Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
ReviewElements not Graded in the Cardiac Enhanced Recovery After Surgery Guidelines Might Improve Postoperative Outcome: A Comprehensive Narrative Review.
Enhanced Recovery Programs (ERPs) are protocols involving the whole patient surgical journey. These protocols are based on multimodal, multidisciplinary, evidence-based, and patient-centered approaches aimed at improving patient recovery after a surgical intervention. Such programs have shown striking positive results in different surgical specialties. ⋯ Their recommendations included 22 perioperative interventions that may be part of any cardiac ERP. However, various components integrated in already-published cardiac ERPs were neither graded nor reported in these recommendations. The goals of the current review are to present published cardiac ERPs and their effects on patient outcomes and reported components incorporated into these ERPs and to discuss the objectives and scope of cardiac ERPs.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Randomized Controlled TrialUltrasound-Guided Long-Axis Versus Short-Axis Femoral Artery Catheterization in Neonates and Infants Undergoing Cardiac Surgery: A Randomized Controlled Study.
The objective of the present study was to compare ultrasound-guided long-axis (LAX) and short-axis (SAX) femoral artery catheterization in neonates and infants undergoing cardiac surgery. ⋯ With a single experienced operator performing the ultrasound-guided femoral artery cannulation, the LAX technique resulted in a higher first puncture success rate and shorter time to cannulation than the SAX technique.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
ReviewPerioperative Spinal Cord Ischemia After Cardiac Surgery Not Involving the Aorta: A Review of the Literature.
Spinal cord ischemia (SCI) associated with aortic surgery is well-described; however, SCI after cardiac surgery not involving the aorta is an unusual and underappreciated phenomenon. The authors reviewed the literature and found 54 case reports of perioperative spinal cord ischemia in nonaortic surgery. ⋯ Patient comorbidities, such as high blood pressure, hypercholesterolemia, diabetes, and peripheral vascular disease, also may play a role in the development of this adverse outcome. The authors review the literature to define further possible mechanisms, surgical techniques, and patient factors that could contribute to the risk of perioperative SCI after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Review Case ReportsTwo Consecutive Cases of Quadricuspid Aortic Valve and a Review of 149 Cases.
The quadricuspid aortic valve (QAV) is a rare congenital anomaly that typically is unrelated to other cardiac anomalies. It usually is discovered incidentally through imaging modalities such as echocardiogram or computed tomography angiogram, during surgery, or autopsy. ⋯ However, review of case reports can be very useful in rare medical conditions such as QAV. In this manuscript, in addition to presenting two cases of QAV, the authors reviewed 149 cases of QAV from 2010 to 2020 from published case studies and series in order to gain a better insight into the characteristics of the patient population with QAV and its management.
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J. Cardiothorac. Vasc. Anesth. · Mar 2022
Observational StudyNon-Thyroidal Illness Syndrome-Associated Multiorgan Dysfunction After Surgical Repair of Type A Aortic Dissection.
The purpose of this cohort study was to investigate the relationship between non-thyroidal illness syndrome (NTIS) and severe multiorgan dysfunction, measured by Sequential Organ Failure Assessment score ≥11, after surgical repair of type A aortic dissection (TAAD). ⋯ Non-thyroidal illness syndrome was associated closely with multiorgan dysfunction after surgical repair of TAAD, which may be correlated further with an increased incidence of in-hospital mortality and complications.