Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Randomized Controlled Trial Comparative StudyTranexamic acid reduces blood loss in off-pump coronary artery bypass surgery.
This study was designed to evaluate the hemostatic effect of tranexamic acid in off-pump coronary artery bypass surgery. ⋯ Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery. Tranexamic acid appears to be effective in reducing postoperative bleeding and the need for allogeneic blood products.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
ReviewRecent advances in perioperative medicine: highlights from the literature for the cardiothoracic and vascular anesthesiologist.
There have been major advances in perioperative cardiothoracic and vascular medicine. Because of promising data, steroids, statins, and endothelin antagonists are being clinically tested in randomized trials with adult cardiac surgical patients. In vascular surgical patients, recent meta-analysis has revealed that interventions such as beta-blockade or endovascular stenting for peripheral vascular lesions may not improve outcome overall. ⋯ Perioperative renal dysfunction after adult cardiac surgery is significantly reduced by the infusion of sodium bicarbonate. Although promising, further trials are required. Taken together, these recent advances will have significant influence on the future practice of cardiovascular and thoracic anesthesia as the ongoing search for perioperative outcome improvement achieves results.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Comparative StudyEvaluation and comparison of early hemodynamic changes after elective mitral valve replacement in patients with severe and mild pulmonary arterial hypertension.
To evaluate and compare early hemodynamic changes after elective mitral valve replacement (MVR) in patients with severe and mild pulmonary arterial hypertension (PAH). ⋯ PAP returns to near-normal values in patients with severe preoperative PAH and to normal values in patients with mild preoperative PAH immediately after MVR. The outcome after surgery in patients with severe PAH is comparable to those with mild PAH.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Comparative StudyThe role of epicardial echocardiography in the measurement of transvalvular flow velocities during aortic valve replacement.
The purpose of this study was to compare transvalvular flow velocities obtained by transesophageal echocardiography and epicardial echocardiography (EE) during aortic valve replacement (AVR). ⋯ Peak transaortic valve velocities and VTI measured with epicardial echocardiography are higher in comparison to measurements via TEE in patients undergoing AVR. The precise role of epicardial echocardiography in the comprehensive echocardiographic examination of patients undergoing aortic valve replacement needs further evaluation.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Comparative StudyThe influence of the preoperative immune response on blood transfusion requirements in patients undergoing cardiac surgery.
The purpose of this study was to evaluate the influence of preoperative type I and II immune responses on blood transfusion requirements. ⋯ A low preoperative Th1 immune response, as assessed by the proportion of CD4+ T-helper-producing TNF-alpha, was associated with a higher blood transfusion rate.