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Con: We Should Not Enforce the Use of Ultrasound as a Standard of Care for Obtaining Central Venous AccessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Authors: Eugene A. Hessel Tags: Pro and Con Source Type: journals

Case 5—2009 Severe Lactic Acidosis During Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 medica...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Authors: Sung (Jason) Chi, Erica Stein, Mark A. Chaney, Marco Ranucci, Michael H. Wall Tags: Case Conference Source Type: journals

Real-Time 3-Dimensional Echocardiographic Assessment of Current Continuous-Flow Rotary Left Ventricular Assist DevicesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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% desp...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Authors: Javier G. Castillo, Anelechi C. Anyanwu, David H. Adams, Thandiwe Nyirenda, Gregory W. Fischer Tags: Emerging Technology Review Source Type: journals

Transesophageal Echocardiographic Imaging of the Branches of the Aorta: A Guide to Obtaining These Images and Their Clinical UtilityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Authors: Pamela Salerno, Andrew Jackson, Martin Shaw, Phillip Spratt, Paul Jansz Tags: Review Articles Source Type: journals

Cardioprotection by Volatile Anesthetics: Established Scientific Principle or Lingering Clinical Uncertainty?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, intrac...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Authors: Paul S. Pagel Tags: Editorial Source Type: journals

Guide for AuthorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Source Type: journals

Articles to Appear in Future IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Source Type: journals

MastheadEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 28, 2009 Category: Anesthesiology Source Type: journals

Cardiac Calendar—2009 to 2012Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 16, 2009 Category: Anesthesiology Authors: George Silvay Tags: Cardiac Calendar Source Type: journals

Recent Progress in Heart Failure Treatment and Heart TransplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 outcom...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 16, 2009 Category: Anesthesiology Authors: John G.T. Augoustides, Hynek Riha Tags: Expert Review Source Type: journals

Pro: Ultrasound Should Be the Standard of Care for Central Catheter InsertionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 clin...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 16, 2009 Category: Anesthesiology Authors: John G.T. Augoustides, Albert T. Cheung Tags: Pro and Con Source Type: journals

Cardiac Calendar—2009 to 2011Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Authors: George Silvay Tags: Cardiac Calendar Source Type: journals

Con: Mitral Regurgitation Can Be Reliably Assessed Under General AnesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 - July 23, 2009 Category: Anesthesiology Authors: Dalia A. Banks Tags: Pro and Con Source Type: journals

Pro: Mitral Regurgitation Can Be Reliably Assessed Under General AnesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 improv...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Authors: Robina Matyal Tags: Pro and Con Source Type: journals

Intraoperative Classification of Mitral Valve Dysfunction: The Role of the Anesthesiologist in Mitral Valve ReconstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 re...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Authors: Gregory W. Fischer, Anelechi C. Anyanwu, David H. Adams Tags: Review Article Source Type: journals

Perioperative Transthoracic Echocardiography: “Universal Acid”?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Authors: Gerard R. Manecke, Daniel P. Vezina Tags: Editorial Source Type: journals

Guide for AuthorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Source Type: journals

Articles to Appear in Future IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Source Type: journals

MastheadEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 23, 2009 Category: Anesthesiology Source Type: journals

CASE 4—2009 Severe Reexpansion Pulmonary Edema After Minimally Invasive Aortic Valve Replacement: Management Using Extracorporeal Membrane OxygenationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 in...
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 14, 2009 Category: Anesthesiology Authors: Adam L. Shires, Thomas M. Green, Haley L.P. Owen, Thomas N. Hansen, Zafar Iqbal, Sandeep Markan, R. Eric Lilly, Paul S. Pagel, Peter D. Slinger, Joseph J. DeRose Tags: Case Conference Source Type: journals

Recent Advances in Aortic Valve Disease: Highlights From a Bicuspid Aortic Valve to Transcatheter Aortic Valve ReplacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 4, 2009 Category: Anesthesiology Authors: John G.T. Augoustides, Yanika Wolfe, Elizabeth K. Walsh, Wilson Y. Szeto Tags: Expert Review Source Type: journals

Case 3—2009 Robotically Assisted Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Authors: Alfredo Ceballos, Mark A. Chaney, Pierre T. LeVan, Joseph J. DeRose, Francis Robicsek Tags: Case Conference Source Type: journals

Continuous Arterial Pressure Waveform–Based Cardiac Output Using the FloTrac/Vigileo: A Review and Meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 accepte...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Authors: Jochen Mayer, Joachim Boldt, Reagan Poland, Amanda Peterson, Gerard R. Manecke Tags: Emerging Technology Review Source Type: journals

The Role of Epicardial Echocardiography in the Measurement of Transvalvular Flow Velocities During Aortic Valve ReplacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Authors: Ravi Taneja, Bert Quaghebeur, Larry W. Stitt, Mackenzie A. Quantz, Lin R. Guo, Bob Kiaii, Daniel T. Bainbridge Tags: Original Articles Source Type: journals

Catheter-Based Aortic Valve ReplacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 c...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Authors: David J. Cook, Kent H. Rehfeldt Tags: Editorial Source Type: journals

Guide for AuthorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Source Type: journals

Articles to Appear in Future IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Source Type: journals

MastheadEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 23, 2009 Category: Anesthesiology Source Type: journals

Association Between Tumor Necrosis Factor α 308G/A Polymorphism and Increased Proinflammatory Cytokine Release After Cardiac Surgery With Cardiopulmonary Bypass in the Korean PopulationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 20, 2009 Category: Anesthesiology Authors: Seung Zhoo Yoon, In-Jin Jang, Yoon Ji Choi, Mae Hwa Kang, Hye Ja Lim, Young Jin Lim, Hye Won Lee, Seong Ho Chang, Suk Min Yoon Tags: Original Articles Source Type: journals

Multisite Near-Infrared Spectroscopy Predicts Elevated Blood Lactate Level in Children After Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 17, 2009 Category: Anesthesiology Authors: Sujata B. Chakravarti, Alexander J.C. Mittnacht, Jason C. Katz, Khahn Nguyen, Umesh Joashi, Shubhika Srivastava Tags: Original Articles Source Type: journals

Epidemiology of Deep Sternal Wound Infection in Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 19, 2009 Category: Anesthesiology Authors: Farzan Filsoufi, Javier G. Castillo, Parwis B. Rahmanian, Stafford R. Broumand, George Silvay, Alain Carpentier, David H. Adams Tags: Original Articles Source Type: journals

Cardiac Calendar—2009 to 2011Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2009 Category: Anesthesiology Authors: George Silvay Tags: Cardiac Calendar Source Type: journals

Recent Advances in Perioperative Medicine: Highlights From the Literature for the Cardiothoracic and Vascular AnesthesiologistEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2009 Category: Anesthesiology Authors: John G.T. Augoustides, Prakash Patel Tags: Expert Review Source Type: journals

A Current View of Cerebral Protection in Aortic Arch RepairEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 17, 2009 Category: Anesthesiology Authors: Bilgin Emrecan, Engin Tulukoğlu Tags: Special Article: Surgical Opinion and Review Source Type: journals

The Rationale for Intraoperative Blood Salvage in Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 s...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 13, 2009 Category: Anesthesiology Authors: Henrik Jönsson Tags: Review Articles Source Type: journals

The Effects of Sevoflurane on Systemic and Pulmonary Inflammatory Responses After Cardiopulmonary BypassEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2009 Category: Anesthesiology Authors: Eun Jung Cho, Jong Hyun Yoon, Sung Jin Hong, Sun Hee Lee, Sung Bo Sim Tags: Original Articles Source Type: journals

Perioperative Statin Therapy Is Associated With a Significant and Dose-Dependent Reduction of Adverse Cardiovascular Outcomes After Coronary Artery Bypass Graft SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 wer...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2009 Category: Anesthesiology Authors: Alexandre Ouattara, Hamina Benhaoua, Yannick Le Manach, Nejma Mabrouk-Zerguini, Omar Itani, Amer Osman, Marc Landi, Bruno Riou, Pierre Coriat Tags: Original Articles Source Type: journals

The Effect of Xenon on Isoflurane Protection Against Experimental Myocardial InfarctionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2009 Category: Anesthesiology Authors: Jan H. Baumert, Marc Hein, Christina Gerets, Thomas Baltus, Klaus E. Hecker, Rolf Rossaint Tags: Original Articles Source Type: journals

A Comparison of the Deflecting-Tip Bronchial Blocker With a Wire-Guided Blocker or Left-Sided Double-Lumen TubeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2009 Category: Anesthesiology Authors: Virginie Dumans-Nizard, Ngai Liu, Pierre-Antoine Laloë, Marc Fischler Tags: Original Articles Source Type: journals

Increased Preoperative White Blood Cell Count Predicts Postoperative Atrial Fibrillation After Coronary Artery Bypass SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2009 Category: Anesthesiology Authors: Manuel L. Fontes, David Amar, Amy Kulak, Kathryn Koval, Hao Zhang, Weiji Shi, Howard Thaler Tags: Original Articles Source Type: journals

The Airway Scope: An Aid Also in Transesophageal Echocardiography Probe PlacementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2009 Category: Anesthesiology Authors: Hirotoshi Kitagawa, Yasuhiko Imashuku, Toji Yamazaki Tags: Letters to the Editor Source Type: journals

A Rare Cause of an Entrapped Pulmonary Artery CatheterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2009 Category: Anesthesiology Authors: Neal S. Gerstein, Damian DeLeon Tags: Letters to the Editor Source Type: journals

Central Venous Oxygen Saturation: Is It Time To Find Its Clinical Applications?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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: Journa...
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2009 Category: Anesthesiology Authors: Gumersindo Solares, Manuel Gomez-Fleitas Tags: Letters to the Editor Source Type: journals

Two Cases of Tracheal Rupture After Endotracheal IntubationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 1, 2009 Category: Anesthesiology Authors: Ali Alagöz, Fatma Ulus, Hilal Sazak, Akif Çamdal, Eser Savkilioglu Tags: Letters to the Editor Source Type: journals