Noteworthy Cardiac Literature 2019: Cerebral Protection, Zone 2 Arch, Intravascular Ultrasonography in Dissection, Heart Allocation, and Mitral Durability

2020 ◽  
Vol 24 (2) ◽  
pp. 187-191
Author(s):  
Christian V. Ghincea ◽  
T. Brett Reece ◽  
Muhammad Aftab ◽  
Joseph C. Cleveland ◽  
Jay D. Pal
Keyword(s):  
Cardiac Surgery ◽  
Heart Transplant ◽  
Surgical Techniques ◽  
Cerebral Protection ◽  
Intravascular Ultrasonography ◽  
Protection Zone ◽  
Allocation System ◽  
Mitral Repair

The year of 2019 continues to have notable literature advancing the practice of cardiac surgery. In this article, topics of discussion will include the evolution of cerebral protection, the advancement of arch surgical techniques, the heart transplant allocation system, and mitral repair approach and durability.

A Complex Mitral Valve Reconstruction: A Case Report

2005 ◽  
Vol 6 (2) ◽  
pp. 27
Author(s):  
Dimitrios Buklas ◽  
Massimo Massetti ◽  
Eric Saloux ◽  
Eugenio Neri ◽  
Olivier LePage ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Techniques ◽  
Mitral Valve Insufficiency ◽  
Left Ventricular ◽  
Mitral Valve Reconstruction ◽  
Mitral Repair ◽  
Valve Reconstruction ◽  
Valve Insufficiency ◽  
Valve Function ◽  
Valvular Function

Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, sliding leaflet, single chordal transposition, "flip-over" leaflet, and ring annuloplasty techniques were applied, and postsurgical correct valve function was documented by results of a left ventricular saline filling test and transesophageal echocardiography control. Complex mitral valve repairing techniques can be combined to reestablish valvular function.

Pharmacological Cerebral Protection in Cardiac Surgery: An Update

2017 ◽  
Vol 4 (1) ◽  
pp. 23-37 ◽  
Author(s):  
Henry Liu ◽  
Rayhan Tariq ◽  
Geoffrey Liu ◽  
Ling Yu
Keyword(s):  
Cardiac Surgery ◽  
Cerebral Protection

scholarly journals Improved Access to Heart Re-Transplantation with the New Heart Transplant Allocation System

2021 ◽  
Vol 40 (4) ◽  
pp. S224
Author(s):  
M. Jani ◽  
R.L. Grayburn ◽  
M.G. Dickinson ◽  
E. Watson ◽  
T. Boeve ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Allocation System

The Waiting Game: Waitlist Times and Outcomes for Highly Sensitized Patients in the New Heart Transplant Allocation System

2021 ◽  
Vol 40 (4) ◽  
pp. S16
Author(s):  
Y. Kaka ◽  
A. Ganapathi ◽  
S. Emani ◽  
R. Kahwash ◽  
A. Hasan ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Allocation System

scholarly journals Comparison of the cerebroprotective effect of inhalation anaesthesia and total intravenous anaesthesia in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e014629 ◽  
Author(s):  
Feng Chen ◽  
Guangyou Duan ◽  
Zhuoxi Wu ◽  
Zhiyi Zuo ◽  
Hong Li
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Meta Analysis ◽  
Cerebral Protection ◽  
Neurological Dysfunction ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Inhalation Anaesthesia

ObjectiveNeurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA.DesignSearching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis.ResultsA total of 1485 studies were identified. After eliminating duplicate articles and screening titles and abstracts, 445 studies were potentially eligible. After applying exclusion criteria (full texts reported as abstracts, review article, no control case, lack of outcome data and so on), 13 studies were selected for review. Our results demonstrated that the primary outcome related to S100B level in the inhalation anaesthesia group was significantly lower than in the TIVA group after CPB and 24 hours postoperatively (weighted mean difference (WMD); 95% CI (CI): −0.41(–0.81 to –0.01), −0.32 (−0.59 to −0.05), respectively). Among secondary outcome variables, mini-mental state examination scores of the inhalation anaesthesia group were significantly higher than those of the TIVA group 24 hours after operation (WMD (95% CI): 1.87 (0.82 to 2.92)), but no significant difference was found in arteriovenous oxygen content difference, cerebral oxygen extraction ratio and jugular bulb venous oxygen saturation, which were assessed at cooling and rewarming during CPB.ConclusionThis study demonstrates that anaesthesia with volatile agents appears to provide better cerebral protection than TIVA for patients undergoing cardiac surgery with CPB, suggesting that inhalation anaesthesia may be more suitable for patients undergoing cardiac surgery.

Video-Assisted Pericardial Fenestration for Effusions after Cardiac Surgery

2009 ◽  
Vol 17 (5) ◽  
pp. 480-482 ◽  
Author(s):  
Georgios P Georghiou ◽  
Eyal Porat ◽  
Avi Fuks ◽  
Bernardo A Vidne ◽  
Milton Saute
Keyword(s):  
Cardiac Surgery ◽  
Pericardial Effusion ◽  
Surgical Techniques ◽  
Lung Ventilation ◽  
Pericardial Window ◽  
Invasive Approach ◽  
Video Assisted ◽  
Institutional Experience ◽  
Pericardial Fenestration ◽  
Thoracoscopic Technique

Delayed-onset pericardial effusion following cardiac surgery can give rise to significant morbidity due to its presentation as well as management by traditional surgical techniques. An institutional experience of a video-assisted thoracoscopic technique to create a pericardial window, with the advantages of a minimally invasive approach combined with excellent visualization in such patients, was reviewed. A retrospective analysis was conducted on all patients undergoing video-assisted thoracoscopic for delayed pericardial effusion after cardiac surgery from January 2001 to January 2006 at our center. Seven patients with echocardiographically diagnosed delayed tamponade underwent video-assisted thoracoscopy; 5 were receiving anticoagulants after valve replacement, and 2 had undergone heart transplantation. Pericardial windows were created under general anesthesia and single-lung ventilation using 2 to 3 trocars. Mean operative time was 45 min. There were no complications of the thoracoscopic technique. Video-assisted thoracoscopic creation of a pericardial window is safe and effective treatment for loculated pericardial effusions secondary to cardiac surgery.

Acute Kidney Injury following Cardiac Surgery

2015 ◽  
pp. 451-480
Author(s):  
Bryan Romito ◽  
Joseph Meltzer
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Surgical Techniques ◽  
Kidney Injury ◽  
Renal Physiology ◽  
General Management ◽  
Novel Biomarkers ◽  
Short And Long Term ◽  
And Function

The primary goal of this chapter is to provide the reader with an overview of basic renal physiology and function and to review the identification, pathogenesis, and treatment of acute kidney injury following cardiac surgery. Particular focus will be directed toward the diagnostic criteria for acute kidney injury, short- and long-term impacts on patient outcomes, role of novel biomarkers, mechanisms of acute renal injury, general management principles, preventative strategies, and the influence of anesthetic and surgical techniques on its development. The content of this chapter will serve to underscore a particularly harmful but likely underappreciated problem affecting patients in the cardiothoracic critical care setting.

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