Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Observational StudyThe Effects of Positioning on the Volume/Location of the Internal Jugular Vein Using 2-Dimensional Tracked Ultrasound.
To investigate the effects of different positioning on the volume/location of the internal jugular vein (IJV) using 2-dimensional (2D) tracked ultrasound. ⋯ Trendelenburg position significantly increased the CSA of the IJV, thus facilitating IJV cannulation. This new 3D reconstruction method permits the creation of a 3D volume through a tracked 2D ultrasound scanning system with image acquisition and integration and may prove useful in providing the user with a "road map" of the vascular anatomy of a patient's neck or other anatomic structures.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Sex Differences in Long-Term Outcomes After Surgical Aortic Valve Replacement: A Nationwide Propensity-matched Study.
Women are considered to have poorer prognoses after cardiac surgery, although evidence is scarce. The authors studied sex differences and long-term outcomes after surgical aortic valve replacement (SAVR). ⋯ Baseline-matched long-term survival after SAVR is similar between sexes. Men had increased risk of bleeding, early re-surgery after SAVR, and infective endocarditis when using biological prosthesis.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Intraoperative Assessment of Hepatic Vein Tracings in Constrictive Pericarditis During Surgical Pericardiectomy.
CONSTRICTIVE PERICARDITIS is characterized by progressive inflammation and fibrosis of the pericardium. It manifests with symptoms of heart failure. The only effective treatment is surgical pericardiectomy. ⋯ In this e-challenge, the authors focus on the hepatic vein Doppler tracing as a means to show improvement in diastolic function during positive pressure ventilation in a patient undergoing pericardiectomy. This case demonstrates a severely blunted diastolic flow pattern in the hepatic vein that is reversed after successful pericardiectomy. Also, it shows blunted flow during systole compared to diastole post-pericardiectomy, indicating high right atrial pressure.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Review Meta AnalysisLocal Versus General Anesthesia in Nonemergency Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis.
The purpose of this systematic review was to assess the perioperative clinical outcomes in using local/regional anesthesia (LA/RA) or general anesthesia (GA) in patients undergoing endovascular abdominal aortic aneurysm repair. A comprehensive electronic literature search was undertaken from inception to September 2018, identifying all randomized and nonrandomized studies comparing LA/RA versus GA in patients with abdominal aortic aneurysm who underwent endovascular repair. A total of 12,024 patients (n = 1,664 LA/RA, n = 10,360 GA) were analyzed from 12 observational studies included in this analysis. ⋯ Thirty-day morality was not different between the 2 cohorts (2% v 1.7%; p = 0.97). Use of LA/RA in selective endovascular abdominal aortic aneurysm repair procedures provides satisfactory and comparable perioperative outcomes with those of GA, with the advantage of a shorter hospital stay. A large randomized controlled trial or multicenter study is required to confirm the present study's findings.