The year in cardiothoracic and vascular anesthesia: Selected highlights from 2010

Michael Andritsos, Nina Singh, Prakash Patel, Ashish Sinha, Jens Fassl, Tygh Wyckoff, Hynek Riha, Chris Roscher, Balachundar Subramaniam, Harish Ramakrishna, John G.T. Augoustides

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

The aortic valve treatment revolution continues with the maturation of aortic valve repair and the dissemination of transcatheter aortic valve implantation. The recent publication of comprehensive multidisciplinary guidelines for diseases of the thoracic aorta has assigned important roles for the cardiovascular anesthesiologist and perioperative echocardiographer. Although intense angiotensin blockade improves outcomes in heart failure, it might further complicate the maintenance of perioperative systemic vascular tone. Ultrafiltration as well as intensive medical management guided by the biomarker brain natriuretic peptide improves outcomes in heart failure. Continuous-flow left ventricular assist devices have further improved outcomes in the surgical management of heart failure. Major risk factors for bleeding in the setting of these devices include advanced liver disease and acquired von Willebrand syndrome. The metabolic modulator perhexiline improves myocardial diastolic energetics to achieve significant symptomatic improvement in hypertrophic cardiomyopathy. A landmark report was also published recently that outlines the major areas for future research and clinical innovation in this disease. Landmark trials have documented the outcome importance of perioperative cerebral oxygen saturation monitoring as well as the outcome advantages of the Sano shunt over the modified Blalock-Taussig shunt in the Norwood procedure. Furthermore, the development and evaluation of pediatric-specific ventricular assist devices likely will revolutionize the mechanical management of pediatric heart failure. A multidisciplinary review has highlighted the priorities for future perioperative trials in congenital heart disease. These pervasive developments likely will influence the future training models in pediatric cardiac anesthesia.

Original languageEnglish (US)
Pages (from-to)6-15
Number of pages10
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume25
Issue number1
DOIs
StatePublished - Feb 2011

Keywords

  • Blalock-Taussig shunt
  • Norwood procedure
  • Sano shunt
  • angiotensin
  • aortic aneurysm
  • aortic dissection
  • aortic valve
  • aortic valve repair
  • cerebral oxygen saturation
  • congenital heart disease
  • endovascular aortic repair
  • guidelines
  • heart failure
  • hypertrophic cardiomyopathy
  • metabolic modulator
  • model for end-stage liver disease
  • natriuretic peptide
  • near-infrared
  • perhexiline
  • perioperative management
  • spectroscopy
  • thoracic aorta
  • transcatheter aortic valve implantation
  • ultrafiltration
  • ventricular assist device
  • von Willebrand syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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  • Cite this

    Andritsos, M., Singh, N., Patel, P., Sinha, A., Fassl, J., Wyckoff, T., Riha, H., Roscher, C., Subramaniam, B., Ramakrishna, H., & Augoustides, J. G. T. (2011). The year in cardiothoracic and vascular anesthesia: Selected highlights from 2010. Journal of Cardiothoracic and Vascular Anesthesia, 25(1), 6-15. https://doi.org/10.1053/j.jvca.2010.11.001