Cardiac surgery is associated with significant postoperative pain that can affect patients' recovery and quality of life. Optimal analgesia after cardiac surgery can be challenging due to patients' coexisting morbidities and frequently observed adverse effects when opioids are used to treat postoperative pain. In this current era of enhanced recovery and fast track extubation, the use of multimodal analgesia for pain management after cardiac surgery is expanding. Regional analgesia is an integral part of multimodal analgesia and has garnered more attention since the development of fascial plane blocks. There is variability among individuals, institutions, and practices in the analgesic approaches used to treat postoperative pain in cardiac surgical patients because of lack of consensus or guidelines. This practice advisory was developed with the overall goal of identifying opportunities for improving postoperative pain relief and pain-related outcomes after cardiac surgery and guiding perioperative providers through the provision of clinically relevant evidence-based recommendations.

Acute type A aortic dissection (ATAAD) is a cardiovascular emergency with high mortality and morbidity. We compared the effects on outcomes of single arterial cannulation (SAC) via axillary, femoral, or ascending aorta with double arterial cannulation (DAC) via axillary and femoral artery during ATAAD repair.

In 2019, coronary artery bypass grafting (CABG) made up more than one-half of all adult cardiac surgical procedures in the United States, with an estimated 301,077 procedures performed, of which 161,816 were isolated CABG, and approximately 25% of which were performed in women. Women undergoing CABG are statistically more likely to present for surgery at an older age, with a greater burden of comorbidities such as diabetes and hypertension, and in decompensated clinical states (eg, acute myocardial infarction or cardiogenic shock) versus their male counterparts. However, sex has been shown to be an independent risk factor for worse outcomes even when controlling for these differences. Although evidence has long suggested that women seem to be at significantly increased risk of adverse perioperative outcomes and worse long-term outcomes, overall trends for patients undergoing CABG in the United States (US) have improved over the last decades. Despite this, the recent evidence from Gaudino et al suggests that the outcomes gap between men and women has not improved. In their cohort study examining 1,297,204 patients undergoing isolated CABG from 2011 to 2020 in the US, women had a higher unadjusted risk of operative (30-day) morbidity and mortality, with no signs of improvement in this gap over the study period, suggesting that a greater understanding of and attention to sex-based outcomes in CABG operations are warranted. A thorough understanding of this discrepancy and the possible contributing factors is essential to improving outcomes for women undergoing CABG.

The effects of anesthetics on electroencephalograms and cerebral perfusion remain understudied in children with congenital heart disease. With regard to this, we compared inhalational anesthesia induction and intravenous anesthesia induction.

To assess the association of hospital teaching status with outcomes of patients presenting with type B aortic dissection (TBAD).

Prior studies suggest an association of anemia and blood transfusion with increased morbidity and mortality in patients undergoing cardiac surgery. However, the impact of perioperative anemia and blood transfusion on clinical outcomes in patients undergoing major vascular surgery has been poorly defined yet. The primary objectives of this scoping review were to determine the extent of the evidence base that links anemia and blood transfusions to mortality and cardiovascular outcomes in patients undergoing major vascular surgery, and identify recurring themes or gaps in the literature to guide future research.

These highlights focus on research published in the year 2022 and is divided into preoperative, intraoperative, and postoperative sections. The preoperative section includes research on the assessment and optimization of candidates for heart transplantation; donor optimization and the use of extended donors; organ protection systems; donation after circulatory death allografts; recipient factors including cannabis use, sex, race, and comorbidities such as obesity, diabetes mellitus, and peripartum cardiomyopathy; the effects of the 2018 heart allocation policy change on waitlist and postoperative mortality; updates on heart transplantation in patients with coronavirus disease 2019; in pediatric patients; and those who require a bridge to transplant. The intraoperative section includes the use of a multidisciplinary team, a proposed transfusion algorithm, bench surgery on the allograft, and size matching. The postoperative section focuses on the research on the development and management of tricuspid regurgitation, echocardiography, arrhythmia management, and, finally, xenotransplantation.

The Aveir DR dual-chamber Leadless Pacemaker system (Abbott Laboratories) was recently approved by the US Food and Drug Administration and is heralded to be the next generation of leadless pacemakers. Earlier generations of leadless pacemakers could only provide single-chamber right ventricular pacing, limiting their application to a small subset of patients in whom pacemaker therapy is indicated. With the expansion of pacing therapy, the Aveir DR system expands availability of leadless pacing to more patients. Although there have been prior documented experiences with the earlier generation of leadless pacemakers, the addition of a second leadless pacemaker to provide dual-chamber pacing adds new complexities. It is essential to understand what makes the Aveir DR system unique if an anesthesiologist were to come across one perioperatively.

To assess the capability of the Acute Physiology and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA) scores, Cardiac Surgery Score (CASUS), and Survival After VA-ECMO (SAVE) in predicting outcomes among a cohort of patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Because of changing rules and regulations in insurance and reimbursement, critical care physicians must adapt their billing practices to meet the challenges of these complex changes. Reimbursement for critical care billing varies substantially across the country, and staffing models must consider this heterogeneity. This article summarizes the current state of critical care billing and addresses the requirements to generate a critical care bill and the potential circumstances that may result in a denial of payment.

To assess perioperative right ventricular (RV) echocardiographic indices and their relationship to vasopressor and inotropic support in cardiac surgical patients. The authors hypothesized that a reduction in echocardiographic parameters of RV function would be associated with a longer duration of vasopressor and inotropic support in the intensive care unit (ICU).