Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Anesthetic Considerations for Minimally Invasive, Off-Pump, HeartMate III Implantation.
The authors developed and utilized an anesthetic protocol for the management of an off-pump approach for minimally invasive Heartmate III (HM3) implantation. Their goal was to determine if this method was safe and feasible for patients with in-situ mechanical support. ⋯ In this single-center study, the authors have described the anesthetic consideration for the implantation of the HM3 left ventricular assist device using a complete sternal-sparing technique without the use of cardiopulmonary bypass. Their results have shown, in a case series of 8 patients, that this is a safe and feasible alternative to traditional techniques in patients with existing mechanical support.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Case ReportsA Case of Transient Mitral Regurgitation: Not Everything Is Always What It Seems.
Mitral regurgitation (MR) is a common form of valvular heart disease that is associated with significant morbidity and mortality. MR can be broadly classified into 2 different categories: primary and secondary MR. ⋯ Without acute changes in loading conditions, myocardial blood flow, or rhythm disturbances, functional MR typically is not transient. In this E-Challenge, the authors show a transient and completely reversible acute and severe form of functional MR with the use of multimodal echocardiography.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Case ReportsCoagulopathy Management of an Acute Type A Aortic Dissection in a Patient Taking Apixaban.
This paper reports the successful management of a patient with acute type A Penn B thoracic aortic dissection who was on apixaban therapy for atrial fibrillation. Emergency surgery was performed due to the patient's clinical deterioration, with innominate artery compromise and severe aortic valve regurgitation. ⋯ No additional blood products were required. The patient recovered fully and was discharged home.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Coagulation Profile of Neonates Undergoing Arterial Switch Surgery With Crystalloid Priming of the Cardiopulmonary Bypass Circuit.
The aim was to evaluate changes in the coagulation profile of cyanotic neonates, to analyze the effects of cardiopulmonary bypass (CPB) with crystalloid priming on their coagulation status, and to determine factors predicting a requirement for hemostasis-derived transfusion. ⋯ Guidance from ROTEM analyses facilitates hemostasis management after neonatal CPB. Circuit miniaturization with transfusion-free CPB is associated with acceptable changes in ROTEM in most patients, and allows sufficient hemostasis without any HD transfusions in most patients.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Observational StudyNew-Onset Atrial Arrhythmias Are Independently Associated With In-Hospital Mortality in Veno-Venous Extracorporeal Membrane Oxygenation.
To explore if atrial arrhythmias are associated with in-hospital mortality in veno-venous extracorporeal membrane oxygenation (VV-ECMO) patients. ⋯ New-onset atrial arrhythmias are a frequent complication during VV-ECMO and are independently associated with excessive in-hospital mortality. Thus, their presence may serve as an important prognostic tool in this patient population.