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Seminars in Cardiothoracic and Vascular Anesthesia

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https://www.readbyqxmd.com/read/28709382/severe-aortic-valve-stenosis-due-to-alkaptonuric-ochronosis
#1
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/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#2
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/28592182/perioperative-and-anesthetic-considerations-in-atrioventricular-septal-defect
#3
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...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28549395/utility-and-clinical-profile-of-dexmedetomidine-in-pediatric-cardiac-catheterization-procedures-a-matched-controlled-analysis
#4
Ricardo Riveros, Natalya Makarova, Efrain Riveros-Perez, Praneeta Chodavarapu, Wael Saasouh, Hüseyin Oğuz Yılmaz, Evis Cuko, Rovnat Babazade, Stephen Kimatian, Alparslan Turan
BACKGROUND: Dexmedetomidine is increasingly used in children undergoing cardiac catheterization procedures. We compared the percentage of surgical time with hemodynamic instability and the incidence of postoperative agitation between pediatric cardiac catheterization patients who received dexmedetomidine infusion and those who did not and the incidence of postoperative agitation. MATERIALS AND METHODS: We matched 653 pediatric patients scheduled for cardiac catheterization...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28490233/update-on-finger-application-type-noninvasive-continuous-hemodynamic-monitors-cnap-and-ccnexfin-physical-principles-validation-and-clinical-use
#5
Eugene P Raggi, Tetsuro Sakai
The CNAP HD Monitor (CNSystems, Graz, Austria) and the ccNexfin (The ClearSight System: Edwards Lifesciences Corporation, Irvine, CA) are continuous, noninvasive blood pressure monitors using a finger-application device. These devices show a promising ability to allow for rapid detection of hemodynamic derangement when compared with oscillometry. The accuracy and precision of these devices as blood pressure monitors has been evaluated when compared with intra-arterial catheters. Additionally, they can be used to measure beat-to-beat cardiac output (CO)...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28486870/long-term-cardiac-morbidity-and-mortality-in-patients-with-aortic-valve-disease-following-liver-transplantation-a-case-matching-study
#6
Ramona Nicolau-Raducu, Thomas Marshall, Hamang Patel, Kelly Ural, Joseph Koveleskie, Susan Smith, Donald Ganier, Bryan Evans, Brian Fish, William Daly, Ari J Cohen, George Loss, Amjad Bokhari, Bobby Nossaman
INTRODUCTION: This retrospective study examined the role of aortic valve (AV) disease in patients who underwent orthotopic liver transplantation (OLT) to determine the incidence of postoperative cardiac morbidity and mortality when compared with a matched control group without AV disease. METHODS: Patients were included in the AV group if diagnosed with aortic stenosis (AS) or aortic regurgitation or had received AV replacement prior to OLT. The AV group (n = 53) was matched to a control group (n = 212) with the following preoperative variables: type of organ transplanted, age, gender, race, body mass index, MELD, redo-transplantation, preoperative renal replacement therapy, nonalcoholic steatohepatitis, viral hepatitis, diabetes, and coronary artery disease...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28482761/lack-of-association-between-adrenoreceptor-genotype-and-the-vasoconstriction-response-to-dexmedetomidine
#7
Robert H Friesen, Dobromir Slavov, Shelley D Miyamoto, R J Ing, Wells B LaRiviere, Matthew R G Taylor
An exaggerated vasoconstriction response to dexmedetomidine, an α-2 adrenergic agonist, has been associated with 2 genotypes: a deletion in the α-2B adrenoreceptor gene ( ADRA2B deletion) and SNP rs9922316 in the gene for protein kinase C type β ( PRKCB). We hypothesized that children with a marked systemic vascular resistance index (SVRI) increase following intravenous dexmedetomidine bolus would carry these genotypes. Following institutional review board approval, DNA samples from 16 children with transplanted hearts who participated in a study in the cardiac catheterization laboratory of hemodynamic responses to dexmedetomidine boluses underwent genotyping by polymerase chain reaction (PCR) amplification and PCR Sanger sequencing for the ADRA2B deletion and for PRKCB rs9922316...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28482733/surgical-considerations-in-atrioventricular-canal-defects
#8
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.
May 1, 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
#9
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...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28506196/sir-william-harvey-congenital-heart-disease-and-anesthesia
#10
Mark D Twite
No abstract text is available yet for this article.
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28506195/cardiac-calendar-2017-2020
#11
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28190371/occupational-radiation-exposure-of-anesthesia-providers-a-summary-of-key-learning-points-and-resident-led-radiation-safety-projects
#12
Rachel R Wang, Amanda H Kumar, Pedro Tanaka, Alex Macario
Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a "high" or "very high" concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring...
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28118786/mathematical-analysis-and-physical-profile-of-blalock-taussig-shunt-and-sano-modification-procedure-in-hypoplastic-left-heart-syndrome-review-of-the-literature-and-implications-for-the-anesthesiologist
#13
Efrain Riveros Perez, Ricardo Riveros
The first stage of surgical treatment for hypoplastic left heart syndrome (HLHS) includes the creation of artificial systemic-to-pulmonary connections to provide pulmonary blood flow. The modified Blalock-Taussig (mBT) shunt has been the technique of choice for this procedure; however, a right ventricle-pulmonary artery (RV-PA) shunt has been introduced into clinical practice with encouraging but still conflicting outcomes when compared with the mBT shunt. The aim of this study is to explore mathematical modeling as a tool for describing physical profiles that could assist the surgical team in predicting complications related to stenosis and malfunction of grafts in an attempt to find correlations with clinical outcomes from clinical studies that compared both surgical techniques and to assist the anesthesiologist in making decisions to manage patients with this complex cardiac anatomy...
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27401860/a-rare-case-of-anomalous-left-coronary-artery-from-the-pulmonary-artery-bland-white-garland-syndrome-in-a-68-year-old-woman
#14
S Michael Roberts, Trey Banbury, Anand Mehta
Anomalous left coronary artery from the pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is a rare congenital coronary anomaly that results in altered myocardial perfusion and a left to right shunt. It occurs in 1:300000 live births and represents 0.24% to 0.46% of all congenital cardiac diseases. Despite its rarity, it is one of the most common causes of ischemia and infarction in children. Ninety percent of these patients will die within the first year of life if untreated and diagnosing this abnormality in adulthood is extremely rare...
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28423985/anesthetic-approach-for-endoscopic-repair-of-acquired-tracheoesophageal-fistula
#15
Sina Ghaffaripour, Fouad G Souki, Kianfa Martinez-Lu, Gisele Wakim
Tracheoesophageal fistula develops in 5 % to 15 % of patients with esophageal cancer. Metal stent placement can be used for treatment. Stent placement can result in aspiration, hemorrhage, perforation, migration, and pneumonia. Patients may present for medical attention with unanticipated worsening of the fistula and stent displacement requiring special anesthetic care. We discuss the perianesthetic management of a patient with malignant tracheoesophageal fistula and stent migration who presented for endoscopic esophageal stent replacement...
April 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28388863/perioperative-coagulation-management-of-a-hemophilia-a-patient-during-cardiac-surgery
#16
Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, Kenichi A Tanaka
Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined...
April 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28219274/cardiac-calendar-2017-2020
#17
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28219273/noteworthy-literature-published-in-2016-for-thoracic-organ-transplantation-anesthesiologists
#18
Kathirvel Subramaniam, Soheyla Nazarnia
This article is first in the series to review the published literature on perioperative issues in patients undergoing thoracic solid organ transplantations. We present recent literature from 2016 on preoperative considerations, organ preservation, intraoperative anesthesia management, surgical techniques, postoperative complications, and the impact of perioperative management on short- and long-term outcomes that are pertinent to thoracic transplantation anesthesiologists.
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28134011/noteworthy-literature-published-in-2016-for-thoracic-surgery
#19
Julissa E Jurado, Brendon Stiles
The past year has produced several important articles in the field of thoracic surgery, spanning many different diseases. Thoracic surgeons continue to investigate methods to perform complex operations and procedures less invasively, with the least possible morbidity to our patients. We also continue to critically evaluate new technology and procedures to ensure that they meet our rigorous standards for oncologic efficacy and for management of benign disease. Importantly, as we continue to evolve, thoracic surgeons have remained focused on optimizing processes of care, both inside and outside the operating room...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28134010/noteworthy-literature-published-in-2016-for-cardiac-surgery
#20
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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