Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2018
Editorial CommentA Split From Conventional Blood Component Therapy?
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J. Cardiothorac. Vasc. Anesth. · Feb 2018
Anesthetic and Perioperative Considerations for Combined Heart-Kidney Transplantation.
To describe detailed perioperative features of combined heart and kidney transplant (HKT). ⋯ Anesthesiologists should be actively involved in perioperative strategies on how to manage these critical patients with severe cardiac and noncardiac comorbidities applying their expertise to HKT procedure.
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J. Cardiothorac. Vasc. Anesth. · Feb 2018
ReviewAnesthetic Considerations for Transcatheter Pulmonary Valve Replacement.
The introduction of transcatheter therapy for valvular heart disease has revolutionized the care of patients with valvular disorders. Pathologic regurgitation or stenosis of the pulmonary valve, right ventricular outflow tract, or a right ventricle-to-pulmonary artery conduit represent emerging indications for transcatheter therapy. ⋯ In this review, the pathophysiology and indications for transcatheter pulmonary valve replacement and possible complications unique to this procedure are reviewed. Anesthetic management, including preoperative assessment, intraoperative considerations, and early postoperative monitoring, are discussed.
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J. Cardiothorac. Vasc. Anesth. · Feb 2018
Randomized Controlled TrialMultilevel Thoracic Paravertebral Block Using Ropivacaine With/Without Dexmedetomidine in Video-Assisted Thoracoscopic Surgery.
Thoracic paravertebral block (TPVB) is reported to have advantages in postoperative pain management in unilateral thoracic surgeries. Previous studies have demonstrated that dexmedetomidine could be used as an adjuvant to local anesthetics, with the aim of prolonging the duration of neural blockade. However, little is known about whether such a combination could improve the quality of postoperative analgesia compared with local anesthetic only when TPVB is used for patients undergoing video-assisted thoracoscopic surgery (VATS). ⋯ Compared with ropivacaine only, the addition of dexmedetomidine, 1 μg/kg, to local anesthetic for multilevel TPVB in patients undergoing VATS prolonged the duration of postoperative analgesia and improved patient satisfaction without serious side effects when combined with postoperative intravenous nonsteroidal anti-inflammatory drug administration.