Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2015
ReviewNew Frontiers in Aortic Therapy: Focus on Current Trials and Devices in Transcatheter Aortic Valve Replacement.
The first decade of clinical experience with transcatheter aortic valve replacement since 2002 saw the development of 2 main valve systems, namely the Edwards Sapien balloon-expandable valve series and the Medtronic self-expanding CoreValve. These 2 valve platforms now have achieved commercial approval and application worldwide in patients with severe aortic stenosis whose perioperative risk for surgical intervention is high or extreme. ⋯ There are currently 2 major trials, PARTNER II and SURTAVI, that are both evaluating the role of transcatheter aortic valve replacement in intermediate-risk patient cohorts. The results from these landmark trials may usher in a new clinical paradigm for transcatheter aortic valve replacement in its second decade.
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J. Cardiothorac. Vasc. Anesth. · Apr 2015
ReviewMitral Valve Repair: An Echocardiographic Review: Part 2.
Echocardiographic imaging of the mitral valve before and immediately after repair is crucial to the immediate and long-term outcome. Prior to mitral valve repair, echocardiographic imaging helps determine the feasibility and method of repair. After the repair, echocardiographic imaging displays the new baseline anatomy, assesses function, and determines whether or not further management is necessary. ⋯ This information will improve treatment options, timing of invasive therapies, and advancements of repair techniques to yield better short- and long-term patient outcomes. The purpose of this review was to connect the echocardiographic evaluation with the surgical procedure. Bridging the pre- and post-CPB imaging with the surgical procedure allows a greater understanding of mitral valve repair.
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J. Cardiothorac. Vasc. Anesth. · Apr 2015
Review Meta AnalysisThe Use of Preoperative B-Type Natriuretic Peptide as a Predictor of Atrial Fibrillation After Thoracic Surgery: Systematic Review and Meta-Analysis.
To determine whether elevated preoperative B-type natriuretic peptide (NP) measurements are an independent predictor of atrial fibrillation (AF) in patients having thoracic surgery. ⋯ Patients with an elevated preoperative NP measurement are at an increased risk of postoperative AF. There may be value in incorporating NP measurement into existing AF risk prediction models.
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J. Cardiothorac. Vasc. Anesth. · Apr 2015
Randomized Controlled TrialPreoperative Point-of-Care Platelet Function Testing in Cardiac Surgery.
To investigate if the use of preoperative platelet function testing (PFT) as part of a transfusion algorithm reduced blood product usage in coronary artery bypass surgery (CABG). ⋯ Preoperative PFT as part of a point-of-care testing-based transfusion algorithm led to a reduction in blood transfusion. There is a potential cost saving in those who have taken an ADP-receptor antagonist within 5 days.
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J. Cardiothorac. Vasc. Anesth. · Apr 2015
Risk Factors Related to Transfusion Requirements in Patients Undergoing Implantation of Ventricular Assist Devices.
The identification of transfusion risk factors in patients receiving left ventricular assist devices to allow for targeted use of blood conservation strategies and improved blood utilization. ⋯ Beta-blockers may be a modifiable factor to decrease transfusions. The association between international normalized ratio and platelet transfusions suggests that better determination of the type of coagulopathy may promote more appropriate transfusions.