Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Review Meta AnalysisIncidence, Risk Factors, and Prognosis of Tricuspid Regurgitation After Cardiac Implantable Electronic Device Implantation: A Systematic Review and Meta-analysis.
This study aimed to determine the pooled incidence, risk factors, and clinical prognosis of tricuspid regurgitation (TR) deterioration after implantation of a cardiac implantable electronic device (CIED). The study was designed as a meta-analysis of randomized controlled trials and observational studies. Patients with indications for CIEDs were selected as participants and CIED implantation was the intervention. ⋯ TR is a common complication after CIED implantation. Lead interference and pacemaker implantation time were risk factors for TR worsening. Compared with patients without TR deterioration after pacemaker implantation, patients with TR deterioration had a poorer prognosis.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Meta AnalysisEvaluating the Impact of Cardiopulmonary Bypass Priming Fluids on Bleeding After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis.
Cardiopulmonary bypass (CPB) predisposes young children to coagulopathy. The authors evaluated possible effects of CPB priming fluids on perioperative bleeding in pediatric cardiac surgery. ⋯ This systematic review of current evidence did not show an effect of different CPB priming solutions on 24-hour blood loss. The analysis was limited by heterogeneity within the dataset regarding population, type of intervention, dosing, and the chosen comparator, compromising any conclusions.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
ReviewRight Ventricular Assist Device With Extracorporeal Membrane Oxygenation for Bridging Right Ventricular Heart Failure to Lung Transplantation: A Single-Center Case Series and Literature Review.
Right ventricular heart failure (RVHF) is a critical complication in patients with respiratory failure, particularly among those who transitioned to lung transplantation using venovenous (VV) extracorporeal membrane oxygenation (ECMO). In these patients, both cardiac and respiratory functions are supported using venoarterial or venoarterial-venous ECMO. However, these modalities increase the risk of device-related complications, such as thromboembolism, bleeding, and limb ischemia, and they may disturb early rehabilitation. Due to these limitations, a right ventricular assist device with an oxygenator (Oxy-RVAD) using ECMO may be considered for patients with RVHF with VV ECMO. ⋯ The study suggested that Oxy-RVAD using ECMO may be a viable option for bridging patients with RVHF to lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
ReviewHow We Would Treat Our Own Pulmonary Hypertension if We Needed to Undergo Cardiac Surgery.
Pulmonary hypertension (PH) is a disease that has many etiologies and is particularly prevalent in patients presenting for cardiac surgery, with which it is linked to poor outcomes. This manuscript is intended to provide a comprehensive review of the impact of PH on the perioperative management of patients who are undergoing cardiac surgery. ⋯ The authors postulate that a thoughtful, multidisciplinary approach is required to deliver excellent perioperative care. Furthermore, they use an index case to illustrate the implications of managing a patient with pulmonary hypertension who presents for cardiac surgery with cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Jun 2022
Anesthesia in Children With Pulmonary Hypertension: Clinically Significant Serious Adverse Events Associated With Cardiac Catheterization and Noncardiac Procedures.
To determine the incidence of clinically significant serious adverse events in a contemporary population of pediatric patients with pulmonary hypertension who require anesthesia and identify factors associated with adverse outcomes. ⋯ Serious adverse events were common in this cohort. Careful planning to minimize anesthesia time in young children with pulmonary hypertension should be undertaken, and these factors considered in designing risk mitigation strategies.