Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Case ReportsThe Many Faces of the Interatrial Septum: A Diagnostic Dilemma and Considerations for Defect Closure Device Selection.
PATENT FORAMEN ovales (PFOs) and atrial septal defects (ASDs) are 2 examples of interatrial septal pathology.1 The presence of a PFO is a well-known risk factor for cryptogenic stroke.1,2 Newer evidence over the course of the last decade suggests percutaneous device closure of PFOs significantly reduces the subsequent risk of recurrent stroke.2 Among ASDs, the ostium secundum type is the most common pathology and, due to its anatomy, is most amenable to transcatheter closure.1 The tools that are available to percutaneously close these different pathologies vary, and choosing the correct device for the procedure can have significant impact on the clinical outcome. The authors here present a case that highlights how the differentiation of an ASD from a PFO using 2-dimensional (2D) and 3-dimensional (3D) echocardiography can affect the clinical decision-making and outcome in a challenging structural heart disease case.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Randomized Controlled TrialThe Effect of Erector Spinae Plane Block and Combined Deep and Superficial Serratus Anterior Plane Block on Acute Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Study.
The study aimed to compare the analgesic effects of erector spinae plane block (ESPB) and a combination of the deep and superficial serratus anterior plane block (C-SAPB) methods in patients who underwent video-assisted thoracoscopic surgery (VATS). ⋯ Patients who underwent VATS receiving ESPB or C-SAPB had similar pain scores, opioid consumption, and side effects during the first postoperative 24 hours. At the same time, the fact that the duration of the block procedure was similar in both groups showed that multisite serratus anterior plane block can be an effective alternative method in analgesic treatment after VATS, considering that it easily can be applied. The authors here think that C-SAPB can be a good alternative to ESPB because the outcomes of both applications are similar, and C-SAPB easily can be seen and applied with ultrasound.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Randomized Controlled TrialFeasibility and Usefulness of Self-Hypnosis in Patients Undergoing Double-Lung Transplantation During the Pre- and Postoperative Periods: A Randomized Study.
Hypnosis can reduce pain and anxiety in surgical patients. This study aimed to demonstrate that implementing self-hypnosis in the setting of lung transplantation could improve patients' pain and quality of life. ⋯ Implementation of self-hypnosis is possible, but the study failed to demonstrate an improvement in patients' experience, perhaps due to the variable compliance with the technique.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Angiotensin II in Patients With Shock on Mechanical Circulatory Support: A Single-Center Retrospective Case Series.
To describe angiotensin II (ANGII) use in patients on mechanical circulatory support (MCS). To evaluate the efficacy and safety of ANGII in patients with shock on MCS. ⋯ This study suggested that ANGII may provide a salvage treatment option in patients on MCS with refractory vasodilatory shock. There are several safety considerations with the use of ANGII in these patients. Prospective randomized controlled trials are needed to evaluate the safety and efficacy of ANGII in patients on MCS.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
External Validation of the ACTA-PORT Transfusion Risk Score in Older Cardiac Surgery Patients at Risk of Frailty.
Accurate preoperative transfusion risk stratification may serve to better manage older patients undergoing cardiac surgery. Therefore, the aim of the present study was to externally validate the existing Association of Cardiothoracic Anesthetists perioperative risk of blood transfusion (ACTA-PORT) score in a population ≥70 years of age scheduled for cardiac surgery. Furthermore, the study authors investigated the additional prognostic value of individual frailty variables to this transfusion risk score. ⋯ External validation of the original ACTA-PORT score showed good discrimination and moderate calibration in older patients at risk of frailty undergoing cardiac surgery. Updating the original ACTA-PORT improved the predictive performance. Careful evaluation of additional frailty domains did not add prognostic value to the ACTA-PORT score.