Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2010
Epicardial real-time 3-dimensional echocardiography with the use of a pediatric transthoracic probe: a technical approach.
The aim of the present study was to suggest a simple and comprehensive method for performing real-time 3-dimensional (3D) epicardial echocardiography with a pediatric probe small enough for the surgical field. Intraoperative echocardiography is a necessary tool for planning and performing cardiac surgery. Although epicardial intraoperative echocardiography is intended for few patients, it is a part of an exhaustive approach to intraoperative echocardiography. ⋯ Three-dimensional epicardial echocardiography is feasible, and in the x-plane modality it is quicker than standard epicardial 2-dimensional examination. According to the judgment of independent observers, it provides high-quality and reproducible images, which are particularly valuable for mitral valve repair.
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J. Cardiothorac. Vasc. Anesth. · Feb 2010
Review Meta AnalysisReducing mortality in cardiac surgery with levosimendan: a meta-analysis of randomized controlled trials.
The authors performed a meta-analysis to evaluate whether levosimendan is associated with improved survival in patients undergoing cardiac surgery. ⋯ Levosimendan has cardioprotective effects that could result in a reduced postoperative mortality. A large randomized controlled study is warranted in this setting.
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J. Cardiothorac. Vasc. Anesth. · Feb 2010
Randomized Controlled TrialA prospective, randomized study of the effects of continuous ultrafiltration in hepatic patients after cardiac valve surgery.
The use of continuous ultrafiltration may be effective in preventing the hepatic decompensation in cirrhotic patients after valvular heart surgery with cardiopulmonary bypass (CPB). The authors aimed to evaluate the effects of continuous ultrafiltration on the need for blood transfusion, liver function tests, duration of postoperative ventilatory support, and the length of the intensive care unit (ICU) stay in cirrhotic patients undergoing valvular heart surgery. ⋯ The authors concluded that continuous ultrafiltration reduced postoperative bleeding and blood transfusions, improved liver function, and shortened the hospital stay in cirrhotic patients after valvular heart surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2010
Comparative StudySafety and efficacy of tranexamic acid compared with aprotinin in thoracic aortic surgery with deep hypothermic circulatory arrest.
This study was conducted to evaluate the safety and efficacy of high-dose tranexamic acid (TA) compared with aprotinin in patients who underwent thoracic aortic surgery with deep hypothermic circulatory arrest (DHCA). ⋯ Aprotinin appeared more effective in reducing blood product use after thoracic aortic surgery in this limited cohort. Aprotinin use also appeared to be associated with postoperative renal dysfunction. The choice of antifibrinolytic appeared to not be associated with cardiac, neurologic, or respiratory outcomes or survival after thoracic aortic surgery requiring DHCA.