Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
Preexisting Right Ventricular Diastolic Dysfunction and Postoperative Cardiac Complications in Patients Undergoing Nonemergency Coronary Artery Bypass Surgery.
To evaluate whether the presence of preexisting right ventricular diastolic dysfunction (RVDD) in patients undergoing coronary artery bypass grafting (CABG) is associated with a greater incidence of postoperative cardiac complications. ⋯ Preoperative RVDD, cardiopulmonary bypass, and female sex are independent risk factors for the development of PHF after CABG in coronary artery disease patients. The decreased Et/At ratio was the best echocardiographic marker predicting PHF development after CABG. Nevertheless, the possibility of assessing preoperative diastolic RV function to predict the development of PHF after CABG requires confirmation in additional studies.
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
ReviewThe Impact of Anesthetic Regimen on Outcomes in Adult Cardiac Surgery: A Narrative Review.
Despite improvements in surgical techniques and perioperative care, cardiac surgery still is burdened by relatively high mortality and frequent major postoperative complications, including myocardial dysfunction, pulmonary complications, neurologic injury, and acute kidney injury. Although the surgeon's skills and volume and patient- and procedure-related risk factors play a major role in the success of cardiac surgery, there is growing evidence that also optimizing perioperative care may improve outcomes significantly. The present review focuses on the aspects of perioperative care that are strictly related to the anesthesia regimen, with special reference to volatile anesthetics and neuraxial anesthesia, whose effect on outcome in adult cardiac surgery has been investigated extensively.