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Cardiovascular heart anesthesia intensive care cardiac surgery

Morten Schmidt, Michael Maeng, Morten Madsen, Henrik Toft Sørensen, Lisette Okkels Jensen, Carl-Johan Jakobsen
The WDHR (Western Denmark Heart Registry) is a seminational, multicenter-based registry with longitudinal registration of detailed patient and procedure data since 1999. The registry includes as of January 1, 2017 approximately 240,000 coronary angiographies, 90,000 percutaneous coronary interventions, 60,000 cardiac computed tomographies, 40,000 cardiac operations, and 2,000 transcatheter aortic valve replacements. Positron emission tomography/computed tomography, single-photon emission computed tomography, and magnetic resonance imaging are soon to be added...
March 20, 2018: Journal of the American College of Cardiology
Nurdan Bedirli, Berrin Işık, Mehrnoosh Bashiri, Kutluk Pampal, Ömer Kurtipek
RATIONALE: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. PATIENT CONCERNS: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil...
January 2018: Medicine (Baltimore)
Juan Gu, Yunxia Cai, Bin Liu, Sheng Lv
BACKGROUND: We describe the anesthetic management for cesarean section in a pregnant woman with uncorrected double-outlet right ventricle. The anesthetic method, treatment of complications and lessons are discussed. CASE PRESENTATION: A 28-year-old woman visited our emergency room for progressive dyspnea and recurrent hemoptysis at 30 weeks' gestation. Her New York Heart Association functional class was III-IV. Echocardiography indicated that she had congenital heart disease of double-outlet right ventricle...
2016: SpringerPlus
Derek J Hausenloy, Luciano Candilio, Richard Evans, Cono Ariti, David P Jenkins, Shyam Kolvekar, Rosemary Knight, Gudrun Kunst, Christopher Laing, Jennifer Nicholas, John Pepper, Steven Robertson, Maria Xenou, Tim Clayton, Derek M Yellon
BACKGROUND: Whether remote ischemic preconditioning (transient ischemia and reperfusion of the arm) can improve clinical outcomes in patients undergoing coronary-artery bypass graft (CABG) surgery is not known. We investigated this question in a randomized trial. METHODS: We conducted a multicenter, sham-controlled trial involving adults at increased surgical risk who were undergoing on-pump CABG (with or without valve surgery) with blood cardioplegia. After anesthesia induction and before surgical incision, patients were randomly assigned to remote ischemic preconditioning (four 5-minute inflations and deflations of a standard blood-pressure cuff on the upper arm) or sham conditioning (control group)...
October 8, 2015: New England Journal of Medicine
Rasoul Azarfarin, Nasibeh Ashouri, Ziae Totonchi, Hooman Bakhshandeh, Alireza Yaghoubi
BACKGROUND: There are different risk factors that affect the intensive care unit (ICU) stay after cardiac surgery. OBJECTIVES: The aim of this study was to evaluate possible risk factors influencing prolonged ICU stay in a large referral hospital. PATIENTS AND METHODS: We conducted a case-control study to determinate causes of prolonged ICU stay in 280 adult patients undergoing cardiac surgery in a tertiary care center for cardiovascular patients, Tehran, Iran...
November 2014: Research in Cardiovascular Medicine
Mohammad Irfan Akhtar, Mohammad Hamid, Fauzia Minai, Amina Rehmat Wali, Anwar-Ul-Haq, Muneer Aman-Ullah, Khalid Ahsan
BACKGROUND AND AIMS: Early extubation after cardiac operations is an important aspect of fast-track cardiac anesthesia. In order to reduce or eliminate the adverse effects of prolonged ventilation in pediatric congenital heart disease (CHD) surgical patients, the concept of early extubation has been analyzed at our tertiary care hospital. The current study was carried out to record the data to validate the importance and safety of fast-track extubation (FTE) with evidence. MATERIALS AND METHODS: A total of 71 patients, including male and female aged 6 months to 18 years belonging to risk adjustment for congenital heart surgery-1 category 1, 2, and 3 were included in this study...
July 2014: Journal of Anaesthesiology, Clinical Pharmacology
H Riha, J Fassl, P Patel, T Wyckoff, J Choi, J G Augoustides
Significant variability in transfusion practice persists despite guidelines. Although the lysine analogues are effective antifibrinolytics, safety concerns exist with high doses tranexamic acid. Despite recombinant activated factor VII promising results in massive bleeding after cardiac surgery, it significantly increases arterial thromboembolic risk. Aortic valve repair may evolve to standard of care. Transcatheter aortic valve implantation is an established therapy for aortic stenosis. The cardiovascular anesthesiologist features prominently in the new guidelines for thoracic aortic disease...
2011: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
Ronald A Bronicki, David S Cooper
The practice of pediatric cardiac intensive care depends on a collaborative effort from all disciplines involved in the care of critically ill pediatric patients with cardiovascular disease. The 8th International Conference of the Pediatric Cardiac Intensive Care Society was reflective of this collaborative effort as experts from several disciplines, including neonatology, critical care, cardiology, neurology, anesthesia and surgery, gathered to discuss the latest advances in the care of pediatric cardiovascular disease, beginning with the fetus and extending into adulthood...
March 2011: Expert Review of Cardiovascular Therapy
Angela Jerath, Annette Vegas, Massimiliano Meineri, Candice Silversides, Christopher Feindel, Scott Beattie, Michael Corrin, Gordon Tait
PURPOSE: Transesophageal echocardiography (TEE) is becoming a standard imaging tool during cardiac surgery as well as an important diagnostic tool in cardiology and in intensive care, resulting in an increasing demand for TEE training. To address the problem of limited time for learning during TEE studies, we have developed a novel online application that allows users to visualize each of the 20 standard diagnostic TEE views in conjunction with a three-dimensional (3D) heart model that can be rotated and "cut away" above the echo plane to reveal the internal cardiac structures...
January 2011: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Alex Bekker, Sorosch Didehvar, Sunmi Kim, John G Golfinos, Erik Parker, Andrew Sapson, Michael Haile, Richard Kline, Mitchell Lee
BACKGROUND: Acute blood pressure (BP) elevations in neurosurgical patients are associated with serious neurologic, cardiovascular, or surgical site complications. Clevidipine, an ultra-short-acting dihydropyridine calcium antagonist, has been shown to be efficacious and safe for acute hypertension in cardiac surgery. This study assessed the efficacy and safety of clevidipine in controlling perioperative hypertension in the neurosurgical setting. METHODS: Patients scheduled for intracranial surgery were prospectively enrolled after giving consent...
October 2010: Journal of Neurosurgical Anesthesiology
G Erdös, I Tzanova, U Schirmer, J Ender
OBJECTIVE: The primary objective of this nationwide survey carried out in department of cardiac anesthesia in Germany was to identify current practice with regard to neuromonitoring und neuroprotection. METHODOLOGY: The data are based on a questionnaire sent out to all departments of cardiac anesthesia in Germany between October 2007 und January 2008. The anonymized questionnaire contained 26 questions about the practice of preoperative evaluation of cerebral vessels, intra-operative use of neuromonitoring, the nature und application of cerebral protective measures, perfusion management during cardiopulmonary bypass, postoperative evaluation of neurological status, and training in the field of cerebral monitoring...
March 2009: Der Anaesthesist
Frederic T Billings, Susheel K Kodali, Jack S Shanewise
Aortic valvular stenosis remains the most common debilitating valvular heart lesion. Despite the benefit of aortic valve (AV) replacement, many high-risk patients cannot tolerate surgery. AV implantation treats aortic stenosis without subjecting patients to sternotomy, cardiopulmonary bypass (CPB), and aorta cross-clamping. This transcatheter procedure is performed via puncture of the left ventricular (LV) apex or percutaneously, via the femoral artery or vein. Patients undergo general anesthesia, intense hemodynamic manipulation, and transesophageal echocardiography (TEE)...
May 2009: Anesthesia and Analgesia
Sherif S Zaky, Amgad H Hanna, Wael A Sakr Esa, Meng Xu, Cheryl Lober, Daniel I Sessler, Gonzalo Gonzalez-Stawinski, Robert M Savage, C Allen Bashour
OBJECTIVES: The primary objective of this study was to analyze perioperative intra-aortic balloon pump (IABP) insertion in patients undergoing cardiac surgery in the authors' institution from 1995 to 2005 and to propose an explanation for changes in use over this period. A secondary objective was to assess patient variables associated with IABP use. DESIGN: This is a retrospective study including patients who underwent cardiac surgery between 1995 and 2005. SETTING: The Cardiothoracic Anesthesia Patient Registry of a single teaching institution was queried to obtain the required information...
August 2009: Journal of Cardiothoracic and Vascular Anesthesia
Satoshi Toyama, Fumimaro Hatori, Ayako Shimizu, Toshio Takagi
PURPOSE: Several reports indicate that a neutrophil elastase inhibitor, sivelestat, may have prophylactic efficacy against a systemic inflammatory response after cardiovascular surgery with cardiopulmonary bypass (CPB). We evaluated the clinical pulmonary and cardiac effects of sivelestat. METHODS: We performed a retrospective study of 25 pediatric patients who underwent elective cardiovascular surgery with CPB for ventricular septal defect with pulmonary hypertension...
2008: Journal of Anesthesia
S Gil, C Atiénzar, Y Filella, M Fernández, R Borrás, A Miranda
Coronary artery disease is rarely detected during labour and the puerperium. We report the case of a 31-year-old primigravida at 38 weeks of gestation with hypercholesterolaemia and a family history of coronary heart disease, who presented with septal acute myocardial infarction. We decided to perform a caesarean section under general anaesthesia. The patient was later admitted to the intensive care unit. There were no complications during or after surgery. Cardiac ultrasound showed septal hypokinesia with normal systolic function and coronary angiography revealed normal coronary vessels...
January 2006: International Journal of Obstetric Anesthesia
Toshikatsu Yagihara, Junjiro Kobayashi, Hitoshi Ogino, Koji Kagisaki, Sotaro Hanai
After a new medical expense system "DPC (Diagnosis Procedure Combination)" had been introduced in 2003, the change in the medical treatment fee was evaluated according to each cardiovascular surgical field. Application of the DPC is limited to hospitalization fee in the general ward by a fixed daily amount The former payment system remains for operation, anesthesia, and some invasive examinations such as cardiac catheterization, therefore, the influence of the DPC introduction on cardiovascular surgery was minimum...
October 2005: Nihon Geka Gakkai Zasshi
Kouji Wake, Toshio Takanishi, Toshimitsu Kitajima, Kenji Hayashi, Hiroyuki Takahashi, Hideaki Sakio
A 23-year-old woman at 35 weeks of gestation was scheduled for emergency cesarean section because of preeclampsia. Anesthesia was induced with thiopental 250 mg, and her trachea was intubated following administration of vecuronium 7 mg. Anesthesia was maintained with oxygen and sevoflurane (0.5%). Immediately after the start of the surgical procedure, she developed severe bradycardia and hypotension followed by cardiac arrest. She was resuscitated, and her heart beat resumed 30 min after the start of the resuscitation...
October 2003: Masui. the Japanese Journal of Anesthesiology
Shobha Malviya, Terri Voepel-Lewis, Monica Siewert, Uma A Pandit, Lori Q Riegger, Alan R Tait
BACKGROUND: Otherwise healthy children who present for elective surgery with an upper respiratory infection (URI) may be at risk for perioperative respiratory complications. This risk may be increased in children with congenital heart disease who undergo cardiac surgery while harboring a URI because of their compromised cardiopulmonary status. Therefore, this study was designed to determine the incidence of peri- and postoperative complications in children undergoing cardiac surgery while harboring a URI...
March 2003: Anesthesiology
Nicola D'Attellis, Didier Loulmet, Alain Carpentier, Alain Berrebi, Cyril Cardon, Renaud Severac-Bastide, Jean-Noel Fabiani, Denis Safran
OBJECTIVE: To assess the feasibility of endoscopic telemanipulated cardiac surgery and describe the anesthetic, postoperative, and surgical implications of minimally invasive robotic-assisted cardiac surgery. DESIGN: Prospective study. SETTING: Cardiovascular and transplant center, university hospital. PARTICIPANTS: Twenty patients (13 men, 7 women) scheduled for either coronary artery bypass graft surgery or valve surgery...
August 2002: Journal of Cardiothoracic and Vascular Anesthesia
S M Millar, R P Alston, P J Andrews, M J Souter
Perioperative levels of jugular bulb oxyhaemoglobin saturation (Sj(O(2))) and lactate concentration (Lj), and postoperative duration of Sj(O(2))<50% were compared between patients undergoing coronary artery bypass grafting (CABG) (n=86), heart valve (n=14) and abdominal aortic (n=16) surgery. Radial artery and jugular bulb blood samples were aspirated after induction of anaesthesia, during re-warming on cardiopulmonary bypass (CPB) (36 degrees C), on arrival in the intensive care unit (ICU) and, subsequently, at 1, 2 and 6 h after ICU admission...
August 2001: British Journal of Anaesthesia
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