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Cardiothoracic and Vascular Anesthesia

Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
2016: Cochrane Database of Systematic Reviews
Harish Ramakrishna, Jacob T Gutsche, Adam S Evans, Prakash A Patel, Menachem Weiner, Steven T Morozowich, Emily K Gordon, Hynek Riha, Ronak Shah, Kamrouz Ghadimi, Elizabeth Zhou, Rohesh Fernadno, Jeongae Yoon, Mathew Wakim, Lance Atchley, Stuart J Weiss, Erica Stein, George Silvay, John G T Augoustides
No abstract text is available yet for this article.
January 2016: Journal of Cardiothoracic and Vascular Anesthesia
Jacob T Gutsche, Prakash A Patel, Frederick C Cobey, Harish Ramakrishna, Emily K Gordon, Hynek Riha, Aris Sophocles, Kamrouz Ghadimi, Michael Fabbro, Lourdes Al-Ghofaily, Sy-Yeu S Chern, Sophia Cisler, Gurmukh S Sahota, Elizabeth Valentine, Stuart J Weiss, Michael Andritsos, George Silvay, John G T Augoustides
No abstract text is available yet for this article.
February 2015: Journal of Cardiothoracic and Vascular Anesthesia
Harish Ramakrishna
Patients with pulmonary hypertension continue to present for both cardiac and non-cardiac surgery in greater numbers worldwide, and are usually managed by cardiothoracic anesthesiologists. These specialists have traditionally used intravenous therapy in the operating room to manipulate hemodynamics (cardiac output systemic and pulmonary vascular resistance), to effectively manage these high risk patients. General anesthesia involves the administration of both intravenous and inhaled drug therapy to achieve the desired goals, i...
2014: Recent Patents on Cardiovascular Drug Discovery
J G Reves
This is an historical account of the accomplishments of the Society of Cardiovascular Anesthesiologists from its founding in 1989 to the present. It is written on the occasion of the 35th anniversary of the founding of this organization. The society accomplishments include providing a means to educate anesthesiologists and others about the perioperative care of patients undergoing cardiac, thoracic, and vascular surgery. The society has led accreditation of transesophageal echocardiography and education in cardiothoracic anesthesia...
August 2014: Anesthesia and Analgesia
Harish Ramakrishna, Benjamin A Kohl, Jacob T Gutsche, Jens Fassl, Prakash A Patel, Hynek Riha, Kamrouz Ghadimi, William J Vernick, Michael Andritsos, George Silvay, John G T Augoustides
This article reviewed selected research highlights of 2013 that pertain to the specialty of cardiothoracic and vascular anesthesia. The first major theme is the commemoration of the sixtieth anniversary of the first successful cardiac surgical procedure with cardiopulmonary bypass conducted by Dr Gibbon. This major milestone revolutionized the practice of cardiovascular surgery and invigorated a paradigm of mechanical platforms for contemporary perioperative cardiovascular practice. Dr Kolff was also a leading contributor in this area because of his important contributions to the refinement of cardiopulmonary bypass and mechanical ventricular assistance...
February 2014: Journal of Cardiothoracic and Vascular Anesthesia
Peggy Contrera, Mary Cushing
Aortic stenosis is the most frequently acquired heart disease, and the prevalence is rising because of the aging population. If the disease is left untreated, survival in symptomatic patients averages only 2 to 3 years. Surgical aortic valve replacement is the only definitive treatment, yet 30% of elderly patients are not considered candidates because the presence of comorbidities makes the risk of sternotomy and cardiopulmonary bypass prohibitively high. Transcatheter aortic valve replacement (TAVR) is an innovative, high-tech, less invasive alternative...
October 2013: AANA Journal
J G T Augoustides, P Patel, K Ghadimi, J Choi, Y Yue, G Silvay
INTRODUCTION: Deep hypothermic circulatory arrest for adult aortic arch repair is still associated with significant mortality and morbidity. Furthermore, there is still significant variation in the conduct of this complex perioperative technique. This variation in deep hypothermic circulatory arrest practice has not been adequately characterized and may offer multiple opportunities for outcome enhancement. The hypothesis of this study was that the current practice of adult deep hypothermic circulatory arrest in China has significant variations that might offer therapeutic opportunities for reduction of procedural risk...
2013: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
Philip Batista, Nicholas Cavaricchi, Hitoshi Hirose
SESSION TYPE: Critical Care Student/Resident Case Report Posters IIPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Aortic dissections commonly extend beyond the renal arteries with varying effects ranging from asymptomatic to renal failure. We report a case of aortic dissection with initial renal compromise, which was continuously monitored utilizing direct renal oximetry for evaluation of real-time renal perfusion and function.CASE PRESENTATION: A 65 year-old female with a long history of uncontrolled hypertension presented with acute retrosternal chest pain radiating to the back for 12 hours...
October 1, 2012: Chest
R Lakhdhar, M Drissa, H Drissa
BACKGROUND: Atrial septal defect (ASD) is one of the most common causes of congenital heart disease manifested in adulthood. AIM: To describe clinical and likelihood picture of adults over 60 years born with an ASD type II. METHODS: We performed a retrospective study of adult'sASD referred toourinstitutionfrom 1985 through 2010. Clinical, electrocardiographic, echocardiographic and hemodynamic data were reviewed. On follow up study, patients were investigated by echocardiography, ECG and assessed for quality of life by a questionnaire RESULTS: Among forty ASD type II manifested in adulthood which were referred to our department of cardiology five cases of ASD manifested in the sixth decades (2 men and 3 women)...
April 2013: La Tunisie M├ędicale
Meredith Rumon Goodwin, Kimberly Rae Blasius, Jordan Brand, George Silvay
Advances in the surgical approach to thoracic aortic aneurysm repairs have led to the increasing use of one-lung ventilation. Today's practice of cardiothoracic and vascular anesthesia requires a clear understanding of the techniques available for lung separation and the technical skills necessary to employ them. In this article, we discuss and evaluate the options for one-lung ventilation in thoracic aortic aneurysm repair with regard to preoperative, intraoperative, and postoperative management.
June 2013: Seminars in Cardiothoracic and Vascular Anesthesia
J Fassl, H Riha, H Ramakrishna, N Singh, T Wyckoff, C Roscher, J G T Augoustides
The hybrid operating room is the venue for transcatheter therapy with the convergence of three specialties: cardiac surgery, cardiovascular anesthesiology, and interventional cardiology. Transcatheter aortic valve replacement is proof that cardiac specialists have embraced the endovascular revolution. Since pharmacologic and ischemic myocardial conditioning are safe and effective, they are currently the focus of multiple trials. Angiotensin blockade, anemia and endoscopic saphenous vein harvesting worsen outcome after coronary artery bypass grafting (CABG)...
2010: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
H Riha, P Patel, E Valentine, B Lane, J G T Augoustides
The past year has witnessed major advances in of cardiovascular anesthesia and intensive care. Perioperative interventions such as anesthetic design, inotrope choice, glycemic therapy, blood management, and noninvasive ventilation have significant potential to enhance perioperative outcomes even further.The major theme for 2011 is the international consensus conference that focused on ancillary interventions likely to reduce mortality in cardiac anesthesia and intensive care. This landmark conference prioritized volatile anesthetics, levosimendan, and insulin therapy for their promising life-saving perioperative potential...
2012: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
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
L Buratti
INTRODUCTION: With the continuing worldwide shortage of anesthesiologists, the demands of clinical duties allow very little time for research activities. Every dedicated biomedical center should provide doctors and scientists with the proper environment to facilitate education, clinical practice and research activities and promote publication in international peer-review journals. METHODS: In this observational study, the Scopus database was searched for publications ( 2004-2009 ) to identify the most prolific authors among Italian anesthesiologists and intensive care specialists working in Italy...
2009: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
Harish Ramakrishna, Christopher Reidy, Hynek Riha, Aris Sophocles, Bernard J Lane, Prakash A Patel, Michael Andritsos, Kamrouz Ghadimi, John G T Augoustides
Cardiothoracic and vascular critical care has emerged as a subspecialty due to procedural breakthroughs, an aging population, and a multidisciplinary collaboration. This subspecialty now has a dedicated professional society, recently published guidelines, and plans for standardized certification. This paradigm shift represents a major collaboration opportunity for our specialty. The rise of evidence-based perioperative practice has produced a culture of large trials in our specialty to search for solutions to the challenging outcome questions...
February 2013: Journal of Cardiothoracic and Vascular Anesthesia
Paul S Pagel, Judith A Hudetz
OBJECTIVE: The bibliometrics of the anesthesiology literature has shifted substantially during the past 3 decades. The present authors analyzed the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) at selected time intervals from 1990 to 2011 to quantify temporal variations in geographic publication patterns. The authors also determined whether previously described reductions in North American research productivity were accompanied by similar decreases in the number of other forms of publication in JCVA...
April 2013: Journal of Cardiothoracic and Vascular Anesthesia
Pranit N Chotai, Nabil A Ebraheim
Posterior sternoclavicular dislocation is an uncommon injury and often remains initially undiagnosed due to variable clinical presentation and inadequate visualization of the joint on plain radiographs. It is frequently associated with serious and life-threatening injuries involving the trachea, esophagus, or great vessels. A 15-year-old boy was knocked to the ground during wrestling and landed on his left shoulder. He presented 6 days after trauma with increasing arm swelling and pain. A Doppler ultrasound revealed deep vein thrombosis involving the left shoulder and arm...
October 2012: Orthopedics
Michele L Sumler, Michael J Andritsos, Randal S Blank
Interactions between the cardiovascular and respiratory systems are complex and profound. General anesthesia, muscle relaxation, and positive-pressure ventilation all impose physiological effects on cardiovascular function. In patients presenting for pulmonary resection, additional effects resulting from positioning, 1-lung ventilation, surgical procedures, and contraction of the pulmonary vascular bed may impose an additional physiological burden. For most patients with adequate pulmonary and cardiovascular reserve, these effects are well tolerated...
March 2013: Seminars in Cardiothoracic and Vascular Anesthesia
Prakash A Patel, Harish Ramakrishna, Michael Andritsos, Tygh Wyckoff, Hynek Riha, John G T Augoustides
There have been rapid advances in oral anticoagulation. The oral factor Xa inhibitors rivaroxaban and apixaban and the oral direct thrombin inhibitor dabigatran recently have been rigorously evaluated. These novel anticoagulants will usher in a new paradigm for perioperative anticoagulation. Perioperative blood conservation in cardiac surgery recently has been highlighted in the updated guidelines by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons. These recommendations reflect a comprehensive evaluation of the recent evidence to optimize transfusion practice...
February 2012: Journal of Cardiothoracic and Vascular Anesthesia
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