Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · May 2021
ReviewA Narrative Review for Cardiac Anesthesiologists of the 2019 Expert Consensus on Operator and Institutional Recommendations for Transcatheter Mitral Valve Intervention.
US Food and Drug Administration approval of the edge-to-edge clip repair device (MitraClip; Abbott Laboratories, Abbott Park, IL) in 2013 led to wide adoption of the device for treatment of severe primary mitral regurgitation in patients unsuitable for surgery. Demonstration of favorable outcomes in the setting of secondary mitral regurgitation by the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial in 2019 provided an additional impetus to the transcatheter mitral interventional program. ⋯ This document has direct implications for the cardiac anesthesiologist involved in the care of these patients because a broader understanding of pertinent issues is essential to function as an effective clinical member within the multidisciplinary team. As such, this narrative review serves to highlight the salient features of the "2019 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Mitral Valve Intervention: A Joint Report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons," focuses on issues pertinent to the cardiac anesthesiologist, and provides an outline for the clinical context and evolution of transcatheter mitral valve interventions.
-
J. Cardiothorac. Vasc. Anesth. · May 2021
Observational StudyEnd-of-Procedure Volume Responsiveness Defined by the Passive Leg Raise Test Is Not Associated With Acute Kidney Injury After Cardiopulmonary Bypass.
Renal hypoperfusion is a common mechanism of cardiac surgery-related acute kidney injury (CS-AKI). However, the optimal amount of volume resuscitation to correct systemic hypoperfusion and prevent the postoperative development of CS-AKI has been a subject of debate. The goal of this study was to assess the association of volume responsiveness determined by stroke volume variation using the passive leg raise test (PLRT) at chest closure, with the development of CS-AKI according to the Kidney Disease Improving Global Outcomes criteria. ⋯ End-of-procedure volume responsiveness is not associated with a high risk for postoperative CS-AKI.
-
J. Cardiothorac. Vasc. Anesth. · May 2021
Observational StudyPreoperative Electrocardiogram and Perioperative Methods for Predicting New-Onset Atrial Fibrillation During Lung Surgery.
To investigate if preoperative electrocardiogram scores and perioperative surgical methods could predict new-onset atrial fibrillation during lung surgery. ⋯ Preoperative electrocardiogram markers can be used together with surgical methods as strong predictors to identify those patients at a high risk for new-onset atrial fibrillation during lung surgery.