title: Major themes for 2013 in cardiothoracic and vascular anaesthesia and intensive care.
abstract: There has been significant progress throughout 2013 in cardiothoracic and vascular anaesthesia and intensive care. There has been a revolution in the medical and interventional management of atrial fibrillation. The medical advances include robust clinical risk scoring systems, novel oral anticoagulants, and growing clinical experience with a new antiarrhythmic agent. The interventional advances include left atrial appendage occlusion for stroke reduction, generalization of ablation techniques in cardiac surgery, thoracoscopic ablation techniques, and the emergence of the hybrid ablation procedure. Recent European guidelines have defined the organization and practice of two subspecialties, namely general thoracic surgery and grown-up congenital heart disease. The pivotal role of an effective multidisciplinary milieu is a central theme in both these clinical arenas. The anaesthesia team features prominently in each of these recent guidelines aimed at harmonizing delivery of perioperative care for these patient cohorts across Europe. Web-Enabled Democracy-Based Consensus is a system that allows physicians worldwide to agree or disagree with statements and expert consensus meetings and has the potential to increase the understanding of global practice and to help clinicians better define research priorities. This "Democratic based medicine", firstly used to assess the interventions that might reduce perioperative mortality has been applied in 2013 to the setting of critically ill patient with acute kidney injury. These advances in 2013 will likely further improve perioperative outcomes for our patients.
authors.affiliation: Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Gutsche
authors.affiliation: Cardiothoracic Anesthesiology and Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine Prague, Czech Republic.
authors.forename: H
authors.initials: H
authors.lastname: Riha
authors.affiliation: Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: P
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Sahota
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: E
authors.initials: E
authors.lastname: Valentine
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ghadimi
authors.affiliation: Anesthesiology and Critical Care, Icahn School of Medicine, Mount Sinai Hospital, New York, New York, USA.
authors.forename: G
authors.initials: G
authors.lastname: Silvay
authors.affiliation: Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: J G T
authors.initials: JG
authors.lastname: Augoustides
keywords: European Society of Cardiology.; ablation therapy; anaesthesia team; apixaban; atrial fibrillation; bleeding; clinical risk scoring system; dabigatran; general thoracic surgery; grown-up congenital heart disease; guidelines; hybrid procedure; left atrial appendage occlusion; minimally invasive surgery; multidisciplinary milieu; novel oral anticoagulants; rivaroxaban; stroke; vernakalant