Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2022
Editorial CommentScore2: A New Updated Algorithm to Predict Cardiovascular Disease Risk in Europe.
The recently published guidelines of the European Society of Cardiology for the prevention of cardiovascular diseases presented in August 2021 at the virtual European Society of Cardiology congress recommend the use of the SCORE2 risk index instead of the classic SCORE risk index to calculate the cardiovascular risk (specifically, ten-year fatal and nonfatal risk) in a healthy population under the age of 70 years, with a level of evidence IB. This new risk index was developed with the collaboration of about 200 investigators, including 45 cohorts in 13 countries with 700,000 participants, and covers the known risk factors for heart and circulatory diseases such as age, sex, lipid levels, blood pressure, and smoking. In addition, it divides the countries into four groups of risk and uses a competing risk model, adjusting the risk for the probability of having another event, which enables better estimation of the risk of fatal and nonfatal events in a younger population (40-69 years).
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J. Cardiothorac. Vasc. Anesth. · Jan 2022
Preliminary Study of Serum Biomarkers Associated With Delirium After Major Cardiac Surgery.
The objective of this study was to identify novel serum biomarkers specific to postoperative delirium after major cardiac surgery to provide insight into the pathologic processes involved in delirium and its sequelae. ⋯ FGF-21, FGF-23, interleukin-6, and monocyte chemotactic protein-3 serum levels were increased postoperatively in patients who developed delirium after major cardiac surgery. This study identified two members of the FGF family as potential putative systemic biomarkers for postoperative delirium after cardiac surgery, suggesting a possible role for metabolic recovery in the pathophysiologic mechanisms underlying neurocognitive dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Jan 2022
Unilateral Pulmonary Edema After Robotically Assisted Mitral Valve Repair Requiring Veno-Venous Extracorporeal Membrane Oxygenation.
Unilateral pulmonary edema (UPE) is an uncommon yet potentially life-threatening complication of minimally invasive cardiac surgery (MICS). Most frequently described after robotically assisted mitral valve (MV) repair, it is characterized by right lung edema, hypoxemia, hypercapnia, pulmonary hypertension, and hemodynamic instability beginning minutes-to-hours after separation from cardiopulmonary bypass (CPB). The authors describe a severe case with refractory hypoxemia requiring veno-venous (VV) extracorporeal membrane oxygenation (ECMO) after robotically assisted MV repair.
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J. Cardiothorac. Vasc. Anesth. · Jan 2022
Case ReportsFactor V Deficiency (Owren's Disease) in a Patient at High Risk for Transfusion-Associated Circulatory Overload and Bleeding During Laser Lead Extraction.
Congenital factor V deficiency is an extremely rare abnormality and may be associated with significant bleeding as a result of trauma or surgery. Perioperative management primarily includes the administration of fresh frozen plasma to replace the deficient clotting factor. Acute administration of multiple blood products is a risk factor for transfusion-associated circulatory overload. Herein, the case of a 71-year-old man with an ejection fraction of 13% and a history of congenital factor V deficiency who was at risk for significant bleeding and transfusion-associated circulatory overload who underwent successful complex extraction of a right atrial pacing lead is reported.