Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Observational StudyFeasibility of Intraoperative 3-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Aortic Valve Replacement: A Prospective Observational Pilot Study.
To assess the feasibility of intraoperative 3-dimensional speckle-tracking-based myocardial deformation analysis for evaluation of twist, torsion, and strain using speckle tracking, and to investigate the immediate changes in these parameters after aortic valve replacement. ⋯ 3D speckle-tracking-based myocardial deformation analysis from intraoperative TEE datasets is feasible in >60% of patients with aortic valve stenosis. There were no statistically significant differences in GLS, CS, twist, or torsion between the intraoperative examinations.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients.
To assess the association of hospital teaching status with outcomes of patients presenting with type B aortic dissection (TBAD). ⋯ Hospital teaching status alone was not associated with in-hospital mortality or 30-day readmission in TBAD patients. At teaching hospitals, management by TEVAR and greater hospital volume were associated with in-hospital mortality and 30-day readmission outcome, respectively.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Case ReportsPulmonary Artery Pseudoaneurysm Due to Pulmonary Artery Catheter Placement: A New Minimally Invasive Approach to Solve a Life-threatening Complication.
This article discusses a pulmonary artery pseudoaneurysm (PAP) formation following pulmonary artery catheter (PAC) placement for cardiac surgery. The patient, an 82-year-old female with a history of hypertension and chronic heart failure, underwent elective mitral and tricuspid valve surgery. After surgery, bleeding was observed in the endotracheal tube, indicating a potential complication. ⋯ While conservative, surgical, and interventional approaches are discussed, the preferred treatment is coil embolization due to its effectiveness and minimal invasiveness. The authors emphasize the importance of rapid diagnosis, multidisciplinary collaboration, and the feasibility of using the pulmonary artery route for embolization to rapidly reach the lesion to stabilize. Overall, the case demonstrates the successful resolution of a life-threatening complication through timely intervention and coordinated teamwork.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Utility of Frailty Index in Predicting Adverse Outcomes in Patients With the Same American Society of Anesthesiologists Class in Video-assisted Thoracoscopic Surgery.
To investigate the utility of the five-item Modified Frailty Index (MFI-5) as a preoperative risk-stratification tool in video-assisted thoracoscopic surgery (VATS) for patients with the same American Society of Anesthesiologists (ASA) class. ⋯ The MFI-5 is a comorbidity-based scale that can be calculated preoperatively and considers distinct, but complementary information to the ASA class. Among VATS patients with identical ASA classes 2 and 3, the MFI-5 further stratified risk for reintubation and ventilator dependence >48 hours postsurgery.