Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Comparative Study Observational StudyPatient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care Versus General Anesthesia.
The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. ⋯ Patient selection for TF-TAVR with MAC can be formalized and implemented successfully. MAC allows for the minimizing of patient exposure to unnecessary interventions and improving resource utilization in suitable TAVR patients. Selection requires a multidisciplinary clinical decision-making process. MAC demonstrates good outcomes compared with GA, yet it is important to have a cardiac anesthesiologist present in the event of emergency conversion to GA.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Incidence and Risk Factors of Delirium in Patients After Type-A Aortic Dissection Surgery.
To study the incidence and related risk factors for postoperative delirium after type-A aortic dissection in patients who underwent Sun's procedure (total arch replacement using a tetrafurcate graft with stented elephant trunk implantation). ⋯ Delirium is a common postoperative complication of aortic dissection. Cerebrovascular disease history, surgery and cardiopulmonary bypass duration, postoperative hypoxia, and intubation time are independently associated with the development of delirium. Early diagnosis of delirium and modifying these factors properly may be helpful to improve patients' prognosis.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Changes in Tricuspid Annular Geometry in Patients with Functional Tricuspid Regurgitation.
To determine whether the indices of tricuspid annular dynamics that signify irreversible tricuspid valvular remodeling can improve surgical decision making by helping to better identify patients with functional tricuspid regurgitation who could benefit from annuloplasty. ⋯ As compared to NTR TVs, FTR is associated with identifiable indices of tricuspid annular structural changes that are indicative of irreversible remodeling.