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

Cardiac Calendar 2016-2020
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Tags: Cardiac Calendar 2016-2020 Source Type: research

Immediate ICU Care for Patients Following Aortic Arch Surgery
Patients undergoing aortic arch surgery are at high risk for stroke, delirium, low cardiac output, respiratory failure, renal failure, and coagulopathy. A significantly higher mortality is seen in patients experiencing any of these complications when compared with those without complications. As surgical, perfusion, and anesthetic techniques improve, the incidence of major complications have decreased. A recent paradigm shift in cardiac surgery has focused on rapid postoperative recovery, and a similar change has affected the care of patients after arch surgery. Nevertheless, a small subset of patients experience significa...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Hlaing, M. Tags: Reviews Source Type: research

Hybrid Techniques for Aortic Arch Aneurysm Repair
Open repair of the aortic arch remains the gold standard for aortic aneurysms and dissections. However, in elderly patients with comorbidities, and in patients where prolonged cardiopulmonary bypass time and circulatory arrest may pose a significant risk, hybrid techniques in repairing the aortic arch have become quite attractive. Hybrid arch surgery includes a combination of endovascular and open surgery that allows surgeons to operate on the arch in a safe and expeditious manner with potential decrease in morbidity and mortality. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Sultan, I., Bavaria, J. E., Szeto, W. Tags: Reviews Source Type: research

Elephant Trunk: Argument for All Arches
Conclusions. Today, total arch replacement with elephant trunk provides simplified staged surgery but, nonetheless, remains a complex surgical procedure. Although many proximal aortic procedures may be addressed with ascending and partial transverse arch replacement, when total or complete transverse arch replacement is required, then the use of the elephant trunk technique, whether standard or frozen, should be considered. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Tanaka, A., Estrera, A. L. Tags: Reviews Source Type: research

Aortic Arch Replacement in Patients With Chronic Dissection: Special Considerations
The progressive expansion of residual, chronic DeBakey type I dissection often necessitates repair of the aortic arch and the distal aorta (ie, descending thoracic and thoracoabdominal aorta). The vast majority of patients with chronic aortic dissection facing aortic arch surgery are survivors of emergent proximal aortic repair for acute dissection, and thus, these patients now face a reoperative procedure necessitating a redo median sternotomy. One approach for repairing the chronic type I aortic dissection incorporates total transverse aortic arch replacement with and without an elephant trunk extension; an elephant trun...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: de la Cruz, K. I., Green, S. Y., Preventza, O. A., Coselli, J. S. Tags: Reviews Source Type: research

Total Aortic Arch Replacement: Advantages of Varied Techniques
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique—each having its own advantages. In addition, thoracic...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Shelstad, R. C., Reeves, J. G., Yamanaka, K., Reece, T. B. Tags: Reviews Source Type: research

Hemiarch: The Real Operation for Ascending Aortic Aneurysm
The extent and technique of resection for ascending aortopathies remains debated. The 2 main camps are divided into those who believe in the hemiarch resection utilizing hypothermic circulatory arrest and those who feel that the same goal can be accomplished with just an ascending aortic resection with an aortic cross clamp. While this debate continues to happen within groups and in some cases even in the same hospital, it certainly has not happened in the literature. There are no studies directly comparing the safety and efficacy of these 2 ideologies. The aim of this review is to present the little data that do exist and...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Singh, R., Yamanaka, K., Reece, T. B. Tags: Reviews Source Type: research

Arterial Cannulation and Cerebral Perfusion Strategies for Aortic Arch Operations
Neurologic injuries following aortic arch operations can be devastating, with stroke occurring in up to 12% of elective operations and significant cerebral dysfunction occurring in up to 25% of cases. The primary challenge unique to aortic arch operations involves interruption of direct perfusion of the brachiocephalic vessels during arch reconstruction. For this reason, neuroprotection is paramount. The 2 main modes of protection are (1) reducing metabolic demand through hypothermia and (2) limiting, or even eliminating, the ischemic period. Preoperative selection of the cerebral perfusion plan for each operation is imper...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Foley, L. S., Yamanaka, K., Reece, T. B. Tags: Reviews Source Type: research

A Clinical Protocol for Goal Directed Cerebral Perfusion during Aortic Arch Surgery
Conclusion: Our clinical protocol may offer higher flow rates, avoid complications associated with additional cannulae, and provide an easy setup for dual arterial perfusion. Additionally, GDP has enhanced our understanding of metabolic physiology and may facilitate the development of a better cerebral protection strategy. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Mosca, M. S., Justison, G., Reece, T. B. Tags: Reviews Source Type: research

Temperature Management for Aortic Arch Surgery
Surgical treatment of aortic arch disease is a technically challenging procedure that requires complex circulation management strategies involving the use of hypothermic circulatory arrest. The definition of hypothermia has evolved with comfort and surgical adjuncts. This review describes the various circulation and temperature management strategies used during hemiarch and total arch replacement. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Chen, E. P., Leshnower, B. G. Tags: Reviews Source Type: research

Neurophysiological Intraoperative Monitoring During Aortic Arch Surgery
Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by systemically cooling the patient prior to circulatory arrest. Neurophysiological intraoperative monitoring (NIOM) is often used during the course of these procedures to provide contemporaneous assessment of brain status to help direct circulatory management decisions and detect brain ischemia. In this review, we discuss the characteristics of electrocerebral activity throu...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Keenan, J. E., Benrashid, E., Kale, E., Nicoara, A., Husain, A. M., Hughes, G. C. Tags: Reviews Source Type: research

Anesthetic Considerations for Surgery on the Aortic Arch
Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist’s perspective, with particular emphasis on transesophageal echo evaluation and coagulation management. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Wilkey, B. J., Weitzel, N. S. Tags: Reviews Source Type: research

Indications for Aortic Arch Intervention
Surgery of the aortic arch is arguably one of the most complex areas of cardiac surgery. Despite that, studies and guidelines have not sufficiently addressed the aortic arch specifically. In general, indications for aortic arch intervention parallel those of the ascending aorta. Herein we review indications for aortic arch intervention in various aortic pathologies based on the scant evidence available combined with surgical expertise and expert opinion. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Al-Atassi, T., Khoynezhad, A. Tags: Reviews Source Type: research

Perioperative Management for Complex Aortic Arch Disease
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - November 5, 2016 Category: Anesthesiology Authors: Reece, T. B., Weitzel, N. S. Tags: Guest Editorial Source Type: research

Prolonged Intraoperative Cardiac Resuscitation Complicated by Intracardiac Thrombus in a Patient Undergoing Orthotopic Liver Transplantation
We report the case of successful resuscitation after prolonged cardiac arrest during orthotopic liver transplantation. After reperfusion, the patient developed ventricular tachycardia, complicated by intracardiac clot formation and massive hemorrhage. Transesophageal echocardiography demonstrated stunned and nonfunctioning right and left ventricles, with developing intracardiac clots. Treatment with heparin, massive transfusion and prolonged cardiopulmonary resuscitation ensued for 51 minutes. Serial arterial blood gases demonstrated adequate oxygenation and ventilation during cardiopulmonary resuscitation. Cardiothoracic ...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - July 18, 2016 Category: Anesthesiology Authors: Kim, S., DeMaria, S., Cohen, E., Silvay, G., Zerillo, J. Tags: Case Report Source Type: research