Cardiovascular & Thoracic Anesthesia


Research Summary for Max Kanevsky, MD, PhD

I am interested in defining mechanisms by which ion channels protect myocardium from ischemic injury. My current project uses a combination of patch-clamp recording, immunocytochemistry and transgenic mouse techniques to address the role of voltage- and calcium-activated potassium (BK) channels in the cardioprotective effect of volatile general anesthetics.

Reseach Summary for Pieter van der Starre, MD, PhD

The monitoring of the processed EEG (Patient State Index) in patients undergoing cardiac surgery with deep hypothermic circulatory arrest has started. The first endpoint is to find "normal" EEG patterns, to be able to discover abnormal patterns in specific patients in the future, and to try to prevent negative outcome.

The same form of processed EEG is monitored during the testing of ICD devices which are implanted in patients with end-stage heart failure. The level of anesthesia, which allows safe testing without hemodynamic compromise will be determined.

Processed EEG will also be the monitor of choice in a study to determine when to start anesthesia again after weaning from cardiopulmonary bypass. Patients may be hemodynamically unstable after bypass, and anesthesia may in addition jeopardize hemodynamics. If the resumption of anesthesia can be timed according to the EEG monitoring, these effects may be prevented.

Transesophageal echocardiography (TEE) is well accepted in cardiac anesthesia as a way of intraoperative monitoring. More patients are having stents placed into the thoracic aorta because of aneurysms or dissections instead of surgical corrections. A study takes place evaluating the value of TEE in intrathoracic stent placement, particularly in the patient who has renal dysfunction and does not tolerate large volumes of contrast.

Tissue oxygenation is an important factor for positive outcome in surgery or ICU. Pulse oximetry is well established as monitor for the saturation of the arterial blood, but is not able to indicate the adequacy of the oxygenation of the tissues. Visible-light tissue oximetry is a new way of monitoring tissue oxygenation, independent of the pulsatility of flow. A study is designed to evaluate this monitor during cardiopulmonary bypass assessing the adequacy of flow, particularly during weaning from bypass and in the early bypass period.

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