Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2010
Multicenter Study Comparative StudyThe impact of immediate extubation in the operating room after cardiac surgery on intensive care and hospital lengths of stay.
To determine if lengths of stay in intensive care and the hospital are associated with extubation in the operating room at the conclusion of cardiac surgery. ⋯ Selection of patients for immediate extubation in the operating room by experienced clinicians was associated with shorter ICU and hospital stays. Immediate extubation rarely resulted in tracheal re-intubation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2010
ReviewProgress in perioperative medicine: focus on statins.
Beyond cholesterol reduction, statins have multiple beneficial influences on vascular endothelial function, atherosclerotic plaque stability, inflammation, and thrombosis. These favorable pleiotropic effects may be the basis for their perioperative risk reduction in cardiothoracic and vascular procedures. The published evidence suggests that statins offer significant outcome benefits throughout perioperative practice. ⋯ The pleiotropic effects of statins also appear to have therapeutic roles in the progression of valve disease, sepsis, and venous thrombosis. Further trials are required to provide data to drive their safe and comprehensive perioperative application for optimal patient outcome both in the short term and the long term. Because there are multiple randomized trials currently in progress throughout perioperative medicine, it is very likely that the indications for statins will be expanded significantly.
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J. Cardiothorac. Vasc. Anesth. · Oct 2010
Comparative StudyAnesthesia and perioperative management of patients undergoing transcatheter aortic valve implantation: analysis of 90 consecutive patients with focus on perioperative complications.
To describe, from the point of view of anesthesia and intensive care specialists, the perioperative management of high-risk patients with aortic stenosis who underwent transcatheter (transfemoral and transapical) aortic valve implantation (TAVI). The authors specifically focused on immediate postoperative complications. ⋯ Despite their severe comorbidities, the mortality of the patients in this cohort was below that predicted by cardiac surgery risk scores. Monitoring, hemodynamic instability, and the frequency of complications require management and follow-up of these patients in similar ways as for open cardiac surgery. The frequency of complications in this cohort was comparable to that published by other groups.
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J. Cardiothorac. Vasc. Anesth. · Oct 2010
Comparative StudyAscending aortic aneurysms: asymmetrical differences in aortic cross-sectional wall motion detected by epiaortic echocardiography.
To evaluate in vivo cross-sectional conformational changes of ascending aortic wall excursion in patients undergoing resection for aortic aneurysm with those undergoing elective coronary artery bypass grafting (CABG) using epi-aortic echocardiography. ⋯ This in vivo study documented a lack of asymmetric aortic wall motion in ascending aortic aneurysms. In contrast, both the internal and external control groups (aneurysm neck and CABG) demonstrated asymmetric wall motion. The lack of asymmetric wall motion may be an important aspect of aneurysm pathophysiology and key to the development of management strategies for timing of surgical intervention.
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J. Cardiothorac. Vasc. Anesth. · Oct 2010
Comparative StudyComparison of the endotracheal cardiac output monitor to thermodilution in cardiac surgery patients.
To compare cardiac output (CO) measurements from a novel endotracheal bioimpedance cardiac output monitor device (ECOM; ConMed, Irvine, CA) to simultaneous pulmonary artery thermodilution (TD) CO. ⋯ ECOM did not adequately agree with TD in patients undergoing cardiac surgery.