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pulmonary hypertension anesthesia

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https://www.readbyqxmd.com/read/29652270/pulmonary-hypertension-and-cardiac-anesthesia-anesthesiologist-s-perspective
#1
REVIEW
Manjula Sudeep Sarkar, Pushkar M Desai
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#2
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29629260/acute-right-ventricular-failure-postintubation-in-a-mitral-stenosis-patient
#3
Sridhar Reddy Musuku, Saroj Pani, John Cagino
Mitral stenosis (MS) is prevalent in 0.02-0.2% of the population in developed countries. The pathophysiology of MS results in elevated left atrial pressures and over-time results in pulmonary hypertension (HTN) which ultimately affects the right ventricle. In addition, MS restricts the diastolic filling of the left ventricle. Therefore, during induction patients with MS are limited by their ability to increase cardiac output by increasing stroke volume. Anesthesia goals in severe MS are to avoid sudden changes in heart rate, as well as systemic and pulmonary artery pressures...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#4
M U Ziegler, H Reinelt
BACKGROUND: Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI)...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29611831/anesthetic-management-for-concomitant-correction-of-congenital-cardiac-defects-and-long-o-ring-tracheal-stenosis-a-role-for-heliox-report-of-2-cases
#5
Sylvain Mauron, David Longchamp, Marie-Hélène Perez, René Prêtre, Kishore Sandu, Stefano Di Bernardo, Yann Boegli, Mirko Dolci
We present 2 infants with the rare association of long congenital tracheal stenosis, ventricular septal defect, and pulmonary hypertension. We describe a step-by-step assessment of the patients and the necessary procedures for a successful concomitant repair of both cardiac and tracheal malformations. The use of a helium-oxygen mixture (heliox) for the induction of anesthesia and pre-cardiopulmonary bypass is discussed.
March 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29602472/local-anesthesia-for-percutaneous-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-fewer-pulmonary-complications
#6
Kathryn Van Orden, Alik Farber, Marc L Schermerhorn, Philip P Goodney, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Percutaneous endovascular aneurysm repair (EVAR) can be performed with general anesthesia (GA) or local anesthesia (LA). Our goal was to assess perioperative outcomes comparing anesthesia type in percutaneous EVAR. METHODS: The Vascular Quality Initiative database was queried for all exclusively percutaneous EVAR procedures. Univariable analysis was used to compare which patients were offered LA. Multivariable analysis was used to determine the independent effect of anesthesia type...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29567039/corrigendum-to-extracorporeal-support-during-bilateral-sequential-lung-transplantation-in-patients-with-pulmonary-hypertension-risk-factors-and-outcomes-journal-of-cardiothoracic-and-vascular-anesthesia-volume-31-2-2017-418-425
#7
Pranav R Shah, Michael L Boisen, Daniel G Winger, Jose Marquez, Christian A Bermudez, Jay K Bhama, Norihisa Shigemura, Jonathan D'Cunha, Kathirvel Subramaniam
No abstract text is available yet for this article.
March 19, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29525197/perioperative-management-of-pregnant-women-with-idiopathic-pulmonary-arterial-hypertension-an-observational-case-series-study-from-china
#8
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29492464/a-retrospective-analysis-on-patients-at-high-risk-for-obstructive-sleep-apnea-undergoing-ear-nose-and-throat-surgeries
#9
Karina Woodling, Juan Fiorda-Diaz, Bradley A Otto, Christie A Barnes, Alberto A Uribe, Sergio D Bergese, Vedat Yildiz, Nicoleta Stoicea, Michael G Guertin
Background: Obstructive sleep apnea (OSA) may be related to episodes of oxygen de-saturation, hypercapnia, cardiovascular dysfunction, cor-pulmonale, and pulmonary hypertension. STOP-BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial...
February 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29434629/transcatheter-versus-surgical-aortic-valve-replacement-in-severe-symptomatic-aortic-stenosis
#10
REVIEW
Tsigkas Grigorios, Despotopoulos Stefanos, Makris Athanasios, Koniari Ioanna, Armylagos Stylianos, Davlouros Periklis, Hahalis George
Aortic stenosis (AS) is the most common type of valvular heart disease in the elderly. Surgical aortic valve replacement (SAVR) has been the standard practice for treating severe, symptomatic AS, but recently new treatment options have emerged. Transcatheter aortic valve replacement (TAVR) is now an established treatment option in patients at high surgical risk. In this review, we focus on recent developments and compare the two treatment methods in specific populations in terms of efficacy and safety (e.g...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29433561/pregnancy-outcome-in-a-pregnant-patient-with-idiopathic-pulmonary-arterial-hypertension-a-case-report-and-review-of-the-literature
#11
Farid Rashidi, Hossein Sate
BACKGROUND: Idiopathic pulmonary arterial hypertension is a rare and progressive condition which is aggravated by the physiologic changes during pregnancy. Because of high mortality rate, most physicians recommend early termination of pregnancy in patients with idiopathic pulmonary arterial hypertension. CASE PRESENTATION: Here we describe a case of a 30-year-old primigravida Caucasian housewife with functional class 1 idiopathic pulmonary arterial hypertension and a positive vasoreactive response to adenosine who had a full-term non-complicated delivery...
February 13, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29429213/-effect-of-acidic-oligosaccharides-on-p-selectin-of-pulmonary-hypertensive-rats-induced-by-monocrotaline
#12
Z Feng, Y Hu, N N An, W J Feng, T Hu, Y J Mao
Objective: To observe the effects of acidic oligosaccharides (AOS) on P-selectin levels in the serum and the pulmonary arteries of pulmonary hypertensive rats induced by monocrotaline. Methods: Sixty healthy adult male Sprague-Dawley rats were randomly divided into control group (n=10), model group (n=10), Alprostadil group (n=10), low-dose AOS group (AOS-L, n=10), medium-dose AOS group (AOS-M, n=10) and high-dose AOS group (AOS-H, n=10). The rat model of pulmonary arterial hypertension was made by a single intraperitoneal injection of monocrotaline(60 mg/kg)...
February 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29395721/can-total-knee-arthroplasty-be-performed-safely-as-an-outpatient-in-the-medicare-population
#13
P Maxwell Courtney, Mark I Froimson, R Michael Meneghini, Gwo-Chin Lee, Craig J Della Valle
BACKGROUND: The Centers for Medicare and Medicaid Services has solicited public comments for the 2017 Proposed Rule to consider removing total knee arthroplasty (TKA) from the Inpatient Only List. The purpose of this study is to compare the complication rates between outpatient (same-day discharge), short-stay (discharge within 1 day), and inpatient TKA and to identify the ideal candidates for a short-stay or outpatient procedure. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for patients over age 65 years who underwent TKA from 2014 to 2015...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29383330/bilateral-prone-percutaneous-nephrolithotomy-under-epidural-in-candidate-for-lung-transplant-case-report-and-review-of-literature
#14
Ricardo Manuel de Oliveira Soares, Alexander Paul Glaser, Jason Evan Cohen, Obianuju Okocha, Robert Brewster Nadler
Background: Percutaneous nephrolithotomy (PCNL) is a procedure typically performed under general anesthesia (GA); however, many patients might be considered unfit for GA and locoregional anesthesia is their only chance to have the procedure done. Case Presentation: A 60-year-old Middle-Eastern female with end-stage lung disease underwent evaluation for lung transplant; she was found to have severe restrictive pattern on steroid and continuous oxygen therapy, pulmonary hypertension with dilated right ventricle, chronic anemia, and asthma...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29336386/retrospective-study-of-complete-atrioventricular-canal-defects-anesthetic-and-perioperative-challenges
#15
Aniruddha Ramesh Janai, Wilfried Bellinghausen, Edwin Turton, Carmine Bevilacqua, Waseem Zakhary, Martin Kostelka, Farhad Bakhtiary, Joerg Hambsch, Ingo Daehnert, Florian Loeffelbein, Joerg Ender
OBJECTIVE: The objective of this study was to highlight anesthetic and perioperative management and the outcomes of infants with complete atrioventricular (AV) canal defects. DESIGN: This retrospective descriptive study included children who underwent staged and primary biventricular repair for complete AV canal defects from 1999 to 2013. SETTING: A single-center study at a university affiliated heart center. PARTICIPANTS: One hundred and fifty-seven patients with a mean age at surgery of 125 ± 56...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29325324/-obstetric-outcome-in-pregnancy-complained-with-pulmonary-hypertension
#16
C X Zhu, W Xiong, J Yang, H Q Chen, G Niu, Z L Wang
Objective: To identify whether pregnancy outcomes vary by the severity of pulmonary hypertension. Methods: A retrospective study was conducted on 78 cases of pregnancies complained with pulmonary hypertension who delivered in the First Affiliated Hospital, Sun Yat-sen University from 2006 to 2016.The selected cases were divided into three groups according to severity of pulmonary hypertension: mild pulmonary hypertension group (mild PAH group) was defined as a mean pulmonary artery pressure 30-49 mmHg, moderate pulmonary hypertension (moderate PAH group) as mean pulmonary artery pressure 50-69 mmHg and severe pulmonary hypertension (severe PAH group) as mean pulmonary artery pressure 70 mmHg or greater...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29298372/multidisciplinary-perioperative-management-of-pulmonary-arterial-hypertension-in-patients-undergoing-noncardiac-surgery
#17
José L Díaz-Gómez, Juan G Ripoll, Isabel Mira-Avendano, John E Moss, Gavin D Divertie, Ryan D Frank, Charles D Burger
OBJECTIVES: To describe the effect of implementing a contemporary perioperative pulmonary hypertension (PH)-targeted protocol in patients with pulmonary arterial hypertension (PAH) undergoing noncardiac surgery (NCS). METHODS: The data of consecutive patients with PAH diagnosed by right heart catheterization who underwent NCS between January 1, 2006 and February 9, 2016 were reviewed. Patient demographics, etiology of PAH, clinical features, diagnostic data, utilization of PH-specific medications, and trend of perioperative complications rate were recorded during the study period...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29203759/-right-hemicolectomy-under-spinal-anesthesia-due-to-cancer-of-ascending-large-bowel-case-report
#18
Gniewomir Ćwiertnia, Michał Dyaczyński
Surgery procedures of the abdomen cavity are commonly performed in general anaesthesia. Patients from high risk group with circulatory insufficiency, respiratory failure pose a problem. They undergo surgical procedures for life indications and emergency cases. Regional anaesthesia can be an alternative for general anaesthesia, and makes planned surgical treatment possible for this group of patients. The study presents the case of 79-year-old male with chronic obstructive pulmonary disease, after left lung upper lobectomy, arterial hypertension, who underwent operation due to ascending large bowel cancer under spinal anaesthesia as planned...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29187656/-perioperative-safety-of-tibetan-children-with-congenital-heart-disease-undergoing-cardiac-surgery-and-anesthesia-in-low-altitude-area
#19
Yundan Pan, Jiaojiao Niu, Gang Qin, Lu Wang, Fan Zhang, E Wang
To observe the clinical parameters and short-term prognosis of Tibetan high-altitude area children with congenital heart disease undergoing surgery and anaesthesia in low-altitude area, and to investigate the perioperative safety of the treatment.
 Methods: From January, 2016 to December, 2016, 14 children with congenital heart disease who underwent surgery were assigned into 2 groups (n=7 each): the high-altitude area group (X group, children from Tibetan Autonomous Region) and the low-altitude area group (H group, children from Hunan Province)...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#20
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
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