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.

Management of Intra-Aortic Balloon Pumps
Intra-aortic balloon pumps (IABPs) continue to be the most widely used cardiac support devices with an annual estimate of 200 000 IABPs placed worldwide. IABPs enhance myocardial function by maximizing oxygen supply and minimizing oxygen demand. The use of IABPs is not without risk, with major vascular injury, ischemia, and infection being the most common complications, especially in high-risk patients. While recent studies have questioned the use of IABPs in patients with cardiogenic shock secondary to myocardial infarction, these studies have limitations making it difficult to formulate definitive conclusions. This revie...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 14, 2015 Category: Anesthesiology Authors: Webb, C. A.- J., Weyker, P. D., Flynn, B. C. Tags: Articles Source Type: research

Intensive Care Unit Management of Transcatheter Aortic Valve Recipients
Severe aortic stenosis is an increasingly prevalent disease that continues to be associated with significant mortality. Transcatheter aortic valve replacements have been used as an alternative to surgical aortic valve replacement in high-risk patients with multiple comorbidities. In this review, we discuss postoperative considerations pertinent to the successful management of these complicated patients in the intensive care unit. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 14, 2015 Category: Anesthesiology Authors: Lo, J., Hill, C. Tags: Articles Source Type: research

How Should We Manage Arrest Following Cardiac Surgery?
Perioperative arrest occurs in thousands of cardiac surgical patients annually, yet standard resuscitation methods are ineffective or potentially harmful. These "high risk, low volume" events typically occur in well-monitored patients in the highly specialized environment of the operating room or intensive care unit, with a short list of likely causes of arrest, making a protocolized approach to management feasible and desirable. An evidence-based guideline for resuscitation specific to the cardiac surgical patient was first published by Dunning et al in 2009 and adopted by the European Resuscitation Council the following ...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 14, 2015 Category: Anesthesiology Authors: Ley, S. J. Tags: Articles Source Type: research

Routine Postoperative Care of Patients Undergoing Coronary Artery Bypass Grafting on Cardiopulmonary Bypass
The postoperative course of a patient undergoing cardiac surgery (CS) is dictated by a largely predictable set of interactions between disease-specific and therapeutic factors. ICU personnel need to quickly develop a detailed understanding of the patient’s current status and how critical care resources can be used to promote further recovery and eventual independence from external support. The goal of this article is to describe a typical operative and postoperative course, with emphasis on the latter, and the diagnostic and therapeutic options necessary for the proper care of these patients. This paper will focus on...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 14, 2015 Category: Anesthesiology Authors: Lighthall, G. K., Olejniczak, M. Tags: Articles Source Type: research

Postoperative Care of Cardiac Surgery Patients . . . Finishing What You Started
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - May 14, 2015 Category: Anesthesiology Authors: Lighthall, G. K. Tags: Editorial Source Type: research

Successful Rescue of an Adult With Refractory Anaphylactic Shock and Abdominal Compartment Syndrome With Venoarterial Extracorporeal Membrane Oxygenation and Bedside Laparotomy
We present a patient treated with venoarterial ECMO for refractory shock following anaphylaxis who developed ACS that was successfully treated with urgent decompressive laparotomy performed in the intensive care unit. This case report highlights the role of abdominal compartment syndrome as a rare but potentially fatal cause of low circuit flow in ECMO-supported patients and proposes a stepwise approach to decision making in this setting. Urgent decompressive laparotomy is potentially lifesaving in this circumstance, and should be urgently considered once other causes of low ECMO flow have been excluded. (Source: Seminars ...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Weiss, G. M., Fandrick, A. D., Sidebotham, D. Tags: Clinical Challenge Source Type: research

Elevated Transaortic Valvular Gradients After Combined Aortic Valve and Mitral Valve Replacement: An Intraoperative Dilemma
We describe a case of a critically ill patient with endocarditis and acute lung injury, who presented for combined aortic valve and mitral valve replacement. Transesophageal echocardiographic assessment, post–cardiopulmonary bypass, revealed high transaortic valvular gradients due to encroachment of the mitral prosthesis strut on the left ventricular outflow tract, which was compounded by a small, hypertrophied, and hyperkinetic left ventricle. Discontinuation of inotropic support, administration of fluids, phenylephrine, and esmolol led to resolution of the high gradients and prevented further surgery. (Source: Semi...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Essandoh, M., Portillo, J., Zuleta-Alarcon, A., Castellon-Larios, K., Otey, A., Sai-Sudhakar, C. B. Tags: Clinical Challenge Source Type: research

Circadian Rhythms in Anesthesia and Critical Care Medicine: Potential Importance of Circadian Disruptions
The rotation of the earth and associated alternating cycles of light and dark—the basis of our circadian rhythms—are fundamental to human biology and culture. However, it was not until 1971 that researchers first began to describe the molecular mechanisms for the circadian system. During the past few years, groundbreaking research has revealed a multitude of circadian genes affecting a variety of clinical diseases, including diabetes, obesity, sepsis, cardiac ischemia, and sudden cardiac death. Anesthesiologists, in the operating room and intensive care units, manage these diseases on a daily basis as they sign...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Brainard, J., Gobel, M., Bartels, K., Scott, B., Koeppen, M., Eckle, T. Tags: General Reviews Source Type: research

High Thoracic Epidural in Cardiac Anesthesia: A Review
High thoracic epidural analgesia (HTEA) offers a distinctive opportunity to enhance postoperative recovery for the thoracic surgery patient. In the modern hospital setting with day of admission surgery, the logistics of insertion of the epidural catheter has become increasingly difficult. The greatest limitation to its use might be the believed increased risk of epidural hematoma associated with anticoagulation during cardiopulmonary bypass. The aim of this review is to give an overview of complications and effect on outcomes with focus on cardiac performance and postoperative glycemic control and kidney function. Patients...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Jakobsen, C.-J. Tags: General Reviews Source Type: research

Transcatheter Aortic Valve Replacement: From the Femoral Artery to the Left Ventricular Apex--The Spectrum to Access
The role of transcatheter aortic valve replacement (TAVR) continues to evolve and expand at a rapid pace. The advanced age and frailty of many TAVR candidates often presents complex vascular access challenges when contemplating the exact route of valve delivery. As the indications and approved routes of delivery have evolved, so have the direct open vascular and percutaneous techniques paramount to success. We review the spectrum of access options that may be available for consideration during TAVR procedures and highlight the "pearls and pitfalls" of each technique. We additionally highlight reasons a technique may be pre...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Feezor, R. J., Janelle, G. M., Klodell, C. T. Tags: General Reviews Source Type: research

The Year in Thoracic Surgery: Highlights From 2014
The year 2014 produced several noteworthy articles that have advanced the care of thoracic surgery patients. Further knowledge has been gained regarding screening and treatment of early stage lung cancer. The use of neoadjuvant therapy for subsets of patients with esophageal cancer continues to evolve. Endobronchial therapy for emphysema is reported in a multicenter trial. The purpose of this review is to highlight the major advances in thoracic surgical disease in the year 2014. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Weyant, M. J. Tags: The Perioperative Year in Review 2014 Source Type: research

Noteworthy Literature in Cardiac Surgery for 2014
Year 2014 has provided insight into the optimal care of surgical patients with cardiovascular disease. In mitral disease, the management of degenerative mitral regurgitation and ischemic mitral insufficiency are moving in the opposite directions. In aortic disease, the description of arch procedures is becoming more definable for comparisons across approaches, while the treatment of acute type B dissections is becoming more aggressive, yet deliberate. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Cleveland, J. C., Reece, T. B. Tags: The Perioperative Year in Review 2014 Source Type: research

The Year in Review: Anesthesia for Congenital Heart Disease 2014
Congenital cardiac anesthesiology is a rapidly expanding field at both ends of the life spectrum. The care of the unborn child with congenital heart disease is becoming highly specialized in regional centers that offer advanced imaging techniques, coordinated specialist care, and potentially fetal interventions. As more children with congenital heart disease survive to adulthood, patients and their health care providers are facing new challenges. The growing volume of publications reflects this expanding field of congenital cardiac anesthesiology. This year in review article highlights some developing trends in the literat...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Ing, R. J., Twite, M. D. Tags: The Perioperative Year in Review 2014 Source Type: research

Noteworthy Articles in 2014 for Cardiothoracic Anesthesiologists
In 2014, cardiothoracic anesthesiology again generated high-quality scientific work published in highly regarded journals. Our specialty continues to make significant strides in the creation and implementation of protocols to improve outcomes in our patients, which undoubtedly contribute to a safer hospital environment for patients and employees alike. Another theme that stirred a lot of interest in the past year is the search for patient-centered treatment plans. Even though we are still some time away from truly personalized medicine, our specialty starts to ask and answer exciting questions: Would we treat patient A any...
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Hilberath, J. N., Sotillo, C. L., Muehlschlegel, J. D. Tags: The Perioperative Year in Review 2014 Source Type: research

The Year in Review 2014
(Source: Seminars in Cardiothoracic and Vascular Anesthesia)
Source: Seminars in Cardiothoracic and Vascular Anesthesia - February 9, 2015 Category: Anesthesiology Authors: Weitzel, N. S. Tags: Editorial Source Type: research