Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Mitral Valve Repair in Patients with Chronic Kidney Disease: Long-Term Outcomes and Cardiac Remodeling.
Literature examining mitral valve repair (MVr) outcomes in patients with chronic kidney disease (CKD) is largely limited to short-term outcomes and percutaneous approaches. This study is the first to present long-term outcomes of mortality and morbidity with paired cardiac remodeling data from patients with CKD undergoing surgical MVr. ⋯ In patients with CKD undergoing MVr, eGFR is a predictor of decreased long-term survival and residual mitral regurgitation at 1 year. Further investigation is required to optimize postoperative outcomes in this patient population.
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Because of changing rules and regulations in insurance and reimbursement, critical care physicians must adapt their billing practices to meet the challenges of these complex changes. Reimbursement for critical care billing varies substantially across the country, and staffing models must consider this heterogeneity. This article summarizes the current state of critical care billing and addresses the requirements to generate a critical care bill and the potential circumstances that may result in a denial of payment.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Anesthetic Management for Ventricular Tachycardia Ablation: A National Anesthesia Clinical Outcomes Registry Analysis.
The authors analyzed anesthetic management trends during ventricular tachycardia (VT) ablation, hypothesizing that (1) monitored anesthesia care (MAC) is more commonly used than general anesthesia (GA); (2) MAC uses significantly increased after release of the 2019 Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias; and (3) anesthetic approach varies based on patient and hospital characteristics. ⋯ GA has remained the primary anesthetic type for VT ablation despite the 2019 Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias suggested its avoidance in idiopathic VT. Achieving widespread clinical practice change is an ongoing challenge in medicine, emphasizing the importance of developing effective implementation strategies to facilitate awareness of guideline release and subsequent adherence to and adoption of recommendations.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
Multicenter Study Observational StudyShould the Vasoactive Inotropic Score be a Determinant for Early Initiation of VA ECMO in Postcardiotomy Cardiogenic Shock?
The authors investigated the role of early venoarterial extracorporeal membrane oxygenation (VA ECMO) implantation in patients with postcardiotomy cardiogenic shock (PCS) on mortality and morbidity when integrating vasoactive-inotropic score (VIS) and type of catecholamine support. ⋯ When matching integrated the pre-ECMO VIS and the type of catecholamines, VA ECMO remained associated with high mortality and morbidity, suggesting that VIS alone should not be used as a main determinant of VA ECMO implantation.