Annals of Cardiac Anaesthesia

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Now showing 1 - 20 of 1468
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    30-day mortality after coronary artery bypass grafting and valve surgery has greatly improved over the last decade, but the 1-year mortality remains constant.
    (2015-04) Hansen, Laura Sommer; Hjortdal, Vibeke Elisabeth; Andreasen, Jan Jesper; Mortensen, Poul Erik; Jakobsen, Carl-Johan
    Introduction: European system for cardiac operative risk evaluation (EuroSCORE) is a valuable tool in control of the quality of cardiac surgery. However, the validity of the risk score for the individual patient may be questioned. The present study was carried out to investigate whether the continued fall in short‑term mortality reflects an actual improvement in late mortality, and subsequently, to investigate EuroSCORE as predictor of 1‑year mortality. Methods: A population‑based cohort study of 25,602 patients from a 12‑year period from three public university hospitals undergoing coronary artery bypass grafting (CABG) or valve surgery. Analysis was carried out based on EuroSCORE, age and co‑morbidity factors (residual EuroSCORE). Results: During the period the average age increased from 65.1 ± 10.0 years to 68.9 ± 10.7 years (P < 0.001, one‑way ANOVA), and the number of females increased from 26.0% to 28.2% (P = 0.0012, Chi‑square test). The total EuroSCORE increased from 4.67 to 5.68 while the residual EuroSCORE decreased from 2.64 to 1.83. Thirty‑day mortality decreased from 4.07% in 1999–2000 to 2.44% in 2011–2012 (P = 0.0056; Chi‑square test), while 1‑year mortality was unchanged (6.50% in 1999–2000 vs. 6.25% in 2011–2012 [P = 0.8086; Chi‑square test]). Discussion: The study demonstrates that both co‑morbidity and age has a great impact on 30‑day mortality. However, with time the impact of co‑morbidity seems less. Thus, age is more important than co‑morbidity in late mortality. The various developments in short and long‑term mortality are not readily explained. Conclusion: Although 30‑day mortality of CABG and valve surgery patients has decreased during the 12‑year period, the 1‑year mortality remains the same.
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    3D Virtual Bronchoscopy as an Aid to Airway Management in a Patient with Anterior Mediastinal Mass
    (Wolters Kluwer – Medknow, 2024-04) Arora, Divya; Tewari, Prabhat; Shamshery, Chetna; Chandra, Bipin; Gupta, Archna; Pal, Lily
    Mediastinal masses pose one of the great challenges for any anesthesiologist during airway maintenance, underlining the need to devise a well?formulated plan to avoid perioperative complications. As a general rule, such patients are managed with spontaneous ventilation without the use of muscle relaxants and awake intubation. We report a case of a 66?year?old male with severe dyspnea, having a very large invasive anterior mediastinal mass, causing left lung collapse for urgent debulking surgery. The tracheobronchial compromise was ruled out using three?dimensional reconstruction on computed tomography imaging (virtual bronchoscopy) and that helped in using general anesthesia with muscle relaxation for subsequent endotracheal intubation and surgery.
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    Abdominal compartment syndrome after surgical repair of Type A aortic dissection
    (Wolters Kluwer - Medknow, 2018-10) Ampatzidou, Fotini; Madesis, Athanasios; Kechagioglou, George; Drossos, George
    Abdominal compartment syndrome is associated with severe dysfunction of intra-abdominal and intrathoracic organs. Medical therapy, with the goal of reducing intra-abdominal pressure, leads to improvement in organ perfusion.
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    Abnormal mitral valve apparatus in a case of hypertrophic obstructive cardiomyopathy: Intraoperative transesophageal echocardiography
    (Wolters Kluwer - Medknow, 2018-07) Aggarwal, Neelam; Khanuja, Jasbir Singh; Arora, Sameer Saurabh; Maria, Rahul
    Hypertrophic obstructive cardiomyopathy is a relatively common disorder that signifies asymmetric hypertrophy of interventricular septum causing obstruction of the left ventricular outflow tract (LVOT). However, more recent studies have shown that during ventricular systole, flow against an abnormal mitral valve apparatus results in drag forces on the part of the leaflets. The mitral leaflet is pushed into the LVOT to obstruct it. We present a case where intraoperative transesophageal echocardiography played a crucial role in defining the etiology of LVOT obstruction that subsequently helped in deciding the surgical plan.
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    Absent left main coronary artery.
    (2007-01-26) Goel, Sanjay; Dhir, Achal
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    Absent right superior vena cava and persistent left superior vena cava in a patient with bicuspid aortic valve with aortic stenosis
    (Wolters Kluwer - Medknow, 2018-04) Gupta, Kushant; Bhuvana, Vijayakanth; Bansal, Varun; Ray, Ruma; Kumar, Arkalgud Sampath
    Persistent left superior vena cava (LSVC) with absent right SVC (RSVC) is a rare congenital anomaly. If undetected, the condition may pose difficulties in central venous catheter insertion, pacemaker electrode insertion, and cannulation during cardiopulmonary bypass. We describe a case of persistent LSVC with absent RSVC, who was diagnosed to have bicuspid aortic valve with aortic stenosis.
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    Absent right superior vena cava in visceroatrial situs solitus: surgical and anaesthetic implications.
    (2006-07-19) Kale, Suresh Babu; Reddy, Venkat; Mohanty, Prashanta Kumar; Patil, Rahul; Jariwala, Pankaj
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    Absent superior vena cava in tetralogy of fallot
    (Wolters Kluwer - Medknow, 2018-04) Shah, Tejas R; Hiremath, Channabasavaraj S; Diwakar, Anitha; Rema, Krishna Manohar Soman
    Absent superior vena cava (SVC) is an asymptomatic congenital systemic venous anomaly which is rarely detected and compatible with normal life. Undiagnosed absent SVC may cause problems during cardiac catheterization or cardiac surgery. We present our surgical experience in a patient with tetralogy of Fallot who had undiagnosed absent SVC.
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    Accidental administration of norepinephrine due to breech in a closed infusion system.
    (2006-01-19) Kumar, Anand; Mehta, Yatin; Chauhan, Rajesh
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    Accidental arterial puncture during right internal jugular vein cannulation in cardiac surgical patients.
    (2016-10) Maddali, Madan Mohan; Venkitaramanan, Arun; Al-Ajmi, Ahmed Wala; Al-Bahrani, Maher Jaffer; Cheskey, Manoj Jayatilaka; Arora, Ram Nishant
    Background: The primary aim of this study was to compare the incidence of accidental arterial puncture during right internal jugular vein (RIJV) cannulation with and without ultrasound guidance (USG). The secondary end points were to assess if USG improves the chances of successful first pass cannulation and if BMI has an impact on incidence of arterial puncture and the number of attempts that are to be made for successful cannulation. Settings and Design: Prospective observational study performed at a single tertiary cardiac care center. Material and methods: 255 consecutive adult and pediatric cardiac surgical patients were included. In Group I (n = 124) USG was used for the right internal jugular vein cannulation and in Group II (n = 81) it was not used. There were 135 adult patients and 70 pediatric patients. Statistical analysis: Demographic and categorical data were analyzed using Student ‘t’ test and chi- square test was used for qualitative variables. Results: The overall incidence of accidental arterial puncture in the entire study population was significantly higher when ultrasound guidance was not used (P < 0.001). In subgroup analysis, incidence of arterial puncture was significant in both adult (P = 0.03) and pediatric patients (P < 0.001) without USG. First attempt cannulation was more often possible in pediatric patients under USG (P = 0.03). In adult patients USG did not improve first attempt cannulation except in underweight patients. Conclusions: USG helped in the avoidance of inadvertent arterial puncture during RIJV cannulation and simultaneously improved the chances of first attempt cannulation in pediatric and in underweight adult cardiac surgical patients.
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    Accidental cannulation of aberrant radial artery.
    (2014-01) Sathish, N; Prasad, S R; Nagesh, K S; Jagadeesh, A M
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    Accuracy of Intraoperative Transesophageal Echocardiographic Doppler Parameters in Assessing the Right Ventricular Diastolic Function After Repair of Tetralogy of Fallot in Pediatric Patients
    (Wolters Kluwer – Medknow, 2025-03) Panidapu, Nagarjuna; Babu, Saravana; Dharan, Baiju S.; Sen, Barsha; Koshy, Thomas
    Background: This study aimed to assess the accuracy of tricuspid spectral Doppler (E/A) and tissue Doppler parameters (E/E’) to diagnose right ventricular diastolic dysfunction (RVDD) in comparison to American Society of Echocardiography (ASE criteria) in pediatric tetralogy of Fallot (TOF) patients after surgical repair. Methods: This prospective, observational study was done at a tertiary care hospital involving 40 pediatric TOF patients aged less than 2 years who underwent complete intracardiac repair with cardiopulmonary bypass (CPB). Echocardiographic observations were made using a pediatric transesophageal echocardiography probe after surgical repair in the post?CPB period. The ASE?described parameters (late diastolic forward flow in the main pulmonary artery, right atrial dilatation, inferior vena cava dilatation, and hepatic venous flow reversal) were acquired to diagnose the RVDD. The tricuspid Doppler parameters (E/A and E/E’) were measured, and its predictive ability to diagnose RVDD was analyzed and compared with the ASE criteria. Results: Based on the ASE criteria, 13 patients (32.5%) were diagnosed to have RVDD. We found that an E/E’ ratio of ? 6.26 and an E/A ratio of >1.34 can be taken as the cutoff for diagnosing the RVDD. Based on the tricuspid Doppler parameters (E/A > 1.34 and E/E’ >6.26), 17 patients (42.5%) were diagnosed to have RVDD, which was comparable to that of the diagnosis by ASE criteria ( P > 0.05). Conclusion: The results suggested that the use of tricuspid Doppler parameters can be equally accurate and reproducible to the current ASE?described echocardiographic parameters for diagnosing RVDD after surgical repair of TOF.
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    Action is the foundational key to all success" (Pablo Picasso).
    (2013-04) Mittnacht, Alexander J C
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    Activated clotting time tube malfunction: A rare cause of heparin overdose.
    (2013-04) Kumar, Bhupesh; Badamali, Ashok Kumar
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    Active Paradoxical and Pulmonary Emboli in a First Trimester Pregnancy
    (Wolters Kluwer - Medknow, 2022-12) Nicholas, Suraci; Shifman, Monica; Kumar, Annadita; HaskeNicholasx, Michael; Shifman, Monica; Kumar, Annadita; Haske, Michael
    Capturing a paradoxical embolism in real?time has been a challenge in recent literature. We present the unique case of a 33?year?old, G3P2 female at 8 weeks gestation presenting with dyspnea. An active thrombus through an undiagnosed patent foramen ovale was found requiring emergent surgical intervention with a positive outcome. The presence of a deep vein thrombosis, inferior vena caval thrombus, patent foramen ovale, and pulmonary artery thrombi was contemporarily documented. To our knowledge, there is minimal literature with this presentation.
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    Acute Acquired Immune Thrombocytopenia After Cardiac Surgery: A Challenging Case
    (Wolters Kluwer - Medknow, 2023-03) Auci, Elisabetta; Vetrugno, Luigi; Riccardi, Ilaria; Vendramin, Igor; Livi, Ugolino; Bassi, Flavio; Bove, Tiziana
    Thrombocytopenia is a common condition that recognizes an infinite number of possible causes, especially in specific settings like the one covered in this case report: the postoperative period of cardiac surgery. We report a case of an old male with multiple comorbidities who underwent a coronary angioplasty procedure and aortic valve replacement. He showed severe thrombocytopenia in the postoperative days. Differential diagnosis required a big effort, also for the experts in the field. Our goal was to aggressively treat the patient with prednisolone, platelets, and intravenous immunoglobulins to maximize the prognosis. Our patient developed no complications and was discharged successfully