Annals of cardiac anaesthesia
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Observational Study
Propensity-matched analysis of association between preoperative anemia and in-hospital mortality in cardiac surgical patients undergoing valvular heart surgeries.
Anaemia is associated with increased post-operative morbidity and mortality. We retrospectively assess the relationship between preoperative anaemia and in-hospital mortality in valvular cardiac surgical population. ⋯ Preoperative anaemia is an independent risk factor associated with in-hospital mortality in patients undergoing valvular heart surgery.
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Several studies have analyzed the long-term survival after transcatheter aortic valve implantation (TAVI). However, no previous studies have looked at survival beyond 1-year with respect to the type of anesthesia. ⋯ Our results demonstrate that the type of anesthesia and the access route do not influence mid-term survival after TAVI.
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Observational Study
Noninvasive estimation of left atrial pressure with transesophageal echocardiography.
The pulmonary artery catheter (PAC) has historically been used to measure cardiac filling pressures of which pulmonary capillary wedge pressure (PCWP) has been used as a surrogate of left atrial pressure (LAP) and left ventricular end-diastolic pressure. Increasingly, the use of the PAC has been questioned in the perioperative period with multiple large studies unable to clearly demonstrate benefit in any group of patients, resulting in a declining use in the perioperative period. Alternative methods for the noninvasive estimation of left-sided filling pressures are required. Echocardiography has been used to provide noninvasive estimation of PCWP and LAP, based on evaluating mitral inflow velocity with the E and A waves and looking at movement of the mitral annulus with tissue Doppler (e'). ⋯ Noninvasive measurements of E/e' in general cardiac surgical patients have only a modest correlation and does not reliably estimate PCWP.
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The reported prevalence of chronic obstructive pulmonary disease (COPD) varies among different groups of cardiac surgical patients. Moreover, the prognostic value of preoperative COPD in outcome prediction is controversial. ⋯ Among post-CABG complications, patients with different levels of COPD based on STS definition, more frequently developed respiratory failure. This finding may imply the prognostic value of preoperative pulmonary function test for determining COPD severity and postoperative morbidities.
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Letter Case Reports
Hematuria in a child eight hours, postcardiac surgery.