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Anesthesia for Cardiac Surgery

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https://www.readbyqxmd.com/read/28231375/predictors-of-adverse-events-after-neck-dissection-an-analysis-of-the-2006-2011-national-surgical-quality-improvement-program-nsqip-database
#1
Umang Jain, Jessica Somerville, Sujata Saha, Jon P Ver Halen, Anuja K Antony, Sandeep Samant, John Y Kim
While neck dissection is an important primary and adjunctive procedure in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database was performed to identify factors associated with adverse events (AEs) in patients undergoing neck dissection. A total of 619 patients were identified, using CPT codes specific to neck dissection. Of the 619 patients undergoing neck dissection, 142 (22.9%) experienced an AE within 30 days of the surgical procedure...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28223056/transcatheter-aortic-valve-in-valve-implantation-using-lotus-valve-for-failed%C3%A2-surgical-bioprostheses
#2
Fausto Castriota, Roberto Nerla, Antonio Micari, Caterina Cavazza, Francesco Bedogni, Luca Testa, Matteo Montorfano, Mauro Del Giglio, Alberto Cremonesi
BACKGROUND: Patients with failed bioprostheses are an increasing population at high risk for redo surgery. Valve-in-valve transcatheter aortic valve implantation is a promising alternative but a limited number of first-generation devices have proven efficacy in all cases. METHODS: Patients with degenerated bioprostheses at high risk for redo surgery were included in the registry after being assigned to valve-in-valve intervention by a local heart team. Main basal and follow-up data (at 1 month and 6 months) of patients undergoing valve-in-valve transcatheter aortic valve implantation with the Lotus valve system (Boston Scientific, Natick, MA) in three high-volume Italian centers were entered in the registry...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219918/clinical-outcomes-of-remote-ischemic-preconditioning-prior-to-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Brian Pierce, Indra Bole, Vaiibhav Patel, David L Brown
BACKGROUND: Multiple randomized controlled trials of remote ischemic preconditioning (RIPC) prior to cardiac surgery have failed to demonstrate clinical benefit. The aim of this updated meta-analysis was to evaluate the effect of RIPC on outcomes following cardiac surgery. METHODS AND RESULTS: Searches of PubMed, Cochrane, EMBASE, and Web of Science databases were performed for 1970 to December 13, 2015. Randomized controlled trials comparing RIPC with a sham procedure prior to cardiac surgery performed with cardiopulmonary bypass were assessed...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28217069/can-ultrasound-guided-subcostal-transverse-abdominis-plane-block-be-used-as-sole-anesthetic-technique
#4
Pooja Bihani, Pradeep Bhatia, Swati Chhabra, Pradeepika Gangwar
Subcostal transverse abdominis plane (TAP) block anesthetizes area of the abdomen with cutaneous innervation of T6-T10 dermatomes. These abdominal field blocks become very advantageous when cardiac patient presents for noncardiac surgeries as sole anesthetic or as a part of multimodal anesthesia. A 58-year-male came for open surgical repair of subxiphoid incisional hernia developed post coronary artery bypass grafting (CABG). Echocardiography showed hypokinesia of left ventricle (LV) in the left anterior descending (LAD) artery territory, dilated LV, and ejection fraction of 30%, and coronary angiography after 6 months of CABG showed 70% stenosis of LAD...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#5
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#6
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28192894/remote-ischemic-preconditioning-in-cardiac-anesthesia-a-review-focusing-on-translation
#7
Christian Stoppe, Patrick Meybohm, Carina Benstoem, Andreas Goetzenich
INTRODUCTION: Remote Ischaemic Conditioning (RIC) is a powerful cardioprotective strategy. Its clinical application is simple, cheap and so far free from secondary side effects. Given the heterogeneous results of recent large-scale clinical trials, its clinical relevant benefit is still doubted. EVIDENCE ACQUISITION: Following a MEDLINE-based search on all publications concerning RIC in experimental or clinical settings, this review focuses on the translation from bench to bedside...
February 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#8
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#9
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183555/vasoplegic-syndrome-during-whipple-procedure
#10
Tejesh C Anandaswamy, Geetha C Rajappa, Harish Krishnamachar
Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183549/hypocapnia-measured-by-end-tidal-carbon-dioxide-tension-during-anesthesia-is-associated-with-increased-30-day-mortality-rate
#11
Philippe Dony, Michele Dramaix, Jean G Boogaerts
STUDY OBJECTIVE: To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS). DESIGN: Retrospective, observational study. SETTING: Surgical theaters of the University Hospital Center of Charleroi. PATIENTS: Five thousand three hundred seventeen patients ASA I-IV undergoing various surgical procedures (except pediatric and cardiac surgery) under general anesthesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28182690/impact-of-dexmedetomidine-on-the-incidence-of-delirium-in-elderly-patients-after-cardiac-surgery-a-randomized-controlled-trial
#12
Xue Li, Jing Yang, Xiao-Lu Nie, Yan Zhang, Xue-Ying Li, Li-Huan Li, Dong-Xin Wang, Daqing Ma
BACKGROUND: Delirium is a frequent complication after cardiac surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the impact of perioperative dexmedetomidine administration on the incidence of delirium in elderly patients after cardiac surgery. METHODS: This randomized, double-blinded, and placebo-controlled trial was conducted in two tertiary hospitals in Beijing between December 1, 2014 and July 19, 2015. Eligible patients were randomized into two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28179009/benefits-of-ultra-fast-track-anesthesia-in-left-ventricular-assist-device-implantation-a-retrospective-propensity-score-matched-cohort-study-of-a-four-year-single-center-experience
#13
Rashad Zayat, Ares K Menon, Andreas Goetzenich, Gereon Schaelte, Ruediger Autschbach, Christian Stoppe, Tim-Philipp Simon, Lachmandath Tewarie, Ajay Moza
BACKGROUND: The use of left ventricular assist devices (LVADs) has gained significant importance for treatment of end-stage heart failure. Fast-track procedures are well established in cardiac surgery, whereas knowledge of their benefits after LVAD implantation is sparse. We hypothesized that ultra-fast-track anesthesia (UFTA) with in-theater extubation or at a maximum of 4 h. after surgery is feasible in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 3 and 4 patients and might prevent postoperative complications...
February 8, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28169116/utilization-and-effectiveness-of-desmopressin-acetate-after-cardiac-surgery-supplemented-with-point-of-care-hemostatic-testing-a-propensity-score-matched-analysis
#14
David Orlov, Stuart A McCluskey, Jeannie Callum, Vivek Rao, Jacobo Moreno, Keyvan Karkouti
OBJECTIVES: To explore the utilization pattern and hemostatic effectiveness of desmopressin acetate (DDAVP) supplemented with point-of-care (POC) hemostatic testing in contemporary cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single quaternary care university hospital. PARTICIPANTS: The study comprised 2,468 consecutive patients undergoing cardiac surgery-1,237 before and 1,231 after the introduction of POC testing...
November 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28152655/inflammatory-cytokine-response-and-cardiac-troponin-i-changes-in-cardiopulmonary-bypass-using-two-cardioplegia-solutions-del-nido-and-modified-st-thomas-a-randomized-controlled-trial
#15
Farhad Gorjipour, Maziar Gholampour Dehaki, Ziae Totonchi, Seyed Javad Hajimiresmaiel, Rasoul Azarfarin, Hamidreza Pazoki-Toroudi, Mohammad Mahdavi, Mahtab Korbi, Mahyar Gholampour Dehaki, Behrouz Soltani, Fazel Gorjipour
BACKGROUND: Long intervals of del Nido (DN) solution administration, 90 minutes, may result in rewarming of the myocardial tissue and elevate metabolic demand and hypoxia. This will potentially increase inflammatory response due to ischemia-reperfusion injury. We conducted this study to compare the inflammatory response between patients receiving DN and multi-dose St Thomas' cardioplegia solution (MST) in cardiopulmonary bypass (CPB) surgery for the correction of tetralogy of Fallot (TF)...
February 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#16
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128660/cardiac-failure-in-a-trisomy-9-patient-undergoing-anesthesia-a-case-report
#17
Cara J Riley, Timothy Moore, Lauren Eagelston, Dale Burkett, Scott Auerbach, Richard J Ing
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28122159/hypothermia-and-targeted-temperature-management-in-cats-and-dogs
#18
Andrea Brodeur, Annie Wright, Yonaira Cortes
OBJECTIVE: To review current knowledge surrounding the effects, treatment, and prognosis of hypothermia in people, dogs, and cats, as well as the application of therapeutic hypothermia in clinical medicine. ETIOLOGY: Hypothermia may be a primary or secondary condition, and may be due to environmental exposure, illness, medications, anesthesia, or trauma. Hypothermia has been applied therapeutically in human medicine for a variety of conditions, including postcardiac arrest...
January 25, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28112459/deep-sedation-vs-general-anesthesia-in-232-patients-undergoing-percutaneous-mitral-valve-repair-using-the-mitraclip-%C3%A2-system
#19
Patrick Horn, Katharina Hellhammer, Michael Minier, Monika A Stenzel, Verena Veulemans, Tienush Rassaf, Peter Luedike, Julia Pohl, Jan Balzer, Tobias Zeus, Malte Kelm, Ralf Westenfeld
OBJECTIVES: To investigate in a series of 232 patients whether the MitraClip(®) procedure can be performed safely using deep sedation (DS) without general anesthesia (GA). BACKGROUND: Transcatheter mitral valve repair using the MitraClip(®) system is a safe and effective therapy for severe mitral regurgitation (MR) in patients who are at high operative risk or are unsuitable for surgery. For these patients, avoidance of GA might be beneficial. METHODS: Between 2011 and 2015, we performed 232 MitraClip(®) procedures for the treatment of severe MR...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28111104/associated-risk-factors-and-complications-in-vascular-surgery-patients-requiring-unplanned-postoperative-reintubation
#20
Ethan Y Brovman, Talora L Steen, Richard D Urman
OBJECTIVE: To determine the frequency of reintubation within 30 days in vascular surgery patients and the associated risk factors and complications. DESIGN: Retrospective cohort study with univariate and multivariate analyses of risk factors and outcomes from data collected by the American College of Surgeons National Surgical Quality Improvement Program. SETTING: All institutions participating in the American College of Surgeons National Surgical Quality Improvement Program...
November 5, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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