Abstract:
:Left ventricular assist device (LVAD) therapy has greatly improved outcomes in patients with end-stage heart failure. However, development of right ventricular failure (RVF) in LVAD recipients is associated with increased long- and short-term morbidity and mortality. The incidence of RVF after LVAD placement is difficult to assess due to the lack of a common definition. Risk-score models attempting to identify patients at risk for RVF prior to the placement of LVADs had equivocal outcomes. With the exception of cardiac magnetic resonance, right ventricle (RV) imaging lacks accuracy. Echocardiographic evaluation is expanded to 3D technology and deformation imaging in an attempt to get further insight into the functional reserve of the RV in states of abnormal RV function. Beyond commonly use agents, pharmacological treatment for RVF and post-bypass vasoplegia in LVAD patients include the off-label use of methylene blue and/or hydroxycobalamin. Communication among the perioperative team may be beneficial for early initiation of temporary right-sided mechanical support in order to avoid RVF-related complications. As long-term RVADs are unavailable, currently approved treatment of prolonged RVF is limited to heart transplantation or the placement of a total artificial heart as bridge-to-transplant. Strategies to improve outcome in this patient population should include better risk stratification for RVF prior to LVAD placement as well as frank discussions about LVAD candidacy in patients ineligible for transplantation. The development of durable right-sided mechanical support would improve the scope of care of LVAD patients developing persistent RVF.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Turner KRdoi
10.1053/j.jvca.2018.07.047subject
Has Abstractpub_date
2019-04-01 00:00:00pages
1105-1121issue
4eissn
1053-0770issn
1532-8422pii
S1053-0770(18)30599-8journal_volume
33pub_type
杂志文章,评审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 test the reproducibility of Sonoclot coagulation analysis (SCA; Sienco Inc, Morrison, CO). The authors wished to determine if the mix/release of the preloaded celite activator in standard Sono-cuvettes could be responsible for the high variation coefficients for SCA parameters with citrated whole blood and...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(99)90209-4
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Intraoperative monitoring of myogenic motor evoked potentials to transcranial electrical stimulation (tc MEPs) is a new method to assess the integrity of the motor pathways. The authors studied the effects of 50% nitrous oxide (N2O) and a low-dose propofol infusion on tc MEPs paired electrical stimulation dur...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(99)90169-6
更新日期:1999-02-01 00:00:00
abstract::Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.05.037
更新日期:2017-10-01 00:00:00
abstract::Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem c...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.11.041
更新日期:2018-10-01 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::In this review, the authors discussed criteria for diagnosing ALI; incidence, etiology, preoperative risk factors, intraoperative management, risk-reduction strategies, treatment, and prognosis. The anesthesiologist needs to maintain an index of suspicion for ALI in the perioperative period of thoracic surgery, partic...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2009.10.032
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:Adequate maintenance of hypnosis during anesthesia throughout surgery using sevoflurane alone was investigated. In addition, sevoflurane pharmacokinetics during cardiopulmonary bypass were analyzed. DESIGN:This was a pilot pharmacokinetic study. SETTING:Tertiary care university hospital. PARTICIPANTS:The s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.12.018
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:Mesenteric ischemia is still a fatal event after cardiac procedures. No adequate intraoperative methods are available to monitor the gastrointestinal mucosal microcirculation in real-time conditions. The aim of the study was to assess a newly designed microprobe using laser Doppler flowmetry and remission sp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.07.003
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Because propofol is known to reduce vascular resistance, the objective of this study was to compare the indices of hepatosplanchnic circulation and oxygenation during cardiopulmonary bypass (CPB) in patients anesthetized with either propofol or midazolam/halothane. DESIGN:A prospective, randomized, nonblinde...
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(98)90195-1
更新日期:1998-08-01 00:00:00
abstract::Survival of patients with congenital heart disease has significantly improved over the last 2 decades, confronting interventionalists, surgeons, anesthesiologists, cardiologists, and intensivists with often unfamiliar complex pathophysiology in the perioperative setting. Aside from cardiac catheterization, echocardiog...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.11.036
更新日期:2020-05-01 00:00:00
abstract::Middle aortic syndrome (MAS) is a rare vascular disease occurring in pediatric patients. MAS describes narrowing of the abdominal aorta, often referred to as abdominal coarctation. Extra-aortic vessels are commonly involved, including the renal and mesenteric arteries. Pediatric patients with MAS frequently present wi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.07.130
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the left ventricular lusitropic effects of epinephrine versus milrinone after cardiopulmonary bypass. DESIGN:Prospective randomized study. SETTING:Single institution, university teaching hospital. PARTICIPANTS:Adult patients undergoing coronary artery bypass grafti...
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.2005.03.011
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:Helium produces preconditioning by activating prosurvival kinases, but the roles of reactive oxygen species (ROS) or mitochondrial adenosine triphosphate-regulated potassium (K(ATP)) channels in this process are unknown. The authors tested the hypothesis that ROS and mitochondrial K(ATP) channels mediate hel...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2008.04.005
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:Predictors of operative outcome in patients with severely depressed left ventricular ejection fraction (LVEF) undergoing coronary artery bypass grafting (CABG) remain poorly defined. This study aims to identify preoperative variables that are associated with increased postoperative length of hospital stay or ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.03.017
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To assess the impact of regional supplemented general anesthesia (RSGEN) on regional myocardial function during abdominal aortic surgery (AAS). DESIGN:Prospective randomized study. SETTING:Single academic medical center. PARTICIPANTS:Seventy-three patients scheduled for infrarenal aortic aneursymectomy. I...
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)90201-9
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:Recent studies have demonstrated that perioperative myocardial ischemia, detected by electrocardiography, is a risk factor for myocardial infarction. ST-segment analyzers and hemodynamic monitors may be useful for on-line detection in perioperative and critical care environments. However, independent perform...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80230-7
更新日期:1995-12-01 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:The authors compared thoracic epidural with ON-Q infiltrating catheters in patients having open thoracotomy to determine whether one method better relieves postoperative pain and would allow earlier discharge from the hospital and, hence, cost savings. DESIGN:Retrospective chart review. SETTING:University h...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.02.017
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Cardiopulmonary bypass (CPB) provides a unique circumstance to study the effects of drugs on the systemic vasculature. Thus, this study was designed to evaluate the effects of sodium bicarbonate on the systemic circulation during CPB in humans. DESIGN:Randomized, double-blind study. SETTING:Tertiary care u...
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.2007.06.001
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the hypothesis that meperidine induces a dilator response in the feline pulmonary vascular bed, and to identify receptors involved in the mediation or modulation of these effects. DESIGN:Prospective vehicle controlled study. SETTING:University research laboratory. SUBJ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.10.003
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:To determine the incidence of postoperative diaphragm dysfunction as diagnosed by ultrasonography. DESIGN:Explorative prospective observational study. SETTING:University intensive care unit. PARTICIPANTS:One hundred consecutive patients undergoing elective cardiac surgery. INTERVENTIONS:Diaphragm ultraso...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.038
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To study adult patients in the immediate postoperative period after cardiac surgery and determine whether cardiac output (CO) and systemic vascular resistance (SVR) are generally within normal limits and whether clinical assessment of CO provides an adequate approximation to guide treatment. DESIGN:Prospecti...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.29631
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To assess the value of gastric intramucosal pH measurement in patients with low output after cardiac surgery. DESIGN:Prospective clinical study. SETTING:University hospital. PARTICIPANTS:Fifteen patients with low output after cardiac surgery were included. Those who survived the first postoperative day (n ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90211-1
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To compare dexmedetomidine-based to propofol-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). DESIGN:Randomized, open label. SETTING:Twenty-five centers in the United States and Canada. PARTICIPANTS:Two hundred ninety-five adults undergoing CABG surgery. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s1053-0770(03)00200-3
更新日期:2003-10-01 00:00:00
abstract::The development of echocardiography was driven, in part, by a need to diagnose mitral regurgitation in patients undergoing finger fracture commissurotomy in the 1950s. Decades later, color Doppler became the cornerstone for noninvasive evaluation of mitral regurgitation. The authors present 2 cases of calcific mitral ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.08.018
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To determine the degree of hemodynamic and airway compromise in infants and children undergoing anesthesia for primary cardiac tumors. DESIGN:Retrospective study. SETTING:Tertiary-care, academic children's hospital. PARTICIPANTS:Patients <18 years old who had undergone anesthesia and surgery for resection ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.126952
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To understand whether different anesthesia and analgesia methods affected the incidence of chronic postsurgical pain (CPSP) in patients who underwent uniportal video-assisted lung surgery and to explore the influence factors of CPSP. DESIGN:Retrospective study. SETTING AND PARTICIPANTS:A total of 120 patie...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.10.046
更新日期:2020-04-01 00:00:00
abstract::Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation or, in some patients, as a bridge to recovery. LVAD withdrawal with ventricular recovery represents the optimal outcome for patients previously implan...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.12.043
更新日期:2021-01-05 00:00:00
abstract::Two-dimensional visualization of complex congenital heart disease has limitations in that there is variation in the interpretation by different individuals. Three-dimensional printing technology has been in use for decades but is currently becoming more commonly used in the medical field. Congenital heart disease serv...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.11.037
更新日期:2018-08-01 00:00:00