Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2017
Review Meta AnalysisPulmonary Complications After Open Abdominal Aortic Surgery: A Systematic Review and Meta-Analysis.
Postoperative pulmonary complications (PPC) are among the most common complications after noncardiac surgery. Men, smokers, and elderly patients with chronic obstructive pulmonary disease or heart failure are more likely to experience PPC. The majority of patients undergoing vascular surgery belong in these categories and are at higher risk of developing PPC. Moreover, the surgical site is one of the most important risk factors associated with PPC, and aortic surgery carries the highest risk. The aim of this systematic review was to obtain an additional understanding of the real incidence of PPC after open abdominal aortic surgery and the impact of PPC on survival. ⋯ Incidence of PPC after open abdominal aortic surgery is high and is associated with increased postoperative morbidity and mortality.
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J. Cardiothorac. Vasc. Anesth. · Apr 2017
Multicenter StudyPerioperative Strokes and Early Outcomes in Mitral Valve Surgery: A Nationwide Analysis.
To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. ⋯ Age, female sex, emergency surgery, arrhythmias, hypertension, renal failure, coagulopathy, neurologic disorders, weight loss, fluid and electrolyte imbalance, anemia, postoperative cardiac arrest, and myocardial infarction were found to be significant predictors of morbidity and mortality after mitral valve surgery, with perioperative strokes posing the strongest risk. The trends in the last 10 years indicated a decrease in mortality and an increase in morbidity. Preoperative risk stratification and intraoperative identification for impending strokes appear warranted.
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J. Cardiothorac. Vasc. Anesth. · Apr 2017
Letter Case ReportsChikungunya and Coronary Artery Bypass Graft Surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 2017
Comparative StudyTricuspid Annular Plane Systolic Excursion: Comparing Transthoracic to Transesophageal Echocardiography.
Tricuspid annular plane systolic excursion (TAPSE) represents movement of the lateral annulus of the tricuspid valve toward the apex and denotes right ventricular contractility in the long axis. In transesophageal echocardiography with the probe in the mid-esophagus, TAPSE occurs at a significant angle to the M-mode scan line. The authors describe a novel method to assess TAPSE in 2 dimensions (2D) and compare this with an established method. ⋯ Transesophageal 2D-TAPSE appeared to be a reliable and simple method to assess right ventricular function, and demonstrated a close correlation with transthoracic M-TAPSE.
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J. Cardiothorac. Vasc. Anesth. · Apr 2017
2D Echocardiographic Evaluation of Right Ventricular Function Correlates With 3D Volumetric Models in Cardiac Surgery Patients.
The early diagnosis and treatment of right ventricular (RV) dysfunction are of critical importance in cardiac surgery patients and impact clinical outcome. Two-dimensional (2D) transesophageal echocardiography (TEE) can be used to evaluate RV function using surrogate parameters due to complex RV geometry. The aim of this study was to evaluate whether the commonly used visual evaluation of RV function and size using 2D TEE correlated with the calculated three-dimensional (3D) volumetric models of RV function. ⋯ The 2D assessment of right ventricular function based on visual estimation as frequently used in clinical practice appeared to be a reliable method of RV functional evaluation. However, 2D assessment of RV size seemed unreliable and should be used with caution.