Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 2009
Epidemiology of deep sternal wound infection in cardiac surgery.
The aim of this study was to investigate the incidence and predictors of deep sternal wound infection (DSWI) in a contemporary cohort of patients undergoing cardiac surgery. The early and late outcomes of patients with this complication also were analyzed. ⋯ DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2009
An 11-year, single-institution analysis of intra-aortic balloon pump use in cardiac surgery.
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. ⋯ From 1995 to 2005, preoperative, intraoperative, and postoperative IABP use decreased by approximately 60% in cardiac surgery patients. Simultaneously, the use of TEE and milrinone each doubled. Although a cause-effect relationship cannot be established from the present study's observational data, the trends coincide and may be related.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2009
Predictors of prolonged mechanical ventilation after aortic arch surgery with deep hypothermic circulatory arrest plus antegrade selective cerebral perfusion.
The predictors of prolonged mechanical ventilation after aortic arch surgery with deep hypothermic circulatory arrest have not been comprehensively evaluated. The present study was designed to identify variables associated with prolonged ventilation in a group of aortic arch surgery patients from a single center. ⋯ The authors identified 4 preoperative and intraoperative predictors associated with increased risk of prolonged mechanical ventilation. This is helpful to identify patients with increased risk for prolonged ventilation, develop preemptive strategies, and allocate medical resources.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2009
The feasibility of speckle tracking for intraoperative assessment of regional myocardial function by transesophageal echocardiography.
The authors aimed to examine the feasibility of intraoperative transesophageal echocardiography (TEE) acquisition of a non-Doppler-based, speckle tracking-derived myocardial deformation parameter (strain) immediately before and after coronary artery bypass graft (CABG) surgery in patients with reduced left ventricular (LV) function. ⋯ Strain calculation from TEE images is feasible during cardiac surgery and correlates well with WMS but has better interobserver agreement. Strain analysis, but not WMS, detected wall motion differences between normally perfused and ischemic segments. This simple method allows objective intraoperative quantification of myocardial segment function and may become an important monitoring tool in the future.