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Cardiothoracic and Vascular Anesthesia—Clinical Management and Challenges
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Cardiothoracic and Vascular Anesthesia—Clinical Management and Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 25 July 2026 | Viewed by 2116

Special Issue Editors

Dr. Marko Zdravković

E-Mail Website
Guest Editor
Department of Anesthesiology, University Medical Centre Maribor, Maribor, Slovenia
Interests: cardio-thoracic anesthesia; cardio-thoracic intensive care; hemodynamics; airway management; mechanical ventilation; pain management; diversity, equity and inclusion
Prof. Dr. Vlatka Sotosek

E-Mail Website
Guest Editor
1. Department of Anesthesiology, Reanimatology, Emergency and Intensive Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
2. Department of Clinical Medical Sciences II, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia
3. Department of Anesthesiology, Intensive Care and Pain Treatment, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
Interests: anesthesia; intensive care; pain management; anesthesiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Due to the increasing number of patients with cardiovascular diseases, anesthesiologists and intensivists are confronted with an increasing number of cardiothoracic and vascular procedures. Advances in surgical and endovascular interventions arose from technological development. Similarly, anaesthetic techniques and perioperative patient management have evolved significantly over the last few decades. Both surgical and anaesthetic procedures impact the course of patient management, from prehabilitation to intervention and immediate treatment and rehabilitation. In addition, new strategies in the intensive care are leading to a better recovery.

In this Special Issue, we invite authors to submit articles on clinical findings and innovations in cardio-thoracic and vascular anesthesia. We look forward to original research articles and reviews. 

Dr. Marko Zdravković
Prof. Dr. Vlatka Sotosek
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac anesthesia
  • thoracic anesthesia
  • vascular anesthesia
  • innovation
  • perioperative medicine
  • healthcare
  • outcomes
  • challenges

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Published Papers (3 papers)

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Research

17 pages, 556 KB  
Article
Intraoperative High-Volume Diuresis During Off-Pump Coronary Artery Bypass Grafting: Risk Factors and Clinical Impact
by Yuxi Hou, Fangyi Luo, Shuwen Li, Fei Cai and Jun Ma
J. Clin. Med. 2026, 15(6), 2331; https://doi.org/10.3390/jcm15062331 - 18 Mar 2026
Viewed by 151
Abstract
Background: Intraoperative high-volume diuresis is a common but under-recognized phenomenon during off-pump coronary artery bypass grafting (OPCABG). Its clinical correlates and implications for perioperative management remain incompletely characterized. Methods: This single-center retrospective cohort study included 1274 adults undergoing elective OPCABG between January and [...] Read more.
Background: Intraoperative high-volume diuresis is a common but under-recognized phenomenon during off-pump coronary artery bypass grafting (OPCABG). Its clinical correlates and implications for perioperative management remain incompletely characterized. Methods: This single-center retrospective cohort study included 1274 adults undergoing elective OPCABG between January and August 2025. High-volume diuresis was defined as urine output ≥ 5 mL·kg−1·h−1. Multivariable logistic regression was used to identify factors independently associated with intraoperative high-volume diuresis. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Results: High-volume diuresis occurred in 39.6% of patients. Older age, hypertension and greater intraoperative fluid infusion were independently associated with high-volume diuresis, whereas preoperative diuretic and greater cumulative exposure to systolic blood pressure < 100 mmHg were inversely associated with diuresis. The multivariable model demonstrated acceptable discrimination (AUC = 0.756). Postoperative outcomes, including acute kidney injury, duration of mechanical ventilation, intensive care unit stay, and hospital length of stay, did not differ between groups. Conclusions: Intraoperative high-volume diuresis during OPCABG reflects complex physiological and hemodynamic responses and can be anticipated based on preoperative and intraoperative factors. These findings support a more individualized interpretation of urine output and perioperative management strategies in OPCABG. Full article
(This article belongs to the Special Issue Cardiothoracic and Vascular Anesthesia—Clinical Management and Challenges)
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14 pages, 1075 KB  
Article
High-Flow Nasal Oxygenation During Sedation for Transcatheter Aortic Valve Replacement: The HIGH-OXY-TAVR Randomised–Controlled Trial
by Marc Giménez-Milà, Antoni Manzano-Valls, Omar Abdul-Jawad, María José Arguis, Salvatore Brugaletta, Thiago Carnaval, Maria José Carretero, Eduardo Flores-Umanzor, Xavier Freixa, Cristina Ibañez, Stefano Italiano, Manuel López-Baamonde, Samira Martínez-Otero, Purificación Matute, Mireia Pozo, Ricard Navarro-Ripoll, Juan Manuel Perdomo, Ander Regueiro, Irene Rovira, Francisco Javier Vega, Sebastián Videla and Manel Sabatéadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(23), 8347; https://doi.org/10.3390/jcm14238347 - 24 Nov 2025
Viewed by 893
Abstract
Background: Data on high flow nasal oxygenation (HFNO) efficacy in hypoxia prevention in transcatheter aortic valve replacement (TAVR) are conflictive. We aimed to determine the benefit of HFNO in preventing the occurrence of desaturations during TAVR. Methods: An investigator-initiated, proof of concept, single-centre, [...] Read more.
Background: Data on high flow nasal oxygenation (HFNO) efficacy in hypoxia prevention in transcatheter aortic valve replacement (TAVR) are conflictive. We aimed to determine the benefit of HFNO in preventing the occurrence of desaturations during TAVR. Methods: An investigator-initiated, proof of concept, single-centre, randomised, and controlled trial on 132 adult patients who were scheduled to undergo transfemoral TAVR was conducted. Patients were randomised (1:1) to HFNO (H-group) with a flow rate of 50 L min−1 and FiO2 0.6 or standard of care oxygen therapy (S-group). The primary endpoint was the number of patients with a desaturation episode (SpO2 < 93%) for >10 s during TAVR. Secondary outcomes included arterial partial pressure of oxygen (pO2) 45 min from sedation start and changes in glomerular filtration rate from baseline to 12 h post-procedure. Results: Between 23 November and 24 July, a per-protocol analysis was performed in a total of 125 patients (H-group n = 64; S- group n = 61; 49 females). The number of patients with any desaturation episode was significantly lower in the H-group [13/64 (20%, 95% CI: 12–32%)] than in the S-group [31/61 (51%, 95% CI: 39–63%), RR: 0.39 (95%CI: 0.23–0.68)]. At 45 min, mean (SD) pO2 was higher in the H-group (24(9.8) kPa vs. 16.7(7.5) kPa; p < 0.005). A significant improvement in delta median (IQR) difference on glomerular filtration rate was observed in the H-group [1.6(−1–7.9) mL min−1 1.73 m−2] with respect to the S-group [0.2(−6.1–3.1) mL min−1 1.73 m−2; p-value: 0.013]. Conclusions: This trial demonstrated that HFNO provides a better oxygenation pattern than standard oxygen therapy during TAVR. Larger studies focusing on long-term clinical outcomes are warranted to evaluate the benefit of HFNO during sedation for TAVR procedures. Full article
(This article belongs to the Special Issue Cardiothoracic and Vascular Anesthesia—Clinical Management and Challenges)
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14 pages, 835 KB  
Article
Respiratory System Compliance Predicts Outcome After Lung Transplantation—A Retrospective Single Center Study
by Cecilia Veraar, Stefan Schwarz, Peter Wohlrab, Johannes Geilen, Arabella Fischer, Thomas Neugebauer, Caroline Hillebrand, Bernhard Moser, Konrad Hoetzenecker, Martin Dworschak, Marcus J. Schultz and Edda M. Tschernko
J. Clin. Med. 2025, 14(19), 6941; https://doi.org/10.3390/jcm14196941 - 30 Sep 2025
Viewed by 684
Abstract
Background: Outcome prediction in patients undergoing lung transplantation (LUTX) for end-stage pulmonary disease can be challenging. We examined the prognostic value for mortality of respiratory system compliance (CRS) and mechanical power of ventilation (MP) at end of surgery in patients undergoing [...] Read more.
Background: Outcome prediction in patients undergoing lung transplantation (LUTX) for end-stage pulmonary disease can be challenging. We examined the prognostic value for mortality of respiratory system compliance (CRS) and mechanical power of ventilation (MP) at end of surgery in patients undergoing LUTX for end-stage pulmonary disease. Methods: In this single-center retrospective study, we included 755 patients undergoing LUTX between 2014 and 2023. The primary endpoint of this study was 1-year mortality, with 30-day mortality serving as a secondary endpoint. We conducted both univariate and multivariate analyses and constructed Receiver Operating Characteristic curves. Results: Of 755 patients, 1.9% and 12.2% patients died within 30 days and 1 year after LUTX. Fifteen-point four percent of all patients required extracorporeal membrane oxygenation (ECMO) prolongation into the early postoperative period. CRS, but not MP was higher in 1-year survivors compared to non-survivors [median 25.8 mL/cmH2O (20.1, 32.1) and 22.5 mL/cmH2O (15.2, 28.4); p < 0.001] and [median 10.0 J/min (7.8, 12.0) and 9.3 J/min (6.2, 13.1); p = 0.329]. Moreover, low CRS < 25.1 mL/cmH2O remained an independent factor for increased 1-year mortality after LUTX. Additionally, increased MP and CRS were predictive for 30-day survival with an acceptable area under the curve of 0.758 (95% CI: 0.6–0.8; p < 0.001) and 0.735 (95% CI: 0.5–0.9; p = 0.003), and a sensitivity and specificity of 51% and 75.5% for MP and 50% and 85% for CRS, respectively. Conclusions: Postoperative CRS serves as a significant independent predictor for short and long-term outcome in patients undergoing LUTX with and without ECMO prolongation into the early postoperative period. Full article
(This article belongs to the Special Issue Cardiothoracic and Vascular Anesthesia—Clinical Management and Challenges)
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