Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2021
Use of the Hypotension Prediction Index During Cardiac Surgery.
The hypotension prediction index (HPI) is a novel parameter developed by Edwards Lifesciences (Irvine, CA) that is obtained through an algorithm based on arterial pressure waveform characteristics. Past studies have demonstrated its accuracy in predicting hypotensive events in noncardiac surgeries. The authors aimed to evaluate the use of the HPI in cardiac surgeries requiring cardiopulmonary bypass (CPB). ⋯ HPI predicted hypotensive episodes during cardiac surgeries with a high degree of sensitivity and specificity.
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J. Cardiothorac. Vasc. Anesth. · Jun 2021
Observational StudyEffect of Systemic Vascular Resistance on the Reliability of Noninvasive Hemodynamic Monitoring in Cardiac Surgery.
To assess the effect of systemic vascular resistance (SVR) on the reliability of the ClearSight system (Edwards Lifesciences, Irvine, CA) for measuring blood pressure (BP) and cardiac output (CO). ⋯ The ClearSight system showed an acceptable accuracy in measuring BP and tracking BP changes in various SVR states; however, the accuracy of CO measurement and its trending ability in various SVR states was poor.
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J. Cardiothorac. Vasc. Anesth. · Jun 2021
Case ReportsSuspected Lower Extremity Ischemia After End-to-Side Femoral Arterial Grafting for VA-ECMO.
Lower extremity ischemic complications are frequently encountered after femoral cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Many are attributed to mechanical obstruction of distal arterial blood flow related to intraluminal positioning of the arterial cannula. ⋯ Side- arm grafting instead of direct arterial cannulation is suggested as an alternative. Here, the authors present a case wherein a patient developed suspected lower extremity ischemia from hyperperfusion after femoral VA-ECMO cannulation during use of an arterial side- arm graft, calling into question the benefits of this cannulation strategy.
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J. Cardiothorac. Vasc. Anesth. · Jun 2021
Association Between Three-Dimensional Left Ventricular Outflow Tract Area and Gradients After Myectomy in Hypertrophic Obstructive Cardiomyopathy.
Determine whether the intraoperative three-dimensional left ventricular outflow tract cross-sectional area may be inversely correlated with pressure gradients as a determinant of surgical success after septal myectomy in hypertrophic cardiomyopathy patients. ⋯ Three-dimensional left ventricular outflow tract area measurements with transesophageal echocardiography after myectomy correlated fairly well with postoperative transesophageal pressure gradients. Patients with residual transthoracic elevated gradients after surgery at follow-up had a smaller transesophageal area and higher transesophageal pressure gradients immediately after the procedure. However, transesophageal pressure gradients after myectomy correlated poorly with follow-up transthoracic gradients at rest.