André Y. Denault

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Near-infrared spectroscopy (NIRS) is a technique that can be used as a noninvasive and continuous monitor of the balance between cerebral oxygen delivery and consumption. The authors develop and propose an algorithm for the use of NIRS based on optimizing factors that can affect cerebral oxygen supply/demand. These factors are the position of the vascular(More)
The importance of right ventricular (RV) function in cardiovascular disease and cardiac surgery has been recognized for several years. RV dysfunction has been shown to be a significant prognostic factor in cardiac surgery and heart transplantation. In the first article of this review, key features of RV anatomy, physiology, and assessment were presented. In(More)
STUDY OBJECTIVES To define the relation between systolic arterial pressure (SAP) changes during ventilation and left ventricular (LV) performance in humans. DESIGN Prospective repeat-measures series. SETTING University of Pittsburgh Medical Center Operating Room. PATIENTS Fifteen anesthetized cardiac surgery patients before and after cardiopulmonary(More)
OBJECTIVE Cardiopulmonary bypass triggers a systemic inflammatory response that alters pulmonary endothelial function, which can contribute to pulmonary hypertension. Milrinone is a type III phosphodiesterase inhibitor. The objective of this study was to compare the effects of inhaled and intravenous milrinone on the pulmonary endothelium-dependent(More)
Diastolic function is receiving more attention since echocardiographic measurements were developed and have become widely available. The importance and significance of diastolic dysfunction (DD) observed before cardiac surgery and its relationship with adverse outcomes, such as difficult separation from cardiopulmonary bypass (CPB), have not been fully(More)
PURPOSE Magnesium potentiates the effect of nondepolarizing neuromuscular blocking agents. It is used in cardiac anesthesia to prevent hypertension and arrhythmias. This study was performed to measure the interaction between magnesium and cisatracurium in cardiac surgery. METHODS Twenty patients scheduled for elective cardiac surgery were randomly(More)
BACKGROUND Automated echocardiographic measures of left ventricular (LV) cavity area are closely correlated with changes in volume and can be coupled with LV pressure to construct pressure-area loops in real time. The objective was to rapidly estimate LV contractility from the end-systolic relations of cavity area (as a surrogate for LV volume) and femoral(More)
PURPOSE To determine the relative impact of each category-based TEE indication according to the ASA guidelines. METHODS In 851 patients undergoing cardiac surgery, TEE clinical indications were classified as category I or II according to the ASA guidelines. Category I indications are patients in which TEE is considered useful and category II are those(More)
OBJECTIVE To determine the importance of the mean arterial pressure-to-mean pulmonary artery pressure ratio (MAP/MPAP) in cardiac surgical patients. DESIGN Retrospective and prospective studies (3 groups). SETTING Tertiary care hospital. PARTICIPANTS Cardiac surgical patients (1,557). INTERVENTION Retrospective analysis (group 1), induction of(More)
BACKGROUND Several risk factors have been shown to increase mortality in cardiac surgery. However, the importance of left ventricular end-diastolic pressure (LVEDP) as an independent risk factor before cardiac surgery is unclear. Method. This observational study investigated 3024 consecutive adult patients who underwent cardiac surgical procedures at the(More)