( (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354238 Wed, 01 Apr 2009 04:00:00 +0100 2354238 http://www.medworm.com/index.php?rid=2354237&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008003613%2Fabstract%3Frss%3Dyes Conclusion: Postoperative C-reactive protein does not seem to be a useful marker in predicting outcome after 48 hours in the intensive care unit. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354237 Wed, 01 Apr 2009 04:00:00 +0100 2354237 http://www.medworm.com/index.php?rid=2354236&cid=s_37061_5_f&fid=37061&url=http%3A%2F%2Fwww.jcvaonline.com%2Farticle%2FPIIS1053077008003522%2Fabstract%3Frss%3Dyes Conclusion: Postoperative heart failure after aortic valve replacement is still a very serious condition with increased early mortality. The results of the present study suggest that an elevated BNP level on arrival in the ICU is an independent predictor of postoperative heart failure after aortic valve replacement. In the authors' opinion, an increased BNP level on arrival in the ICU may support early diagnosis and allow optimal management of heart failure after aortic valve replacement. (Source: Journal of Cardiothoracic and Vascular Anesthesia) Journal of Cardiothoracic and Vascular Anesthesia journals http://www.medworm.com/rss/comments.php?id=2354236 Wed, 01 Apr 2009 04:00:00 +0100 2354236