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Intraoperative TEE

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https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#1
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28473968/utilization-of-intraoperative-real-time-three-dimensional-transoesophageal-echocardiography-to-objectively-assess-improvement-in-synchronization-and-regional-wall-motion-after-coronary-reperfusion
#2
Abhishek Karnwal, Clinton Z Kakazu, Sonia Shah, Bassim Omari, Charu Dutt Arora
It is well known that myocardial ischemia leads to Regional Wall Motion Abnormalities (RWMAs) and reversible depression of Left Ventricular (LV) systolic function. Transoesophageal Echocardiography (TEE) is an established tool for early diagnosis of new RWMAs. However, evaluation of RWMAs by echocardiography is largely qualitative and relies on visual assessment of wall segments. Evaluation of LV systolic function and Ejection Fraction (EF) is more reproducible and accurate with Real-Time 3D Echocardiography (RT3DE) as compared with two-dimensional and M-mode techniques...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28459719/profound-obstructive-hypotension-from-prone-positioning-documented-by-transesophageal-echocardiography-in-patient-with-scoliosis-a-case-report
#3
Arnoley S Abcejo, Juan Diaz Soto, Courtney Castoro, Sarah Armour, Timothy R Long
In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28449514/left-ventricular-outflow-tract-obstruction-due-to-a-left-ventricular-myxoma-that-was-misidentified-as-an-accessory-mitral-valve-tissue
#4
Seung-Hoon Baek, Hee Young Kim, Hyae Jin Kim, Sang Wook Shin, Hye Jin Kim, Yun Mi Choi, Eun Ji Choi, Eunjung Chang, Hong-Sik Son
We report obstruction of the left ventricle outflow tract (LVOT) caused by cardiac myxoma that was misidentified as an accessory mitral valve tissue preoperatively. A 65-year-old woman presented with chest discomfort that persisted for 7 days. Transthoracic echocardiography (TTE) revealed a mobile, low-echogenic, balloon-shaped mass attached to the anterior mitral valve leaflet and papillary muscle, which was suspected to be an accessory mitral valve tissue. Because the mass caused LVOT obstruction and it could result in hemodynamic instability, emergency operation was performed...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28442684/enhanced-trabeculectomy-the-moorfields-safer-surgery-system
#5
Peng Tee Khaw, Mark Chiang, Peter Shah, Freda Sii, Alastair Lockwood, Ashkan Khalili
Trabeculectomy with antifibrotic treatment is still the most popular incisional procedure for glaucoma filtration surgery (GFS) worldwide. The advent of antifibrotic agents reduced failure due to scarring but resulted in increased complications. Advances in trabeculectomy surgery have been driven by the need to minimise the risk of: (1) complications and (2) surgical failure. This chapter covers preoperative, intraoperative, and postoperative strategies, which improve the outcome of GFS. Strategies to reduce the risk of complications centre on the prevention of postoperative hypotony by minimising the risk of overdrainage, postoperative wound leaks, and poor bleb morphology...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28433951/transesophageal-echocardiography-in-the-evaluation-of-the-trauma-patient-a-trauma-resuscitation-transesophageal-echocardiography-exam
#6
REVIEW
Stefan W Leichtle, Andrew Singleton, Mandeep Singh, Matthew J Griffee, Joshua M Tobin
The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28423128/peratrial-device-closure-of-atrial-septal-defect-under-transesophageal-echocardiographic-guidance-without-fluoroscopy-compared-to-conventional-on-pump-surgical-closure
#7
Zhixiang Guo, Chengxin Zhang, Huan Wang, Shenglin Ge
Objective: This study is designed to evaluate the advantages between peratrial device closure under transesophageal echocardiographic guidance and open heart surgery in atrial septal defect. Methods: From November 2011 to September 2014, 28 patients with atrial septal defect were treated. Fourteen patients received peratrial device closure under transesophageal echocardiographic guidance (TEE group) and 14 patients received cardiopulmonary bypass (CPB group). Clinical parameters during intraoperative and postoperative periods were examined...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28359486/intraoperative-bioprosthetic-valve-dysfunction-causing-severe-mitral-regurgitation
#8
Philip Y K Pang, Susan Garwood, Sabet W Hashim
Structural degeneration of bioprosthetic valves usually occurs gradually over time. Failure of a bioprosthetic valve immediately after implantation is extremely rare. Possible causes include obstruction of valve leaflets from preserved subvalvular tissue during chordal-sparing mitral valve replacement (MVR) or strut entrapment by suture loops. We report 2 cases of acute bioprosthetic mitral valve (MV) dysfunction involving newly implanted Perimount Theon (Edwards Lifesciences, Irvine, CA) bioprostheses, causing severe transvalvular mitral regurgitation (MR)...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28326754/supporting-imaging-modalities-for-improving-diagnosis-of-prosthesis-endocarditis-preliminary-results-of-a-single-center-experience-with-fluorine-18-fluorodeoxyglucose-positron-emission-tomography-computed-tomography
#9
Anna Kokalova, Angelo M Dell'AQUILA, Nemanja Avramovic, Sven Martens, Christian Wenning, Jürgen R Sindermann
AIM: The aim of current study was to evaluate the role of PET-CT in the diagnosis of prosthetic valve endocarditis (PVE). METHODS: This is a single-center study including 13 PET/CT examinations performed between February 2009 and March 2016 in 13 patients (76.9% men, mean age 68.1 years, IQR 11.1) because of suspect of PVE. Median interval time between first operation and PET/CT examination was 19.02 months (lQR 85.5). Final diagnosis was made according to pathological criteria (histological and microbiological) of the Duke classification...
March 21, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28323763/prospective-randomized-clinical-trial-investigating-the-effect-of-the-reamer-irrigator-aspirator-on-the-volume-of-embolic-load-and-respiratory-function-during-intramedullary-nailing-of-femoral-shaft-fractures
#10
Jeremy A Hall, Michael D McKee, Milena R Vicente, Zachary A Morison, Niloofar Dehghan, Christine E Schemitsch, Hans J Kreder, Brad Petrisor, Emil H Schemitsch
OBJECTIVES: We sought to determine whether the use of the Reamer-Irrigator-Aspirator (RIA) device resulted in a decreased amount of fat emboli compared with standard reaming (SR) when performing intramedullary (IM) nailing of femoral shaft fractures. DESIGN: Prospective randomized clinical trial. SETTING: Multi-centered trial, level I trauma centers. PATIENTS/PARTICIPANTS: All eligible patients who presented to participating institutions with an isolated femoral shaft fracture amenable to fixation with antegrade IM nailing...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28268005/feasibility-of-intraoperative-water-testing-in-aortic-valve-repair-direct-visualization-from-left-ventricle-with-a-videoscope
#11
Shunsuke Miyahara, Takanori Oka, Hiroaki Takahashi, Takeshi Inoue, Masamichi Matsumori, Hiroshi Tanaka, Yutaka Okita
OBJECTIVE: We describe a simple method to assess the aortic valve using a videoscope inserted in the left ventricle (LV-VS) during valve-sparing root replacement. The aim of this study was to evaluate the feasibility of this technique by comparing it with the findings of postoperative transesophageal echocardiography (TEE). METHODS: Thirty-six patients (29 male, mean age 45.4 ± 20.1 years) undergoing aortic root reimplantation were assessed intraoperatively with LV-VS...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28235505/tension-pneumomediastnum-a-rare-cause-of-acute-intraoperative-circulatory-collapse-in-the-setting-of-unremarkable-tee-findings
#12
Jonathan B Weaver, Avinash B Kumar
DESIGN: Case report. SETTING: Operating room. PATIENT: 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. INTERVENTIONS: A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28100426/ferumoxytol-mra-for-transcatheter-aortic-valve-replacement-planning-with-renal-insufficiency
#13
Kimberly Kallianos, Travis S Henry, Yerem Yeghiazarians, Jeffrey Zimmet, Kendrick A Shunk, Elaine E Tseng, Vaikom Mahadevan, Michael D Hope
BACKGROUND: Computed tomography angiography (CTA) is the test of choice for pre-procedure imaging of transcatheter aortic valve replacement (TAVR) candidates. The iodinated contrast required, however, increases the risk of renal dysfunction in patients with pre-existing renal failure. Ferumoxytol is a magnetic resonance imaging (MRI) contrast agent that can be used with renal failure. Its long vascular resonance time allows gated MRA sequences that approach CTA in image quality. We present respiratory and cardiac gated MRA enabled by ferumoxytol that can be post-processed in an analogous fashion to CTA...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28094007/obtaining-the-biomechanical-behavior-of-ascending-aortic-aneurysm-via-the-use-of-novel-speckle-tracking-echocardiography
#14
Mohammed Alreshidan, Nastaran Shahmansouri, Jennifer Chung, Vynka Lash, Alexander Emmott, Richard L Leask, Kevin Lachapelle
INTRODUCTION: Ex vivo measurement of ascending aortic biomechanical properties may help understand the risk for rupture or dissection of dilated ascending aortas. A validated in vivo method that can predict aortic biomechanics does not exist. Speckle tracking transesophageal echocardiography (TEE) has been used to measure ventricular stiffness; we sought to determine whether speckle TEE could be adapted to estimate aortic stiffness in vivo and compare these findings with those obtained by ex vivo tissue measurements...
December 20, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28065230/effectiveness-of-secundum-atrial-septal-defect-occlusion-with-the-septal-occluder-through-right-chest-small-incision-clinical-analysis-of-140-cases
#15
Song-Yi Qian, Zong-Gang Zhang, Jun Liu, Yong-Zhong Guo, Sheng Guo, Zhong-Yuan Ma, Yu-Kui DU, Ti Ai Li Ai Ze-Zi Mai, Jian-Shuang Tao, Peng Liu
Objective To evaluate the feasibility and effectiveness of secundum atrial septal defect(ASD)occlusion with the septal occluder through right-chest small incision. Methods The clinical data of 140 secundum ASD patients (47 males and 93 females) aged 3-63 years who were treated in our center from August 2004 to July 2014 were retrospectively analyzed. The diameter of ASD was 6 to 36 mm. Under general anesthesia, all patients underwent intraoperative transtsophageal echocardiography (TEE), during which no associated cardiac deformity was found...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28007380/the-effect-of-transesophageal-echocardiography-probe-placement-on-intracuff-pressure-of-an-endotracheal-tube-in-infants-and-children
#16
Mineto Kamata, Mumin Hakim, Dmitry Tumin, Senthil G Krishna, Aymen Naguib, Joseph D Tobias
OBJECTIVES: To evaluate the effects of transesophageal echocardiography (TEE) probe insertion on the endotracheal cuff pressure (CP). DESIGN: Prospective observational study. SETTING: Single standing, not-for-profit pediatric hospital. PARTICIPANTS: A total of 80 pediatric patients (aged 6 days to 18.4 years) who underwent cardiac surgery and intraoperative TEE. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Following anesthesia induction and endotracheal intubation, the CP was recorded at 4 points: before the insertion of the TEE (P1), at TEE insertion (P2), during TEE examination (P3), and after the probe was advanced into the stomach (P4)...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27939049/impact-of-methodologic-differences-in-three-dimensional-echocardiographic-measurements-of-the-aortic-annulus-compared-with-computed-tomographic-angiography-before-transcatheter-aortic-valve-replacement
#17
Omar K Khalique, Nadira B Hamid, Jonathon M White, David J Bae, Susheel K Kodali, Tamim M Nazif, Torsten P Vahl, Jean-Michel Paradis, Isaac George, Martin B Leon, Rebecca T Hahn
BACKGROUND: Three-dimensional (3D) echocardiographic (3DE) imaging is an alternative to multi-detector row computed tomography (MDCT) for aortic annular measurement before transcatheter aortic valve replacement (TAVR). A commonly used direct planimetry from a reconstructed short-axis view has not been compared with semiautomated 3DE methods. Typically accepted optimal cutoffs for percent prosthesis-area oversizing of the balloon-expandable SAPIEN or SAPIEN XT valve to native annular size are approximately 5% to 15%...
December 6, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27916237/transesophageal-speckle-tracking-echocardiography-improves-right-ventricular-systolic-function-assessment-in-the-perioperative-setting
#18
Nicholas W Markin, Mohammed Chamsi-Pasha, Jiangtao Luo, Walker R Thomas, Tara R Brakke, Thomas R Porter, Sasha K Shillcutt
BACKGROUND: Perioperative evaluation of right ventricular (RV) systolic function is important to follow intraoperative changes, but it is often not possible to assess with transthoracic echocardiographic (TTE) imaging, because of surgical field constraints. Echocardiographic RV quantification is most commonly performed using tricuspid annular plane systolic excursion (TAPSE), but it is not clear whether this method works with transesophageal echocardiographic (TEE) imaging. This study was performed to evaluate the relationship between TTE and TEE TAPSE distances measured with M-mode imaging and in comparison with speckle-tracking TTE and TEE measurements...
December 1, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27882249/surviving-all-odds-a-unique-case-of-multiple-congenital-unruptured-sinus-of-valsalva-aneurysms-involving-both-left-and-right-coronary-sinuses-with-biventricular-dysfunction-and-heart-block
#19
Aniketh Vijay B, Vikrant Vijan, Navin Mathew
Aneurysms of the sinus of Valsalva are very uncommon, with an incidence ranging from 0.1 to 3.5% of all congenital heart defects. Very few cases have been reported in the literature that presented with involvement of two or more sinuses. We report a case of 27-year-old male with a history of exertional breathlessness of one-month duration. After complete evaluation using transesophageal echocardiography (TEE) and multiple detector computed tomography (MDCT) scanning, the patient was diagnosed to have large congenital unruptured sinus of Valsalva aneurysms involving both left and right coronary sinuses with extension into the interventricular septum...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27837084/intraoperative-diagnosis-of-intracardiac-thrombus-during-orthotopic-liver-transplantation-with-transesophageal-echocardiography-a-case-series-and-literature-review
#20
Adam A Dalia, Hisham Khan, Antolin S Flores
Anesthesia for orthotopic liver transplantation (OLT) is challenging for any anesthesiologist as the patients undergoing this procedure are among the most critically ill. Adding to the underlying complexity of OLT management is the rare complication of an intracardiac thrombus (ICT). Intracardiac thrombi can present following liver allograft reperfusion resulting in high morbidity and mortality. Currently there is no consensus treatment for ICT, and the gold standard for diagnosis is intraoperative transesophageal echocardiography (TEE); these 2 factors lead to a dangerous amalgam of the difficulty in diagnosing and treating the disease...
November 10, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
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