Seminars in cardiothoracic and vascular anesthesia
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Semin Cardiothorac Vasc Anesth · Mar 2018
ReviewNoteworthy Literature published in 2017 for Perioperative Echocardiography.
In this inaugural review, we present noteworthy advances in perioperative echocardiography relevant to the cardiac anesthesiologist. These studies come from different clinical realms including advances in mitral valve imaging, perioperative echocardiographic evaluation, and critical care echocardiography. The importance of perioperative echocardiography continues to grow with cardiac anesthesiologists positioned in a critical role throughout the perioperative care continuum.
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Semin Cardiothorac Vasc Anesth · Mar 2018
ReviewNoteworthy Literature Published in 2017 for Thoracic Transplantation Anesthesiologists.
Thoracic organ transplantation constitutes a significant proportion of all transplant procedures. Thoracic solid organ transplantation continues to be a burgeoning field of research. This article presents a review of remarkable literature published in 2017 regarding perioperative issues pertinent to the thoracic transplant anesthesiologists.
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Semin Cardiothorac Vasc Anesth · Mar 2018
Case ReportsDelayed Development of Malignant Hyperthermia Following Cardiopulmonary Bypass.
Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. ⋯ Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period. In this article, we present a case of the development of postoperative MH in the cardiac intensive care unit after elective open heart surgery with cardiopulmonary bypass.
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Semin Cardiothorac Vasc Anesth · Dec 2017
Review Case ReportsPerioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery.
Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. ⋯ The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.
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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.