Abstract:
:Pulmonary thromboendarterectomy (PTE) remains the only curative surgery for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Postoperative intensive care unit care challenges providers with unique disease physiology, operative sequelae, and the potential for detrimental complications. Central concerns in patients with CTEPH immediately after PTE relate to neurologic, pulmonary, hemodynamic, and hematologic aspects. Institutional experience in critical care for the CTEPH population, a multidisciplinary team approach, patient risk assessment, and integration of current concepts in critical care determine outcomes after PTE surgery. In this review, the authors will focus on specific aspects unique to this population, with integration of current available evidence and future directions. The goal of this review is to provide the cardiac anesthesiologist and intensivist with a comprehensive understanding of postoperative physiology, potential complications, and contemporary intensive care unit management immediately after pulmonary endarterectomy.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Kratzert WB,Boyd EK,Saggar R,Channick Rdoi
10.1053/j.jvca.2019.03.005subject
Has Abstractpub_date
2019-11-01 00:00:00pages
3110-3126issue
11eissn
1053-0770issn
1532-8422pii
S1053-0770(19)30265-4journal_volume
33pub_type
杂志文章,评审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: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:Although failure to achieve an adequate activated coagulation time (ACT) after full heparinization before cardiopulmonary bypass often is attributed to antithrombin (AT) deficiency, it remains unclear if this is a causative mechanism of decreased heparin responsiveness. Therefore, the authors determined the r...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2012.03.011
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To compare radial and femoral artery perfusion pressure during initiation and various stages of cardiopulmonary bypass (CPB). DESIGN:Prospective study. SETTING:The cardiac center of a tertiary referral teaching institute. PARTICIPANTS:Sixty consecutive patients of all ages undergoing a variety of cardiac o...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract::The care of patients undergoing cardiac surgery is becoming more complex, in part owing to the increasing burden of comorbid disease, frailty, and psychosocial issues. Many risk factors for postoperative morbidity and mortality are potentially modifiable if identified and treated in a timely fashion before surgery. Ca...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.01.023
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To ascertain if protective ventilation can attenuate the damaging postoperative pulmonary effects of cardiopulmonary bypass (increases in airway pressure, decreases in lung compliance, and increases in shunt). DESIGN:Prospective, randomized clinical trial. SETTING:Single university hospital. PARTICIPANTS:T...
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:10.1053/jcan.2000.9487
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. DESIGN:In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male a...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.06.022
更新日期:2017-04-01 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::Over the past 2 decades, the discipline of palliative care has evolved and expanded such that it is now the standard of care for a variety of acute and chronic processes. Although there are recommendations encouraging incorporation of palliative care into the routine management of patients with chronic cardiac process...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2018.04.047
更新日期:2019-03-01 00:00:00
abstract::Hospital CEOs are concerned about more than just cost of services to their patients. The advancement of patient car along with maintaining or improving patient safety are also key elements to the CEO, to limit patient risks, hospital liability, and negative public relations. The CEO is accountable to the hospital staf...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.06.003
更新日期:2004-08-01 00:00:00
abstract::Tricuspid regurgitation is a notable aspect of congestive heart failure and is linked with worse outcomes if untreated. Functional tricuspid regurgitation commonly is seen in patients with heart failure, particularly in patients presenting for surgical management, such as those for mechanical cardiac assist device imp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2020.06.022
更新日期:2020-06-12 00:00:00
abstract::The efficacy of interpleural administration of sufentanil, 50 micrograms, was compared with that of 150 mg of bupivacaine, 0.5%, with epinephrine, 5 micrograms/mL, or saline, in 30 patients (N = 10 in each group) undergoing lateral thoracotomy. Sufentanil, bupivacaine, or saline was administered interpleurally after i...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90307-7
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the incidence and significance of abnormal hepatic Doppler venous flow velocities as signs of an abnormal right ventricular filling pattern before cardiac surgery. DESIGN:Retrospective and prospective validation study. SETTING:Tertiary care hospital. PARTICIPANTS:...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.11.052
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of JM-1232(-) on norepinephrine (10(-6) mol/L)- and high K(+) (40 mmol/L)-induced contractions in isolated human gastroepiploic arteries (GEA), and to compare them with the effects of midazolam and propofol. In addition, to investigate whether the benzodiazepine-receptor antagonist,...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.03.013
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To study the acute effects of angiotensin-converting enzyme inhibition by intravenous enalaprilat infusion in patients with left ventricular dysfunction after cardiac surgery. DESIGN:Prospective, consecutive sample, before-after trial. SETTING:Surgical intensive care unit in a tertiary care university hospi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90009-4
更新日期:1997-08-01 00:00:00
abstract::Inadvertent postoperative hypothermia in the cardiac surgical patient can have various adverse physiologic effects. Previous studies have investigated the relationship of patient, surgical, and anesthetic factors with postoperative hypothermia in patients undergoing noncardiac surgery. This study was designed to asses...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80186-7
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:Intraoperative Doppler-determined renal resistive index (RRI) is a promising early acute kidney injury (AKI) biomarker. As RRI continues to be studied, its clinical usefulness and robustness in research settings will be linked to the ease, efficiency, and precision with which it can be interpreted. Therefore,...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.04.014
更新日期:2018-10-01 00:00:00
abstract::Patients with abdominal aortic aneurysms (AAA) have a high incidence of associated cardiac disease. If a patient presents with both severe coronary artery disease and a large AAA, a staged procedure of cardiac surgery (CS) followed by AAA resection may present too great a risk of aneurysm rupture and death. A combined...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(94)90163-5
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine quantitatively the effects of consumption, hemodilution, and blood loss on coagulation and fibrinolytic factor levels during cardiopulmonary bypass. DESIGN:A combination of measured levels of prothrombin, antithrombin, fibrinogen, plasminogen, and antiplasmin along...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.11.046
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to evaluate the effect of ventricular morphology on perioperative outcomes during Fontan surgery. DESIGN:Retrospective cohort study. SETTING:Single standing, not-for-profit pediatric hospital. PARTICIPANTS:A total of 72 patients who underwent Fontan surgery using cardiopu...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.07.024
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:Cerebral near-infrared spectroscopy (NIRS) was evaluated for use in monitoring global oxygenation in adult patients after cardiac surgery. DESIGN:Prospective, randomized clinical monitoring study. SETTING:Intensive care unit for cardiac surgery; university hospital. PARTICIPANTS:The study included 35 patie...
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.2006.09.010
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To compare changes in blood flow in a grafted internal mammary artery (IMA) after cardiopulmonary bypass (CPB) in response to the administration of milrinone or nitroglycerin and to establish the effects of alpha-adrenergic stimulation. DESIGN:Randomized study. SETTING:A university medical center hospital ...
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:10.1053/jcan.2001.28316
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To review the anesthetic management for percutaneous transcatheter closure of perimembranous ventricular septal defect (VSD) with an Amplatzer asymmetric occluder device and to highlight the hemodynamic effects and potential complications associated with its delivery. DESIGN:Retrospective review of prospecti...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.05.023
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN:Retrospective study. SETTING:Tertiary care university hospital. PARTICIPANTS:All consecutive HKT recipients aged 18 years and older. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:After approval of the In...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.09.018
更新日期:2018-02-01 00:00:00
abstract::A stuck mechanical valve leaflet is a well-known cardiovascular complication; however, a stuck bioprosthetic valve is a rare but potentially fatal complication. Herein a case of stuck bioprosthetic mitral valve caused by a loop of suture, which was detected on intraoperative 3-dimensional (3D) transesophageal echocard...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type:
doi:10.1053/j.jvca.2020.07.007
更新日期:2020-07-08 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::Since DeBakey's replacement of an aortic arch aneurysm using cardiopulmonary bypass and individual perfusion of the brachiocephalic and carotid arteries, selective cerebral perfusion has been used as an effective method of cerebral protection. Although interest in this technique waned with the evolution of hypothermic...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(96)80181-9
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:In minimally invasive surgical ablation for atrial fibrillation during video-assisted thoracoscopy surgery, one-lung ventilation (OLV) with a double- lumen tube is commonly employed. In contrast with the majority of thoracic procedures, the patient lies supine; thus, the protective effect of gravity is lost a...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.03.064
更新日期:2020-11-01 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::Quality improvement, research, and reporting of outcome results can be stratified by preoperative risk by using a logistic regression equation or scores to correct for multiple risk factors. The more than 30-fold mortality differences between lowest and highest risk patients make it critical to stratify outcome result...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(98)90018-0
更新日期:1998-06-01 00:00:00