Ειδικευόμενος: Nάζου Γεωργία
ΚΑΛΟΣΩΡΙΣΜΑ
Αγαπητοί συνάδελφοι,
Ως μέλη της ομάδας εργασίας Καρδιο – Θώρακο– Αγγειο αναισθησίας, θα θέλαμε να εκφράσουμε τις θερμές μας ευχαριστίες προς την Ελληνική Αναισθησιολογική Εταιρεία για την τιμή και την εμπιστοσύνη που μας έδειξε, επιλέγοντάς μας να στελεχώσουμε και να εκπροσωπήσουμε τον συγκεκριμένο τομέα της ειδικότητάς μας.
Η Καρδιο-Θωρακο-Αγγειο- χειρουργική αλλά και η επεμβατική καρδιολογία προσφέρουν πλέον περισσότερο από ποτέ ένα ταχέως αναπτυσσόμενο οπλοστάσιο διαγνωστικών και θεραπευτικών μεθόδων σε έναν πληθυσμό με αυξανόμενη νοσηρότητα, γεγονός που προκαλεί την ανάγκη όλων των εμπλεκόμενων ιατρικών υποειδικοτήτων να προσφέρουν την υψηλότερη ποιότητα φροντίδας. Είναι υποχρέωση των αναισθησιολόγων με εμπειρία στις επεμβάσεις αυτές, να μεταλαμπαδεύσουν τις γνώσεις τους στις νεότερες γενιές, να τις εκπαιδεύσουν σε
τεχνικές που κατέχουν και να κρατήσουν ζωντανό το ενδιαφέρον όλων των εμπλεκομένων, ανταλλάσσοντας γνώσεις, εμπειρίες, δεξιότητες και αναλύοντας δεδομένα απο τη διεθνή βιβλιογραφία.
Σε αυτή την κατεύθυνση λοιπόν, οι στόχοι της ομάδας μας είναι οι εξής:
- Να προωθήσουμε το υψηλότερο επίπεδο περιεγχειρητικής διαχείρισης και φροντίδας για τους ασθενείς που υποβάλλονται σε καρδιο-θωρακο-αγγειο χειρουργικές επεμβάσεις,
- να προωθήσουμε την ανάπτυξη της τέχνης και της επιστήμης της καρδιο-θωρακο-αγγειο αναισθησίας, να ενθαρρύνουμε την πρωτότυπη έρευνα και τη συνεργασία με ομάδες με παρόμοιο τρόπο σκέψης,
- να συμμετέχουμε ενεργά σε όλα τα θέματα που αφορούν την εκπαίδευση μελλοντικών αναισθησιολόγων με ενδιαφέρον στον συγκεκριμένο τομέα και τέλος να εκπροσωπούμε τις απόψεις μας όπου αυτό κριθεί σκόπιμο.
Στο πλαίσιο των επιστημονικών μας στόχων, επιδιώκουμε: τη δημιουργία δεξαμενής νέων επιστημονικών δεδομένων, τη σύσταση συγγραφικής ομάδας για την εκπόνηση εργασιών, και την διαμόρφωση πρωτοκόλλων και μελετών που θα συμβάλουν στην τεκμηριωμένη ανάπτυξη του
τομέα μας. Ευπρόσδεκτοι είναι συνάδελφοι από όλη την Ελλάδα, από τον δημόσιο και ιδιωτικό τομέα, που επιθυμούν να συνεργαστούν μαζί μας στην κατεύθυνση της περαιτέρω διεύρυνσης και ενδυνάμωσης της ομάδας μας τόσο σε θεωρητικό όσο και σε
πρακτικό επίπεδο.
Με εκτίμηση
Τα μέλη της ομάδας εργασίας Καρδιο – Θώρακο– Αγγειο αναισθησίας
ΠΡΟΤΕΙΝΟΜΕΝΗ ΒΙΒΛΙΟΓΡΑΦΙΑ ΣΥΝΟΠΤΙΚΑ
ΚΑΡΔΙΑ
1) Dryden A, et al. Anaesthesia for transcatheter mitral valve repair. BJA Educ. 2023 May;23(5):189-195. doi: 10.1016/j.bjae.2023.01.004. Epub 2023 Feb 24. PMID: 37124172; PMCID: PMC10140472.
2) Petronio AS, et al. Anaesthetic management of transcatheter aortic valve implantation: results from the Italian CoreValve registry. EuroIntervention. 2016 Jun 20;12(3):381-8. doi: 10.4244/EIJY15M03_05. PMID: 25772903.
3) Hayanga HK, et al. Anesthetic management for transcatheter aortic valve replacement: A national anesthesia clinical outcomes registry analysis. Ann Card Anaesth. 2023 Jan-Mar;26(1):29-35. doi: 10.4103/aca.aca_311_20. PMID: 36722585; PMCID: PMC9997468.
4) Leonardi S, et al. Composition, structure, and function of heart teams: a joint position paper of the ACVC, EAPCI, EACTS, and EACTA focused on the management of patients with complex coronary artery disease requiring myocardial revascularization. Eur J Cardiothorac Surg. 2021 Apr 13;59(3):522-531. doi: 10.1093/ejcts/ezaa402. PMID: 33459337.
5) American Heart Association Council on Cardiovascular Surgery and Anesthesia; and Council on Basic Cardiovascular Sciences. Considerations of Intraoperative Transesophageal Echocardiography During Adult Cardiac Surgery: A Scientific Statement From the American Heart Association. Circulation. 2025 Jul 15;152(2):129-145. doi: 10.1161/CIR.0000000000001342. Epub 2025 Jun 12. PMID: 40501376.
6) EACTS/EACTAIC/EBCP Scientific Document Group. 2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP. Eur J Cardiothorac Surg. 2025 May 6;67(5):ezae352. doi: 10.1093/ejcts/ezae352. PMID: 39385500; PMCID: PMC12257489.
7) Nicoara A, et al. Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach: From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons. J Am Soc Echocardiogr. 2020 Jun;33(6):692-734. doi:10.1016/j.echo.2020.03.002. Erratum in: J Am Soc Echocardiogr. 2020 Nov;33(11):1426. doi: 10.1016/j.echo.2020.08.020. PMID: 32503709.
8) Ihtasham A, et al. Innovative strategies in coagulation management for cardiothoracic surgery: a narrative review of pharmacological and nonpharmacological approaches. J Cardiothorac Surg. 2025 Jul 16;20(1):305. doi: 10.1186/s13019-025-03406-w. PMID: 40671109; PMCID: PMC12269227.
9) Grant MC, et al. Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS). Ann Thorac Surg.2024 Apr;117(4):669-689. doi: 10.1016/j.athoracsur.2023.12.006. Epub 2024 Jan 28.Erratum in: Ann Thorac Surg. 2024 Aug;118(2):524-525. doi: 10.1016/j.athoracsur.2024.06.006. PMID: 38284956.
10) Flachskampf FA, et al. Recommendations for transoe sophageal echocardiography: EACVI update 2014. Eur Heart J Cardiovasc Imaging. 2014 Apr;15(4):353-65. doi: 10.1093/ehjci/jeu015. Epub 2014 Feb 19. PMID: 24554131.
ΑΓΓΕΙΑ
1) McGinigle KL, et al. A framework for perioperative care for lower extremity vascular bypasses: A Consensus Statement by the Enhanced Recovery after Surgery (ERAS®) Society and Society for Vascular Surgery. J Vasc Surg. 2023 May;77(5):1295-1315. doi: 10.1016/j.jvs.2023.01.018. Epub 2023 Mar 16. Erratum in: J Vasc Surg.2023 Aug;78(2):564. doi: 10.1016/j.jvs.2023.05.033. Erratum in: J Vasc Surg. 2023 Dec;78(6):1585. doi: 10.1016/j.jvs.2023.09.032. PMID: 36931611.
2) McGinigle KL, egt al. Perioperative care in open aortic vascular surgery: A consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery. J Vasc Surg. 2022 Jun;75(6):1796-1820. doi: 10.1016/j.jvs.2022.01.131. Epub 2022 Feb 16. PMID: 35181517.
ΘΩΡΑΚΑΣ
1) Batchelor TJP, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg. 2019 Jan 1;55(1):91-115. doi: 10.1093/ejcts/ezy301. PMID: 30304509.
2) Low DE, et al. Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg. 2019 Feb;43(2):299-330. doi: 10.1007/s00268-018-4786-4. PMID: 30276441.
3) Merli G, et al. Recommendations for airway control and difficult airway management in thoracic anesthesia and lung separation procedures. Minerva Anestesiol. 2009 Jan-Feb;75(1-2):59-78; 79-96. English, Italian. Epub 2008 Nov 6. PMID: 18987567.
4) Piccioni F, et al; AIPO, Associazione Italiana Pneumologi Ospedalieri; SIAARTI, Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva; SIC, Società Italiana di Chirurgia; SICT, Società Italiana di Chirurgia Toracica; SIET, Società Italiana di Endoscopia Toracica; SIP, Società Italiana di Pneumologia. Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in
Thoracic surgery (PACTS) part 1: preadmission and preoperative care. Perioper Med (Lond). 2020 Dec 1;9(1):37. doi: 10.1186/s13741-020-00168-y. PMID: 33292657; PMCID: PMC7704118.
5) Piccioni F, et al; AIPO, Associazione Italiana Pneumologi Ospedalieri; SIAARTI, Società Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva; SIC, Società Italiana di Chirurgia; SICT, Società Italiana di Chirurgia Toracica; SIET, Società Italiana di Endoscopia Toracica; SIP, Società Italiana di Pneumologia. Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care. Perioper Med (Lond). 2020 Oct 23;9:31. doi: 10.1186/s13741-020-00159-z. PMID: 33106758; PMCID: PMC7582032.
6) Campos JH, Feider A. Hypoxia During One-Lung Ventilation-A Review and Update. J Cardiothorac Vasc Anesth. 2018 Oct;32(5):2330-2338. doi: 10.1053/j.jvca.2017.12.026. Epub 2017 Dec 19. PMID: 29361458.
7) Campos JH. Lung isolation techniques for patients with difficult airway. Curr Opin Anaesthesiol. 2010 Feb;23(1):12-7. doi: 10.1097/ACO.0b013e328331e8a7. PMID: 19752725.
8) Collins SR, Titus BJ, Campos JH, Blank RS. Lung Isolation in the Patient With a Difficult Airway. Anesth Analg. 2018 Jun;126(6):1968-1978. doi: 10.1213/ANE.0000000000002637. PMID: 29189274.
ΣΗΜΑΝΤΙΚΕΣ ΠΡΟΣΦΑΤΕΣ ΔΗΜΟΣΙΕΥΣΕΙΣ
1) Cerebral Oximetry Index Guided Blood Pressure Management During Cardiopulmonary Bypass Reduces
Postoperative Delirium in Patients with Acute Type A Aortic Dissection
DOI: https://doi.org/10.1053/j.jvca.2025.04.013 Published: Journal of Cardiothoracic and Vascular Anesthesia July 2025
Authors: Xizhi Chen, Wei Xie, Weiwei Li, Ju Gao
Summary:
This study aimed to investigate whether cerebral oximetry index (COx)-guided blood pressure management during cardiopulmonary bypass (CPB) could reduce postoperative delirium (POD) in patients undergoing acute type A aortic dissection (ATAAD) repair;
A single-center, prospective, randomized controlled trial;A single-center,prospective, randomized controlled trial;
A total of 157 adult patients undergoing emergency repair for ATAAD were enrolled; The COx-guided group (n = 76) received individualized MAP targets based on COx, while the control group (n = 81) received standard MAP targets of 60–80 mmHg;
The primary outcome was the incidence of POD within the first 7 postoperative days, which occurred less frequently in the COx-guided group than in the control group (15% vs 30%; RR 0.50; 95% CI 0.28–0.89; p = 0.039).
Secondary outcomes in the COx-guided group included lower delirium severity (DRS-R98: 5 vs 10, p=0.033) and shorter postoperative delirium duration (0 vs 2 days,p=0.045).
The COx-guided group demonstrated lreduced postoperative cerebral infarction (1.3% vs 8.6%, p=0.037), reduced acute kidney injury (27.6% vs 43.2%, p=0.042), faster extubation (16.9 vs 18.4 hours, p=0.027), and a shorter ICU stay (7.3 vs 8.2 days, p=0.042).
Conclusions:
COx-guided individualized blood pressure management showed promising associations with lower POD incidence and improved outcomes in selected ATAAD patients
These findings remain hypothesis-generating and require validation in larger
multicenter studies alongside the development of standardized, practical protocols
to support safe and effective wider adoption.
2) Opioid-sparing Anesthesia in Cardiac Surgery: A Meta-analysis
DOI: https://doi.org/10.1053/j.jvca.2025.06.040
Published: Journal of Cardiothoracic and Vascular Anesthesia November 2025
Authors: Michela Rauseo, Lucia Mirabella, Angelo Antonio Carrideo, Francesco Paolo
Padovano, Leonarda Pia Cantatore, Paolo Vetuschi, Stefania Da Lima, Gianluca
Paternoster, Gilda Cinnella
Summary:
This systematic review and meta-analysis aimed to evaluate the effects of opioid-sparing versus opioid-based anesthesia in adult patients undergoing cardiac surgery;
Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies;
The study included 27 studies (8 RCTs and 19 observational cohorts) with a total of 58,998 adult cardiac surgery patients;
The overall risk of bias was low to moderate, with moderate heterogeneity (I² =38–67%) justifying the use of random-effects models across all analyses.
Primary outcomes demonstrated significantly lower intraoperative and early postoperative opioid use in the opioid-sparing group compared with opioid-based anesthesia (pooled mean difference −2.48 MME; 95% CI −2.60 to −2.35; p < 0.001).
Opioid-sparing strategies were associated with a shorter ICU stay (OR 1.32; 95% CI 1.14–1.51), reduced mechanical ventilation duration (OR 1.46; 95% CI 1.24–1.72),and lower postoperative pain scores at 12 hours (OR 1.18; 95% CI 1.07–1.30).
No significant difference in postoperative mortality was observed between the opioid-sparing and opioid-based groups (OR 0.20; 95% CI 0.04–1.14).
Conclusions:
Opioid-sparing anesthesia in cardiac surgery significantly reduces opioid consumption, ventilation duration, and ICU stay without increasing short-termmortality.
These findings support the incorporation of opioid-sparing anesthesia into enhanced recovery pathways, highlighting the importance of individualized, patient-centered, and opioid-conscious perioperative care.
LINKS
1) Review J Cardiothorac Vasc Anesth. 2018 Oct;32(5):2330-2338. doi: 10.1053/j.jvca.2017.12.026.
Epub 2017 Dec 19.
Hypoxia During One-Lung Ventilation-A Review and Update
Javier H Campos , Andrew Feider
PMID: 29361458 DOI: 10.1053/j.jvca.2017.12.026
https://pubmed.ncbi.nlm.nih.gov/29361458/
2) Review Curr Opin Anaesthesiol. 2010 Feb;23(1):12-7. doi: 10.1097/ACO.0b013e328331e8a7.
Lung isolation techniques for patients with difficult airway
Javier H Campos
https://pubmed.ncbi.nlm.nih.gov/19752725/
3) Review Anesth Analg. 2018 Jun;126(6):1968-1978. doi: 10.1213/ANE.0000000000002637.
Lung Isolation in the Patient With a Difficult Airway
Stephen R Collins, Brian J Titus, Javier H Campos, Randal S Blank
PMID: 29189274 DOI: 10.1213/ANE.0000000000002637
