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Seminars in Cardiothoracic and Vascular Anesthesia

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https://www.readbyqxmd.com/read/28933249/anesthetic-management-of-laser-lead-extraction-for-cardiovascular-implantable-electronic-devices
#1
Meena Bhatia, Payam Safavi-Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28922985/delayed-development-of-malignant-hyperthermia-following-cardiopulmonary-bypass
#2
Stephen Hall Sams, Stephen Revilla, David Lawrence Stahl
Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. The development of postoperative MH following cardiac surgery is rare, but anesthesiologists and intensivists must maintain a high index of suspicion in order to make a prompt diagnosis. Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28922972/perioperative-anesthetic-management-of-patients-having-liver-transplantation-for-uncommon-conditions
#3
Anthony Bonavia, Justin Pachuski, Dmitri Bezinover
This review focuses on the perioperative anesthetic management of patients having liver transplantation (LT) performed for several uncommon indications or in combination with rare pathology. Conditions discussed in the article include Alagille syndrome, hypertrophic cardiomyopathy, Gilbert's syndrome, porphyria, Wilson's disease, and Budd-Chiari syndrome. In comparison to other indications, LT in these settings is infrequent because of the low incidence of these pathologies. Most of these conditions (with the exception of Gilbert syndrome) are associated with a high probability of significant perioperative complications and increased mortality and morbidity...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28895500/anesthetic-management-of-a-patient-with-tracheal-dehiscence-post-tracheal-resection-surgery
#4
Sang Kim, Maryna Khromava, Jeron Zerillo, George Silvay, Adam I Levine
We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28868984/the-new-kidney-donor-allocation-system-and-implications-for-anesthesiologists
#5
Srikanth Sridhar, Sara Guzman-Reyes, Sam D Gumbert, Semhar J Ghebremichael, Angelina R Edwards, Mark J Hobeika, Wasim A Dar, Evan G Pivalizza
Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28818015/bioglue-associated-loss-of-aortic-valve-leaflet-motility-sonographically-masked-by-both-newly-replaced-mechanical-aortic-and-mitral-valves
#6
Alan Matthew Smeltz, Thomas G Caranasos, Emily G Teeter
BioGlue is a surgical adhesive widely used to help reinforce complex cardiac and vascular repairs. Since its introduction, several case reports have emerged revealing complications that all providers should be mindful of whenever the product is used. This report considers a unique situation where BioGlue was used after double cardiac valve repair that resulted in adhesion of the new mechanical aortic valve leaflets and was difficult to visualize with transesophageal echocardiography.
August 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28709382/severe-aortic-valve-stenosis-due-to-alkaptonuric-ochronosis
#7
Magdy El-Sayed Ahmed, Omar Hussain, David A Ott, Muhammad Aftab
Alkaptonuric ochronosis is a rare cause of aortic valve stenosis. We report the case of a 61-year-old female patient with alkaptonuria who presented to our institute with the clinical picture of severe aortic valve stenosis, which was confirmed by transthoracic echocardiography. On aortotomy, she was noted to have an impressive black discoloration of ascending aorta and the aortic root complex involving the aortic valve leaflets. She underwent an uneventful aortic valve replacement. She was discharged home 10 days postoperatively...
July 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758563/papillary-fibroelastoma-found-with-transesophageal-echocardiography-after-a-normal-transthoracic-echocardiography
#8
Andrew G Cook, Omar Viswanath, Jayanand D'Mello
We present the case of a patient with transient ischemic attacks who was being investigated for multiple embolic strokes. Initial workup, including brain computed tomography, computed tomography angiography, and transthoracic echocardiography (TTE) were negative for a source until transesophageal echocardiography (TEE) found a mass in the left atrium. The TEE differentiated the mass as a rare cardiac papillary fibroelastoma on the left atrial free wall confirmed by postsurgical pathology. This case highlights the importance of TEE as a diagnostic tool for its ability to more accurately differentiate and characterize the tumor compared with TTE...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758562/thromboelastrography-teg-is-still-relevant-in-the-21st-century-as-a-point-of-care-test-for-monitoring-coagulation-status-in-the-cardiac-surgical-suite
#9
Antonio Hernandez Conte, Deena Perotti, Lauren Farac
Since their introduction into clinical practice in the early 1960s, viscoelastic point-of-care (POC) testing-thromboelastrography (TEG) and thromboelastrometry (ROTEM)-has become increasingly popular in intensive care units, operating rooms, and emergency room settings. As TEG has been an established POC viscoelastic testing modality for many years, there has been more research and analysis of its utility and ability to reduce transfusions in the general, cardiac, and liver surgical sectors compared with ROTEM...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758561/troubles-after-swan-ganz-catheter-placement-in-cardiac-surgery
#10
Camilla L'Acqua, Paola Suriano, Sebastiana Gregu, Valeria Mazzanti
No abstract text is available yet for this article.
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758560/facing-the-ever-changing-challenges-of-caring-for-cardiothoracic-and-transplant-surgery-patients
#11
Miklos D Kertai, Mark M Twite, Nathaen Weitzel
No abstract text is available yet for this article.
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758559/small-for-size-syndrome-bridging-the-gap-between-liver-transplantation-and-graft-recovery
#12
Akila Rajakumar, Ilankumaran Kaliamoorthy, Mohamed Rela, M Susan Mandell
In living donor liver transplantation, optimal graft size is estimated from values like graft volume/standard liver volume and graft/recipient body weight ratio but the final functional hepatic mass is influenced by other donor and recipient factors. Grafts with insufficient functional hepatic mass can produce a life-threatening condition with rapidly progressive liver failure called small-for-size syndrome (SFSS). Diagnosis of SFSS requires careful surveillance for signs of inadequate hepatocellular function, residual portal hypertension, and systemic inflammation that suggest rapidly progressive liver failure...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758558/acute-debakey-type-i-dissection-repair-using-frozen-elephant-trunk-the-cleveland-clinic-technique
#13
Muhammad Aftab, Ryan Plichta, Eric E Roselli
Over the past 3 decades, the standard surgical management for acute DeBakey type I aortic dissection has not significantly changed. Most patients undergo ascending aortic replacement with an interposition graft under hypothermic circulatory arrest with selective root replacement. Nevertheless, with the improvement in overall patient care, acute surgical outcomes continue to improve. The frozen elephant trunk (FET) technique was introduced as a modification to conventional elephant trunk to treat extensive degenerative and chronic dissecting aneurysms involving the aortic arch and the proximal descending aorta...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758557/thromboelastometry-versus-rotational-thromboelastography-in-cardiac-surgery
#14
Ahmed Zaky
Evidence exists on the morbiduty and mortality associated with both massive blood loss and transfusion in cardiac surgical patients. Monitoring of the vesicoelastic properties of blood using rotational thromboelastometry and thromboelsatography (TEG) has been a major step towards ameliorating the risks associated with these 2 evils by providing trageted goal-directed blood product resuscitation. Point of care ROTEM and TEG overcome many of the current limitatons of conventional laboratory coagulation testing...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28758556/cardiac-calendar-2017-2020
#15
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28592182/perioperative-and-anesthetic-considerations-in-atrioventricular-septal-defect
#16
Faith J Ross, Viviane G Nasr, Denise Joffe, Gregory J Latham
Atrioventricular septal defect results from a failure of normal endocardial cushion fusion during embryologic cardiac development. This developmental aberration results in defects in the atrial and/or ventricular septum and malformation of the atrioventricular valves. The pathophysiology of atrioventricular septal defect is variable, and ranges from mild left to right shunting similar to a simple atrial septal defect to complex single-ventricle heart disease. This review focuses on the spectrum of atrioventricular septal defect from partial to complete, without associated cardiac defects...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28482733/surgical-considerations-in-atrioventricular-canal-defects
#17
Mahim Malik, Muhammad Khalid Nuri
Atrioventricular canal defects represent a diverse and challenging group of defects. Timing and surgical technique is greatly dependent on morphology of the valve as well as symptoms. Surgical options for repair of these defects are reviewed and presented below.
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28466755/perioperative-management-of-cardiac-transplant-recipients-undergoing-noncardiac-surgery-unique-challenges-created-by-advancements-in-care
#18
Paul T Jurgens, Christina L Aquilante, Robert L Page, Amrut V Ambardekar
Advancements in postcardiac transplant care have resulted in significant reductions in morbidity and increased life expectancy for cardiac transplant recipients. Consequently, many cardiac transplant recipients are living long enough to require subsequent noncardiac surgery. The perioperative care of heart transplant recipients presents a unique challenge as many of the common preoperative risk assessments do not apply to a transplanted heart, immunosuppressive medications have side effects and potential for drug-drug interactions, and the denervated heart results in an altered autonomic physiology and response to medications...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#19
Zeena Husain, Payam Safavi-Naeini, Abdi Rasekh, Mehdi Razavi, Charles D Collard, James M Anton, Daniel A Tolpin
Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation. Unfortunately, despite optimal medical management, thromboembolic events still occur. Recently, there has been a great deal of interest and innovation in finding an alternative to chronic anticoagulation...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28506196/sir-william-harvey-congenital-heart-disease-and-anesthesia
#20
Mark D Twite
No abstract text is available yet for this article.
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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