JournalTOCs

Journal of Cardiac Critical Care TSS
Number of Followers: 1

This is an Open Access Journal

Open Access journal
ISSN (Online) 2456-9224
Published by Thieme Publishing Group

[233 journals]

ECMO and Ventricular Assist Devices as a Bridge to Transplant
- Journal of Cardiac Critical Care TSS 2022; 06: 185-189
  DOI: 10.1055/s-0042-1759861
  
  Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
  
  Artikel in Thieme eJournals:
  Inhaltsverzeichnis open access Volltext
  Journal of Cardiac Critical Care TSS 2022; 06: 185-1892022-12-03T18:31:58+0100
  Issue No: Vol. 06, No. 03 (2022)
Inhaled Milrinone via HFNC as a Postextubation Cardiopulmonary Elixir:
Case Series and Review of Literature
- Authors: Bansal; Noopur, Magoon, Rohan, Kalaiselvan, Jaffrey, ItiShri, ItiShri, Kohli, Jasvinder Kaur, Kashav, Ramesh Chand
  Pages: 190 - 194
  Abstract: Pulmonary hypertension (PH) often complicates perioperative course following pediatric cardiac surgery, often presenting unique challenges to the attending cardiac anesthesiologist. Apart from difficult weaning from cardiopulmonary bypass, PH can often compound weaning from mechanical ventilation in this postoperative subset. From pathophysiological standpoint, the former can be attributed to concurrent detrimental cardiopulmonary consequences of PH as a multisystemic syndrome. Therefore, with an objective to address the affected systems, that is, cardiac and pulmonary simultaneously, we report combined use of inhaled milrinone (a pulmonary vasodilator) through high-frequency nasal cannula (oxygen reservoir and continuous positive airway pressure delivery device), purported to complement each other's mechanism of action in the management of PH, thereby hastening postoperative recovery. The article additionally presents a nuanced perspective on the advantages of combining the aforementioned therapies and hence proposing the same as a possible “postoperative cardiopulmonary elixir.”
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 190-194
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759823
  Issue No: Vol. 06, No. 03 (2022)
Effect of Vitamin D Supplementation on Postoperative Outcomes in Cardiac
Surgery Patients: A Systematic Review
- Authors: Das; Sambhunath, Bej, Punyatoya
  Pages: 195 - 200
  Abstract: Background Vitamin D deficiency is a very common occurrence in cardiac patients. It has been proved that cardiac surgery and cardiopulmonary bypass accelerate the deficiency further. The postoperative outcomes of patients deteriorate in the presence of vitamin D deficiency. Perioperative supplementation of vitamin D is the only solution to the problem. Hence, the present systematic review was conducted to derive the efficacy and safety of vitamin D supplementation on postoperative outcomes in cardiac surgery patients. Method Publications over duration of last 10 years was searched from different database and web sites. The data from full-text research articles were analyzed for the effect on different postoperative outcomes and side effects. Result Eight randomized control trials were retrieved on the effect of perioperative vitamin D supplementation in cardiac surgery patients and their postoperative outcomes. Six articles (75%) were found to be in favor of improvement in postoperative outcome. Two articles (25%) did not find any difference of outcome between the control and treatment group. All the studies observed the restoration of vitamin D to normal and no adverse effects from supplementation. Conclusion Perioperative vitamin D supplementation improves the postoperative outcomes after cardiac surgery. It is effective and safe to supplement vitamin D in cardiac surgery patients.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 195-200
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759822
  Issue No: Vol. 06, No. 03 (2022)
ICU Readmission in Cardiac Surgical Subset: A Problem Worth Pondering
- Authors: Kalaiselvan; Jaffrey, Kashav, Ramesh Chand, Kohli, Jasvinder Kaur, Magoon, Rohan, Shri, Iti, Grover, Vijay, Jhajharia, Narender Singh
  Pages: 201 - 205
  Abstract: Over the past decades, there have been noteworthy advancements in the cardiac surgical practice that have assisted fast-tracking and enhanced recovery after cardiac surgery (ERACS). With that said, intensive care unit (ICU) readmission in this high-risk patient cohort entails a significant morbidity–mortality burden. As an extension of the same, there has been a heightened emphasis on a comprehensive evaluation of the predisposition to readmission following a primary ICU discharge. However, the variability of the institutional perioperative practices and the research complexities compound our understanding of this heterogeneous outcome of readmission, which is intricately linked to both patient and organizational factors. Moreover, a discussion on ICU readmission in the recent times can only be rendered comprehensive when staged in close conjunction to the fast-tracking practices in cardiac surgery. From a more positive probing of the matter, a preventative outlook can likely mitigate a part of the larger problem of ICU readmission. Herein, focused cardiac prehabilitation programs can play a potential role given the emerging literature on the positive impact of the former on the most relevant readmission causes. Therefore, the index review article aims to address the subject of cardiac surgical ICU readmission, highlighting the magnitude and burden, the causes and risk-factors, and the research complexities alongside deliberating the topic in the present-day context of ERACS and cardiac prehabilitation.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 201-205
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759816
  Issue No: Vol. 06, No. 03 (2022)
Beta-Adrenergic Blockade: Is It the Prudent Choice against Sympathetic
Overdrive in Patients with Hypertension or Heart Failure'
- Authors: Chopra; H.K, Pancholia, A.K, Desai, Bhupen N., Sinha, Ajay K., Dabhade, Dhammdeep, Newale, Sanket
  Pages: 206 - 209
  Abstract: The development of hypertension and heart failure is correlated with the hyperactivation of the sympathetic nervous system. Beta-blockers are often considered a good therapeutic option in such clinical scenarios. However, the choice of β-blocker is a concern because of certain aspects like associated metabolic disturbances with their usage. Metoprolol has been reported to have the potential to alleviate sympathetic overdrive in patients with hypertension and heart failure. S-Metoprolol is the chirally pure β-blocker with favorable pharmacological features, improved safety profile, and allied clinical advantages versus racemic metoprolol; given this, can it be an effective therapeutic option against sympathetic overdrive in patients with hypertension and/or heart failure is not fully recognized yet. In this review, we attempted to discuss the current facts around sympathetic overdrive linked with hypertension as well as heart failure and pertaining pharmacological intervention with a focus on β-blockers in these clinical situations with an emphasis on the likely beneficial role of S-metoprolol.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 206-209
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759804
  Issue No: Vol. 06, No. 03 (2022)
COVID 19: Airway Management and Pharmacological Strategies
- Authors: Chandra; Sonal, Narang, Aditi, Choudhuri, Pratiti, Gupta, Kapil
  Pages: 210 - 215
  Abstract: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 has since resulted in more than 250 million cases worldwide and over 50 million deaths. Although treatment is mainly supportive, with oxygen therapy being the mainstay, various pharmacological treatment modalities have also been explored. In this review, we have evaluated the available evidence on airway management as well as medical management and highlighted the possible interventions that may be effective in care of critically ill patients.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 210-215
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759862
  Issue No: Vol. 06, No. 03 (2022)
Technical Details of Transwindow Fenestrated, Unidirectional, Valved,
Aorticopulmonary Fabric Patch Closure of Aortopulmonary Window (UKC's
Modification): A Video Presentation
- Authors: Chowdhury, Ujjwal K., George, Niwin, B; Sushamagayatri, Chandhirasekar, Balaji, Goja, Shikha, Manjusha, Nagasai, Pandey, Niraj Nirmal, Kapoor, Poonam Malhotra
  Pages: 216 - 218
  Abstract: A 10-year-old female patient diagnosed with isolated type I aortopulmonary window and severe pulmonary arterial hypertension who underwent repair of the aortopulmonary window via Johansson's transwindow approach using a unidirectional, fenestrated, valved, aorticopulmonary patch. The preoperative pulmonary vascular resistance was 9.0 Woods units/m2 that reduced to 4.0 Woods units/m2 after oxygen (100%) and nitric oxide (80 ppm) administration. The postoperative recovery was uneventful.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 216-218
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759805
  Issue No: Vol. 06, No. 03 (2022)
Technical Details of Rechanneling of Obstructive Coronary Sinus Type of
Totally Anomalous Pulmonary Venous Connection Using Malm's Coronary Sinus
Cutback Technique and Left Atrial Augmentation: A Video Presentation
- Authors: Chowdhury, Ujjwal K., George, Niwin, B; Sushamagayatri, Chandhirasekar, Balaji, Goja, Shikha, Manjusha, Nagasai, Pandey, Niraj Nirmal, Kapoor, Poonam Malhotra
  Pages: 219 - 221
  Abstract: Obstructive coronary sinus totally anomalous pulmonary venous connection although rare, is associated with a high mortality. A 2-month-old female child diagnosed with obstructive coronary sinus type of totally anomalous pulmonary venous connection and severe pulmonary arterial hypertension underwent complete unroofing of the coronary sinus by the “coronary sinus cutback technique” of Malm with left atrial augmentation and atrial septal fenestration.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 219-221
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759806
  Issue No: Vol. 06, No. 03 (2022)
Heparin-Induced Fever in a Cardiac Transplant Candidate
- Authors: Patel; Payal Rohit, Giacomino, Bria
  Pages: 222 - 224
  Abstract: Patient admitted to intensive care units frequently have fevers. A less common cause for fever is a drug-induced fever. For patients who are candidates for heart transplantation, persistent fevers can place a hold on their transplant candidacy until the etiology is found and the fevers resolve. We present a case of a patient with dilated cardiomyopathy who experienced fevers thought secondary to heparin that improved only with discontinuation of therapy and later underwent successful heart transplantation. Only three prior case reports of heparin-induced fevers are currently described in literature.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 222-224
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759811
  Issue No: Vol. 06, No. 03 (2022)
Idiopathic Left Posterior Fascicular Ventricular Tachycardia in Children:
A Case Report
- Authors: Ari; Abhijit, Singh, Manjeet
  Pages: 225 - 227
  Abstract: The incidence of idiopathic ventricular tachycardia is scarce; however, it is the most common type of ventricular tachycardia in previously normal children. Left posterior fascicular ventricular tachycardia is one of them, and many times it is mismanaged as paroxysmal supraventricular tachycardia. The characteristic features of this arrhythmia are a monomorphic tachycardia, right bundle branch block, and superior axis. This type of arrhythmia is highly sensitive to verapamil, even in infancy, but refractory to adenosine or amiodarone. As nonrecognition of this condition can be fatal, it should be identified early.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 225-227
  PubDate: 2022-12-03T18:31:58+0100
  DOI: 10.1055/s-0042-1759814
  Issue No: Vol. 06, No. 03 (2022)
Should We Implement Type and Screen Transfusion Policy in Pediatric
Cardiac Surgery to Improve Patient Blood Management'
- Journal of Cardiac Critical Care TSS 2022; 06: 228-229
  DOI: 10.1055/s-0042-1759830
  
  Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
  
  Artikel in Thieme eJournals:
  Inhaltsverzeichnis open access Volltext
  Journal of Cardiac Critical Care TSS 2022; 06: 228-2292022-12-03T18:31:57+0100
  Issue No: Vol. 06, No. 03 (2022)
Papillary Muscle Rupture following Acute Myocardial Infarction
- Authors: Singh; Ajmer, Nanda, Chinmaya, Mehta, Yatin
  Pages: 230 - 232
  Abstract: Rupture of a papillary muscle after acute myocardial infarction is a rare but potentially fatal complication. It can lead to acute, severe mitral regurgitation, pulmonary edema, cardiogenic shock, and death. Immediate surgical intervention in the form of mitral valve repair/replacement with concomitant coronary revascularization can reduce mortality. We herein report such a case who presented with cardiogenic shock and made a successful outcome after emergent surgery.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 230-232
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759803
  Issue No: Vol. 06, No. 03 (2022)
Ankle Block for Acute Pain Management in a Patient with Mitral Valve
Prolapse and Infective Endocarditis with Dry Gangrene of Toes
- Authors: Das; Sambhunath, Prakash, Mohit, Anandan, Vishnu
  Pages: 233 - 234
  Abstract: Ankle block represents a regional anesthesia technique to provide anesthesia for the procedures related to the foot. It is mainly used as a sole anesthesia technique or as an adjunct for postoperative pain relief in foot operations. It is an infiltrative block with advantages like being technically easier, safe, having minimal side effects, and having a high success rate. Management of postoperative pain is an essential service provided by a cardiac anesthesiologist to patients undergoing operative procedures, but the knowledge in providing regional anesthesia may be used beyond the operating room or critical care unit. In the present case, we administered an ankle block to alleviate the pain in case of dry gangrene.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 233-234
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759808
  Issue No: Vol. 06, No. 03 (2022)
A Trip Down the Memory Lane of Dr. Frank Gollan, an Achilles of
Extracorporeal Oxygenation
- Authors: Pradeep; Doniparthi, Malakar, Jaydeep
  Pages: 235 - 238
  Abstract: Every health care professional does his best for mankind, but handling a patient on extracorporeal circulation places cardiac surgeons, cardiac anesthetists, and perfusionists in a separate class of health professional altogether. This is a humble effort to reminisce the research work done by Dr. Frank Gollan since his instrumental time to the current day practice, without whom it is impossible to imagine open heart surgery and circulatory arrest.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 235-238
  PubDate: 2022-12-03T18:31:57+0100
  DOI: 10.1055/s-0042-1759807
  Issue No: Vol. 06, No. 03 (2022)
Extracorporeal Membrane Oxygenation for Lung Transplantation
- Journal of Cardiac Critical Care TSS 2022; 06: 097-099
  DOI: 10.1055/s-0042-1757364
  
  Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
  
  Artikel in Thieme eJournals:
  Inhaltsverzeichnis open access Volltext
  Journal of Cardiac Critical Care TSS 2022; 06: 097-0992022-09-21T18:36:00+01:00
  Issue No: Vol. 06, No. 02 (2022)
Extracorporeal Life Support Organization Registry Report 2022
- Journal of Cardiac Critical Care TSS 2022; 06: 100-102
  DOI: 10.1055/s-0042-1757394
  
  Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
  
  Artikel in Thieme eJournals:
  Inhaltsverzeichnis open access Volltext
  Journal of Cardiac Critical Care TSS 2022; 06: 100-1022022-09-21T18:35:59+01:00
  Issue No: Vol. 06, No. 02 (2022)
Retrospective Analysis of Arterial Carbon Dioxide Level and Arterial pH
Level at the Time of Initiation of Respiratory ECMO and Outcome
- Authors: Oza; Pranay, Umbarkar, Rajendra, Goyal, Venkat, Shukla, Pranali
  Pages: 103 - 107
  Abstract: Introduction Respiratory extracorporeal membrane oxygenation (ECMO) is well established and its popularity has increased during coronavirus disease 2019 (COVID-19) time. The efficacy of ECMO has been proved in refractory respiratory failure with varied etiology. More than 85,000 respiratory ECMO cases (neonatal, pediatric, adult) registered as per Extracorporeal Life support Organization (ELSO) statistics April 2022 report, with survived to discharge or transfer ranging from 58 to 73%. Early initiation of ECMO is usually associated with shorter ECMO run and better outcome. Many patient factors have been associated with mortality while on ECMO. Pre-ECMO patient pH and arterial partial pressure of carbon dioxide (paCO2) have been associated with poor outcome. We designed a retrospective study from a single tertiary care center and analyzed our data of all respiratory ECMO (neonatal, pediatric, and adult) to understand the effect of pre ECMO, paCO2, and arterial pH to ECMO outcome. Methods It is a retrospective analysis of data collected of patients with acute respiratory failure managed on ECMO from January 2010 to December 2021. Pre-ECMO (1–6 hours before initiation), paCO2, and arterial pH level were noted and analyzed with primary and secondary outcome. Primary outcome goal was survivor and discharged home versus nonsurvivor, while secondary goal was the number of ECMO days and incidence of neurological complications. The statistical analysis was done for primary outcome and incidences of neurological complications and p-value obtained by using chi-squared method. Meta-analysis was done by classifying the respiratory ECMO cases in three major category—COVID-19, H1N1 non-COVID-19, and H1N1 respiratory failure. Results The total 256 patients of respiratory failure were treated with ECMO during specified period by Riddhi Vinayak Multispecialty Hospital ECMO team. Data analysis of 251 patients (5 patients were transferred for lung transplant, hence been not included in study) done. Patients were divided on the basis of pH level less than 7.2 and more than 7.2 and analyzed for primary and secondary outcome. Similarly, patients were divided on the basis of paCO2 level of less than 45 and more than 45.Patient with pre-ECMO pH level more than 7.2 has statistically better survived extracorporeal life support (ECLS) (p-value: 0.008) and survival to discharge home (p-value: 0.038) chances. Pre-ECMO paCO2 level of less than 45 also showed better survival chance of survived ECLS (46.67 vs. 36.02) and survived to discharge home (42.22 vs. 31.06) but not statistically significant (p-value: 0.15 and 0.18, respectively). There was no significant difference in average number of ECMO days in patient survived to discharge home with paCO2 less than 45 and more than 45 (15.7 vs. 11.1 days), and also in pH more than 7.2 and pH less than 7.2 (15.8 vs. 11.6). The incidence of neurological complications was also found lower in patient with pH more than 7.2 (7.5 vs. 17.3%, p-value: 0.034) and in paCO2 level of less than 45 (4.4 vs. 12.65, p-value: 0.15). Conclusion Pre-ECMO arterial pH of more than 7.2 (statistically significant) and paCO2 of less than 45 (statistically not significant) have definitely better survival chances and have lesser incidences of neurological complications. There was no significance difference in the number of ECMO days in either group.
  Authors recommends early initiation of ECMO for mortality and morbidity benefits.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 103-107
  PubDate: 2022-09-21T18:35:54+01:00
  DOI: 10.1055/s-0042-1757395
  Issue No: Vol. 06, No. 02 (2022)
Postoperative Fluid Therapy in Adult Cardiac Surgical Patients and Acute
Kidney Injury: A Prospective Observational Study
- Authors: Sahu; Manoj Kumar, Yagani, Seshagiribabu, Singh, Sarvesh Pal, Singh, Ummed, Singh, Dharmraj, Panday, Shivam
  Pages: 114 - 119
  Abstract: Background Normal saline (0.9% NS) is a common intravenous fluid used worldwide. Recent studies have shown that NS use is associated with increased incidence of acute kidney injury (AKI) and a need for renal replacement therapy (RRT). The practice is changing toward using balanced solutions to prevent AKI. Postcardiac surgery patients are more prone to develop AKI after cardiopulmonary bypass (CPB). We aim to study the type of fluid administrated, incidence of AKI, need for RRT, and overall outcome of these patients. Methods This prospective observational study was conducted in the cardiothoracic intensive care unit (cardiothoracic and vascular surgery intensive care unit) in a cohort of 197 adult patients who underwent on pump cardiac surgery in our hospital from July 2021 to October 2021 as a pilot study. Data was analyzed using SPSS 20.0 (IBM, Chicago, Illinois, United States). A p-value
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 114-119
  PubDate: 2022-09-21T18:35:54+01:00
  DOI: 10.1055/s-0042-1755434
  Issue No: Vol. 06, No. 02 (2022)
Does Preoperative Plasma Endothelin-1 Level Influences the Postoperative
Events in Patients Undergoing Coronary Artery Bypass Grafting (CABG)'
Revisiting Endothelin-1 Molecule in CABG Patients
- Authors: Choudhury; Minati, Hote, Milind, Kapoor, Poonam Malhotra, Saini, Savita, Kiran, Usha
  Pages: 120 - 125
  Abstract: Endothelin-1 (ET-1) is a powerful physiological vasoconstrictor release in response to endothelial injury. Increased synthesis of endothelin is associated with myocardial ischemia and reperfusion injury. The normal level varies between 0.2 and 18.5 pg/mL that maintains normal vascular homeostasis. We hypothesized that there exists a correlation between ET-1 and clinical outcome in patient undergoing elective coronary artery bypass grafting (CABG) surgery under cardiopulmonary bypass.Fifty-eight patients undergoing elective on-pump CABG were enrolled in the study. Blood sample for plasma ET-1 was taken before anesthesia induction. The median ET-1 level was 5 pg/mL (range: 0.6–30.33 pg/mL). The inotropic and intraaortic balloon pump requirement was significantly higher among patients having baseline ET-1 level more than 14.24pg/mL (p = 0.001in each case). A similar finding was observed in the duration of mechanical ventilation, intensive care unit stay, and duration of hospital stay (r = 0.68, p = 0.000; r = 0.58, p = 0.000; and r = 0.61, p = 0.000 respectively). The occurrence of complications was also more in individuals with higher baseline ET-1 level. The p-value was significant for occurrence infection, arrhythmia, renal and respiratory problems as observed in postoperative period by using Mann–Whitney U test.This study concludes that higher level of preoperative ET-1 levels correlates well to adverse clinical outcome in patients undergoing on-pump CABG surgery, so herein it can be used as a single independent parameter to predict postoperative outcome.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 120-125
  PubDate: 2022-09-21T18:35:54+01:00
  DOI: 10.1055/s-0042-1757362
  Issue No: Vol. 06, No. 02 (2022)
Inhaled Milrinone via HFNC as a Postextubation Cardiopulmonary Elixir:
Case Series and Review of Literature
- Authors: Bansal; Noopur, Magoon, Rohan, Kalaiselvan, Jaffrey, Shri, Iti, Kohli, Jasvinder Kaur, Kashav, Ramesh Chand
  Pages: 126 - 130
  Abstract: Pulmonary hypertension (PH) often complicates perioperative course following pediatric cardiac surgery, often presenting unique challenges to the attending cardiac anesthesiologist. Apart from difficult weaning from cardiopulmonary bypass, PH can often compound weaning from mechanical ventilation in this postoperative subset. From pathophysiological standpoint, the former can be attributed to concurrent detrimental cardiopulmonary consequences of PH as a multisystemic syndrome. Therefore, with an objective to address the affected systems, that is, cardiac and pulmonary simultaneously, we report combined use of inhaled milrinone (a pulmonary vasodilator) through high-frequency nasal cannula (oxygen reservoir and continuous positive airway pressure delivery device), purported to complement each other's mechanism of action in the management of PH, thereby hastening postoperative recovery. This article additionally presents a nuanced perspective on the advantages of combining the aforementioned therapies and hence proposing the same as a possible “postoperative cardiopulmonary elixir.”
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 126-130
  PubDate: 2022-09-21T18:35:57+01:00
  DOI: 10.1055/s-0042-1757366
  Issue No: Vol. 06, No. 02 (2022)
Pathophysiology and Management of Hypercoagulation in Infectious Diseases
- Authors: Tandayam; Abhishek, Syed, Mujtaba Hussain Naqvi, Kumar, Gaurav
  Pages: 131 - 140
  Abstract: Numerous systemic infections may have hypercoagulation as one of the complications, which may range from asymptomatic presentation of elevation of biochemical markers of coagulation such as that of fibrin and thrombin generation, to a much severe, symptomatic, life-threatening, disseminated intravascular coagulation (DIC), which results in the formation of thrombi in the microvasculature of various organs. This phenomenon contributes to increase in morbidity and mortality in various infectious diseases. The current review discusses various mechanisms of hypercoagulation during infections such as tissue factor activation, endothelial cell activation, inhibition of physiological anticoagulant pathways, and fibrinolysis inhibition. The review also discusses pathophysiological changes in the coagulation system and its management in the recent pandemic of COVID-19. The article also discusses role of various parenteral and oral anticoagulants in the management of infectious diseases. The review provides clinical data on various anticoagulants used during hospitalization and extended prophylaxis for the management of venous thromboembolism in various infections. Methodology Because this is a review of published literature and no humans or animals were involved, ethical committee approval was not required and patient consent was not required.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 131-140
  PubDate: 2022-09-21T18:35:54+01:00
  DOI: 10.1055/s-0042-1757370
  Issue No: Vol. 06, No. 02 (2022)
Transesophageal Echocardiography (TEE)-Guided Paravalvular Leak (PVL)
Closure: Expanding Horizons Beyond Operating Room
- Authors: Singh; Rashmi, Kapoor, Poonam Malhotra
  Pages: 141 - 145
  Abstract: Paravalvular leak (PVL) is a common, yet challenging entity occurring due to dehiscence of the annular tissue around the prosthetic valve, resulting in regurgitation of blood retrogradely. Although any prosthetic valve can be subjected to the risk of developing PVL, it is most commonly reported with the mitral valve followed by the aortic valve. The incidence of mitral PVL is around 7 to 17%, whereas with the aortic valve it is 5 to 10%. Symptomology can vary from asymptomatic patients with mild PVL to disabling symptoms pertaining to heart failure and hemolysis. TEE plays a pivotal role in the overall assessment along with procedural guidance for their closure. Multiple two-dimensional (2D) imaging views are required to scan the entire sewing ring diameter of a prosthetic valve. Three-dimensional (3D) TEE can give crucial information such as the number, size, shape, and circumference of the defects. 3D mitral en face view can give anatomical localization of the defect. During the procedure, TEE can assist in the confirmation of the position of the guidewire through the defect and not through the prosthetic valve. It also helps to conform to the adequate positioning of the vascular plug device and unrestrictive movement of the native prosthetic heart valve. TEE when combined with fluoroscopy can help in real-time guidance of passage of the guidewire and transcatheter device in relation to the prosthetic valve. Recently, Ahmed et al have named this technology as “Fusion Technique,” where they have combined real-time 2D and 3D TEE with fluoroscopy to facilitate the closure of PVL. Now that the time of minimally invasive surgery has taken over conventional surgery and fast tracking and enhanced recovery after surgery (ERAS) is the need of the moment, percutaneous PVL closure is preferred over surgical PVL closure. A study done by Gakrinho et al showed that percutaneous PVL closure has a reasonable success rate along with a low complication rate and the results are comparable to surgical treatment in high-risk patients. We hereby share our experience of the successful closure of PVL via the transcatheter technique using various 2D and 3D techniques.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 141-145
  PubDate: 2022-09-21T18:36:00+01:00
  DOI: 10.1055/s-0042-1757369
  Issue No: Vol. 06, No. 02 (2022)
Sepsis Associated with Extracorporeal Membrane Oxygenation
- Authors: Jain; Aashish, Mehta, Yatin
  Pages: 146 - 150
  Abstract: Sepsis in patients on extracorporeal membrane oxygenation (ECMO) remains a serious complication. Its presence is a poor prognostic marker and increases overall mortality. Adult patients with prolonged duration on ECMO are at high risk of developing sepsis. Ventilator-associated pneumonia and bloodstream infections are the main sources of infection these patients. A strong early suspicion, drawing adequate volume for blood cultures, and early and timely administration of empirical antibiotics can help control the infection and decrease the morbidity and mortality. The diagnostic and the treatment are both challenging. Cardiac patients have increased risk of nosocomial infection while on ECMO, which may be in part due to longer cannulation times, as well as increased likelihood of undergoing major procedures or having an open chest.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 146-150
  PubDate: 2022-09-21T18:36:00+01:00
  DOI: 10.1055/s-0042-1757392
  Issue No: Vol. 06, No. 02 (2022)
Role of Cerebral Oximetry in Extracorporeal Membrane Oxygenation
- Authors: Shastri; Naman
  Pages: 151 - 154
  Abstract: Cerebral oximetry, which is based on near-infrared spectroscopy (NIRS) technology, is an optical technique that allows for noninvasive and continuous monitoring of brain oxygenation by determining cerebral tissue blood oxygen saturation. Many research and observational studies were performed with neonates using various types of NIRS/cerebral oximetry monitors. However, no food and drug administration (FDA) approved-cerebral oximeter is available for neonates. Successful validation of cerebral oximetry for the FDA has been done in human adult volunteer studies under protocols in which jugular bulb and arterial blood samples were obtained under different levels of fractional inspired oxygen levels.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 151-154
  PubDate: 2022-09-21T18:35:56+01:00
  DOI: 10.1055/s-0042-1757393
  Issue No: Vol. 06, No. 02 (2022)
Echocardiography for Left Ventricular Assist Device Patients
- Authors: Menon; Priya, Kapoor, Poonam Malhotra, Choudhury, Minati
  Pages: 155 - 161
  Abstract: Heart transplantation is the only cure for patients with end-stage heart failure; the shortage of donors has led to a high mortality rate among these patients. A left ventricular assist device (LVAD) is a device to provide mechanical circulatory support for patients unresponsive to heart failure therapy. Echocardiography should be considered an indispensable tool in the evaluation of patients with an LVAD. In fact, as outlined in this review, it provides useful and readily available information that could be crucial for the patient's survival. In the preoperative assessment, it is important to detect through echocardiography conditions and parameters that could hint the development of a postoperative complication, in order to treat them before LVAD implant or to consider the patient ineligible to this advanced treatment.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 155-161
  PubDate: 2022-09-21T18:36:00+01:00
  DOI: 10.1055/s-0042-1757363
  Issue No: Vol. 06, No. 02 (2022)
Technical Details of Redo Aortic Valve Replacement Using St. Jude Medical
Mechanical Prosthesis in a Patient with Thrombosed Aortic Mechanical
Prosthesis: A Video Presentation
- Authors: George; Niwin, Sankhyan, Lakshmi Kumari, Goja, Shikha, Avneesh, Sheil, Raghuprakash, Sumanth, Gupta, Shradha, Pandey, Niraj Nirmal, Chowdhury, Ujjwal K.
  Pages: 162 - 164
  Abstract: Current consensus guidelines of the American Heart Association and European Society of Cardiology uniformly recommend either type of prosthetic valve for patients aged between 60 and 70 years and mechanical prosthesis for patients aged less than 60 years. These recommendations are based on the results of randomized controlled trials that demonstrated no significant difference in late survival. Two of these trials compared mechanical and bioprosthetic valve models implanted in 1970s and 1980s. The other two trials included patients undergoing aortic valve replacement. Contemporary data are limited to small single-center studies
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 162-164
  PubDate: 2022-09-21T18:35:56+01:00
  DOI: 10.1055/s-0042-1757367
  Issue No: Vol. 06, No. 02 (2022)
Redo Mitral Valve Replacement Using St. Jude Medical Mechanical Prosthesis
via Transseptal Approach in a Patient with Degenerated Mitral Epic
Bioprosthesis: A Video Presentation
- Authors: Goja; Shikha, George, Niwin, Sankhyan, Lakshmi Kumari, Raghuprakash, Sumanth, Gupta, Shradha, Sharma, Shweta, Kapoor, Poonam Malhotra, Chowdhury, Ujjwal K.
  Pages: 165 - 167
  Abstract: A 58-year-old male patient with degenerated St. Jude Epic mitral bioprosthesis underwent successful mitral valve replacement using 29 mm St. Jude Medical mechanical prosthesis. Case history presented here to prevent organ injury via a transeptal approach for a degenerated epic bioprosthesis.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 165-167
  PubDate: 2022-09-21T18:35:56+01:00
  DOI: 10.1055/s-0042-1757365
  Issue No: Vol. 06, No. 02 (2022)
Plugging the Unplugged: Simultaneous Percutaneous Closure of Anterior
Mitral Leaflet and Aortic Root Perforation
- Authors: Nanda; Chinmaya, Banerjee, Sudipto, Mehta, Yatin
  Pages: 168 - 169
  Abstract: There are very few case reports of percutaneous device closure of anterior mitral leaflet perforation. We describe here a case of simultaneous percutaneous closure of aortic root perforation and anterior mitral perforation. These cases are challenging as they are presently done in high-risk patients with no guidelines described to date.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 168-169
  PubDate: 2022-09-21T18:36:00+01:00
  DOI: 10.1055/s-0042-1756471
  Issue No: Vol. 06, No. 02 (2022)
Transesophageal Echocardiographic Illustration of Postinfarction
Ventricular Septal Rupture
- Authors: Das; Devishree, Prakash, Mohit, Makhija, Neeti
  Pages: 170 - 172
  Abstract: Postinfarction ventricular septal rupture (VSR) is a rare but dreaded mechanical complication of myocardial infarction. Moreover, patient develops cardiogenic shock or congestive heart failure requiring early surgical intervention. To optimize surgical repair, perioperative confirmation, determining location of VSR and adequacy of repair, is mandatory. Assessment can be obtained by the transesophageal echocardiography (TEE). Use of two- and three-dimensional TEE techniques clearly delineate size and shape of septal rupture and involvement of other cardiac structures. We report a patient presenting with postinfarction VSR for elective VSR repair and surgical revascularization and implication of TEE in perioperative management.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 170-172
  PubDate: 2022-09-21T18:35:57+01:00
  DOI: 10.1055/s-0042-1757368
  Issue No: Vol. 06, No. 02 (2022)
The Importance of TEE Examination in Patients with Pseudoaneurysm of Arch
of Aorta Post-TEVAR Procedure
- Authors: Mital; Tanya, Kapoor, Poonam Malhotra
  Pages: 173 - 176
  Abstract: A 57-year-old male patient presented to the emergency department with acute onset severe and tearing pain in the back. He was a chronic smoker and was a known hypertensive. He was admitted in view of type B aortic dissection with entry tear distal to left subclavian artery (LSCA) and underwent thoracic endovascular aortic repair (TEVAR) procedure for the same. Two stents (34–30–200mm size, Ankura, Lifetech, Nanshan District, Shenzhen, China) were placed overlapping each other to cover the dissection flap starting from distal end of left common carotid artery to proximal part of celiac artery. Post-stenting, patient developed recurrent episodes of melena, abdominal distension, and fever that were managed conservatively. Two months later, a routine follow-up computed tomographic aortic angiography revealed a focal contrast filled outpouching (2.1*1.9cm) extending from the proximal part of endovascular stent with surrounding thrombosis from anterior wall of the aortic arch. On inspecting the arch vessels, an ostial occlusion of LSCA was also discovered. Routine blood investigations were all within normal limits. Two-dimensional echocardiography showed a normal biventricular function with concentric left ventricular hypertrophy. All valves were normal.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 173-176
  PubDate: 2022-09-21T18:35:59+01:00
  DOI: 10.1055/s-0042-1756473
  Issue No: Vol. 06, No. 02 (2022)
Splenic Artery Pseudoaneurysm—A Concern for the Anesthesiologist
- Authors: Singh; Ankita, Makhija, Neeti, Somani, Shruti, Verma, Mansi, Kumar, Sanjeev
  Pages: 181 - 184
  Abstract: Pseudoaneurysms as compared with aneurysms lack a true wall and have a higher propensity of rupture. Visceral artery pseudoaneurysms are uncommon and are life-threatening. We, hereby, report anesthetic management of a rare case of splenic artery pseudoaneurysm that accompanied the dilatation of aorta from its origin extending up to its bifurcation.
  Citation: Journal of Cardiac Critical Care TSS 2022; 06: 181-184
  PubDate: 2022-09-21T18:35:57+01:00
  DOI: 10.1055/s-0042-1756472
  Issue No: Vol. 06, No. 02 (2022)

HOME > Browse the 73 Subjects covered by JournalTOCs
Subject	Total Journals