Abstract:
OBJECTIVE:Diagnosis of perioperative myocardial infarction (P-MI) after coronary artery bypass graft (CABG) surgery traditionally relied on a combination of electrocardiographic and enzyme assay changes. Patients with Q-wave P-MIs who survive to hospital discharge have a poorer long-term prognosis. Troponin assays are more sensitive and specific for detecting minor P-MI, with an increased incidence of P-MI being reported. This study investigated if P-MI after CABG surgery, as defined by troponin-I isozyme (cTn-I), correlated with long-term outcome. DESIGN:A prospective, observational study. SETTING:A single-institution, cardiothoracic specialty hospital. PARTICIPANTS:Seventy patients undergoing elective CABG surgery. INTERVENTIONS:Patients (n = 70) were stratified into low-risk and high-risk groups according to the absence (cTn-I <15 microg/L) or presence (cTn-I >or=15 microg/L) of P-MI after CABG surgery. Patients with (n = 24) and without (n = 46) P-MI were then followed for 3 years after CABG surgery to determine the impact of cTn-I-defined P-MI on long-term outcome. MEASUREMENTS AND MAIN RESULTS:Most patients felt that their quality of life and activity index had improved and that their symptoms of angina had lessened at 12-month follow-up. However, cardiovascular event-free survival was significantly less in patients with P-MI (p = 0.01) 3 years postoperatively. The incidence for cardiovascular events was 0.24 versus 0.65 (p = 0.049) in those patients without and with P-MI, respectively. The hazard ratio (2.9; 95% confidence interval, 1.3-9.4) for cardiovascular incidents was also significantly greater in patients with P-MI. More specifically, the incidence of arrhythmia was 2.4% versus 26.1% (p < 0.01), and the incidence of vascular events was 4.9% versus 26.1% (p = 0.02) in patients without and with P-MI, respectively. CONCLUSIONS:It was shown that P-MI as defined by cTn-I is associated with an increased long-term incidence of adverse cardiovascular events. An elevated peak cTn-I level (>or=15 microg/L) identified patients at increased risk but did not have a powerful positive predictive value for either cardiovascular (48%) or vascular (26%) complications. However, a peak cTn-I <15 microg/L was a negative predictor of adverse vascular outcome (95%). This may have implications for postoperative patient follow-up.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Riedel BJ,Grattan A,Martin CB,Gal J,Shaw AD,Royston Ddoi
10.1053/j.jvca.2006.01.015subject
Has Abstractpub_date
2006-12-01 00:00:00pages
781-7issue
6eissn
1053-0770issn
1532-8422pii
S1053-0770(06)00004-8journal_volume
20pub_type
杂志文章abstract::The recurrent or new trends of early extubation after cardiac surgery are here to stay in the 1990s. The preoperative status does not necessarily predict the postoperative course and prolonged mechanical ventilation following cardiac surgery should not be uncritically considered as routine. All patients should be asse...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(05)80105-3
更新日期:1995-08-01 00:00:00
abstract::Intramyocardial hematomas are a rare complication of myocardial infarctions. Normally restricted to the left ventricle, in certain scenarios, such as after a percutaneous coronary intervention, intramyocardial hematomas also can occur in the left atrium. Herein, the case of a 74-year-old man who presented to the autho...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.053
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To evaluate whether exogenous surfactant therapy may be useful in adult patients with acute lung injury or acute respiratory distress syndrome, using a meta-analysis of published clinical trials. DESIGN:A comprehensive literature search was performed to identify all randomized clinical trials examining the e...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析
doi:10.1053/j.jvca.2011.11.006
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:Continuous thermodilution cardiac output (CCO) measurement was clinically evaluated in patients who underwent coronary revascularization using hypothermic low-flow, low-pressure cardiopulmonary bypass (CPB). DESIGN:Prospective study. SETTING:University hospital setting. PARTICIPANTS:30 cardiac surgical pat...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80095-3
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the best predictors of successful extubation after cardiac surgery, by modifying the rapid shallow breathing index (RSBI) based on patients' anthropometric parameters. DESIGN:Single-center prospective observational study. SETTING:Two general intensive care units at a s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.06.022
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To examine pump-prime aprotinin action on coagulation and fibrinolysis in patients undergoing primary coronary revascularization. DESIGN:A prospective randomized study. SETTING:A university hospital. PARTICIPANTS:Forty-three patients were randomly assigned to either group A, 21 patients treated with 2 x 1...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(97)90116-6
更新日期:1997-12-01 00:00:00
abstract::The ASA Closed Claims Project has generated a standardized collection of case summaries of adverse anesthetic outcomes, with the objectives of identifying major areas of anesthesiologist liability and the contribution of substandard care to anesthetic injury. Seventy-six (3%) of the files in the project's current data...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(94)90608-4
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:The value of a simplified, focused intraoperative transesophageal echocardiography (TEE) protocol in patients undergoing liver transplantation (LT) is unknown. We sought to create and assess a 5-view LT TEE examination focused on 5 prespecified common causes of hypotension during LT. DESIGN:Retrospective coh...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.01.028
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To compare methylene blue with hydroxocobalamin as a rescue therapy for vasoplegic syndrome. DESIGN:Retrospective cohort. SETTING:Academic medical center. PARTICIPANTS:Patients undergoing cardiothoracic surgery treated for vasoplegic syndrome. INTERVENTIONS:Thirty-five patients were treated with methylene...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.01.033
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To determine if the platelet glass bead retention assay can predict bleeding after cardiac surgery. DESIGN:Prospective, observational study. SETTING:Large, tertiary care, academic medical center. PARTICIPANTS:Forty-three adult patients scheduled to undergo elective cardiac surgery employing cardiopulmonary...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1053/jcan.2001.20274
更新日期:2001-02-01 00:00:00
abstract::Systemic intravenous administration of opioids is the main treatment strategy for intraoperative and postoperative pain management in patients undergoing cardiac surgery with sternotomy. However, using lower doses of opioids may achieve the well-established benefits of the fast-track approach, with minimal opioid-rela...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.07.041
更新日期:2020-12-01 00:00:00
abstract::This study was designed to compare the cardiovascular effects of pipecuronium bromide (PIP) to vecuronium (V) when combined with sufentanil (SF) in patients undergoing coronary artery bypass surgery. Eighty-two patients were studied; 40 were normotensive and 42 had hypertension currently controlled by pharmacological ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/1053-0770(91)90321-j
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:To determine whether postoperative forced-air warming of cardiac bypass patients in the intensive care unit (ICU) results in faster rate of warming and improved outcomes compared with more conventional ICU warming methods. DESIGN:Prospective randomized effectiveness study. SETTING:Three hundred fifty-bed un...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(97)90162-2
更新日期:1997-10-01 00:00:00
abstract::Perioperative myocardial ischemia was evaluated in 36 consecutive carotid endarterectomy procedures carried out on patients with a high (72.2%) prevalence of ischemic heart disease. The procedures were performed under cervical plexus block plus a prophylactic intravenous nitroglycerin infusion. Findings of myocardial ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90002-3
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVES:In a variety of experimental models, propofol has been shown to protect the brain. It was hypothesized that a clinically achievable high dose of propofol would induce cerebral protective effects in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The authors investigated the effects of ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2012.10.013
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To develop a simple and reliable method for quantitating plasma glutamate concentration and apply this method to monitor systemic glutamate levels during coronary artery bypass graft (CABG) surgery, a procedure associated with neurologic deficits. DESIGN:Prospective serial investigation of cardiac surgery pa...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.125148
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the association between general (GA), regional (RA), and local (LA) anesthetic techniques with respect to the development of delirium after vascular surgery. The authors hypothesized that patients undergoing GA for vascular surgery would have a higher incidence of ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.12.003
更新日期:2014-06-01 00:00:00
abstract::This article reviews and updates the recent modifications in patient selection and revisions in the anesthetic approach to MIDCAB surgery. It outlines the changing surgical selection criteria, current ways to assess graft patency, and evolving anesthetic management. A promising new advancement in coronary artery bypas...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(97)90019-7
更新日期:1997-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.07.016
更新日期:2015-02-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.05.003
更新日期:2013-12-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.11.020
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Compare total perioperative opioid use in patients receiving naloxone continuousinfusion (NCI) for spinal cord ischemia prophylaxis, versus patients not receiving NCI, in endovascular aortic repair. DESIGN:Single-center, retrospective cohort review. SETTING:Academic medical center. PARTICIPANTS:Patients un...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.11.043
更新日期:2020-11-24 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.06.002
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness. DESIGN:A prospective observational study. SETTING:A teachi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.06.023
更新日期:2012-04-01 00:00:00
abstract::Complications associated with pulmonary artery catheters (PACs) include interpretation errors, insertion problems, sepsis, thrombosis, and dysrhythmias. Alternatives to the use of PACs include the central venous pressure catheter, measurement of cardiac output by thoracic electrical bioimpedance, gastric tonometry and...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 评论,杂志文章,评审
doi:
更新日期:1998-04-01 00:00:00
abstract::The aim of this study was to evaluate blood salvage provided by an intraoperative blood recovery system (IBRS) and a mediastinal drainage blood recovery system (MBRS) during and after cardiac surgery. Sixty-six patients undergoing aortocoronary bypass surgery were randomly assigned to three groups of 22 patients each....
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/1053-0770(91)90119-e
更新日期:1991-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/1053-0770(93)90113-y
更新日期:1993-02-01 00:00:00
abstract:DESIGN:A prospective, randomized, open study. The regional technique used was not blinded. SETTING:A university teaching hospital. PARTICIPANTS:Forty-eight patients undergoing video-assisted thoracoscopic surgery (VATS) for tumor resection. INTERVENTIONS:Patients received either continuous extrapleural block or cont...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2011.07.026
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To compare the effects of a bolus of milrinone, 50 microg/kg, versus placebo on flow in coronary artery bypass grafts after cardiopulmonary bypass (CPB). DESIGN:A prospective, randomized, double-blind study. SETTING:A university hospital. PARTICIPANTS:Forty-four patients with stable angina and left ventric...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2008.07.005
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Mortality and morbidity of acute kidney injury (AKI) after cardiac surgery still remain high. The authors undertook the present study to evaluate the utility of early postoperative urinary albumin (uAlb) as a diagnostic marker for predicting occurrence of AKI and its severity in pediatric patients undergoing ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.05.194
更新日期:2016-01-01 00:00:00