Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2020
Randomized Controlled TrialReduction of Inflammation by High-Dose Methylprednisolone Does not Attenuate Oxidative Stress in Children Undergoing Bidirectional Glenn Procedure With or Without Aortic Arch or Pulmonary Arterial Repair.
Corticosteroids attenuate an inflammatory reaction in pediatric heart surgery. Inflammation is a source of free oxygen radicals. Children with a cyanotic heart defect are prone to increased radical stress during heart surgery. The authors hypothesized that high-dose methylprednisolone reduces inflammatory reaction and thereby also oxidative stress in infants with a univentricular heart defect undergoing the bidirectional Glenn procedure. ⋯ The proinflammatory reaction and increase in free radical stress were not interrelated during congenital heart surgery in cyanotic infants with a univentricular heart defect undergoing the bidirectional Glenn procedure. High-dose methylprednisolone was ineffective in attenuating free radical stress.
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J. Cardiothorac. Vasc. Anesth. · Jun 2020
Observational StudyEfficacy of Early Goal-Directed Renal Replacement Therapy for the Treatment of Acute Kidney Injury After Heart Transplantation: A Single-Center 10-Year Experience.
Acute kidney injury (AKI) after heart transplantation is a common and serious complication. The present study aimed to evaluate the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of AKI after heart transplantation. ⋯ For heart transplantation recipients with AKI, EGDRRT can reduce the in-hospital mortality and the length of intensive care unit and hospital stays, improve the complete renal recovery rate, and reduce the cost of RRT.
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J. Cardiothorac. Vasc. Anesth. · Jun 2020
Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients With Suspected or Confirmed Coronavirus Disease 2019.
The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and control of COVID-19.
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J. Cardiothorac. Vasc. Anesth. · Jun 2020
Acute Aortic Dissection Surgery: Hybrid Debranching Versus Total Arch Replacement.
It is unclear whether the hybrid debranching or total arch replacement (TAR) technique is preferential in treatment of acute Stanford type A aortic dissection (AAAD) among different age groups. The aim was to compare the clinical outcomes for the two therapeutic strategies. ⋯ In the treatment of AAAD, patients older than 60 years undergoing hybrid debranching surgery had shorter hospital lengths of stay, lower rates of neurologic events and renal insufficiency, and a higher mid-term survival rate compared with the TAR procedure, whereas there was no statistical difference in hybrid debranching versus TAR in patients younger than age 60. Irrespective of reintervention, hybrid debranching can be a promising surgical option for patients with AAAD older than 60 years.