Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
ReviewMesenteric Malperfusion Syndromes in Type A Aortic Dissection: Current Management Strategies.
Acute type A aortic dissection is a surgical emergency associated with high mortality and morbidity. When complicated with mesenteric malperfusion, its management carries a very high mortality. Many innovations in the field of vascular and cardiothoracic surgery in the last two decades have been tried in the continuous efforts to improve on the surgical outcomes. Although some reports have documented better mortality rates with reperfusion-first strategies, there is still room for improvement in the absence of a general consensus on its management.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Incidence of Difficult Laryngoscopy in Adult Congenital Heart Disease Patients: A Retrospective Cohort Study.
To identify the incidence of difficult intubation in patients with adult congenital heart disease (ACHD) undergoing cardiac surgery or catheterization. ⋯ The study authors identified an incidence of difficult laryngoscopy in their cohort of ACHD patients to be 4.3%. Their incidences of difficult laryngoscopy were fewer than that reported in adult patients with noncongenital heart disease. Most importantly, the risk factors associated with difficult laryngoscopy in the normal adult may be different from those presenting with ACHD, necessitating further investigation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients.
To analyze outcomes and risk factors of cardiovascular events in a metropolitan coronavirus disease 2019 (COVID-19) database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race. ⋯ Cardiovascular events were prevalent and associated with worse outcomes in hospitalized patients with COVID-19. Outcomes of cardiovascular events in African American and white COVID-19 patients were similar after propensity score matching analysis. There were common and unique risk factors for cardiovascular events in African American COVID-19 patients when compared with white patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Case ReportsSubaortic Membrane-A Savior in Large Perimembranous Ventricular Septal Defect.
Ventricular septal defects (VSD) are the most common congenital cardiac defect. Patients with large VSDs present early due to an increase in the volume load on the left ventricle and pressure load on the right ventricle. Few of them present late even without surgical intervention, due to partial restriction of perimembranous (PM) VSD, either by the septal leaflet of the tricuspid valve or by aortic valve cusp prolapse into the VSD. The authors observed a novel structure (ie, subaortic membrane in this case) restricting the large PM VSD in a 15-year-old child.
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J. Cardiothorac. Vasc. Anesth. · Dec 2021
Case ReportsThe Use of Cangrelor Infusions After Endovascular Aortic Repair With Prophylactic Lumbar Drain Placement.
Perioperative lumbar drains commonly are placed for spinal cord protection in patients undergoing endovascular aortic repair. However, the logistics of postoperative neuraxial drain removal is challenging in the presence of systemic antithrombotic therapy. ⋯ There were no neurologic complications associated with lumbar drain insertion or removal, and median time to lumbar drain removal was 150 minutes after cangrelor infusion discontinuation. While further study is needed to validate its efficacy and safety, this case series highlights the promise of cangrelor infusions for systemic antithrombotic therapy in the cardiovascular/surgical intensive care unit.