CONTENTS
EDITORIAL
Navigating the Fine Line Between the Bad and Worse: The Issue Is Not the Number, and the Message Is Not “ All or Nothing ”
Domenico Calcaterra, MD , Leslie A. Renfro, MD, and Aryeh Shander, MD __________________________________ 1159
ORIGINAL ARTICLES
Comparison of Two Different Red Blood Cell Transfusion Thresholds on Short-Term Clinical Outcomes of Patients Undergoing Aortic Surgery With Deep Hypothermic Circulatory Arrest
Yongyuan Wang, BA and Hongwen Ji, MD ____________________________________________________________ 1163 Noninvasively Measured Hemoglobin Concentration Refl ects Arterial Hemoglobin Concentration Before but Not After
Cardiopulmonary Bypass in Patients Undergoing Coronary Artery or Valve Surgery
Matthias L. Riess, MD, PhD and Paul S. Pagel, MD, PhD ________________________________________________ 1167
Predictive Value of Intraoperative Thromboelastometry for the Risk of Perioperative Excessive Blood Loss in Infants and Children Undergoing Congenital Cardiac Surgery: A Retrospective Analysis
Eunhee Kim, MD , Haeng Seon Shim, MD, PhD , Won Ho Kim, MD , Sue-Young Lee, MD , Sun-Kyung Park, MD ,
Ji-Hyuk Yang, MD, PhD , Tae-Gook Jun, MD, PhD, and Chung Su Kim, MD, PhD _____________________________ 1172
An Adjusted Calculation Model of Reduced Heparin Doses in Cardiopulmonary Bypass Surgery in a Chinese Population Yufeng Zhang, MD , Kai Liu, MD , Wei Li, MD , Qian Xue, MD , Jiang Hong, MD , Jibin Xu, MD , Lihui Wu, MD ,
Guangyu Ji, MD , Jihong Sheng, MD, and Zhinong Wang, MD _____________________________________________ 1179
Heparin Reversal After Cardiopulmonary Bypass: Are Point-of-Care Coagulation Tests Interchangeable?
Ariane Willems, MD, PhD , Veaceslav Savan, MD, PhD , David Faraoni, MD, PhD , Andr é e De Ville, MD ,
Laurence Rozen, PharmD , Anne Demulder, MD, PhD, and Philippe Van der Linden, MD, PhD ___________________ 1184
A Pharmacokinetic Model for Protamine Dosing After Cardiopulmonary Bypass
Michael I. Meesters, MD , Dennis Veerhoek, CCP , Jan R. de Jong, MD, and Christa Boer, PhD ___________________ 1190
Effi cacy and Safety of Fibrinogen Concentrate in Surgical Patients: A Meta-Analysis of Randomized Controlled Trials Evgeny Fominskiy, MD, PhD , Valeriy A. Nepomniashchikh, MD, PhD , Vladimir V. Lomivorotov, MD, PhD ,
Fabrizio Monaco, MD , Chiara Vitiello, MD , Alberto Zangrillo, MD, and Giovanni Landoni, MD _________________ 1196
Dynamic Variables Fail to Predict Fluid Responsiveness in an Animal Model With Pericardial Effusion Ole Broch, MD , Jochen Renner, MD , Patrick Meybohm, MD , Martin Albrecht, PhD , Jan H ö cker, MD ,
Assad Haneya, MD , Markus Steinfath, MD , Berthold Bein, MD, and Matthias Gruenewald, MD _________________ 1205
Remifentanil Compared With Sufentanil Does Not Enhance Fast-Track Possibilities in Cardiac Surgery — A Randomized Study Rajesh Bhavsar, MD , Pia Katerina Ryhammer, MD , Jacob Greisen, MD , Linda A. Rasmussen, RN,
and Carl-Johan Jakobsen, MD ______________________________________________________________________ 1212
Sevofl urane Versus Total Intravenous Anesthesia for Isolated Coronary Artery Bypass Surgery With Cardiopulmonary Bypass: A Randomized Trial
Valery V. Likhvantsev, MD , Giovanni Landoni, MD , Dmitry I. Levikov, PhD , Oleg A. Grebenchikov, PhD ,
Yuri V. Skripkin, MD, and Rostislav A. Cherpakov, MD ___________________________________________________ 1221
Monitored Anesthesia Care for Subcutaneous Cardioverter-Defi brillator Implantation: A Single-Center Experience Michael K. Essandoh, MD , Andrew J. Otey, BS , Mahmoud Abdel-Rasoul, MS, MPH , Erica J. Stein, MD ,
Katja R. Turner, MD , Nicholas C. Joseph, and Emile G. Daoud, MD ________________________________________ 1228
Monitored Anesthesia Care Versus General Anesthesia: Experience With the Medtronic CoreValve Christopher Palermo, DO, MPH , Meredith Degnan, MD , Keith Candiotti, MD , Tomas Salerno, MD ,
Eduardo de Marchena, MD, and Yiliam Rodriguez-Blanco, MD ____________________________________________ 1234
Outcome After General Anesthesia Versus Monitored Anesthesia Care in Transfemoral Transcatheter Aortic Valve Replacement Paola D ’ Errigo, MStat , Marco Ranucci, MD , Remo Daniel Covello, MD , Fausto Biancari, MD, PhD ,
Stefano Rosato, MStat , Marco Barbanti, MD , Francesco Onorati, MD, PhD , Corrado Tamburino, MD, PhD , Gennaro Santoro, MD , Claudio Grossi, MD , Francesco Santini, MD , Katia Bontempi, MStat , Danilo Fusco, MStat,
and Fulvia Seccareccia, MSc, on behalf of the OBSERVANT Research Group _________________________________ 1238
Function of the Respiratory System in Elderly Patients After Aortic Valve Replacement
Jaros ł aw Stoli n´ ski, MD, PhD , Dariusz Plicner, MD, PhD , Bogus ł aw Gaw e˛ da, MD , Robert Musia ł , MD ,
Kamil Fijorek , Marcin W a˛ sowicz, MD, PhD , Janusz Andres, MD, PhD, and Bogus ł aw Kapelak, MD, PhD __________ 1244
Grading Aortic Stenosis With Mean Gradient and Aortic Valve Area: A Comparison Between Preoperative Transthoracic and Precardiopulmonary Bypass Transesophageal Echocardiography
George Whitener, MD , Joseph Sivak, MD , Igor Akushevich, PhD , Zainab Samad, MD, MHS,
and Madhav Swaminathan, MD, MB, BS, FASE ________________________________________________________ 1254
Moderate Aortic Valvular Insuffi ciency Invalidates Vortex Formation Time as an Index of Left Ventricular Filling Effi ciency in Patients With Severe Degenerative Calcifi c Aortic Stenosis Undergoing Aortic Valve Replacement
Paul S. Pagel, MD, PhD , Brent T. Boettcher, DO , Derek J. De Vry, MD , Julie K. Freed, MD, PhD,
and Zafar Iqbal, MD _____________________________________________________________________________ 1260
Left Ventricular Outfl ow Tract Area Measurements by Planimetry Using Two-Dimensional Simultaneous Orthogonal Plane Imaging During Transesophageal Echocardiography
Sanjay Dwarakanath, MBBS , Gyanendra Sharma, MBBS, and Mary E. Arthur, MD ____________________________ 1266
Outcome Predictors in Patients Presenting With Acute Aortic Dissection
Chen Lingzhi, MM , Zhou Hao, MM , Huang Weijian, MM , Zheng Gaoshu, MM , Sun Chengchao, MM ,
Chen Changxi, MM , Zhao Chuhuan, MM, and Gao Zhan, MM ____________________________________________ 1272
Hemodynamic Testing of Patient-Specifi c Mitral Valves Using a Pulse Duplicator: A Clinical Application of Three-Dimensional Printing
Azad Mashari, MD , Ziyad Knio, BS , Jelliffe Jeganathan, MBBS , Mario Montealegre-Gallegos, MD , Lu Yeh, MD ,
Yannis Amador, MD , Robina Matyal, MD , Rabya Saraf, BA , Kamal Khabbaz, MD, and Feroze Mahmood, MD ______ 1278
Surgical Repair of Mitral Valve Disease in Children: Perioperative Changes in Respiratory Function
Iliona Malaspinas, MD , Ferenc Petak, PhD, DCs , Lionel Chok, MD , Anne Perrin, MD , Anne-Laure Martin, MD ,
Maurice Beghetti, MD, and Walid Habre, MD, PhD _____________________________________________________ 1286
A Score for Predicting Acute Kidney Injury After Coronary Artery Bypass Graft Surgery in an Asian Population Harish Mithiran, FRCS , Glenn Kunnath Bonney, FRCS , Saideep Bose, MD , Srinivas Subramanian, MBBS , Zan Ng Zhe Yan , Seth Yeak Zong En , Evangelos Papadimas, MD , Ishaan Chauhan, MBBS ,
Graeme MacLaren, FRACP, and Theodoros Kofi dis, MD _________________________________________________ 1296
Increasing Occurrence of Postoperative Atrial Fibrillation in Contemporary Cardiac Surgery
Jahangir Khan, MD, PhD , Niina Khan, MD , Eetu Loisa, MS , Jaakko Sutinen, MD, and Jari Laurikka, MD, PhD ____ 1302
Impact of Body Mass Index on Outcomes in Cardiac Surgery
Mei Gao, MD , Jianzhong Sun, MD, PhD , Nilas Young, MD , Douglas Boyd, MD , Zane Atkins, MD , Zhongmin Li, PhD , Qian Ding, MD , James Diehl, MD, and Hong Liu, MD __________________________________________________ 1308
Attenuation of Isofl urane Preconditioning-Induced Acute Cardioprotection in Hypertensive Hypertrophied Hearts
Chen-Hsiu Chen, MD, PhD , Chih-Wei Wu, PhD , Cheng-Dean Shih, PhD , Wei-Hung Lien, MD , Shiao-Lin Huang, MD, and Cheng-Cheng Huang, MD ______________________________________________________________________ 1317
CASE REPORTS
Anesthetic Management of an Acute Bleeding Ventriculo-Cutaneous Fistula
Carla Silva, MD , Filipe Pinheiro, MD , Diana Chieira, MD , Sofi a Marques, MD, and Maria Ros á rio Ó rf ã o, MD _____ 1324
Staged Repair of an Aortopulmonary Fistula From a Large Ascending Aortic Pseudoaneurysm: The Role of Transesophageal Echocardiography
Brett J. Wakefi eld, MD , Daniel Winter, MD, and Andrej Alfi revic, MD _______________________________________ 1329
Left Main Artery Thrombus Complicating Heart Transplantation in a Patient With Heparin-Induced Thrombocytopenia Aju P. Pazhenkottil, MD , Alain Rudiger, MD , Andreas Flammer, MD , Frank Enseleit, MD , Stephan Jacobs, MD ,
Volkmar Falk, MD , Frank Ruschitzka, MD, and Dominique Bettex, MD _____________________________________ 1334
Perioperative Management of Mitral Valve Replacement in an Individual With Bombay Phenotype
Vivek Chowdhry, MD, PDCC, FCCS , Manoranjan Padhi, MD, FNB, FIACTA , Suvakanta Biswal, MS, MCh,
and B.B. Mohanty, MS, MCh, FIACS, FACC, FRSM _____________________________________________________ 1337 Nocturnal Low-Dose Propofol Infusion for the Management of ICU Delirium: A Case Series in Nonintubated Cardiac
Surgery Patients
Jim K. Wong, MD, MS , Sara Nikravan, MD , Bryan G. Maxwell, MD, MPH , Michael A. Marques, MD, PhD,
and Ronald G. Pearl, MD, PhD _____________________________________________________________________ 1340
Descending Aortic Stent Graft Collapse During Frozen Elephant Trunk Repair: Detection Using Invasive Blood Pressure Monitoring and Intraoperative Transesophageal Echocardiography
Devon Cole, MD , Aaron Seller, DO, and Yong G. Peng, MD, PhD, FASE _____________________________________ 1344
Incidental Finding of a Left Atrial Myxoma During Emergency Surgery for Thoracic Aortic Dissection
Wendy K. Bernstein, MD, MBA , Inna Shats, MA, BS, RDCS, FASE, and Babak Ezzati, BA _______________________ 1350
Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in an Infant and Adult: Intraoperative Echocardiographic Comparison
Keerthi Chigurupati, DM , Shrinivas Gadhinglajkar, MD , Rupa Sreedhar, MD , Jayakumar Karunakaran, CVTS, MCh, and Baiju S. Dharan, CVTS, MCh ___________________________________________________________________ 1353
Delayed Paraplegia After Endovascular Treatment of a Thoracoabdominal Aortic Aneurysm Successfully Managed Using Cerebrospinal Fluid Drainage
Manuel Azevedo Mendes, MD , Delphine Szecel, MD , Gregory A. Hans, MD, PhD,
and Natzi Sakalihasan, MD, PhD ___________________________________________________________________ 1358
Residual Mitral Regurgitation Elicited by Right Ventricular Pacing After Mitral Valve Repair
Kazuto Miyata, MD, PhD , Sayaka Shigematsu, MD , Go Watanabe, MD, PhD , Hiroshi Ohtake, MD, PhD ,
Shigeyuki Tomita, MD, PhD , Ryuta Kiuchi, MD, PhD, and Tatsuya Tarui, MD, PhD ___________________________ 1361
REVIEW ARTICLES
Intraoperative Echocardiographic Assessment of Mitral Valve Area After Degenerative Mitral Valve Repair: A Call for Guidelines or Recommendations
Michael Essandoh, MD ___________________________________________________________________________ 1364
Importance of Metabolic Memory in the Development of Vascular Complications in Diabetic Patients
Pastor Luna, MD , Ver ó nica Guarner, PhD , Jos é M. Far í as, MD, PhD , Guadalupe Hern á ndez-Pacheco, PhD,
and Mart í n Mart í nez, PhD _________________________________________________________________________ 1369
Effect of High-Flow Nasal Oxygen on Pulmonary Complications and Outcomes After Adult Cardiothoracic Surgery:
A Qualitative Review
Vasileios Zochios, MD , Andrew A. Klein, MBBS , Nicola Jones, BM Bch, and Thomas Kriz, MBBS ________________ 1379
SPECIAL ARTICLES
Worldwide Opinion on Multicenter Randomized Interventions Showing Mortality Reduction in Critically Ill Patients:
A Democracy-Based Medicine Approach
Antonio Pisano, MD , Giovanni Landoni, MD , Vladimir Lomivorotov, MD, PhD , Marco Comis, MD , Gordana Gazivoda, MD , Massimiliano Conte, MD , Ludhmila Hajjar, MD , Gabriele Finco, MD , Miomir Jovic, MD, PhD , Marta Mucchetti, MD , Jan Kunst ý rˇ , MD , Gianluca Paternoster, MD, PhD ,
Valery Likhvantsev, MD, PhD , Laura Ruggeri, MD , Jun Ma, MD, PhD , Gabriele Alvaro, MD , Nazar Bukamal, MD , Giovanni Borghi, MD , Vadim Pasyuga, MD , Luca Cabrini, MD , Massimiliano Greco, MD, MSc ,
Fabio Guarracino, MD , Rosalba Lembo, MSc , Rosetta Lobreglio, MD , Fabrizio Monaco, MD , Andrea Montisci, MD , Giovanni Pala, MD , Laura Pasin, MD , Marina Pieri, MD , Francesco Santini, MD , Simona Silvetti, MD ,
Massimo Zambon, MD , Martina Baiardo Redaelli, MD , Alberto Castella, MD , Giovanni De Vuono, MD ,
Luca Lucchetta, MD , Alberto Zangrillo, MD, and Rinaldo Bellomo, MD ____________________________________ 1386
Demographics and Scholarly Productivity of American Board of Anesthesiology Volunteers: Results of an Internet-Based Bibliometric Analysis
Paul S. Pagel, MD, PhD ___________________________________________________________________________ 1396
CASE CONFERENCES
CASE 9—2016: Management of a Former Cardiac Anesthesiologist With Increasing Aortic Stenosis Requiring Aortic Valve Replacement
Theodore H. Stanley, MD , Stephen J. Thomas, MD , Daniel Vezina, MD , Brent Wilson, MD, PhD,
and Josh Zimmerman, MD, FASE ___________________________________________________________________ 1404 CASE 10—2016: Hemoglobinopathies and Cardiac Surgery
Farhan Farooqui, MD , Mark A. Chaney, MD , Chryssoula Staikou, MD, PhD, DESA, and Sheela Pai Cole, MD ______ 1409
PRO & CON
Pro: Dexmedetomidine Sedation Should Be Used Routinely for All Post-Cardiac Surgical Patients in the Intensive Care Unit Carly Peterson, MD and Michael Hall, MD ___________________________________________________________ 1419
Con: Dexmedetomidine Sedation Should Not Be Used Routinely for All Post-Cardiac Surgical Patients in the Intensive Care Unit
Richard Sheu, MD , Daniel Cormican, MD, and Matthew McConnell, MD ___________________________________ 1422
EXPERT REVIEW
Transcatheter Aortic Valve Replacement: Clinical Update on Access Approaches in the Contemporary Era Harish Ramakrishna, MD, FASE, FACC , Prakash A. Patel, MD , Jacob T. Gutsche, MD ,
Prashanth Vallabhajosyula, MD , Warren Spitz, MD , Jared W. Feinman, MD , Ronak Shah, MD , Elizabeth Zhou, MD ,
Stuart J. Weiss, MD, PhD, and John G. Augoustides, MD, FASE, FAHA _____________________________________ 1425
DIAGNOSTIC DILEMMAS
Rare Cause of Chest Discomfort and Modest Exercise Intolerance in an Athlete
Brent T. Boettcher, DO , Hemanckur Makker, MD , Timothy J. Olund, MD, and Paul S. Pagel, MD, PhD ____________ 1430
Constrictive Pericarditis and Tricuspid Valve Involvement
Pranav Subbaraya Kandachar, MCh , Suman Subbaraya Kandachar, MD , Madan Mohan Maddali, MD ,
Eapen Thomas, MD, and Sunnykutty Zacharias, FRCS ___________________________________________________ 1435
Air Under the Right Hemidiaphragm
Hemant Digambar Waikar, MD, DA , Rajeeva Pieris, MS, FRCS (England), FRCS (Edinburgh), FCS , Ruwan Ekanayake, MD, MRCP, FRCP (London), FRCP (Edinburgh), FRCP (Glag), FACC, FCCP, and
Alawaturage Nirmala Iranganie Wijesingha, MBBS, MD _________________________________________________ 1437
CARDIAC CALENDAR — 2016 TO 2020
George Silvay, MD, PhD ____________________________________________________________________ e39
LETTERS TO THE EDITOR
A Qualifi ed “ PAT ” on the Back for the Evaluation of Pulmonary Acceleration Time in Cardiac Surgical Patients
Kumar Alok, MD and Jayant Aveek, MD, DM __________________________________________________________ e40
Correspondence Reply
Claude Tousignant, MD, FRCPC ____________________________________________________________________ e41
Optimal Head Rotation for IJV Cannulation: One Size Does Not Fit All
Prachi Kar, MBBS, MD, PDCC and Gopinath Ramachandran, MBBS, MD __________________________________ e42
Response to Letter to the Editor Concerning “ The Optimal Angle of Head Rotation for Internal Jugular Cannulation as Determined by Ultrasound Evaluation ”
Al Solina, MD ___________________________________________________________________________________ e42
Continuous Positive Airway Pressure During Upper Endoscopies: A Bench Study on a Novel Device Luca Cabrini, MD , Isabella Savia , MD, Margherita Bevilacqua , MD, Carmine Domenico Votta, MD ,
Martina Filippini , MD, Giovanni Landoni, MD, and Alberto Zangrillo , MD __________________________________ e43
What Is the Role of Long-Acting Neuromuscular Blocking Agents in Modern Adult Cardiac Surgery?
Marina Pieri, MD , Alessandro Belletti, MD , Giovanni Affronti, MSc , Veronica Dalessandro, MD ,
Ada Carla Alba, MD , Alberto Zangrillo, MD, and Giovanni Landoni, MD ___________________________________ e45
Evaluation of pH in Double-Lumen Tubes Removed After General Anesthesia: A Prospective Observational Study Shiho Deguchi, MD , Nobuyasu Komasawa, MD, PhD , Tomoki Yamasaki, MD , Michi Omori, DMD,
and Toshiaki Minami, MD, PhD _____________________________________________________________________ e46
Right Atrial Transverse Band Prevents a “ Passing-by ” Thrombus From Migrating Into Pulmonary Circulation John Papanikolaou, MD, PhD , Vasiliki Tsolaki, MD, PhD , Demosthenes Makris, MD, PhD ,
Konstantinos Mantzarlis, MD, and Epaminondas Zakynthinos, MD, PhD ____________________________________ e47
Etiologies of Dysphonia
Vladimir V. Merenkov , MD and Alexey N. Kovalev , MD __________________________________________________ e48
Intensive Care and Anesthesia Specialists Would Do More Research If They Could
Marina Pieri, MD , Matteo Aldo Bonizzoni, MD , Rosalba Lembo, MSc , Veronica Dalessandro, MD ,
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