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Perioperative Management of Patients with Preeclampsia: A Comprehensive Review.
Anesthesiology
February 2025
Division of Obstetric Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Preeclampsia is a common condition of pregnancy characterized by hypertension complicated by cerebral, cardiac, hepatic, renal, hematologic, and placental dysfunction. Patients with preeclampsia frequently undergo cesarean delivery, the most common major surgical procedure in the world. They represent a high-risk perioperative cohort suffering significant preventable morbidity and mortality.
View Article and Find Full Text PDFLeft atrial appendage cannulation for left ventricular unloading in a patient with ventricular thrombus on extracorporeal life support.
J Cardiothorac Surg
January 2025
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
Background: Left ventricular unloading is needed in patients on extracorporeal life support (ECLS) with severely impaired left ventricular contractility to avoid stasis and pulmonary congestion, and to promote LV recovery. The presence of thrombi in the LV precludes the use of conventional active unloading methods such as transaortic microaxial pumps or apical LV vents. We describe placement of a vent cannula via the left atrial appendage (LAA) as a useful bailout option.
View Article and Find Full Text PDFNorwood Procedure for Hypoplastic Left Heart With Anomalous Coronary Artery From Pulmonary Trunk.
Ann Thorac Surg Short Rep
September 2024
Department of Pediatric Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
Undetected coronary anomalies at Norwood procedure are associated with poor prognosis due to inadequate myocardial protection. We report a case of anomalous origin of the right coronary artery from the main pulmonary artery trunk with hypoplastic left heart syndrome and aortic atresia. Although, during bilateral pulmonary artery banding as initial palliation, the proximity between the right coronary artery origin and the aortic root made a visual diagnosis difficult, it was diagnosed using computed tomography before the Norwood procedure.
View Article and Find Full Text PDFComparative Analysis of Irrigation Mist and CO vs. Direct CO Blower in On-Pump Coronary Artery Bypass Grafting Anastomosis: Efficacy, Efficiency, and Fibrillation upon De-Clamping and Micro-Embolic Gas Activity Incidence.
Medicina (Kaunas)
December 2024
Department of Cardiac Surgery, Anthea Hospital GVM Care and Research, Via Camillo Rosalba 35/37, 70124 Bari, Italy.
In coronary artery bypass grafting (CABG) on pump, achieving optimal visualization is critical for surgical precision and safety. The use of blowers to clear the CABG anastomosis poses risks, including the formation of micro-embolic gas bubbles, which can be insidious and increase the risk of cerebral or myocardial complications. This retrospective study compares the effectiveness of the use of irrigation mist and CO versus a direct CO blower without irrigation in terms of visualization, postoperative fibrillation, and micro-embolic gas activity.
View Article and Find Full Text PDFEffect of different intraoperative blood pressure regulation levels on postoperative myocardial injury in patients undergoing radical mastectomy for breast cancer after receiving neoadjuvant chemotherapy: a study protocol for a randomised controlled trial.
BMJ Open
January 2025
Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
Introduction: For patients with breast cancer receiving preoperative neoadjuvant chemotherapy with anthracyclines, there is an increased risk of postoperative myocardial injury due to the cardiotoxicity of the chemotherapeutic agents. The optimal intraoperative blood pressure regulation regimen for these patients is unclear. This study is being conducted to determine whether targeting mean arterial pressure (MAP) to 100%-120% of the patient's baseline blood pressure reduces the incidence of myocardial injury after non-cardiac surgery (MINS) compared with targeting MAP to 80%-100%.
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