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Intraoperative TEE

Poonam Malhotra Kapoor, Kanchi Muralidhar, Navin C Nanda, Yatin Mehta, Naman Shastry, Kalpana Irpachi, Aditya Baloria
In 1980, Transesophageal Echocardiography (TEE) first technology has introduced the standard of practice for most cardiac operating rooms to facilitate surgical decision making. Transoesophageal echocardiography as a diagnostic tool is now an integral part of intraoperative monitoring practice of cardiac anaesthesiology. Practice guidelines for perioperative transesophageal echocardiography are systematically developed recommendations that assist in the management of surgical patients, were developed by Indian Association of Cardiac Anaesthesiologists (IACTA)...
October 2016: Annals of Cardiac Anaesthesia
Deepak Prakash Borde, Antony George, Shreedhar Joshi, Suresh Nair, Thomas Koshy, Uday Gandhe, Murali Chakravarthy
CONTEXT: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). AIMS: We hypothesized that variations in practice of intraoperative TEE exist among centers and this survey aimed at analyzing them...
October 2016: Annals of Cardiac Anaesthesia
Hyun Ju Jung, Won-Kyoung Kwon, Sung Jun Lee, Nazri Mohamed, Bo-Mi Shin, Jinyoung Lee, Tae-Yop Kim
BACKGROUND: This study reports the efficacy of intraoperative transesophageal echocardiography (TEE) for evaluation of high take-off coronary ostia and proximal coronary arterial flows as an alternative to preoperative coronary angiography. CASE PRESENTATION: In a 65-year old male undergoing the bicuspid aortic valve (BAV) repair and the extensive remodeling of dilated sinus and tubular junction, and preoperative coronary angiography were unsuccessfully completed due to an allergic reaction to the contrast medium...
October 4, 2016: BMC Anesthesiology
Razvan Purza, Subhamay B Ghosh, Chris Walker, Brett Hiebert, Lillian Koley, G Scott Mackenzie, Hilary P Grocott
BACKGROUND: Although there have been several large reviews documenting the complications following intraoperative transesophageal echocardiography (TEE), most of these prior reports are almost 2 decades old and may not reflect current practices. The purpose of this study was to determine the incidence and types of complications following TEE in a contemporary cardiac surgical population. METHODS: We conducted a retrospective analysis of all cardiac surgical patients having undergone an intraoperative TEE between April 1, 2004, and April 30, 2012...
September 16, 2016: Annals of Thoracic Surgery
G L Wang, H Bi, J F Ye, H X Zhang, L L Ma
OBJECTIVE: To describe a feasible surgical technique for patients with renal cell carcinoma associated with a supradiaphragmatic tumor thrombus that avoids cardiopulmonary bypass procedure. METHODS: We retrospectively analyzed 2 cases with right kidney tumor and tumor thrombus above the diaphragm treated in April and August, 2015. The two patients were both female, aged 73 and 67 years. The tumor sizes of right kidneys were 7.0 cm×6.3 cm×5.7 cm and 8.7 cm×7.0 cm×5...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Richard Lee, Patricia Vassallo, Jane Kruse, S Chris Malaisrie, Vera Rigolin, Adin-Cristian Andrei, Patrick McCarthy
BACKGROUND: Elimination of the left atrial appendage (LAA) attempts to reduce stroke in patients with atrial fibrillation (AF). A retrospective review suggests that various surgical techniques are often unsuccessful and may leave a stump or gap. In a pilot study, we prospectively evaluated 3 surgical techniques with long-term follow up to define effectiveness. METHODS: At a single institution, 28 patients undergoing concomitant AF surgery were randomized prospectively into 1 of 3 techniques of LAA elimination: internal suture ligation (IL), external stapled excision (StEx), and surgical excision (SxEx)...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Naveen G Singh, P S Nagaraja, Divya Gopal, V Manjunath, K S Nagesh, N Manjunatha, Guru Police Patel, Satish Kumar Mishra
BACKGROUND: Abdominal complications being rare but results in high mortality, commonly due to splanchnic organ hypoperfusion during the perioperative period of cardiac surgery. There are no feasible methods to monitor intraoperative superior mesenteric artery blood flow (SMABF). Hence, the aim of this study was to evaluate the feasibility and to measure SMABF using transesophageal echocardiography (TEE) during cardiac surgery under hypothermic cardiopulmonary bypass (CPB). METHODOLOGY: Thirty-five patients undergoing elective cardiac surgery under CPB were enrolled...
July 2016: Annals of Cardiac Anaesthesia
Akiko Ishige, Hiroyuki Tanaka, Tetsuro Ueda, Mikio Ninomiya, Toshiya Ohtsuka
A 41-year-old man with sudden onset of chest oppression and downslope ST depression was diagnosed as having type A aortic dissection with angina pectoris and aortic regurgitation. Intraoperative transesophageal echocardiogram (TEE) showed intimal flap inverting into the left ventricle through the aortic valve. This case was rare in that transient myocardial ischemia was induced not by dissection of the aortic root reaching the coronary ostia but by back-and-forth movement of the intimal flap, covering the coronary ostia and interrupting the coronary artery flow...
September 2011: Journal of Echocardiography
Massimiliano Meineri
Transesophageal echocardiography (TEE) is a very powerful intraoperative monitoring tool. It allows precise assessment of cardiac anatomy together with dynamic quantification of myocardial performance and flows through the heart chambers. With a high safety profile TEE counts few absolute contraindications. Performance of TEE requires dedicated training. Certification pathways are offered in Europe and North America. Focused, basic and advanced scanning protocols have been lately described for intraoperative and emergent use...
August 2016: Minerva Anestesiologica
Yong Sun, Peng Zhu, Pengyu Zhou, Yilong Guo, Shao-Yi Zheng
BACKGROUND: Intraoperative device closure of perimembranous ventricular septal defect(VSD) through a lower mini-sternotomy is safe, less invasive, and has excellent surgical and cosmetic outcomes. Our study is to evaluate the feasibility of closing VSD under guidance of trans-epicardial echocardiography. METHODS: We reviewed the clinical course of 41 patients referred to our institution for minimally invasive closure of perimembranous VSD. The trans-epicardial echocardiography(TEE) was used to monitor the whole procedure to guide the positioning of device and evaluate the operative effect instantly after operation...
2016: Journal of Cardiothoracic Surgery
Kazumi Ono, Hidekuni Hidaka, Yusuke Koyama, Kenzo Ishii, Shinya Taguchi, Mako Kosaka, Nobuki Okazaki, Wakana Tanimoto, Akira Katayama
Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group)...
August 2016: Journal of Anesthesia
Rahul Vasudev, Priyank Shah, Mahesh Bikkina, Fayez Shamoon
Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly causing aortic regurgitation usually in the fifth to sixth decade of life. Earlier, the diagnosis was mostly during postmortem or intraoperative, but now with the advent of better imaging techniques such as transthoracic echocardiography, transesophageal echocardiography (TEE), and cardiac magnetic resonance imaging, more cases are being diagnosed in asymptomatic patients. We present a case of a 39-year-old male who was found to have QAV, with the help of TEE, while undergoing evaluation for a diastolic murmur...
2016: Journal of Clinical Imaging Science
Jyoti K Patel, Andrew C Glatz, Reena M Ghosh, Shannon M Jones, Chitra Ravishankar, Christopher Mascio, Meryl S Cohen
BACKGROUND: Intramural ventricular septal defects (VSDs), residual interventricular communications occurring after repair of conotruncal defects, are associated with poor postoperative outcomes. The ability of intraoperative transesophageal echocardiography (TEE) to identify intramural VSDs has not yet been evaluated. METHODS: Intraoperative TEE and postoperative transthoracic echocardiography (TTE) data in all patients undergoing all biventricular repair of conotruncal anomalies in our hospital between January 1, 2006, and June 30, 2013, were reviewed...
September 2016: Journal of Thoracic and Cardiovascular Surgery
Gabriela Alcaraz, Massimiliano Meineri, Kathleen Dattilo, Marcin Wąsowicz
Budd-Chiari syndrome (BCS) is a congestive hepatopathy caused by hepatic venous outflow obstruction. Torsion of the remnant liver after extended right hepatectomy is a potential cause of acute BCS, and it can lead to acute liver failure or death. We present a case of intraoperative transesophageal echocardiographic (TEE) diagnosis of acute BCS after extended right hepatectomy. TEE allowed timely detection of acute BCS and consequent inferior vena cava obstruction and decreased right atrial filling as the cause of sudden life-threatening hemodynamic collapse unresponsive to intravascular volume therapy and inotropic support...
July 1, 2016: A & A Case Reports
Grzegorz Suwalski, Robert Emery, Leszek Gryszko, Kamil Kaczejko, Jakub Mroz, Andrzej Skrobowski
OBJECTIVES: Epicardial left atrial appendage (LAA) closure with use of occluder is an emerging technique. Absence of remnant LAA stump is major criterion of successful obliteration. The aim of study was to assess early success rate of epicardial LAA closure. METHODS: Fifteen patients with persistent AF and coronary artery disease underwent off-pump coronary revascularization with concomitant ablation and LAA epicardial occlusion with use of two types of occluders...
September 2016: Echocardiography
Neil L Duplantier, Michael Couch, Logan Emory, Joseph M Zavatsky
STUDY DESIGN: This is a case report. OBJECTIVE: Describe the occurrence of cardiac emboli recorded on transesophageal echocardiogram (TEE) after the injection of a topical hemostatic agent into a vertebra prior to performing a pedicle subtraction osteotomy (PSO). SUMMARY OF BACKGROUND DATA: Hemostasis during spinal surgery is critical for adequate visualization and to reduce the risk of perioperative complications. Adult spinal deformity surgery can involve performing PSOs which are useful in cases of fixed spinal deformities and are associated with increased blood loss secondary to epidural and cancellous bleeding...
May 2016: Spine
Alberto Zangrillo, Patrizio Mazzone, Carmine D Votta, Nicola Villari, Paolo Della Bella, Fabrizio Monaco
PURPOSE: Left atrial appendage (LAA) closure is an interventional procedure increasingly used to prevent stroke in patients with permanent atrial fibrillation and contraindications to anticoagulation therapy. As this procedure requires a relatively immobile patient and performance of continuous and prolonged transesophageal echocardiography (TEE), it is usually performed under general anesthesia. In this case series, we describe the feasibility of prolonged TEE for percutaneous LAA closure using a new noninvasive ventilation device that can avoid the need for endotracheal intubation and general anesthesia...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Geehan Suleyman, Robert Tibbetts, Mary Beth Perri, Dora Vager, Yuan Xin, Katherine Reyes, Linoj Samuel, Eman Chami, Patricia Starr, Jennifer Pietsch, Marcus J Zervos, George Alangaden
OBJECTIVE Nosocomial outbreaks caused by Salmonella are rare. We describe the investigation and control of a cluster of novel extended-spectrum β-lactamase (ESBL) Salmonella enterica serotype Isangi in a hospital in southeastern Michigan. METHODS An epidemiologic investigation, including case-control study, assessment of infection control practices and environmental cultures, was performed to identify modes of transmission. Healthcare workers (HCWs) exposed to case patients were screened. Strain relatedness was determined using pulsed-field gel electrophoresis (PFGE); ESBL confirmation was conducted using real-time PCR...
August 2016: Infection Control and Hospital Epidemiology
Vikash Goswami, Bhupesh Kumar, Goverdhan Dutt Puri, Harkant Singh
PURPOSE: The aims of this study were to determine the utility of transesophageal echocardiography (TEE) for identifying spinal canal structures and epidural catheter position and to assess the effect of catheter position on intraoperative hemodynamics and quality of postoperative analgesia. METHODS: Twenty-six adult patients undergoing thoracic surgery were included in this prospective, observational study. An epidural catheter was inserted 7.5 cm or more into the thoracic epidural space using a midline approach and a loss-of-resistance technique...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Abdulraouf M Z Jijeh, Ahmad S Omran, Hani K Najm, Riyadh M Abu-Sulaiman
BACKGROUND: Intraoperative transesophageal echocardiography (TEE) has a major role in detecting residual lesions during and/or after pediatric cardiac surgery. METHODS: All pediatric patients who underwent cardiac surgery between July 2001 and December 2008 were reviewed. The records of surgical procedure, intraoperative TEE, and predischarge transthoracic echocardiograms were reviewed to determine minor and major residual cardiac lesions after surgical repair. RESULTS: During the study period, a total of 2268 pediatric cardiac patients were operated in our center...
April 2016: Journal of the Saudi Heart Association
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