Seminars in Cardiothoracic and Vascular Anesthesia This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

The Anesthetic Management of Transcatheter Aortic Valve Implantation
An increasing number of patients with a high risk for surgery because of advanced age and associated comorbidities that significantly increase the perioperative risk successfully undergo transcatheter aortic valve implantation (TAVI). TAVI is commonly performed under general or local anesthesia or local anesthesia plus mild sedation to achieve a conscious sedation. The anesthetic regimen generally depends on the patient’s clinical profile and the procedural technical characteristics, but the center’s experience and internal organization likely play an important role in anesthetic decision making. The large vari...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 3, 2016 Category: Anesthesiology Authors: Guarracino, F., Baldassarri, R. Tags: Reviews Source Type: research

Design and Implementation of a Perioperative Surgical Home at a Veterans Affairs Hospital
We present our experience implementing Perioperative Surgical Home at one tertiary care university-affiliated Veterans Affairs hospital. This process involved initiating consistent postoperative patient follow-up beyond the postanesthesia care unit, a focus on improving in-hospital acute pain management, creation of an accessible database to track outcomes, developing new clinical pathways, and recruiting additional staff. Today, our Perioperative Surgical Home facilitates communication between various services involved in the care of surgical patients, monitoring of patient outcomes, and continuous process improvement. (S...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 3, 2016 Category: Anesthesiology Authors: Walters, T. L., Howard, S. K., Kou, A., Bertaccini, E. J., Harrison, T. K., Kim, T. E., Shafer, A., Brun, C., Funck, N., Siegel, L. C., Stary, E., Mariano, E. R. Tags: Reviews Source Type: research

Ten Years Experiences With Preoperative Evaluation Clinic for Day Admission Cardiac and Major Vascular Surgical Patients: Model for "Perioperative Anesthesia and Surgical Home"
Admission on the day of surgery for elective cardiac and noncardiac surgery is the prevalent practice in North America and Canada. This approach realizes medical, psychological and logistical benefits, and its success is predicated on an effective outpatient preoperative evaluation. The establishment of a highly functional preoperative clinic with a comprehensive set up and efficient logistical pathways is invaluable. This notion in recent years has included the entire perioperative period, and the concept of a perioperative anesthesia/surgical home (PASH) is gaining popularity. The anesthesiologists as perioperative physi...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 3, 2016 Category: Anesthesiology Authors: Silvay, G., Zafirova, Z. Tags: Reviews Source Type: research

Congenital Cardiac Forum
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 3, 2016 Category: Anesthesiology Authors: Twite, M. D. Tags: Editorials Source Type: research

Perioperative Physicians and Evolving Models of Care
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 3, 2016 Category: Anesthesiology Authors: Weitzel, N. S. Tags: Editorials Source Type: research

Cardiac Calendar 2016 - 2020
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Tags: Cardiac Calendar 2016 - 2020 Source Type: research

Anesthetic Management of a Patient With a Giant Right Atrial Myxoma
We present a case report highlighting the importance of multimodal imaging, adequate preoperative patient optimization, and the anesthetic considerations in the successful management of a patient with a giant 8.3 x 4.7 cm RA myxoma. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Essandoh, M., Andritsos, M., Kilic, A., Crestanello, J. Tags: Clinical Challenges Source Type: research

Diastolic Mitral Regurgitation in a Patient With Complex Native Mitral and Aortic Valve Endocarditis: A Rare Phenomenon With Potential Catastrophic Consequences
We describe a case of diastolic mitral regurgitation in the setting of complex native mitral-aortic valve endocarditis in a patient in normal sinus rhythm and review the etiologic mechanisms of this phenomenon, echocardiographic assessment, and therapeutic implications for hemodynamic management. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Pulido, J. N., Lynch, J. J., Mauermann, W. J., Michelena, H. I., Rehfeldt, K. H. Tags: Clinical Challenges Source Type: research

Tailoring the Blood Ordering Process for Cardiac Surgical Cases Using an Institution-Specific Version of the Maximum Surgical Blood Order Schedule
Conclusions. Using the gold standard C:tx of >2:1 as an indicator of inappropriate blood utilization, our analysis confirmed that excessive crossmatching occurred for several procedures. Now a subset of cardiac surgical cases only requires a type and screen order prior to surgery. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Ural, K. G., Volpi-Abadie, J., Owen, G., Gilly, G., Egger, A. L., Scuderi-Porter, H. Tags: Original Research Source Type: research

Perioperative and Anesthetic Considerations in Ebsteins Anomaly
Ebstein’s anomaly is a complex and heterogeneous form of congenital heart disease characterized by malformation and apical displacement of the tricuspid valve leaflets. Patients may present at any time from the neonatal period to adulthood with symptoms ranging from cardiac failure and cyanosis to paroxysmal arrhythmias. Depending on the timing of presentation, various surgical options are available for the management of symptomatic patients. This review will discuss the perioperative and anesthetic management of patients with Ebstein’s anomaly with reference to the more common surgical approaches. (Source: Sem...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Ross, F. J., Latham, G. J., Richards, M., Geiduschek, J., Thompson, D., Joffe, D. Tags: Congenital Cardiac Forum Source Type: research

Preoperative Physiology, Imaging, and Management of Ebsteins Anomaly of the Tricuspid Valve
Ebstein’s anomaly of the tricuspid valve (TV) refers to an embryological derangement of TV formation causing tethering of the septal and posterior leaflets of the valve to the underlying myocardium and apical displacement of the effective valve annulus, resulting in significant TV insufficiency and dilation of the right heart structures. The pathological abnormalities of the valve can vary significantly, resulting in a wide range of clinical presentations. Fetal diagnosis and neonatal presentations of the disease are typically the most severe and are associated with the highest mortality rates. Patients with less-sev...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Morray, B. Tags: Congenital Cardiac Forum Source Type: research

The Post-Anesthetic Care of Pediatric Patients With Pulmonary Hypertension
This article will instead focus on postoperative care and review the evidence in support of a risk stratification approach for the post-anesthetic disposition of these patients. The total risk for post-anesthetic adverse events includes the patient’s baseline risk factors and the incremental risks imposed by the procedure and anesthetic. A proposal with recommendations to guide practitioners and a table summarizing relevant factors are provided. Last, the readers’ attention is drawn to the heterogeneity of pulmonary hypertensive disease. Pulmonary arterial hypertension (precapillary) differs significantly from ...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Chau, D. F., Gangadharan, M., Hartke, L. P., Twite, M. D. Tags: Post-operative ICU care of the Cardiac Surgical Patient Part III Source Type: research

Insertion and Management of Temporary Pacemakers
Temporary pacemakers are used in a variety of critical care settings. These life-saving devices are reviewed in 2 major categories in this review: first, the insertion and management of epicardial pacemakers after and during cardiac surgery; and second, the insertion of transvenous temporary pacemakers for the emergent treatment of bradyarrhythmias. Temporary epicardial pacemakers are used routinely in patients recovering from cardiac surgery. Borrowing from advances in cardiac resynchronization therapy there are many theoretical and untested benefits to pacing the postoperative cardiac surgery patient. Temporary transveno...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Sullivan, B. L., Bartels, K., Hamilton, N. Tags: Post-operative ICU care of the Cardiac Surgical Patient Part III Source Type: research

Cardiopulmonary Bypass Without Heparin
Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Rehfeldt, K. H., Barbara, D. W. Tags: Post-operative ICU care of the Cardiac Surgical Patient Part III Source Type: research

Noteworthy Literature in Cardiac Surgery 2015
In 2015, the cardiac literature has pushed for change in cardiac practice. The areas are evolving quickly based on new technology, ranging from percutaneous valves in the aortic position to mechanical support. The new devices in both these fields are changing the way patients are cared for very quickly. Another topic evolving is temperature management in aortic arch cases. This field is being pushed more by the threat of endovascular technology creeping into the arch than technology directly causing change in care. But that threat is real and inevitable. Finally, the discussion about optimal conduits is unending in coronar...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 11, 2016 Category: Anesthesiology Authors: Reece, T. B., Cleveland, J. C. Tags: Noteworthy Literature Series 2015 Source Type: research