Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
ReviewPalliative Care for Patients With Advanced Heart Disease.
Over the past 2 decades, the discipline of palliative care has evolved and expanded such that it is now the standard of care for a variety of acute and chronic processes. Although there are recommendations encouraging incorporation of palliative care into the routine management of patients with chronic cardiac processes, such as congestive heart failure, implementation has been challenging, and nowhere more so than in the cardiac surgical population. However, as the boundaries of surgical care have expanded to include progressively more complex cases, increasing attention has been given to the integration of palliative care into their management. In this review article, the authors describe the existing evidence for palliative care team involvement in patients with non-operative and surgical cardiac diseases and examine future directions for growth in this field.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Letter Review Case ReportsIntraoperative Rescue Transesophageal Echocardiography in a Prone Patient.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
ReviewPreparing for a Fellowship in Adult Cardiothoracic Anesthesiology: Resources and Approaches for the Anesthesiology Trainee.
Adult cardiothoracic anesthesiology (ACTA) is a competitive fellowship. Despite increases in both the number of programs offering cardiothoracic fellowships and the number of residents applying each year, there is little direction or advice for prospective candidates. ⋯ The review examines the qualifications that fellowship programs look for in a candidate, including a discussion on professional behavior, and what an applicant can look for in a program. Finally, there is a brief discussion on post-match preparation.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Observational StudyRight Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery.
An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decreased RV peak longitudinal strain (PLSS), as measured by 2-dimensional speckle-tracking echocardiography, is associated with AKI following cardiac surgery. ⋯ In this cohort of cardiac surgery patients, speckle-tracking analysis of RV myocardial performance was feasible. Elevated RV systolic pressure associated with AKI, while speckle tracking-derived echocardiography measurements did not.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Gender Disparities in Cardiovascular Fellowship Training Among 3 Specialties From 2007 to 2017.
Despite women accounting for nearly half of all U. S. medical school graduates, this balanced representation is lacking in the cardiovascular specialties. ⋯ Using enrollment and workforce data from the Accreditation Council for Graduate Medical Education (ACGME), the Association of American Medical Colleges (AAMC), and the Journal of the American Medical Association Annual Report on Graduate Medical Education, trends in cardiovascular fellowship selection among women were examined over a 10-year period (2007-2017). An attempt was also made to better understand barriers that might contribute to any discrepancies, as well as factors that might influence women's choices of cardiovascular specialties over other fields.