Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2020
Case ReportsMitral Valve Repair for Severe Mitral Regurgitation Masked by Constrictive Pericarditis Revealed After Pericardiectomy.
A case of severe mitral regurgitation (MR) that was masked by constrictive pericarditis and revealed after pericardiectomy is presented. Diagnosis was made intraoperatively with transesophageal echocardiography. ⋯ In the patient described, MR was severe with secondary ischemic pathology; therefore the decision was made to repair the mitral valve. Intraoperative transesophageal echocardiography played a major role in the decision making.
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J. Cardiothorac. Vasc. Anesth. · Sep 2020
Randomized Controlled TrialExtraluminal Placement of the Bronchial Blocker in Infants Undergoing Thoracoscopic Surgery: A Randomized Controlled Study.
The purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery. ⋯ Extraluminal use of the BB may provide a solution for a rapid placement and excellent quality of lung isolation, and it may reduce the incidence of intraoperative hypoxemia in infants without increasing the incidence of hoarseness.
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J. Cardiothorac. Vasc. Anesth. · Sep 2020
Postcardiac Surgery Acute Stroke Therapies: A Systematic Review.
To identify interventions for the treatment of acute ischemic stroke after cardiac surgery and to report the efficacy of these treatments. ⋯ Endovascular thrombectomy, with or without IAT, is being used increasingly with success in patients presenting with postcardiac surgery stroke. However, the number of patients reported is too small to confidently understand its overall effect on neurologic outcomes in this setting.
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J. Cardiothorac. Vasc. Anesth. · Sep 2020
ReviewChronic Thromboembolic Pulmonary Hypertension-Management Strategies and Outcomes.
Chronic thromboembolic pulmonary hypertension (CTEPH) is rare but complex pathophysiological disease with hallmark features of chronic thrombotic mechanical obstruction, right ventricular dysfunction, and secondary pulmonary arteriopathy. It increasingly is being understood that chronic infection/inflammation, abnormal fibrinolysis, and cytokines play an important role in pathogenesis such that only a subset of patients with pulmonary embolism develop CTEPH. Diagnosis remains challenging given the lack of early clinical signs and overlap with other cardiopulmonary conditions. ⋯ Use of riociguat has shown promising improvements in functional outcomes up to 2 years after initiation. Endothelin receptor antagonists serve a supplemental role postoperatively or in inoperable CTEPH. The role of drug therapy preoperatively or in tandem with BPA is currently under investigation.