Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)
In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.
Essential Topics in the Management of Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Acute Respiratory Distress Syndrome
Management of mechanical circulatory support in COVID-19 ARDS requires a highly resourced multidisciplinary ICU team and the ability to nimbly develop protocols for care for this new patient population. Here the authors discuss some unique aspects of care using VV ECMO management in COVID-19 ARDS.
Unilateral versus Bilateral Cerebral Perfusion During Aortic Surgery for Acute Type A Aortic Dissection: A Multicentre Study
Unilateral and bilateral ACP are both valid brain protection strategies in the landscape of aortic arch surgery. While admitting all the study limitations, unilateral technique could offer some clinical advantages.
Neurocognitive, Quality of Life, and Behavioral Outcomes for Patients With Covert Stroke After Cardiac Surgery: Exploratory Analysis of Data From a Prospectively Randomized Trial
More than one-half of patients undergoing cardiac surgery demonstrated covert stroke. In this exploratory analysis, covert stroke was not found to be significantly associated with neurocognitive dysfunction 1 month after surgery; evidence of impaired quality of life, anxiety, or depression, albeit a type II error, cannot be excluded.
Invasive Hemodynamic and Physiologic Considerations in Patients Undergoing Extracorporeal Membrane Oxygenation
In conclusion, we wish to stress the importance of a thoughtful interpretation of hemodynamic parameters in patients undergoing ECMO support in order to make appropriate management decisions.
The Role of Three-Dimensional Printed Cardiac Models in the Management of Complex Congenital Heart Diseases
Three-dimensional printed cardiac models contribute to better decision making in complex congenital heart diseases enabling safer execution of any complex congenital heart surgery.
Albumin Use in Bleeding Cardiac Surgical Patients and Associated Patient Outcomes
Albumin use is common but highly variable within and across sites. Albumin use was not associated with improved outcomes. High quality randomized controlled trials should clarify its role in cardiac surgical patients.
Perioperative Management Invited Expert Opinions in 2020 And 2021: Synopsis of 9 “Must Read” Articles
We are grateful to all authors for their insightful contributions across the AATS journals, and we believe that these articles will enrich the knowledge of our readers and facilitate their clinical decision making in the perioperative management of cardiac surgery patients.
The Lower Threshold of Hypothermic Oxygen Delivery to Prevent Neonatal Acute Kidney Injury
The importance of hypothermic DO2i should be highlighted, even when SvO2 was satisfactory. A lower threshold of DO2i > 269 mL min−1 m−2 may help protect neonates from the risk of postoperative AKI.
Allogeneic Blood Transfusion and AIS Surgery: How the NSQIP Database Can Improve Patient Safety
Recognition of excessive allogeneic transfusion rates in our institution through comparative data from the ACS-NSQIP-PEDS database resulted in the modification of transfusion parameters that led to a decrease in allogeneic transfusion rates for AIS patients. The current study highlights the value of a large, well-curated surgical database in optimizing clinical protocols and potentially improving overall surgical morbidity.
Administration of Protamine Through Radial Arterial Access: A Prospective Observational Study
Despite the study limitations, the authors found that protamine administration through radial artery route can effectively neutralize heparin without any significant coagulopathy and postoperative bleeding. We suggest using this derived low dose of protamine (total heparin dose/1.6) through radial arterial route can be practical and efficient to reverse the effect of heparin after cardiac surgery without using central route (ascending aorta or central venous line).
Extrathoracic Superior Vena Cava Bypass With Venous Return Cannulas in Malignant Mediastinal Tumor Surgery
This is a convenient and safe optional technique providing an excellent intrathoracic surgical view for temporary superior vena cava bypass in patients with invasive malignant mediastinal tumor associated with venous return through the hemilateral brachiocephalic vein.