Scholars@Duke
Joseph P. Mathew

Joseph P. Mathew

Jerry Reves, M.D. Distinguished Professor of Cardiac Anesthesiology
Anesthesiology, Cardiothoracic
joseph.mathew@duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2301 Erwin Road, 5692 Hafs Building, Durham, NC 27710

Selected Publications

Neurocognitive Dysfunction After Short (<20 Minutes) Duration Hypothermic Circulatory Arrest.

Journal Article Ann Thorac Surg · September 23, 2024 BACKGROUND: It has long been held that the safe duration of hypothermic circulatory arrest (HCA) is at least 25 to 30 minutes. However, this belief is based primarily on clinical outcomes research and has not been systematically investigated using more sen ... Full text Link to item Cite

Early Beta-Blocker Utilization in Critically Ill Patients With Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article J Intensive Care Med · September 2024 BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice a ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article Anesth Analg · August 1, 2024 BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate ... Full text Link to item Cite

Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate - Severe traumatic brain injury: A TRACK-TBI study.

Journal Article J Clin Neurosci · August 2024 BACKGROUND: Traumatic brain injury (TBI) triggers autonomic dysfunction and inflammatory response that can result in secondary brain injuries. Dexmedetomidine is an alpha-2 agonist that may modulate autonomic function and inflammation and has been increasi ... Full text Link to item Cite

Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.

Conference Anesthesiology · May 1, 2024 BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical and Functional Outcomes Following Moderate-Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · April 1, 2024 OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ... Full text Link to item Cite

A Multicenter Study of Stellate Ganglion Block as a Temporizing Treatment for Refractory Ventricular Arrhythmias.

Journal Article JACC Clin Electrophysiol · April 2024 BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening conditions and can be refractory to conventional drug and device interventions. Stellate ganglion blockade (SGB) has been described as an adjunct, temporizing i ... Full text Link to item Cite

Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery.

Journal Article Circulation · February 27, 2024 BACKGROUND: Deep hypothermia has been the standard for hypothermic circulatory arrest (HCA) during aortic arch surgery. However, centers worldwide have shifted toward lesser hypothermia with antegrade cerebral perfusion. This has been supported by retrospe ... Full text Link to item Cite

The impact of perioperative stroke and delirium on outcomes after surgical aortic valve replacement.

Journal Article J Thorac Cardiovasc Surg · February 2024 OBJECTIVE: The effects of stroke and delirium on postdischarge cognition and patient-centered health outcomes after surgical aortic valve replacement (SAVR) are not well characterized. Here, we assess the impact of postoperative stroke and delirium on thes ... Full text Link to item Cite

Infarct-related structural disconnection and delirium in surgical aortic valve replacement patients.

Journal Article Ann Clin Transl Neurol · February 2024 OBJECTIVE: Although acute brain infarcts are common after surgical aortic valve replacement (SAVR), they are often unassociated with clinical stroke symptoms. The relationship between clinically "silent" infarcts and in-hospital delirium remains uncertain; ... Full text Open Access Link to item Cite

A pilot study of longitudinal changes in neurocognition, white matter hyperintensities, and cortical thickness in atrial fibrillation patients following catheter ablation vs medical management.

Journal Article Heart Rhythm O2 · February 2024 BACKGROUND: Cerebral microembolization and atrophy complicate atrial fibrillation (AF). OBJECTIVES: We aimed to compare changes in neuroimaging findings between AF patients treated with catheter ablation and those treated with medical therapy. METHODS: In ... Full text Link to item Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference The journal of pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference J Pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Link to item Cite

Proning for COVID-19 Patients: A Task-Shifting Feasibility Study

Journal Article Hospital Topics · January 1, 2024 The COVID-19 crisis severely impacted healthcare centers in the pandemic’s epicenter. The shortage of healthcare workers (HCW) frequently utilized for complex interventions in the intensive care unit (ICU), such as proning for acute respiratory distress sy ... Full text Cite

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders among Older Noncardiac Surgery Patients: A Cohort Study

Journal Article Anesthesia and Analgesia · January 1, 2024 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Cite

Role of Blood-Brain Barrier Dysfunction in Delirium following Non-cardiac Surgery in Older Adults.

Journal Article Ann Neurol · December 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... Full text Link to item Cite

Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery.

Journal Article Circulation · October 24, 2023 BACKGROUND: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-sel ... Full text Open Access Link to item Cite

Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Explor · September 2023 OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ... Full text Open Access Link to item Cite

Perioperative changes in neurocognitive and Alzheimer's disease-related cerebrospinal fluid biomarkers in older patients randomised to isoflurane or propofol for anaesthetic maintenance.

Journal Article Br J Anaesth · August 2023 BACKGROUND: Animal studies have shown that isoflurane and propofol have differential effects on Alzheimer's disease (AD) pathology and memory, although it is unclear whether this occurs in humans. METHODS: This was a nested randomised controlled trial with ... Full text Link to item Cite

Association of Brain Injury Biomarkers and Circulatory Shock Following Moderate-Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article J Neurosurg Anesthesiol · July 1, 2023 INTRODUCTION: Early circulatory shock following traumatic brain injury (TBI) is a multifactorial process; however, the impact of brain injury biomarkers on the risk of shock has not been evaluated. We examined the association between neuronal injury biomar ... Full text Open Access Link to item Cite

A Role for Blood-brain Barrier Dysfunction in Delirium following Non-Cardiac Surgery in Older adults.

Journal Article medRxiv · May 10, 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... Full text Link to item Cite

Utilization and Outcomes of Extracorporeal Membrane Oxygenation Following Traumatic Brain Injury in the United States.

Journal Article J Intensive Care Med · May 2023 Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ... Full text Link to item Cite

Neuromodulation therapy for atrial fibrillation.

Journal Article Heart Rhythm · January 2023 Atrial fibrillation has a multifactorial pathophysiology influenced by cardiac autonomic innervation. Both sympathetic and parasympathetic influences are profibrillatory. Innovative therapies targeting the neurocardiac axis include catheter ablation or pha ... Full text Link to item Cite

Hevin/Sparcl1 drives pathological pain through spinal cord astrocyte and NMDA receptor signaling.

Journal Article JCI Insight · December 8, 2022 High endothelial venule protein/SPARC-like 1 (hevin/Sparcl1) is an astrocyte-secreted protein that regulates synapse formation in the brain. Here we show that astrocytic hevin signaling plays a critical role in maintaining chronic pain. Compared with WT mi ... Full text Open Access Link to item Cite

Identification of Trajectory-Based Acute Kidney Injury Phenotypes Among Cardiac Surgery Patients.

Journal Article Ann Thorac Surg · December 2022 BACKGROUND: Acute kidney injury (AKI) is a common and serious complication of cardiac surgical procedures for which unrecognized heterogeneity may underpin poor success in identifying effective therapies. We aimed to identify phenotypically similar groups ... Full text Link to item Cite

Early Vasopressor Utilization Strategies and Outcomes in Critically Ill Patients With Severe Traumatic Brain Injury.

Journal Article Anesth Analg · December 1, 2022 BACKGROUND: Early hypotension after severe traumatic brain injury (sTBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors, commonly norepinephrine and phenylephrine, to suppo ... Full text Link to item Cite

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms.

Journal Article Can J Anaesth · October 2022 PURPOSE: This narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients to these ... Full text Open Access Link to item Cite

A novel evidence-based predictor tool for hospitalization and length of stay: insights from COVID-19 patients in New York city.

Journal Article Intern Emerg Med · October 2022 Predictive models for key outcomes of coronavirus disease 2019 (COVID-19) can optimize resource utilization and patient outcome. We aimed to design and internally validate a web-based calculator predictive of hospitalization and length of stay (LOS) in a l ... Full text Link to item Cite

Risk Factors and Neurological Outcomes Associated With Circulatory Shock After Moderate-Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article Neurosurgery · September 1, 2022 BACKGROUND: Extracranial multisystem organ failure is a common sequela of severe traumatic brain injury (TBI). Risk factors for developing circulatory shock and long-term functional outcomes of this patient subset are poorly understood. OBJECTIVE: To ident ... Full text Link to item Cite

Incidence and Clinical Impact of Myocardial Injury Following Traumatic Brain Injury: A Pilot TRACK-TBI Study.

Journal Article J Neurosurg Anesthesiol · April 1, 2022 BACKGROUND: Traumatic brain injury (TBI) is a major global health problem. Little research has addressed extracranial organ dysfunction following TBI, particularly myocardial injury. Using a sensitive marker of myocardial injury-high sensitivity troponin ( ... Full text Link to item Cite

Utilization of Brain Tissue Oxygenation Monitoring and Association with Mortality Following Severe Traumatic Brain Injury.

Journal Article Neurocrit Care · April 2022 BACKGROUND: The aim of this study was to describe the utilization patterns of brain tissue oxygen (PbtO2) monitoring following severe traumatic brain injury (TBI) and determine associations with mortality, health care use, and pulmonary toxicity. METHODS: ... Full text Open Access Link to item Cite

Association of Vasopressor Choice with Clinical and Functional Outcomes Following Moderate to Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article Neurocrit Care · February 2022 BACKGROUND: Early hypotension following moderate to severe traumatic brain injury (TBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors to support blood pressure following T ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults.

Journal Article J Geriatr Psychiatry Neurol · January 2022 OBJECTIVE: To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults. METHODS: Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent ... Full text Link to item Cite

Risk for non-home discharge following surgery for ischemic mitral valve disease.

Journal Article J Thorac Cardiovasc Surg · December 2021 OBJECTIVES: To determine the frequency and risk factors for non-home discharge (NHD) and its association with clinical outcomes and quality of life (QOL) at 1 year following cardiac surgery in patients with ischemic mitral regurgitation (IMR). METHODS: Dis ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury.

Journal Article Neurocrit Care · October 2021 BACKGROUND/OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly ... Full text Open Access Link to item Cite

Association of Early Multiple Organ Dysfunction With Clinical and Functional Outcomes Over the Year Following Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · October 1, 2021 OBJECTIVES: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ ... Full text Link to item Cite

A Hydropneumothorax That Never Was!

Journal Article Chest · September 2021 Full text Link to item Cite

Paul G. Barash, MD: In Memoriam.

Journal Article Anesth Analg · July 1, 2021 Full text Link to item Cite

Echocardiogram Utilization Patterns and Association With Mortality Following Severe Traumatic Brain Injury.

Journal Article Anesth Analg · April 1, 2021 BACKGROUND: Severe traumatic brain injury (TBI) can result in left ventricular dysfunction, which can lead to hypotension and secondary brain injuries. Although echocardiography is often used to examine cardiovascular function in multiple clinical settings ... Full text Open Access Link to item Cite

Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral Regurgitation.

Journal Article J Am Coll Cardiol · February 16, 2021 BACKGROUND: Whether to repair nonsevere tricuspid regurgitation (TR) during surgery for ischemic mitral valve regurgitation (IMR) remains uncertain. OBJECTIVES: The goal of this study was to investigate the incidence, predictors, and clinical significance ... Full text Open Access Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Postoperative Cognitive Dysfunction and Delirium

Chapter · January 1, 2021 The brain is amazingly interesting and complex. As neuroscience progresses, we gain a broader understanding of specialized regional activity, chemistry and unique interconnections that makes us the fascinating and diverse organisms that we are. However, th ... Full text Cite

Perioperative Management of Valvular Heart Disease

Chapter · January 1, 2021 Valvular heart disease is frequently observed in patients undergoing surgery. As the medical and minimally invasive management of coronary artery disease increases, the number of patients with untreated advanced valvular disease is likely to supersede the ... Full text Cite

Apolipoprotein L1 (APOL1) Coding Variants Are Associated With Creatinine Rise After Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · December 2020 OBJECTIVE: Acute kidney injury (AKI) is a complication of cardiac surgery that is considerably more common in African Americans (1.5-fold). Although homozygous status for apolipoprotein L1 (APOL1) risk alleles is associated with chronic kidney disease in i ... Full text Link to item Cite

Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias.

Journal Article Curr Hypertens Rep · October 23, 2020 PURPOSE OF REVIEW: To highlight the indications, procedural considerations, and data supporting the use of stellate ganglion blockade (SGB) for management of refractory ventricular arrhythmias. RECENT FINDINGS: In patients with refractory ventricular arrhy ... Full text Open Access Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Critical Illness Secondary to Synthetic Cannabinoid Ingestion.

Journal Article JAMA Netw Open · July 1, 2020 IMPORTANCE: Synthetic cannabinoids (SCs), commonly known as K2, spice, or fake weed, are cheap, artificially manufactured recreational drugs that have emerged as a major public health threat in various regions of the US. OBJECTIVE: To describe the clinical ... Full text Link to item Cite

Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation.

Journal Article J Thorac Cardiovasc Surg · June 2020 OBJECTIVE: The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve r ... Full text Link to item Cite

Intraoperative renal resistive index threshold as an acute kidney injury biomarker.

Journal Article J Clin Anesth · May 2020 STUDY OBJECTIVE: The lag in creatinine-mediated diagnosis of cardiac surgery-associated acute kidney injury (AKI) may be impeding the development of renoprotection therapies. Postoperative renal resistive index (RRI) measured by transabdominal Doppler ultr ... Full text Link to item Cite

Stellate Ganglion Blockade for the Treatment of Refractory Ventricular Arrhythmias.

Journal Article JACC Clin Electrophysiol · May 2020 OBJECTIVES: This study sought to describe our institutional experience with establishing a neurocardiology service in an attempt to provide autonomic modulation as a treatment for ventricular arrhythmias (VAs). BACKGROUND: Treatment-refractory VAs are comm ... Full text Link to item Cite

Roadmap for Transforming Preoperative Assessment to Preoperative Optimization.

Journal Article Anesth Analg · April 2020 Preoperative assessment typically equates to evaluating and accepting the presenting condition of the patient (unless extreme) and commonly occurs only a few days before the planned surgery. While this timing enables a preoperative history and examination ... Full text Link to item Cite

Platelets trigger perivascular mast cell degranulation to cause inflammatory responses and tissue injury.

Journal Article Sci Adv · March 2020 Platelet responses have been associated with end-organ injury and mortality following complex insults such as cardiac surgery, but how platelets contribute to these pathologies remains unclear. Our studies originated from the observation of microvascular p ... Full text Link to item Cite

Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic Valve Replacement.

Journal Article Ann Thorac Surg · February 2020 BACKGROUND: Epiaortic ultrasound detects and localizes ascending aortic atherosclerosis. In this analysis we investigated the association between epiaortic ultrasound-based atheroma grade during surgical aortic valve replacement (SAVR) and perioperative ad ... Full text Link to item Cite

Essence of Pacemakers and Its Application After CPB

Chapter · January 1, 2020 Placement and utilization of temporary epicardial pacing wires is a fundamental step in the perioperative care of the cardiac surgical patient. Epicardial pacing wires allow for the diagnosis, prevention and treatment of dysrhythmias-one of the most common ... Full text Cite

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

Neuromodulation for the Treatment of Heart Rhythm Disorders.

Journal Article JACC Basic Transl Sci · August 2019 There is an increasing recognition of the importance of interactions between the heart and the autonomic nervous system in the pathophysiology of arrhythmias. These interactions play a role in both the initiation and maintenance of arrhythmias and are impo ... Full text Link to item Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation.

Journal Article J Am Coll Cardiol · May 21, 2019 BACKGROUND: The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone. OBJECTIVES: This study identified risk factors and outcomes associated wi ... Full text Link to item Cite

Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes.

Journal Article Anesthesiology · April 2019 Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes mod ... Full text Link to item Cite

Implementation of an Innovative Residency Leadership Development Curriculum.

Journal Article A A Pract · April 1, 2019 The role of the anesthesiologist in the perioperative environment requires facility in leadership; however, leadership education is not part of the traditional curriculum for anesthesiology trainees. To address this educational gap, we developed a leadersh ... Full text Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ... Full text Open Access Link to item Cite

The Association of Obstructive Sleep Apnea Risk with Postoperative Cognitive Decline

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2019 Link to item Cite

Depression, Anxiety and Postoperative Cognition in Older Adults

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2019 Link to item Cite

CAUSES AND PREDICTORS FOR 30-DAY RE-ADMISSIONS IN ADULT PATIENTS WITH DIABETIC KETOACIDOSIS IN THE UNITED STATES: A NATIONWIDE ANALYSIS, 2010-2014.

Journal Article Endocr Pract · March 2019 OBJECTIVE: We aimed to determine the causes and predictors for 30-day re-admission following a hospitalization for diabetic ketoacidosis (DKA) in the United States. METHODS: This retrospective cohort study analyzed data from the National Re-admission Datab ... Full text Link to item Cite

Temporary autonomic modulation with botulinum toxin type A to reduce atrial fibrillation after cardiac surgery.

Journal Article Heart Rhythm · February 2019 BACKGROUND: Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery and is associated with worse outcomes. The cardiac autonomic nervous system is implicated in the pathogenesis of POAF. OBJECTIVE: The purpose of this study was to d ... Full text Link to item Cite

Longitudinal Changes in Regional Cerebral Perfusion and Cognition After Cardiac Operation.

Journal Article Ann Thorac Surg · January 2019 BACKGROUND: Cardiac operation has been associated with increased risk of postoperative cognitive decline, as well as dementia risk in the general population. Few studies, however, have examined the impact of coronary revascularization or valve replacement ... Full text Open Access Link to item Cite

Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anaesthetists Practice Advisory for the Management of Perioperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · January 2019 Postoperative atrial fibrillation (poAF) is the most common adverse event after cardiac surgery and is associated with increased morbidity, mortality, and increased hospital and intensive care unit length of stay. Despite progressive improvements in overal ... Full text Link to item Cite

Biatrial maze procedure versus pulmonary vein isolation for atrial fibrillation during mitral valve surgery: New analytical approaches and end points.

Journal Article J Thorac Cardiovasc Surg · January 2019 OBJECTIVE: To use novel statistical methods for analyzing the effect of lesion set on (long-standing) persistent atrial fibrillation (AF) in the Cardiothoracic Surgical Trials Network trial of surgical ablation during mitral valve surgery (MVS). METHODS: T ... Full text Link to item Cite

Society of Cardiovascular Anesthesiologists/European Association of Cardiothoracic Anaesthetists Practice Advisory for the Management of Perioperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

Journal Article Anesth Analg · January 2019 Postoperative atrial fibrillation (poAF) is the most common adverse event after cardiac surgery and is associated with increased morbidity, mortality, and hospital and intensive care unit length of stay. Despite progressive improvements in overall cardiac ... Full text Link to item Cite

Annexin A1 Bioactive Peptide Promotes Resolution of Neuroinflammation in a Rat Model of Exsanguinating Cardiac Arrest Treated by Emergency Preservation and Resuscitation.

Journal Article Front Neurosci · 2019 Neuroinflammation initiated by damage-associated molecular patterns, including high mobility group box 1 protein (HMGB1), has been implicated in adverse neurological outcomes following lethal hemorrhagic shock and polytrauma. Emergency preservation and res ... Full text Link to item Cite

Best Practices for Postoperative Brain Health: Recommendations From the Fifth International Perioperative Neurotoxicity Working Group.

Journal Article Anesth Analg · December 2018 As part of the American Society of Anesthesiology Brain Health Initiative goal of improving perioperative brain health for older patients, over 30 experts met at the fifth International Perioperative Neurotoxicity Workshop in San Francisco, CA, in May 2016 ... Full text Link to item Cite

Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms.

Journal Article Anesthesiology · October 2018 For half a century, it has been known that some patients experience neurocognitive dysfunction after cardiac surgery; however, defining its incidence, course, and causes remains challenging and controversial. Various terms have been used to describe neuroc ... Full text Link to item Cite

Genome-Wide Association Study Links Receptor Tyrosine Kinase Inhibitor Sprouty 2 to Thrombocytopenia after Coronary Artery Bypass Surgery.

Conference Thromb Haemost · September 2018 INTRODUCTION:  Thrombocytopenia after cardiac surgery independently predicts stroke, acute kidney injury and death. To understand the underlying risks and mechanisms, we analysed genetic variations associated with thrombocytopenia in patients undergoing co ... Full text Link to item Cite

Non-cardiac point of care ultrasound in the CCU

Chapter · July 13, 2018 Point-of-care ultrasonography (POCUS) has rapidly emerged as an invaluable tool in the assessment and management of the critically ill CCU patient. Whole-body bedside ultrasound, with evaluation of the heart, lungs, abdomen, and the vascular system, allows ... Full text Cite

Predictive ability of perioperative atrial fibrillation risk indices in cardiac surgery patients: a retrospective cohort study.

Journal Article Can J Anaesth · July 2018 PURPOSE: The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there i ... Full text Link to item Cite

Is Compliance With Surgical Care Improvement Project Cardiac (SCIP-Card-2) Measures for Perioperative β-Blockers Associated With Reduced Incidence of Mortality and Cardiovascular-Related Critical Quality Indicators After Noncardiac Surgery?

Journal Article Anesth Analg · June 2018 BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a cont ... Full text Link to item Cite

Secondary surgical-site infection after coronary artery bypass grafting: A multi-institutional prospective cohort study.

Journal Article J Thorac Cardiovasc Surg · April 2018 OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenti ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal Article Anesthesiology · April 2018 BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patie ... Full text Link to item Cite

Temporal Trends in Difficult and Failed Tracheal Intubation in a Regional Community Anesthetic Practice.

Journal Article Anesthesiology · March 2018 BACKGROUND: When tracheal intubation is difficult or unachievable before surgery or during an emergent resuscitation, this is a critical safety event. Consensus algorithms and airway devices have been introduced in hopes of reducing such occurrences. Howev ... Full text Link to item Cite

Task-related changes in degree centrality and local coherence of the posterior cingulate cortex after major cardiac surgery in older adults.

Journal Article Hum Brain Mapp · February 2018 OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in respo ... Full text Open Access Link to item Cite

Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta-analysis.

Journal Article J Cardiovasc Electrophysiol · December 2017 INTRODUCTION: Treatment refractory ventricular arrhythmias (VAs) are often driven and exacerbated by heightened sympathetic tone. We aim to conduct a systematic review and meta-analysis of published studies of a temporary percutaneous stellate ganglion blo ... Full text Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Hypothermia and cerebral protection strategies in aortic arch surgery: a comparative effectiveness analysis from the STS Adult Cardiac Surgery Database.

Journal Article Eur J Cardiothorac Surg · September 1, 2017 OBJECTIVES: Hypothermic circulatory arrest is essential to aortic arch surgery, although consensus regarding optimal cerebral protection strategy remains lacking. We evaluated the current use and comparative effectiveness of hypothermia/cerebral perfusion ... Full text Link to item Cite

Angiotensin Receptor Blockade Improves Cardiac Surgical Outcomes in Patients With Metabolic Syndrome.

Journal Article Ann Thorac Surg · July 2017 BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhib ... Full text Link to item Cite

Adverse outcomes associated with postoperative atrial arrhythmias after lung transplantation: A meta-analysis and systematic review of the literature.

Journal Article Clin Transplant · April 2017 BACKGROUND: Postoperative atrial arrhythmias (AAs) are common after lung transplantation, but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta-analysis to determine whether AAs after lung transpla ... Full text Link to item Cite

Depressive symptoms and early mortality following lung transplantation: A pilot study.

Journal Article Clin Transplant · February 2017 BACKGROUND: Impaired psychological function is common among lung transplant candidates and may affect clinical outcomes following transplantation. Although numerous studies have examined the relationship between pretransplant depression, quality of life (Q ... Full text Link to item Cite

Mast cell activation and arterial hypotension during proximal aortic repair requiring hypothermic circulatory arrest.

Journal Article J Thorac Cardiovasc Surg · January 2017 OBJECTIVE: Aortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated t ... Full text Open Access Link to item Cite

Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.

Journal Article J Am Geriatr Soc · January 2017 OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Obj ... Full text Open Access Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

Neuroprotective Effects of Annexin A1 Tripeptide after Deep Hypothermic Circulatory Arrest in Rats.

Journal Article Front Immunol · 2017 Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple or ... Full text Link to item Cite

The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial.

Journal Article Front Immunol · 2017 INTRODUCTION: Aside from direct effects on neurotransmission, inhaled and intravenous anesthetics have immunomodulatory properties. In vitro and mouse model studies suggest that propofol inhibits, while isoflurane increases, neuroinflammation. If these fin ... Full text Link to item Cite

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.

Journal Article Can J Anaesth · November 2016 PURPOSE: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral in ... Full text Link to item Cite

Orthopedic surgery modulates neuropeptides and BDNF expression at the spinal and hippocampal levels.

Journal Article Proc Natl Acad Sci U S A · October 25, 2016 Pain is a critical component hindering recovery and regaining of function after surgery, particularly in the elderly. Understanding the role of pain signaling after surgery may lead to novel interventions for common complications such as delirium and posto ... Full text Link to item Cite

In Reply.

Journal Article Anesthesiology · August 2016 Full text Link to item Cite

In Reply

Journal Article Anesthesiology · August 1, 2016 Full text Cite

Comparing Length of Stay Between Patients Taking Rivaroxaban and Conventional Anticoagulants for Treatment of Venous Thromboembolism.

Journal Article Lung · August 2016 BACKGROUND: Recent studies have demonstrated non-inferiority of rivaroxaban when compared to warfarin for the treatment of pulmonary embolism and deep venous thrombosis. Analysis of data from the EINSTEIN trials has demonstrated that patients who received ... Full text Link to item Cite

The Effect of Propofol Versus Isoflurane Anesthesia on Human Cerebrospinal Fluid Markers of Alzheimer's Disease: Results of a Randomized Trial.

Journal Article J Alzheimers Dis · April 15, 2016 BACKGROUND: Preclinical studies have found differential effects of isoflurane and propofol on the Alzheimer's disease (AD)-associated markers tau, phosphorylated tau (p-tau) and amyloid-β (Aβ). OBJECTIVE: We asked whether isoflurane and propofol have diffe ... Full text Open Access Link to item Cite

Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

Journal Article Can J Anaesth · April 2016 BACKGROUND: We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. METHOD ... Full text Open Access Link to item Cite

Gene signatures of postoperative atrial fibrillation in atrial tissue after coronary artery bypass grafting surgery in patients receiving β-blockers.

Journal Article J Mol Cell Cardiol · March 2016 Atrial tissue gene expression profiling may help to determine how differentially expressed genes in the human atrium before cardiopulmonary bypass (CPB) are related to subsequent biologic pathway activation patterns, and whether specific expression profile ... Full text Link to item Cite

Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest.

Journal Article Ann Thorac Surg · February 2016 BACKGROUND: This study aimed to characterize intraoperative electroencephalography (EEG) during moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP), which has not been described previously. METHODS: This was a ... Full text Link to item Cite

Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

Journal Article Anesthesiology · February 2016 BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperat ... Full text Open Access Link to item Cite

Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium.

Journal Article Ann Am Thorac Soc · February 2016 RATIONALE: Delirium is common following lung transplant and is associated with poorer clinical outcomes. The extent to which intraoperative hemodynamic alterations may contribute to postoperative delirium among lung transplant recipients has not been exami ... Full text Link to item Cite

A Case of Pneumonia Caused by Pneumocystis Jirovecii and Cryptococcus Neoformans in a Patient with HTLV-1 Associated Adult T- Cell Leukemia/Lymphoma: Occam's Razor Blunted.

Journal Article Conn Med · February 2016 Adult T-cell leukemia/lymphoma (ATLL) is usually preceded by infection with human T-cell lymphotropic virus I (HTLV-I). Patients with ATLL frequently get opportunistic infections of the lungs, intestines, and central nervous system. Pneumocystis pneumonia ... Link to item Cite

Invited Commentary.

Other Ann Thorac Surg · January 2016 Full text Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal Article Kidney Int · October 2015 Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ... Full text Open Access Link to item Cite

Intraoperative Magnesium Administration Does Not Reduce Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article Anesth Analg · October 2015 BACKGROUND: Hypomagnesemia has been associated with an increased risk of postoperative atrial fibrillation (POAF). Although previous studies have suggested a beneficial effect of magnesium (Mg) therapy, almost all of these are limited by small sample size ... Full text Link to item Cite

Postoperative Cognitive Dysfunction: Minding the Gaps in Our Knowledge of a Common Postoperative Complication in the Elderly.

Journal Article Anesthesiol Clin · September 2015 Postoperative cognitive dysfunction (POCD) is a common complication associated with significant morbidity and mortality in elderly patients. There is much interest in and controversy about POCD, reflected partly in the increasing number of articles publish ... Full text Link to item Cite

Genome-wide association study of new-onset atrial fibrillation after coronary artery bypass grafting surgery.

Journal Article Am Heart J · September 2015 BACKGROUND: Postoperative atrial fibrillation (AF) is a potentially life-threatening complication after coronary artery bypass graft (CABG) surgery. Genetic predisposition may predict risk for developing postoperative AF. METHODS: Study subjects underwent ... Full text Link to item Cite

Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study.

Journal Article Can J Anaesth · June 2015 PURPOSE: Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein epsilon 4 (APOE4) allele is associated with worse outcomes in m ... Full text Link to item Cite

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

Journal Article BMJ Open · May 6, 2015 OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowl ... Full text Open Access Link to item Cite

Delirium affects length of hospital stay after lung transplantation.

Journal Article J Crit Care · February 2015 BACKGROUND: Delirium is relatively common after lung transplantation, although its prevalence and prognostic significance have not been systematically studied. The purpose of the present study was to examine pretransplant predictors of delirium and the sho ... Full text Link to item Cite

Neurocognitive changes after lung transplantation.

Journal Article Ann Am Thorac Soc · December 2014 RATIONALE: Neurocognitive impairments are associated with reduced quality of life and may adversely affect medical compliance, but their prevalence after lung transplantation has not been extensively studied. OBJECTIVES: To examine the frequency of neuroco ... Full text Link to item Cite

Anesthesia for catheter ablation procedures.

Journal Article J Cardiothorac Vasc Anesth · December 2014 Over the past decade, the role of the anesthesiologist has evolved continuously into a sine qua non component of the EP team, having intimate knowledge of the complex interventional procedures and the specific demands of the EP environment. With emphasis o ... Full text Link to item Cite

Acute kidney injury after ex vivo lung perfusion (EVLP).

Journal Article Transplant Proc · December 2014 BACKGROUND: Ex vivo lung perfusion (EVLP) identifies viability for marginal organs but complicates and lengthens lung transplantation surgery. Preliminary evidence supports equivalency for EVLP-assisted versus traditional (non-EVLP) procedures regarding gr ... Full text Link to item Cite

ABO blood group influences transfusion and survival after cardiac surgery.

Journal Article J Thromb Thrombolysis · October 2014 ABO dependent variation in von Willebrand factor (vWf) and procoagulant factor VIII (FVIII) is a plausible mechanism for modulating perioperative hemostasis and bleeding. Group AB has the highest and group O the lowest vWf and FVIII levels. Therefore, we t ... Full text Link to item Cite

Effects of deep hypothermic circulatory arrest on the blood brain barrier in a cardiopulmonary bypass model--a pilot study.

Journal Article Heart Lung Circ · October 2014 BACKGROUND: Neurologic injury is common after cardiac surgery and disruption of the blood brain barrier (BBB) has been proposed as a contributing factor. We sought to study BBB characteristics in a rodent model of cardiopulmonary bypass (CPB) and deep hypo ... Full text Link to item Cite

G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers.

Other Circ Cardiovasc Genet · October 2014 BACKGROUND: We hypothesized that genetic variations in the adrenergic signaling pathway and cytochrome P450 2D6 enzyme are associated with new-onset atrial fibrillation (AF) in patients who underwent coronary artery bypass grafting and were treated with pe ... Full text Link to item Cite

Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation: a 20-year experience.

Journal Article Circulation · June 17, 2014 BACKGROUND: The optimal treatment for ischemic mitral regurgitation remains actively debated. Our objective was to evaluate the relationship between ischemic mitral regurgitation treatment strategy and survival. METHODS AND RESULTS: We retrospectively revi ... Full text Link to item Cite

Quantitative assessment of mitral valve coaptation using three-dimensional transesophageal echocardiography.

Journal Article Ann Thorac Surg · June 2014 BACKGROUND: Functional mitral regurgitation (FMR) occurs as a consequence of left ventricular remodeling and is an independent predictor of adverse outcome. FMR is assessed qualitatively with two-dimensional echocardiography, but accurate quantitation of t ... Full text Link to item Cite

Arterial hyperoxia during cardiopulmonary bypass and postoperative cognitive dysfunction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVE: To determine the effect of arterial normobaric hyperoxia during cardiopulmonary bypass (CPB) on postoperative neurocognitive function. The authors hypothesized that arterial hyperoxia during CPB is associated with neurocognitive decline at 6 wee ... Full text Link to item Cite

Neurological complications of cardiac surgery.

Journal Article Lancet Neurol · May 2014 As increasing numbers of elderly people undergo cardiac surgery, neurologists are frequently called upon to assess patients with neurological complications from the procedure. Some complications mandate acute intervention, whereas others need longer term o ... Full text Link to item Cite

Preoperative CYP2D6 metabolism-dependent β-blocker use and mortality after coronary artery bypass grafting surgery.

Journal Article J Thorac Cardiovasc Surg · April 2014 OBJECTIVE: Recently, the role of β-blockers (BBs) in reducing perioperative mortality has been challenged. The conflicting results might have resulted from the extent of BB metabolism by the cytochrome P-450 (CYP2D6) isoenzyme. The purpose of the present s ... Full text Open Access Link to item Cite

Asymmetric versus symmetric tethering patterns in ischemic mitral regurgitation: geometric differences from three-dimensional transesophageal echocardiography.

Journal Article J Am Soc Echocardiogr · April 2014 BACKGROUND: Ischemic mitral regurgitation (IMR) results from mitral leaflet tethering from left ventricular remodeling. Heterogeneity in local or global left ventricular remodeling can result in differential tethering patterns and affect mitral valve funct ... Full text Link to item Cite

The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.

Journal Article Ann Thorac Surg · March 2014 BACKGROUND: Postoperative acute kidney injury (AKI) is a common serious consequence of cardiac surgery. One recent study found higher AKI rates when anemia and hypotension occurred during cardiopulmonary bypass (CPB) relative to anemia alone. To revalidate ... Full text Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal Article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Comparative effectiveness of pharmacotherapies for prevention of atrial fibrillation following coronary artery bypass surgery.

Journal Article Am J Cardiol · October 1, 2013 Risk of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is high, yet the effectiveness of guideline-recommended preoperative prophylaxis in clinical practice remains uncertain. We determined the utilization and variation of preoperati ... Full text Link to item Cite

Cortical β-amyloid levels and neurocognitive performance after cardiac surgery.

Journal Article BMJ Open · September 20, 2013 INTRODUCTION: Neurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to se ... Full text Open Access Link to item Cite

The impact of video laryngoscopy use during urgent endotracheal intubation in the critically ill.

Journal Article Anesth Analg · July 2013 BACKGROUND: The video laryngoscope (VL) has been shown to improve laryngoscopic views and first-attempt success rates in elective operating room and simulated tracheal intubations compared with the direct laryngoscope (DL). However, there are limited data ... Full text Link to item Cite

Genomic Basis of Perioperative Medicine

Chapter · April 15, 2013 "The Handbook of Clinical Anesthesia, Seventh Edition, is a companion to the parent textbook, Clinical Anesthesia, Seventh Edition. ... Cite

Delayed postmyectomy ventricular septal defect.

Journal Article J Cardiothorac Vasc Anesth · April 2013 Full text Link to item Cite

Determinants of a subject's decision to participate in clinical anesthesia research.

Journal Article Anesth Analg · February 2013 BACKGROUND: A top priority for research studies is to ensure that potential participants receive adequate information to make a truly informed decision. Understanding patient experiences with the recruitment process may identify areas for improvement in th ... Full text Link to item Cite

Predictors of cognitive recovery after cardiac surgery.

Journal Article Anesth Analg · February 2013 BACKGROUND: Postoperative neurocognitive decline occurs frequently. Although predictors of cognitive injury have been well examined, factors that modulate recovery have not. We sought to determine the predictors of cognitive recovery after initial injury f ... Full text Link to item Cite

Neurocognitive outcomes after cardiac surgery.

Journal Article Curr Opin Anaesthesiol · February 2013 PURPOSE OF REVIEW: To summarize recent studies of neurocognitive dysfunction after cardiac surgery, as well as to outline efforts and approaches toward advancing the field. RECENT FINDINGS: Observational studies have improved our understanding of the incid ... Full text Link to item Cite

The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension.

Journal Article Anesthesiol Res Pract · 2013 Background. Postoperative acute kidney injury (AKI) is associated with high mortality and substantial cost after aortocoronary bypass graft (CABG) surgery. We tested the hypothesis that intraoperative systolic blood pressure variation is associated with po ... Full text Open Access Link to item Cite

Changes in neurocognitive functioning following lung transplantation.

Journal Article Am J Transplant · September 2012 Although neurocognitive impairment is relatively common among patients with advanced lung disease, little is known regarding changes in neurocognition following lung transplantation. We therefore administered 10 tests of neurocognitive functioning before a ... Full text Link to item Cite

Patterns of use of perioperative angiotensin-converting enzyme inhibitors in coronary artery bypass graft surgery with cardiopulmonary bypass: effects on in-hospital morbidity and mortality.

Journal Article Circulation · July 17, 2012 BACKGROUND: Despite proven benefit in ambulatory patients with ischemic heart disease, the pattern of use of angiotensin-converting enzyme inhibitors (ACEIs) in coronary artery bypass graft surgery has been erratic and controversial. METHODS AND RESULTS: T ... Full text Link to item Cite

Outcomes of mild therapeutic hypothermia after in-hospital cardiac arrest.

Journal Article Neurocrit Care · June 2012 BACKGROUND: Although the benefits of mild therapeutic hypothermia (MTH) in selected patients after out-of-hospital cardiac arrest have been consistently demonstrated, no controlled trial of MTH in selected patients after in-hospital cardiac arrest (IHCA) h ... Full text Link to item Cite

Optimal surgical management of severe ischemic mitral regurgitation: to repair or to replace?

Journal Article J Thorac Cardiovasc Surg · June 2012 BACKGROUND: Ischemic mitral regurgitation, a complication of myocardial infarction and coronary artery disease more generally, is associated with a high mortality rate and is estimated to affect 2.8 million Americans. With 1-year mortality rates as high as ... Full text Link to item Cite

A comparative evaluation of transesophageal and transthoracic echocardiography for measurement of left ventricular systolic strain using speckle tracking.

Journal Article J Cardiothorac Vasc Anesth · February 2012 OBJECTIVE: The authors hypothesized that the measurement of strain by speckle tracking with transesophageal echocardiography (TEE) is feasible and comparable to transthoracic echocardiography (TTE). DESIGN: A prospective observational comparative study. SE ... Full text Link to item Cite

Population pharmacokinetics of lidocaine administered during and after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · December 2011 OBJECTIVE: The objective of this study was to determine the pharmacokinetics of lidocaine in a 48-hour infusion in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). DESIGN: A retrospective substudy of a clinical trial assessing the eff ... Full text Link to item Cite

Thrombomodulin gene variants are associated with increased mortality after coronary artery bypass surgery in replicated analyses.

Journal Article Circulation · September 13, 2011 BACKGROUND: We tested the hypothesis that genetic variation in thrombotic and inflammatory pathways is independently associated with long-term mortality after coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two separate cohorts of patient ... Full text Link to item Cite

The effect of blood pressure on cerebral outcome in a rat model of cerebral air embolism during cardiopulmonary bypass.

Journal Article J Thorac Cardiovasc Surg · August 2011 OBJECTIVE: Higher mean arterial pressure during cardiopulmonary bypass may improve cerebral outcome associated with cerebral air embolism by increasing emboli clearance and collateral flow to salvage the ischemic penumbra. However, this may come at the exp ... Full text Open Access Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Performance of medical residents in sterile techniques during central vein catheterization: randomized trial of efficacy of simulation-based training.

Journal Article Chest · January 2011 BACKGROUND: Catheter-related bloodstream infection (CRBSI) is a preventable cause of a potentially lethal ICU infection. The optimal method to teach health-care providers correct sterile techniques during central vein catheterization (CVC) remains unclear. ... Full text Link to item Cite

A rapid, safe, and low-cost technique for the induction of mild therapeutic hypothermia in post-cardiac arrest patients.

Journal Article Resuscitation · January 2011 AIM OF STUDY: The benefits of inducing mild therapeutic hypothermia (MTH) in cardiac arrest patients are well established. Timing and speed of induction have been related to improved outcomes in several animal trials and one human study. We report the resu ... Full text Link to item Cite

The relationship of plasma transfusion from female and male donors with outcome after cardiac surgery.

Journal Article J Thorac Cardiovasc Surg · December 2010 OBJECTIVE: Pulmonary dysfunction is common in transfused patients recovering from heart surgery. Plasma transfusion from female donors has been linked with rare catastrophic lung injury, but its relationship with outcome after cardiac surgery is poorly und ... Full text Link to item Cite

Storage age of transfused platelets and outcomes after cardiac surgery.

Journal Article Transfusion · November 2010 BACKGROUND: The relationship between duration of platelet (PLT) storage, currently limited to 5days, and surgical outcomes has not been established. We tested the hypothesis that PLT storage age was associated with adverse outcomes. STUDY DESIGN AND METHOD ... Full text Link to item Cite

Association of the 98T ELAM-1 polymorphism with increased bleeding after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: Hemorrhage continues to be a major problem after cardiac surgery despite the routine use of antifibrinolytic drugs, with striking inter-patient variability poorly explained by already known risk factors. The authors tested the hypothesis that ge ... Full text Link to item Cite

Glycosylated hemoglobin levels and outcome in non-diabetic cardiac surgery patients.

Journal Article Can J Anaesth · June 2010 PURPOSE: In diabetics, elevated preoperative hemoglobin A1c (HbA1c) levels are associated with increased complication rates after cardiac surgery. While many non-diabetics also have elevated HbA1c, the relationship with outcome in these patients is not wel ... Full text Link to item Cite

Neurocognitive dysfunction following cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · June 2010 Postoperative neurocognitive decline (POCD) is the most frequently reported form of brain injury in the cardiac surgery setting. Even though most patients recover over a period of several months, recovery is variable and often transient, and early decline ... Full text Link to item Cite

Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury.

Other Anesthesiology · April 2010 BACKGROUND: Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 ... Full text Link to item Cite

Impact of early renal recovery on survival after cardiac surgery-associated acute kidney injury.

Journal Article Ann Thorac Surg · April 2010 BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major postoperative complication. Although some early recovery is common, its effect on long-term outcomes is unclear. We tested the hypothesis that early renal recovery after CSA-AK ... Full text Link to item Cite

Pulse pressure and long-term survival after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 1, 2010 BACKGROUND: Data from longitudinal studies reveal that widened pulse pressure (PP) is a major predictor of coronary heart disease and mortality, but it is unknown whether PP similarly decreases survival after coronary artery bypass graft (CABG) surgery for ... Full text Link to item Cite

In reply

Journal Article Anesthesiology · January 1, 2010 Full text Cite

Increasing healthcare resource utilization after coronary artery bypass graft surgery in the United States.

Journal Article Circ Cardiovasc Qual Outcomes · July 2009 BACKGROUND: Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been descri ... Full text Link to item Cite

Metabolomic profiling reveals distinct patterns of myocardial substrate use in humans with coronary artery disease or left ventricular dysfunction during surgical ischemia/reperfusion.

Journal Article Circulation · April 7, 2009 BACKGROUND: Human myocardial metabolism has been incompletely characterized in the setting of surgical cardioplegic arrest and ischemia/reperfusion. Furthermore, the effect of preexisting ventricular state on ischemia-induced metabolic derangements has not ... Full text Link to item Cite

Randomized, double-blinded, placebo controlled study of neuroprotection with lidocaine in cardiac surgery.

Journal Article Stroke · March 2009 BACKGROUND AND PURPOSE: Cognitive decline after cardiac surgery remains common and diminishes patients' quality of life. Based on experimental and clinical evidence, this study assessed the potential of intravenously administered lidocaine to reduce postop ... Full text Link to item Cite

Relationship of genetic variability and depressive symptoms to adverse events after coronary artery bypass graft surgery.

Journal Article Psychosom Med · November 2008 OBJECTIVE: To assess genetic variability in two serotonin-related gene polymorphisms (MAOA-uVNTR and 5HTTLPR) and their relationships to depression and adverse cardiac events in a sample of patients undergoing coronary artery bypass surgery. METHODS: A tot ... Full text Link to item Cite

American Society of Echocardiography Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography.

Journal Article J Am Soc Echocardiogr · November 2008 UNLABELLED: ACCREDITATION STATEMENT: The American Society of Echocardiography (ASE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASE designates this educational acti ... Full text Link to item Cite

Pulse pressure and risk of adverse outcome in coronary bypass surgery.

Journal Article Anesth Analg · October 2008 BACKGROUND: Among ambulatory patients, an increase in pulse pressure (PP) is a well-established determinant of vascular risk. The relationship of PP and acute perioperative vascular outcome among patients having coronary artery bypass graft (CABG) surgery ... Full text Link to item Cite

Cognitive outcomes analyses: two steps forward, one step back?

Journal Article J Cardiothorac Vasc Anesth · August 2008 Full text Link to item Cite

The effect of aprotinin on outcome after coronary-artery bypass grafting.

Journal Article N Engl J Med · February 21, 2008 BACKGROUND: Aprotinin has recently been associated with adverse outcomes in patients undergoing cardiac surgery. We reviewed our experience with this agent in patients undergoing cardiac surgery at Duke University Medical Center. METHODS: We retrieved data ... Full text Link to item Cite

ABO blood group and bleeding after coronary artery bypass graft surgery.

Journal Article Blood Coagul Fibrinolysis · December 2007 Low circulating von Willebrand factor levels increase the risk of bleeding after cardiac surgery. Patients with blood group O may be at greatest risk owing to lower baseline levels of von Willebrand factor compared with patients with other blood groups, an ... Full text Link to item Cite

Mitral valve replacement

Journal Article · December 1, 2007 Full text Cite

Intraoperative hyperglycemia and cognitive decline after CABG.

Journal Article Ann Thorac Surg · November 2007 BACKGROUND: Neurocognitive dysfunction (NCD) continues to occur in a significant number of patients after cardiac procedures. The factors influencing its incidence and severity are not completely known. We hypothesized that hyperglycemia, which is known to ... Full text Link to item Cite

Deterioration of regional wall motion immediately after coronary artery bypass graft surgery is associated with long-term major adverse cardiac events.

Journal Article Anesthesiology · November 2007 BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) surgery frequently develop wall motion abnormalities diagnosed by intraoperative transesophageal echocardiography. However, the relation between deterioration in wall motion and postoperat ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal Article Anesthesiology · October 2007 BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery.

Journal Article J Am Coll Cardiol · May 15, 2007 OBJECTIVES: We hypothesized that candidate gene polymorphisms in biologic pathways regulating inflammation, cell matrix adhesion/interaction, coagulation-thrombosis, lipid metabolism, and vascular reactivity are associated with postoperative cognitive defi ... Full text Link to item Cite

Cytokine secretion after cardiac surgery and its relationship to postoperative fever.

Journal Article Cytokine · April 2007 A relationship between the inflammatory response to cardiopulmonary bypass (CPB) and fever after coronary artery bypass graft surgery (CABG) is assumed, but has not been studied. Therefore, we sought to assess the temporal pattern of cytokines' elevation a ... Full text Link to item Cite

Preoperative low molecular weight heparin reduces heparin responsiveness during cardiac surgery.

Journal Article Can J Anaesth · February 2007 PURPOSE: Cardiac surgery with cardiopulmonary bypass requires systemic anticoagulation, defined by an activated clotting time (ACT) of 400-480 sec. Patients with altered heparin responsiveness require disproportionately higher doses of heparin to achieve t ... Full text Link to item Cite

Donepezil for cognitive decline following coronary artery bypass surgery: a pilot randomized controlled trial.

Journal Article Psychopharmacol Bull · 2007 OBJECTIVE: To study the effect of donepezil in treating patients with cognitive decline following coronary artery bypass graft (CABG) surgery. METHODS: Forty-four patients, with at least a 0.5 SD decline at 1 year post-CABG on at least one cognitive domain ... Link to item Cite

Central nervous system injury associated with cardiac surgery.

Journal Article Lancet · August 19, 2006 Millions of individuals with coronary artery or valvular heart disease have been given a new chance at life by heart surgery, but the potential for neurological injury is an Achilles heel. Technological advancements and innovations in surgical and anaesthe ... Full text Link to item Cite

Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery.

Journal Article Circulation · July 4, 2006 BACKGROUND: The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary mechanism in the pathogenesis of postoperative myocardial infarction (PMI), a multifactorial disorder with significant inter-patient variabili ... Full text Link to item Cite

Case report: optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography.

Journal Article Can J Anaesth · July 2006 PURPOSE: Perioperative pulmonary embolism (PE) is associated with significant morbidity and mortality. Intraoperatively, the clinical management of patients with PE can be enhanced by the use of transesophageal echocardiography (TEE) to visualize emboli, a ... Full text Link to item Cite

Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline.

Journal Article Ann Thorac Surg · May 2006 Featured Publication BACKGROUND: Neurocognitive decline after cardiac surgery requiring cardiopulmonary bypass (CPB) may be caused in part by highly prothrombotic atheroemboli to the brain; the source of these emboli is likely the ascending aorta and aortic arch. We examined t ... Full text Link to item Cite

Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery.

Journal Article Psychosom Med · 2006 OBJECTIVE: Although coronary artery bypass grafting (CABG) has been shown to improve quality of life and functional capacity for many patients, recent studies have demonstrated that a significant number of patients exhibit impairment in cognitive function ... Full text Link to item Cite

Genetic polymorphisms and the risk of stroke after cardiac surgery.

Journal Article Stroke · September 2005 BACKGROUND AND PURPOSE: Stroke represents a significant cause of morbidity and mortality after cardiac surgery. Although the risk of stroke varies according to both patient and procedural factors, the impact of genetic variants on stroke risk is not well u ... Full text Link to item Cite

Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting.

Journal Article Circulation · August 30, 2005 BACKGROUND: It is unclear if mild or moderate mitral valve regurgitation (MR) should be repaired at the time of coronary artery bypass grafting (CABG). We sought to determine the long-term effect of uncorrected MR, measured by intraoperative transesophagea ... Full text Link to item Cite

Differential cardiac gene expression during cardiopulmonary bypass: ischemia-independent upregulation of proinflammatory genes.

Journal Article J Thorac Cardiovasc Surg · August 2005 OBJECTIVE: Cardiac surgery with cardiopulmonary bypass induces both systemic and local inflammatory responses implicated in the pathogenesis of myocardial dysfunction. Multifactorial perioperative sources of myocardial injury complicate understanding of th ... Full text Link to item Cite

Atrial fibrillation after cardiac surgery/cardiopulmonary bypass is associated with monocyte activation.

Journal Article Anesth Analg · July 2005 Atrial fibrillation (AF) contributes significantly to morbidity and mortality in as many as one-third of patients after cardiac surgery that requires cardiopulmonary bypass (CPB). Recent data suggest that inflammatory infiltration of the myocardium may pre ... Full text Link to item Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal Article J Thromb Haemost · June 2005 BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2005 OBJECTIVE: The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory respo ... Full text Link to item Cite

Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.

Journal Article Am J Kidney Dis · March 2005 BACKGROUND: Post-cardiac surgery renal dysfunction is a common, serious, multifactorial disorder, with interpatient variability predicted poorly by preoperative clinical, procedural, and biological markers. Therefore, we tested the hypothesis that selected ... Full text Link to item Cite

Brief report: The declining incidence of cerebral hyperthermia during cardiac surgery: a seven-year experience in 6,334 patients.

Journal Article Can J Anaesth · 2005 PURPOSE: Cerebral hyperthermia during rewarming from hypothermic cardiopulmonary bypass (CPB) commonly occurs and has been associated with postoperative neurocognitive dysfunction. Increased awareness of this has likely led to changes in rewarming strategi ... Full text Link to item Cite

Aortic atheroma burden and cognitive dysfunction after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · November 2004 BACKGROUND: Neurocognitive dysfunction (NCD) after coronary artery bypass graft (CABG) surgery is a common problem. Atherosclerotic disease of the aorta is a known risk factor for stroke after cardiac surgery, but its relationship to NCD is unclear. This s ... Full text Link to item Cite

Preliminary report of the effects of complement suppression with pexelizumab on neurocognitive decline after coronary artery bypass graft surgery.

Journal Article Stroke · October 2004 Featured Publication BACKGROUND AND PURPOSE: Pharmacological modulation of complement activation recently has been postulated as a therapeutic target in the treatment of neurological injury. We hypothesized that pexelizumab, a humanized scFv monoclonal antibody directed agains ... Full text Link to item Cite

Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.

Journal Article Anesth Analg · September 2004 Cerebral hyperthermia is common during the rewarming phase of cardiopulmonary bypass (CPB) and is implicated in CPB-associated neurocognitive dysfunction. Limiting rewarming may prevent cerebral hyperthermia but risks postoperative hypothermia. In a prospe ... Full text Link to item Cite

Preliminary report on the interaction of apolipoprotein E polymorphism with aortic atherosclerosis and acute nephropathy after CABG.

Journal Article Ann Thorac Surg · August 2004 BACKGROUND: Renal dysfunction is a serious complication of cardiac surgery that is highly associated with short- and long-term adverse outcome. While the apolipoprotein E (APOE) epsilon4 allele has been linked to the occurrence of both postcardiac surgery ... Full text Link to item Cite

Predictors of inotrope use during separation from cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · August 2004 OBJECTIVE: To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB). DESIGN: Retrospective study of consecutive patients undergoing coronary artery bypas ... Full text Link to item Cite

A multicenter risk index for atrial fibrillation after cardiac surgery.

Journal Article JAMA · April 14, 2004 Featured Publication CONTEXT: Atrial fibrillation is a common, but potentially preventable, complication following coronary artery bypass graft (CABG) surgery. OBJECTIVES: To assess the nature and consequences of atrial fibrillation after CABG surgery and to develop a comprehe ... Full text Link to item Cite

The association of patent foramen ovale and atrial fibrillation after coronary artery bypass graft surgery.

Journal Article Anesth Analg · March 2004 UNLABELLED: Atrial fibrillation (AF) is associated with considerable morbidity and increased resource utilization after coronary artery bypass graft surgery. In this study, we sought to determine whether patent foramen ovale (PFO) and atrial septal aneurys ... Full text Link to item Cite

A randomized controlled trial of the Arctic Sun Temperature Management System versus conventional methods for preventing hypothermia during off-pump cardiac surgery.

Journal Article Anesth Analg · February 2004 UNLABELLED: In this trial we compared the hypothermia avoidance abilities of the Arctic Sun Temperature Management System (a servo-regulated system that circulates temperature-controlled water through unique energy transfer pads adherent to the patient's b ... Full text Link to item Cite

The importance of intraoperative transesophageal echocardiography in endovascular repair of thoracic aortic aneurysms.

Journal Article Anesth Analg · December 2003 UNLABELLED: Endovascular repair of the aorta (EVAR) is a promising alternative to open repair. Transesophageal echocardiography (TEE) is a sensitive imaging modality for aortic disease. We reviewed our experience with TEE in thoracic EVAR. Seven patients u ... Full text Link to item Cite

Cerebral embolization during cardiac surgery: impact of aortic atheroma burden.

Other Br J Anaesth · November 2003 BACKGROUND: Aortic atheromatous disease is known to be associated with an increased risk of perioperative stroke in the setting of cardiac surgery. In this study, we sought to determine the relationship between cerebral microemboli and aortic atheroma burd ... Full text Link to item Cite

Age increases expression and receptor-mediated activation of G alpha i in human atria.

Journal Article J Cardiovasc Pharmacol · November 2003 Recently, we demonstrated that beta2AR and several other Galphas-coupled receptors in human atria also couple to Galphai, a G protein that inhibits adenylyl cyclase (AC). The present study was undertaken to determine whether age increases expression of Gal ... Full text Link to item Cite

Home surveillance program prevents interstage mortality after the Norwood procedure.

Journal Article J Thorac Cardiovasc Surg · November 2003 OBJECTIVE: To determine whether early identification of physiologic variances associated with interstage death would reduce mortality, we developed a home surveillance program. METHODS: Patients discharged before initiation of home surveillance (group A, n ... Full text Link to item Cite

Prevalence of risk factors, and not gender per se, determines short- and long-term survival after coronary artery bypass surgery.

Journal Article J Cardiothorac Vasc Anesth · October 2003 OBJECTIVE: Much attention has been directed towards female gender as an independent risk factor for in-hospital mortality after coronary artery bypass grafting surgery; however, the effects of surgery are known to persist for 6 months or more. Studies that ... Full text Link to item Cite

An assessment of two different methods of left ventricular ejection time measurement by transesophageal echocardiography.

Journal Article Anesth Analg · September 2003 Left ventricular ejection time (LVET) is an important component in evaluating left ventricular performance. This measurement is usually made by measuring the timing of the transaortic valve flow velocity by continuous-wave Doppler. Although M-mode has also ... Full text Link to item Cite

Depression as a risk factor for mortality after coronary artery bypass surgery.

Journal Article Lancet · August 23, 2003 BACKGROUND: Studies that have shown clinical depression to be a risk factor for cardiac events after coronary artery bypass graft (CABG) surgery have had small sample sizes, short follow-up, and have not had adequate power to assess mortality. We sought to ... Full text Link to item Cite

Low serum magnesium level predicts major adverse cardiac events after coronary artery bypass graft surgery.

Journal Article Am Heart J · June 2003 BACKGROUND: Despite improved myocardial protection strategies and enhanced surgical techniques, mortality after coronary artery bypass graft surgery (CABG) remains essentially unchanged. This may be because of the increasing age of patients who undergo pri ... Full text Link to item Cite

Quantitative echocardiographic assessment of regional wall motion and left ventricular asynchrony with color kinesis in cardiac surgery patients.

Journal Article Anesth Analg · May 2003 UNLABELLED: Conventional echocardiographic interpretation of regional wall motion abnormalities is subjective and experience dependent. Delayed contraction in the ejection phase (tardokinesis) and regional systolic asynchrony, sensitive markers of myocardi ... Full text Link to item Cite

Preliminary evaluation of the Arctic Sun temperature-controlling system during off-pump coronary artery bypass surgery.

Journal Article Ann Thorac Surg · April 2003 BACKGROUND: Maintaining normothermia during off-pump coronary artery bypass (OPCAB) surgery is a challenge not met by currently available medical devices and strategies. The purpose of this study was to determine the efficacy of a new thermoregulatory devi ... Full text Link to item Cite

Neutrophil CD11b upregulation during cardiopulmonary bypass is associated with postoperative renal injury.

Journal Article Ann Thorac Surg · March 2003 BACKGROUND: Renal injury remains a persistent complication of cardiopulmonary bypass (CPB) that, when sufficient to require dialysis, increases mortality eight-fold. The high prevalence of renal failure in sepsis and adult respiratory distress syndrome has ... Full text Link to item Cite

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Journal Article Anesth Analg · March 2003 UNLABELLED: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of a ... Full text Link to item Cite

Cardiopulmonary bypass decreases G protein-coupled receptor kinase activity and expression in human peripheral blood mononuclear cells.

Journal Article Anesthesiology · February 2003 BACKGROUND: Cardiopulmonary bypass (CPB) has been implicated in the development of organ injury associated with cardiac surgery. At the molecular level, CPB is accompanied by a pronounced proinflammatory response including an increase in plasma interleukin ... Full text Link to item Cite

Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.

Journal Article Stroke · February 2003 Featured Publication BACKGROUND AND PURPOSE: Although coronary artery bypass graft surgery (CABG) improves the quality of life and functional capacity for numerous patients, many also exhibit impairment in cognitive function immediately after surgery. Although the etiology of ... Full text Link to item Cite

Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass.

Journal Article Semin Thorac Cardiovasc Surg · January 2003 Neurologic injury, in the form of either stroke or more subtle neurocognitive impairment, is a frequent and potentially devastating complication of coronary artery bypass grafting (CABG). The etiology of CABG-associated neurologic injury is likely multifac ... Full text Link to item Cite

Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery.

Journal Article Psychosom Med · 2003 OBJECTIVE: To evaluate gender-related differences in quality of life (QOL) and cognitive function 1 year after coronary artery bypass surgery (CABG) after adjusting for known baseline differences. MATERIALS AND METHODS: Two hundred eighty patients (96 wome ... Full text Link to item Cite

Platelet PlA2 polymorphism and platelet activation are associated with increased troponin I release after cardiopulmonary bypass.

Journal Article Anesthesiology · November 2002 BACKGROUND: The PlA2 polymorphism of platelet glycoprotein IIIa has been identified as a prothrombotic risk factor in a number of cardiovascular settings. The aim of this study was to determine whether the PlA2 polymorphism of platelet glycoprotein IIIa an ... Full text Link to item Cite

Mitral flow propagation velocity identifies patients with abnormal diastolic function during coronary artery bypass graft surgery.

Journal Article Anesth Analg · September 2002 UNLABELLED: Flow propagation velocity (Vp) is a new method of assessing left ventricular (LV) diastolic (D) function that seems to be insensitive to heart rate and preload changes. We hypothesized that Vp <50 cm/s identifies patients with D dysfunction and ... Full text Link to item Cite

Serum creatinine patterns in coronary bypass surgery patients with and without postoperative cognitive dysfunction.

Other Anesth Analg · July 2002 UNLABELLED: Renal dysfunction is common after coronary artery bypass graft (CABG) surgery. We have previously shown that CABG procedures complicated by stroke have a threefold greater peak serum creatinine level relative to uncomplicated surgery. However, ... Full text Link to item Cite

Practice pattern variability for myocardial revascularization: impact on resource use across 24 centers.

Journal Article J Cardiothorac Vasc Anesth · April 2002 OBJECTIVE: To determine the predictors of hospital length of stay (LOS) after elective uncomplicated coronary artery bypass graft surgery. DESIGN: Retrospective analysis of the EPI-1 database, 1991-1993. SETTING: Multicenter; 24 academic, private, federal, ... Full text Link to item Cite

Transesophageal echocardiography interpretation: a comparative analysis between cardiac anesthesiologists and primary echocardiographers.

Journal Article Anesth Analg · February 2002 UNLABELLED: Diagnostic interpretation of intraoperative transesophageal echocardiography (TEE) examinations may vary, particularly when the echocardiographer is also the anesthesiologist. We therefore evaluated the concordance of TEE interpretation as part ... Full text Link to item Cite

Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.

Journal Article Stroke · February 2002 BACKGROUND AND PURPOSE: Temperature is a well-known modulator of experimental cerebral injury. We hypothesized that hyperthermia would be associated with a worsened cognitive outcome after coronary artery bypass graft surgery (CABG). METHODS: Three hundred ... Full text Link to item Cite

The impact of postoperative atrial fibrillation on neurocognitive outcome after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 2002 UNLABELLED: Neurocognitive decline is a continuing source of morbidity after cardiac surgery. Atrial fibrillation occurs often after cardiac surgery and has been linked to adverse neurologic events. We sought to determine whether postoperative atrial fibri ... Full text Link to item Cite

The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery.

Other Anesth Analg · January 2002 UNLABELLED: Neurocognitive dysfunction is a common complication after cardiac surgery. We evaluated in this prospective study the effect of rewarming rate on neurocognitive outcome after hypothermic cardiopulmonary bypass (CPB). After IRB approval and info ... Full text Link to item Cite

Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery.

Journal Article Stroke · December 1, 2001 BACKGROUND AND PURPOSE: The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some ... Full text Link to item Cite

Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery.

Journal Article Anesthesiology · November 2001 BACKGROUND: Despite significant advances in cardiopulmonary bypass (CPB) technology, surgical techniques, and anesthetic management, central nervous system complications occur in a large percentage of patients undergoing surgery requiring CPB. Many centers ... Full text Link to item Cite

Effect of apolipoprotein E genotype on cerebral autoregulation during cardiopulmonary bypass.

Journal Article Stroke · July 2001 BACKGROUND AND PURPOSE: The presence of the apolipoprotein E epsilon4 (apoE4) allele has been associated with cognitive decline after cardiac surgery. We compared autoregulation of cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO(2)), an ... Full text Link to item Cite

Bispectral analysis during cardiopulmonary bypass: the effect of hypothermia on the hypnotic state.

Journal Article J Clin Anesth · June 2001 STUDY OBJECTIVE: To evaluate the hypothesis that the bispectral index (BIS) is not affected by the hypothermia that is associated with cardiopulmonary bypass (CPB). DESIGN: Prospective, observational study. SETTING: Cardiac surgical operating suite of a un ... Full text Link to item Cite

Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Ann Thorac Surg · February 2001 BACKGROUND: Neurocognitive decline, often produced by atherosclerotic plaque embolization, remains a frequent complication of cardiopulmonary bypass. Plaque fragments may initiate local thrombosis, which, in turn, aggravates the embolic insult. Prothrombot ... Full text Link to item Cite

Genetic predictors of perioperative neurological and cognitive injury and recovery

Journal Article Best Practice and Research: Clinical Anaesthesiology · January 1, 2001 In most investigations, genetic and environmental factors have been shown to interact in altering the progression of ageing related disease including stroke and cognitive decline. The perioperative period appears to be no different, with environmental (ope ... Full text Cite

An unexpected flow abnormality

Journal Article Journal of Cardiothoracic and Vascular Anesthesia · June 2000 Full text Cite

An unexpected flow abnormality.

Journal Article J Cardiothorac Vasc Anesth · June 2000 Link to item Cite

The concordance of intraoperative left ventricular wall-motion abnormalities and electrocardiographic S-T segment changes: association with outcome after coronary revascularization. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Anesthesiology · April 1998 BACKGROUND: Transesophageal echocardiography (TEE) and Holter electrocardiography (ECG) are used to detect intraoperative ischemia during coronary artery bypass graft surgery (CABG). Concordance of these modalities and sensitivity as indicators of adverse ... Full text Link to item Cite

Non-invasive cardiopulmonary function assessment system

Journal Article Journal of Clinical Monitoring · December 1, 1997 The Cardiopulmonary Function Assessment System (CPFAS) is a non-invasive, affordable, and accurate device which measures both pulmonary and cardiac function. ... Cite

Cardiovascular pressure-dimension analysis system

Journal Article Journal of Clinical Monitoring · December 1, 1997 Load-independent analysis of myocardial contractility can be rapidly obtained using a LabVIEW based application that integrates ventricular pressure, echocardiographic, and electrocardiographic data. ... Cite

Lymphocyte and monocyte subset changes during cardiopulmonary bypass: effects of aging and gender.

Journal Article J Lab Clin Med · June 1997 Complications of cardiopulmonary bypass (CPB) may be associated with either immune suppression or immune activation, but the specific effects of CPB on many lymphocyte and monocyte subsets are unclear. In addition, the increasing age of patients undergoing ... Full text Link to item Cite

Multicenter study of target-controlled infusion of propofol-sufentanil or sufentanil-midazolam for coronary artery bypass graft surgery. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Anesthesiology · September 1996 BACKGROUND: The use of target-controlled infusions of anesthetics for coronary artery bypass graft surgery has not been studied in detail. The effects of target-controlled infusions of propofol or sufentanil, supplemented by infusions of sufentanil or mida ... Full text Link to item Cite

Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group.

Journal Article JAMA · July 24, 1996 Featured Publication OBJECTIVE: To determine the incidence, predictors, and cost of atrial fibrillation and flutter (AFIB) following coronary artery bypass graft (CABG) surgery. DESIGN: Prospective observational study (MultiCenter Study of Perioperative Ischemia). SETTING: Twe ... Link to item Cite

Atrial fibrillation following coronary artery bypass graft surgery [1]

Journal Article Journal of the American Medical Association · 1996 Cite

Acadesine inhibits neutrophil CD11b up-regulation in vitro and during in vivo cardiopulmonary bypass.

Journal Article J Thorac Cardiovasc Surg · March 1995 Granulocyte adhesion to ischemic tissue, mediated in large part by beta 2 integrin receptors, is important in the pathophysiology of reperfusion injury. Acadesine, a drug that modulates adenosine levels in ischemic tissue, has been shown to reduce reperfus ... Full text Link to item Cite

Quantitative analysis of macrophages and perisinusoidal cells in primary biliary cirrhosis.

Journal Article Histopathology · July 1994 Immunohistochemistry and image analysis were used to quantify alterations in the Kupffer cell and 'activated' perisinusoidal cell populations in the different stages of primary biliary cirrhosis. Anti-CD68 macrophage antibodies were used to detect Kupffer ... Full text Link to item Cite

Non-parenchymal cell responses in paracetamol (acetaminophen)-induced liver injury.

Journal Article J Hepatol · April 1994 We have analysed Kupffer cell and 'activated' perisinusoidal cell populations in liver biopsies from patients with paracetamol (acetaminophen)-induced hepatic necrosis of varying degrees of severity. Kupffer cells were identified immunohistochemically usin ... Full text Link to item Cite

An initial multicenter, randomized controlled trial on the safety and efficacy of acadesine in patients undergoing coronary artery bypass graft surgery. SPI Research Group.

Journal Article Anesth Analg · March 1994 Acadesine (5-amino-4-imidazole carboxamide riboside) is a purine nucleoside analog that has been shown in animals to reduce myocardial ischemic injury by selectively increasing the availability of adenosine in ischemic tissues. Because patients undergoing ... Full text Link to item Cite

ST segment depression during labor and delivery.

Journal Article Anesthesiology · October 1992 ECG changes suggestive of myocardial ischemia are common during cesarean delivery under regional anesthesia. To determine the time course, duration, and significance of these ECG changes, we monitored 111 parturients with continuous ambulatory ECG (Holter) ... Full text Link to item Cite

Cardiopulmonary bypass induces leukocyte-platelet adhesion.

Journal Article Blood · March 1, 1992 Cardiopulmonary bypass (CPB) has been demonstrated to activate platelets, producing an increased number of circulating platelets that have undergone alpha-granule release and express granule membrane protein-140 (GMP-140) on their surface. In vitro, GMP-14 ... Link to item Cite

Hemodynamic monitoring: Past, present, and future

Journal Article Seminars in Anesthesia · January 1, 1992 Cite

Modulation of platelet surface adhesion receptors during cardiopulmonary bypass.

Journal Article Anesthesiology · October 1991 Alterations in platelet receptors critical to adhesion may play a role in the pathogenesis of the qualitative platelet defect associated with cardiopulmonary bypass. Using flow cytometry, we measured changes in the following platelet surface adhesive prote ... Full text Link to item Cite

Emergency tracheal intubation in the postanesthesia care unit: physician error or patient disease?

Journal Article Anesth Analg · December 1990 Inadequate airway maintenance has been a major factor in perioperative morbidity. To determine the incidence and etiology of emergency tracheal intubations in the postanesthesia care unit (PACU), we retrospectively reviewed 13,593 consecutive admissions to ... Full text Link to item Cite