Impact of high spinal anesthesia in pediatric congenital heart surgery on postoperative recovery: a retrospective propensity score-matched study.

Background: High spinal anesthesia (HSA) has been utilized in cardiac surgery; however, there is limited evidence on its impact on facilitating postoperative recovery. This study aimed to evaluate the impact of HSA in pediatric congenital heart surgery on postoperative recovery.

Methods: A single center, propensity score-matched retrospective cohort study was designed using data from pediatric patients under 18 years old, who underwent congenital heart surgeries classified as Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) score 3 or less.

Immediate change following valve deployment in left ventricular systolic and diastolic functions in transcatheter aortic valve replacement: a retrospective cohort study.

Background: Transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic valve disorder. Several studies have reported improvements in systolic and diastolic function following TAVR. However, few studies have addressed immediate post-deployment changes.

AngioVac Procedures: Integration of cardiac surgeon and anesthesiologist-led transesophageal echocardiography: A preliminary report.

Introduction: The AngioVac system is a novel, minimally invasive, endovascular technique used to evacuate intravascular or intracardiac vegetation or thrombus. Although most AngioVac procedures are currently performed by interventionalists, this innovative procedure has been gaining attention among the surgical and anesthesia communities.

Methods: We retrospectively reviewed all patients who underwent the AngioVac procedure performed by a cardiac surgeon between August 2019 and December 2022.

Emergent veno-venous extracorporeal membrane oxygenation during aortic valve replacement following severe re-expansion pulmonary edema: A case report.

Re-expansion pulmonary edema is defined as pulmonary edema that occurs when a chronically collapsed lung rapidly re-expands, most commonly following chest tube placement for pneumothorax, re-expansion of severe atelectasis, and evacuation of pleural effusion. Though it is very rare, the sudden onset and clinical features of re-expansion pulmonary edema make it a lethal complication that requires urgent treatment. We present a 60-year-old patient who underwent an aortic valve replacement with pre-existing large bilateral pleural effusions.

Pioneering the Integration of Artificial Intelligence in Medical Oral Board Examinations.

We evaluated the use of ChatGPT-4, an advanced artificial intelligence (AI) language model, in medical oral examinations, specifically in anesthesiology. Initially proven adept in written examinations, ChatGPT-4's performance was tested against oral board sample sessions of the American Board of Anesthesiology. Modifications were made to ensure responses were concise and conversationally natural, simulating real patient consultations or oral examinations.

Comparison of Time to Intubation of a Double-Lumen Endobronchial Tube Utilizing C-MAC® Versus GlideScope® Versus Macintosh Blade: A Randomized Crossover Manikin Study.

Background: Macintosh blade direct laryngoscopy is widely used for endotracheal intubation. It may, however, provide an incomplete view of the glottis in patients with challenging airway anatomy. Consequently, various video laryngoscopes have been developed to enhance the visualization of the glottis and facilitate intubation.

Transesophageal Echocardiography Assisting in the Identification of Intraabdominal Bleeding During Cardiac Surgery.

We present a case in which intraoperative transesophageal echocardiography (TEE) helped detect intraabdominal bleeding, a rare complication in cardiac surgery. A patient undergoing ascending aortic aneurysm and aortic valve repair had increasing vasopressor and transfusion requirement during sternal closure with TEE imaging revealing a nonspecific, hypoechoic fluid-like collection anterior to the stomach. Discussion between the anesthesiology and surgical teams prompted further investigation including a diagnostic laparoscopy which confirmed the presence of intraabdominal bleeding.

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights From 2023.

This special article is the 16th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series, namely the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology.

Muscle blood flow and vasodilation are blunted at the onset of exercise following an acute bout of ischemia-reperfusion.

Ischemia-reperfusion (I/R) injury can attenuate endothelial function and impair nitric oxide bioavailability. We tested the hypothesis that I/R also blunts the rapid and steady-state hyperemic and vasodilatory responses to handgrip exercise. Ten subjects (8M/2F; 24 ± 4 yr) performed handgrip exercises before and after I/R (20 min of ischemia/20 min of reperfusion) and time control (40-min supine rest) trials.

Transesophageal echocardiography for thoracic spinal cord imaging and confirmation of epidural catheter placement in pediatrics.

Introduction: Transesophageal echocardiography (TEE) use continues to expand to include extracardiac applications. However, there is limited research investigating the use of TEE as a tool to confirm the position of the epidural catheter. This prospective observational study aimed to evaluate whether TEE could be used to visualize the anatomy of the thoracic spinal canal in pediatrics.

Prophylactic Use of Continuous Positive Airway Pressure to Operative Lung During One-Lung Ventilation Can Minimize Bleomycin Pulmonary Toxicity: A Report of Two Cases.

Bleomycin, a common antineoplastic agent, is known to cause bleomycin pulmonary toxicity when the lungs are exposed to a high fraction of inspired oxygen (FiO) level. Thus, intraoperative one-lung ventilation (OLV) is challenging in a patient with bleomycin treatment because maintaining high FiO during OLV is a common practice in thoracic surgery to ensure adequate oxygenation while providing adequate lung isolation. We report two thoracic surgical cases where prophylactic continuous positive airway pressure (CPAP) was applied on the non-dependent lung during OLV while limiting FiO to prevent postoperative respiratory complications.

sp. nov., an aerobic bacteriochlorophyll -containing freshwater bacterium isolated from river epilithic biofilm.

A strictly aerobic bacteriochlorophyll -containing alphaproteobacterium, designated strain S08, was isolated from a biofilm sampled at Tama River in Japan. The non-motile and rod-shaped cells formed pink-beige pigmented colonies on agar plates containing organic compounds and showed absorption maxima at 798 and 866 nm in the near-infrared region, typical for the presence of bacteriochlorophyll . The new bacterial isolate is Gram-negative, oxidase-negative and catalase-positive.

Transcriptome and Deletion Mutant Analyses Revealed that an RpoH Family Sigma Factor Is Essential for Photosystem Production in Roseateles depolymerans under Carbon Starvation.

Roseateles depolymerans is an obligately aerobic bacterium that produces a photosynthetic apparatus only under the scarcity of carbon substrates. We herein examined changes in the transcriptomes of R. depolymerans cells to clarify the expression of photosynthesis genes and their upstream regulatory factors under carbon starvation.

Challenges for Emergent Combined Cesarean Delivery and Type A Aortic Dissection Repair Including Bleeding Management in the Setting of Full Heparinization: A Case Report.

Type A aortic dissection is rare in young females; however, it is associated with a high mortality rate. This case report describes a 30-year-old female at 38 weeks of gestation who presented with acute onset chest pain and hypotension responsive to intravenous fluid therapy. Transthoracic echocardiogram and chest computed tomography angiography confirmed a type A aortic dissection.

Effects of Combined Inorganic Nitrate and Nitrite Supplementation on Cardiorespiratory Fitness and Skeletal Muscle Oxidative Capacity in Type 2 Diabetes: A Pilot Randomized Controlled Trial.

Nitric oxide (NO) stimulates mitochondrial biogenesis in skeletal muscle. However, NO metabolism is disrupted in individuals with type 2 diabetes mellitus (T2DM) potentially contributing to their decreased cardiorespiratory fitness (i.e.

Eight weeks of inorganic nitrate/nitrite supplementation improves aerobic exercise capacity and the gas exchange threshold in patients with type 2 diabetes.

Patients with type 2 diabetes mellitus (T2DM) have reduced exercise capacity, indexed by lower maximal oxygen consumption (V̇o) and achievement of the gas exchange threshold (GET) at a lower % V̇o. The ubiquitous signaling molecule nitric oxide (NO) plays a multifaceted role during exercise and, as patients with T2DM have poor endogenous NO production, we investigated if inorganic nitrate/nitrite supplementation (an exogenous source of NO) improves exercise capacity in patients with T2DM. Thirty-six patients with T2DM (10F, 59 ± 9 yr, 32.

Acute Pulmonary Embolism Caused by Abdominal Pannus Retraction in an Awake Patient in the Operating Room: A Case Report.

We present a 67-year-old woman who was hemodynamically stable with radiographic evidence of saddle pulmonary embolism (PE) in the main pulmonary artery and mobile thrombus in the right heart. Endovascular thrombectomy was scheduled under general anesthesia. Before anesthesia induction, femoral vessel access was planned under local anesthesia in case emergent cardiopulmonary bypass (CPB) was needed.

Dietary Inorganic Nitrate/Nitrite Supplementation Reduces Central and Peripheral Blood Pressure in Patients With Type 2 Diabetes Mellitus.

Background: Patients with type 2 diabetes mellitus (T2DM) have increased cardiovascular risk due to elevated blood pressure (BP). As low levels of nitric oxide (NO) may contribute to increased BP, we determined if increasing NO bioavailability via eight weeks of supplementation with beetroot juice containing inorganic nitrate/nitrite (4.03 mmol nitrate, 0.

sp. nov., a moderately thermophilic chemotrophic bacterium unable to grow on hydrogen gas, isolated from hot spring microbial mats.

A novel thermophilic chemotrophic bacterium, strain SS56, was isolated from Nakabusa Hot Spring, Japan. The isolate was a rod-shaped (1.5-2.

Concomitant aortic valve repair for aortic insufficiency and implantation of left ventricle mechanical support.

Background: Moderate to severe aortic valve insufficiency (AI) in patients undergoing left ventricular assist device (LVAD) implantation is a significant complication which occurs in up to 10.7% of patients in the INTERMACS database and has profound consequences for survival. Preoperative Impella use is associaed with greater post-LVAD AI.

Neotabrizicola shimadae gen. nov., sp. nov., an aerobic anoxygenic phototrophic bacterium harbouring photosynthetic genes in the family Rhodobacteraceae, isolated from a terrestrial hot spring.

A bacteriochlorophyll-containing bacterium, designated as strain N10, was isolated from a terrestrial hot spring in Nagano Prefecture, Japan. Gram-stain-negative, oxidase- and catalase-positive and ovoid to rod-shaped cells showed the features of aerobic anoxygenic phototrophic bacteria, i.e.

Thoracic epidural analgesia in a patient with von Hippel-Lindau disease.

von Hippel-Lindau disease (VHLD) is an autosomal dominant disorder characterized by central nervous system hemangioblastomas and renal tumors. Here, we report a case of thoracic epidural placement in a 35-year-old woman with VHLD presenting for left open heminephrectomy for renal masses. We also reviewed the literature on this topic.