Takotsubo cardiomyopathy after cardiac surgery: A case-series and systematic review of literature.

Background: Takotsubo cardiomyopathy (TTC) is a rare entity after cardiac surgery.

Aims: To describe patients' profile who developed postoperative TTC after cardiac surgery, management, and outcomes.

Methods: We performed a systematic literature search to extract cases of TTC after adult cardiac surgery (from 1990 to 2021).

Use of Almitrine and Inhaled Nitric Oxide in ARDS Due to COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is manifested by an acute respiratory distress syndrome (ARDS) with intense inflammation and endothelial dysfunction leading to particularly severe hypoxemia. We hypothesized that an impaired hypoxic pulmonary vasoconstriction aggravates hypoxemia. The objective of the study was to test the effect of two pulmonary vasoactive drugs on patient oxygenation.

Post-operative Right Ventricular Failure After Cardiac Surgery: A Cohort Study.

Right ventricular failure (RVF) after cardiac surgery is an important risk factor for morbidity and mortality. Its diagnosis is challenging, and thus, its incidence and predictors are not well-established. We investigated the incidence, complications, and variables associated with clinically relevant post-operative RVF.

Diaphragm Dysfunction After Cardiac Surgery: Reappraisal.

Objectives: The aim of this study was to re-investigate the incidence, risk factors, and outcomes of postoperative diaphragmatic dysfunction (DD) with actual cardiac surgery procedures.

Design: Single-center, retrospective, observational study based on a prospectively collected database.

Setting: Tertiary care cardiac surgery center.

Performance of EuroSCORE II and Society of Thoracic Surgeons risk scores in elderly patients undergoing aortic valve replacement surgery.

Background: In cardiac surgery, risk is estimated with models such as EuroSCORE II and the Society of Thoracic Surgeons (STS) score. Performance of these scores may vary across various patient age ranges.

Aim: To assess the effect of patient age on performance of the EuroSCORE II and STS scores, regarding postoperative mortality after surgical aortic valve replacement.

Low Tidal Volume Mechanical Ventilation Against No Ventilation During Cardiopulmonary Bypass in Heart Surgery (MECANO): A Randomized Controlled Trial.

Background: Postoperative pulmonary complications are common after cardiac surgery and have been related to lung collapse during cardiopulmonary bypass (CPB). No consensus exists regarding the effects of maintaining mechanical ventilation during CPB to decrease these complications.

Research Question: To determine whether maintaining low-tidal ventilation (3 mL/kg 5 times/min, with positive end expiratory pressure of 5 cm HO) during CPB (ventilation strategy) was superior to a resting-lung strategy with no ventilation (no ventilation strategy) regarding postoperative pulmonary complications, including mortality.

Pacemaker implantation after aortic valve replacement: rapid-deployment Intuity® compared to conventional bioprostheses.

Objectives: The aim of this study was to compare the incidence of permanent pacemaker (PPM) implantation after aortic valve replacement by rapid-deployment bioprosthesis (RDB) and standard valve (Standard).

Methods: All patients undergoing aortic valve replacement between 2015 and 2018, in 1 centre, were included. A multivariate analysis on the whole cohort and then a propensity score matching were used to compare the 2 groups.

Heart failure with preserved ejection fraction as an independent risk factor of mortality after cardiothoracic surgery.

Background: The prognostic role of heart failure with preserved ejection fraction (HFpEF) remains unclear. This study aimed to assess HFpEF prognostic value after cardiothoracic surgery, adjusting for European System for Cardiac Operative Risk (EuroSCORE II) criteria.

Methods: Patients with left ventricular ejection fraction (LVEF) ≥ 50% undergoing cardiothoracic surgery between 2012 and 2016 were included.

Low tidal volume mechanical ventilation against no ventilation during cardiopulmonary bypass heart surgery (MECANO): study protocol for a randomized controlled trial.

Background: Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery.

Frequency of Recovery from Complete Atrioventricular Block After Cardiac Surgery.

Best timing for permanent pacemaker implantation to treat complete atrioventricular block (AVB) after cardiac surgery is unclear, as late pacemaker dependency was found low in recent observational studies. This study aimed to identify factors associated with spontaneous recovery from AVB. In a prospective and observational cohort, all patients who underwent cardiothoracic surgery during a 14-month-period were included (n = 1,200).

Fluid responsiveness predicted by noninvasive bioreactance-based passive leg raise test.

Purpose: To study the feasibility of predicting fluid responsiveness (FR) by passive leg raising (PLR) using a Bioreactance-based noninvasive cardiac output monitoring device (NICOM).

Method: This prospective, two-center study included 75 consecutive intensive care unit (ICU) adult patients immediately after cardiac surgery. NICOM was used to continuously record cardiac output (CO) at baseline, during a PLR, and then during a 500 ml i.

Comparison of monitoring performance of Bioreactance vs. pulse contour during lung recruitment maneuvers.

Introduction: This study was designed to test the hypothesis of equivalence in cardiac output (CO) and stroke volume (SV) monitoring capabilities of two devices: non invasive transthoracic bioreactance (NICOM), and a pulse contour analysis (PICCO PC) coupled to transpulmonary thermodilution (PICCO TD).

Methods: We included consecutive patients of a single ICU following cardiac surgery. Continuous minute-by-minute hemodynamic variables obtained from NICOM and PICCO PC were recorded and compared in 20 patients at baseline, during a lung recruitment maneuver (20 cmH2O of PEEP) and following withdrawal of PEEP.

Noninvasive cardiac output monitoring (NICOM): a clinical validation.

Objective: To evaluate the clinical utility of a new device for continuous noninvasive cardiac output monitoring (NICOM) based on chest bio-reactance compared with cardiac output measured semi-continuously by thermodilution using a pulmonary artery catheter (PAC-CCO).

Design: Prospective, single-center study.

Setting: Intensive care unit.

[Apical hypertrophic cardiomyopathy: a pitfall in preoperative electrocardiography].

We submit two case reports of apical hypertrophic cardiomyopathy knowing that the diagnosis of one of them has been very intricate at the time of preoperative evaluation. This disease, unfrequent besides Japan, is either silent or induces cardio-vascular symptoms which are often poorly typical. The diagnosis relies on echocardiography using a high frequency probe to reveal an apical hypertrophy.

Assessment of systematic use of intraoperative transesophageal echocardiography during cardiac surgery in adults: a prospective study of 203 patients.

Objective: To determine the usefulness of systematic intraoperative transesophageal echocardiography in a cardiac surgical unit.

Design: Open prospective observational survey.

Setting: University Hospital.

Intraoperative transesophageal echocardiographic assessment of vascular anastomoses in lung transplantation. A report on 18 cases.

Background: In patients after lung transplantation, dysfunction of pulmonary venous and artery anastomoses leading to reoperation is described.

Methods And Results: Pulmonary artery and vein anastomoses were evaluated intraoperatively by monoplane transesophageal echocardiography (TEE) in 18 patients undergoing lung transplantation (nine right, five left single lung transplantations, and four bilateral transplantations). All 13 right pulmonary artery anastomoses and all 22 pulmonary vein anastomoses could be visualized by TEE.

Elastic energy as an index of right ventricular filling.

Background: Right ventricle (RV) preload assessment remains controversial because the complexity of RV geometry is an obstacle to wall stress modeling. We developed a method to evaluate end-diastolic RV elastic energy (EL), a variable that integrates all the stretching effects of venous return and that can be easily estimated at the bedside from the area under the diastolic RV pressure-volume curve. The purpose of this study was to compare the clinical utility of EL and of the two conventional variables used to assess RV filling, ie, right atrial pressure (Pra) and RV end-diastolic volume (EDV).

Single lung transplantation for pulmonary lymphangiomyomatosis. Unexpected need for extracorporeal circulation.

The present case describes an acute respiratory-related hemodynamic failure during a single left lung transplantation in a 32-year-old woman suffering from end-stage pulmonary lymphangiomyomatosis. During the first 5 min of single right lung ventilation, a progressive increase in airway pressure and decrease in tidal volume associated with a decrease in arterial pressure and Spo2 occurred that were successfully countered by reventilation of the left lung. Proper positioning of the double-lumen tube was confirmed with a fiberoptic bronchoscope.

Enoximone vs nicardipine during the early postoperative course of patients undergoing cardiac surgery. A prospective study of two therapeutic strategies.

The hemodynamic effects of enoximone and nicardipine were compared during the early postcardiac surgery period in 40 patients with systemic hypertension and moderate cardiac dysfunction. Patients were prospectively randomized into two groups. Mean right atrial pressure was maintained above 7 mm Hg.

Clonidine premedication for coronary artery bypass grafting under high-dose alfentanil anesthesia: intraoperative and postoperative hemodynamic study.

The purpose of this study was to assess the efficacy of clonidine in achieving perioperative hemodynamic stability in patients undergoing coronary artery bypass grafting performed under high-dose alfentanil anesthesia. Twenty-four patients with left ventricular ejection fraction greater than 0.5 were prospectively studied in a double-blind manner; those requiring emergency procedures were excluded.

[Etomidate modifies hemodynamic response to fentanyl in patients with impaired left ventricular function].

The haemodynamic effects and the side-effects of anaesthesia using high doses of fentanyl were compared in two groups of 12 patients each. All the patients had poor left ventricular function and were scheduled for elective coronary artery bypass graft surgery or valvular replacement. Patients were randomly assigned to either group.

High-dose alfentanil for myocardial revascularization: a hemodynamic and pharmacokinetic study.

It has been suggested that high plasma levels of alfentanil are required in order to control hemodynamic responses to noxious stimuli in patients undergoing myocardial revascularization. The present study was designed to determine the hemodynamic profile in 10 patients and the time course of alfentanil plasma concentrations and pharmacokinetics (7 patients) during and following coronary artery surgery using alfentanil administration based on an overdosage principle. Premedication consisted of lorazepam, 0.

[Spinal anesthesia with bupivacaine without glucose in the elderly: effect of concentration and volume on the hemodynamic profile].

This study aimed to compare the haemodynamic effects of two different glucose-free bupivacaine solutions is thirty patients aged more than 70 years (mean age 82 years) undergoing hip surgery under spinal anaesthesia. They were randomly assigned to two groups, group A to receive 2.5 ml of a 0.