Seminars in cardiothoracic and vascular anesthesia
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Semin Cardiothorac Vasc Anesth · Sep 2017
Review Comparative StudyThromboelastrography (TEG) Is Still Relevant in the 21st Century as a Point-of-Care Test for Monitoring Coagulation Status in the Cardiac Surgical Suite.
Since their introduction into clinical practice in the early 1960s, viscoelastic point-of-care (POC) testing-thromboelastrography (TEG) and thromboelastrometry (ROTEM)-has become increasingly popular in intensive care units, operating rooms, and emergency room settings. As TEG has been an established POC viscoelastic testing modality for many years, there has been more research and analysis of its utility and ability to reduce transfusions in the general, cardiac, and liver surgical sectors compared with ROTEM. The role of TEG versus ROTEM has been greatly disputed, although both continue to be utilized in the cardiac suite to guide transfusion in cardiac surgery as these procedures produce a profoundly different form of bleeding compared to other surgical interventions.
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Semin Cardiothorac Vasc Anesth · Sep 2017
Review Comparative StudyThromboelastometry Versus Rotational Thromboelastography in Cardiac Surgery.
Evidence exists on the morbiduty and mortality associated with both massive blood loss and transfusion in cardiac surgical patients. Monitoring of the vesicoelastic properties of blood using rotational thromboelastometry and thromboelsatography (TEG) has been a major step towards ameliorating the risks associated with these 2 evils by providing trageted goal-directed blood product resuscitation. ⋯ Also, both ROTEM and TEG suffer from some limitations resulting in a lack of agreement on the duperiority of one device versus the other. In this concise review we discuss the operational charecteristics of both devices and the pro-side of the use of ROTEM in cardiac surgery backed with the most recent evidence.
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Semin Cardiothorac Vasc Anesth · Sep 2017
ReviewPerioperative and Anesthetic Considerations in Atrioventricular Septal Defect.
Atrioventricular septal defect results from a failure of normal endocardial cushion fusion during embryologic cardiac development. This developmental aberration results in defects in the atrial and/or ventricular septum and malformation of the atrioventricular valves. The pathophysiology of atrioventricular septal defect is variable, and ranges from mild left to right shunting similar to a simple atrial septal defect to complex single-ventricle heart disease. This review focuses on the spectrum of atrioventricular septal defect from partial to complete, without associated cardiac defects.