Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Prognostic Value of Tricuspid Annular Plane Systolic Excursion and Right Ventricular Outflow Tract Fractional Shortening in Mechanically Ventilated Septic Patients.
The authors aimed to explore whether tricuspid annular plane systolic excursion (TAPSE) and right ventricular outflow fractional shortening (RVOT-FS) were associated with long-term prognosis in mechanically ventilated septic patients. ⋯ TAPSE was an independent predictor of one-year all-cause mortality in mechanically ventilated septic patients. RVOT-FS was not associated with one-year mortality and added no prognostic value to TAPSE in these patients.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Case ReportsThe Utility of Point-of-Care Transesophageal Echocardiography in the Intensive Care Unit for Detecting the Cause of Hemolytic Anemia After Ascending Aorta Replacement.
Hemolysis is well-known as a complication after mitral valve surgery, and hemolytic anemia after valvular surgery in the intensive care unit (ICU) usually leads ICU physicians to a careful imaging examination. However, hemolytic anemia following aortic replacement rarely has been described and little is known. The authors present a patient with hemolytic anemia after ascending aortic replacement for type A aortic dissection repair. ⋯ In the repair surgery, inversion of the inner felt strip that had been applied to the proximal anastomosis of the replacement ascending aorta was confirmed as shown with TEE, and the constricted anastomosis was repaired. Although TTE and CT generally have been used to identify the lesion of mechanical hemolysis after cardiac surgery, point-of-care TEE could have promptly identified the causative lesion in the present patient. Point-of-care TEE in the ICU could become a first-line imaging examination for postoperative hemolysis in cardiac patients.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Observational StudyTwo- or 3-Dimensional Echocardiography-Derived Cardiac Output Cannot Replace the Pulmonary Artery Catheter in Cardiac Surgery.
Three-dimensional (3D) transesophageal echocardiography (TEE) has been shown to be more accurate than 2D TEE for the evaluation of the left ventricular outflow tract area. The aim of the present study was to compare the agreement of 3D echocardiography-derived cardiac output (CO) with thermodilution-derived CO (TDCO) before and after cardiopulmonary bypass (CPB). ⋯ Three-dimensional CO measurements were only modestly correlated with pulmonary artery catheter-derived CO pre-bypass and post-bypass. Despite low bias, the wide LOA from 2D CO, 3D CO-diameter, and 3D-area compared with TDCO suggested that the 2 methods are not interchangeable.