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Intraoperative TEE

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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29128482/aortic-valve-cusp-coaptation-surface-area-using-3-dimensional-transesophageal-echocardiography-correlates-with-severity-of-aortic-valve-insufficiency
#2
Benjamin Sohmer, Reza Jafar, Prakash Patel, Marie-Ève Chamberland, Michel R Labrosse, Munir Boodhwani
OBJECTIVE: The aim of this study was to test both in humans and using finite element (FE) aortic valve (AV) models whether the coaptation surface area (CoapSA) correlates with aortic insufficiency (AI) severity due to dilated aortic roots to determine the validity and utility of 3-dimensional transesophageal echocardiographic-measured CoapSA. DESIGN: Two-pronged, clinical and computational approach. SETTING: Single university hospital. PARTICIPANTS: The study comprised 10 patients with known AI and 98 FE simulations of increasingly dilated human aortic roots...
August 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29116970/assessment-of-tricuspid-annular-motion-by-speckle-tracking-in-anesthetized-patients-using-transesophageal-echocardiography
#3
Tao Shen, Michael H Picard, Lanqi Hua, Sara M Burns, Michael N Andrawes
BACKGROUND: The perioperative assessment of right ventricular (RV) function remains a challenge. Tricuspid annular plane systolic excursion (TAPSE) using M-mode is a widely used measure of RV function. However, accurate alignment of the ultrasound beam with the direction of annular movement can be difficult with transesophageal echocardiography (TEE) to measure TAPSE, precluding effective use of M-mode to measure annular excursion. Tracking of specular reflectors in the myocardium may provide an angle-independent method to assess annular motion with TEE...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29103855/right-ventricular-longitudinal-strain-in-left-ventricular-assist-device-surgery-a-retrospective-cohort-study
#4
Daniel R Beck, Lisa Foley, Jackson R Rowe, Angela F D Moss, Nathaen S Weitzel, T Brett Reece, David A Fullerton, Joseph C Cleveland, Karsten Bartels
OBJECTIVES: Right ventricular (RV) failure is common after left ventricular assist device (LVAD) surgery and is associated with higher mortality. Measurement of longitudinal RV strain using speckle-tracking technology is a novel approach to quantify RV function. The authors hypothesized that depressed peak longitudinal RV strain measured by intraoperative transesophageal echocardiography (TEE) examinations would be associated with adverse outcomes after LVAD surgery. DESIGN: Retrospective cohort study...
July 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28994691/distortion-of-aortic-valve-from-mechanical-traction-imposed-by-the-mitral-valve-prosthesis-the-three-dimensional-transesophageal-echocardiographic-perception
#5
Saravana Babu, Unnikrishnan P Koniparambil, Muthu Kumar, Bineesh K Radhakrishnan, Neelam Aggarwal, Saurabh Nanda
Iatrogenic injury to the aortic valve is a rare but frequently reported complication during mitral valve surgeries. Intraoperative 2-dimensional transesophageal echocardiography (2D TEE) has a major impact in diagnosing these injuries, so that timely intervention is possible. However, 2D TEE has lot of limitations during the perioperative period, which can be overcome by the three dimensional echocardiography (3D-TEE). We report a case where 3D TEE has undoubtedly delineated the cause for distortion of aortic sinus after mitral valve replacement and helped in the successful outcome...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28986069/accuracy-and-usefulness-of-aortic-annular-measurement-using-real-time-three-dimensional-transesophageal-echocardiography-comparison-with-direct-surgical-sizing
#6
Tomoko Nishi, Kentaro Shibayama, Minoru Tabata, Nahoko Kato, Masahiko Noguchi, Hiroshi Okumura, Yuji Kawano, Daisuke Nakatsuka, Kotaro Obunai, Yoshio Kobayashi, Hiroyuki Watanabe
BACKGROUND: There is a paucity of data that demonstrates a clinical impact of anatomical measurements of the aortic annulus by three-dimensional (3D) transesophageal echocardiography (TEE) on surgical aortic valve replacement (AVR). The aim of this study is to validate the accuracy of 3D TEE measurements compared with the direct intraoperative annular diameter and to investigate an impact of 3D TEE on a prediction of AVR with aortic annular enlargement (AAE). METHODS AND RESULTS: We retrospectively enrolled 61 patients who underwent both two-dimension (2D) and 3D TEE and transthoracic echocardiography (TTE) before AVR...
October 3, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28944171/current-state-of-the-art-and-future-of-myectomy
#7
REVIEW
Magdi H Yacoub, Ahmed Afifi, Hesham Saad, Heba Aguib, Ahmed ElGuindy
Surgical relief of left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy (HCM) requires more than septal myectomy. The procedure is currently the gold standard for all symptomatic HCM patients except those with comorbidities. The operation requires an individualized approach to restore the sophisticated functions of the left ventricular outflow tract (LVOT) without injury to the surrounding vital structures. The procedure should be tailored to deal with all the varied components of the obstruction including fibrous trigones, accessory tissues, and papillary muscle fusion...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#8
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28898453/echocardiographic-guidance-and-monitoring-of-left-atrial-appendage-closure-with-atriclip-during-open-chest-cardiac-surgery
#9
Rachele Contri, Sara Clivio, Tiziano Torre, Tiziano Cassina
Left atrial appendage (LAA) closure prevents thromboembolic risk and avoids lifelong anticoagulation due to atrial fibrillation (AF). Nowadays, AtriClip, a modern epicardial device approved in June 2010, allows external and safe closure of LAA in patients undergoing cardiac surgery during other open-chest cardiac surgical procedures. Such a surgical approach and its epicardial deployment differentiates LAA closure with AtriClip from percutaneous closure techniques such as Watchman (Boston Scientific, Marlborough, MA, USA), Lariat (SentreHEART Inc...
October 2017: Echocardiography
https://www.readbyqxmd.com/read/28890667/role-of-3d-echocardiography-in-cardiac-surgery-strengths-and-limitations
#10
REVIEW
Edwin Wilberforce Turton, Jörg Ender
PURPOSE OF REVIEW: This review aims to highlight the general and specific strengths and limitations of intraoperative 3D echocardiography. This article explains the value of real-time three-dimensional transesophageal echocardiography (RT 3D TEE) during cardiac surgery and cardiac interventions. RECENT FINDINGS: Recently published recommendations and guidelines include the use of RT 3D TEE. RT 3 D TEE provides additional value particularly for guidance during cardiac interventions (i...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/28855978/a-case-of-shunting-postoperative-patent-foramen-ovale-under-mechanical-ventilation-controlled-by-different-ventilator-settings
#11
Claudio Pragliola, Sara Di Michele, Domenico Galzerano
A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28852575/a-protocol-for-diagnosis-and-management-of-aortic-atherosclerosis-in-cardiac-surgery-patients
#12
REVIEW
Wouter W Jansen Klomp, George J Brandon Bravo Bruinsma, Arnoud W J Van 't Hof, Jan G Grandjean, Arno P Nierich
In patients undergoing cardiac surgery, use of perioperative screening for aortic atherosclerosis with modified TEE (A-View method) was associated with lower postoperative mortality, but not stroke, as compared to patients operated on without such screening. At the time of clinical implementation and validation, we did not yet standardize the indications for modified TEE and the changes in patient management in the presence of aortic atherosclerosis. Therefore, we designed a protocol, which combined the diagnosis of atherosclerosis of thoracic aorta and the subsequent considerations with respect to the intraoperative management and provides a systematic approach to reduce the risk of cerebral complications...
2017: International Journal of Vascular Medicine
https://www.readbyqxmd.com/read/28833528/intraoperative-assessment-of-transient-and-persistent-regional-left-ventricular-wall-motion-abnormalities-in-patients-undergoing-coronary-revascularization-surgery-using-real-time-three-dimensional-transesophageal-echocardiography-a-prospective-observational
#13
Neelam Aggarwal, Koniparambil P Unnikrishnan, Indranil Biswas, Jayakumar Karunakaran, Puthuvasseri R Suneel
OBJECTIVE: To evaluate the feasibility of intraoperative real time three-dimensional echocardiography (RT3DE) for identification and quantification of transient and persistent regional wall motion abnormalities (RWMAs) in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting (CABG). DESIGN: A prospective observational study SETTING: Single-center study in an academic tertiary care hospital PARTICIPANTS: A series of 42 patients undergoing elective CABG over a 2-year period were included...
August 22, 2017: Echocardiography
https://www.readbyqxmd.com/read/28800987/dynamic-three-dimensional-geometry-of-the-aortic-valve-apparatus-a-feasibility-study
#14
Arash Khamooshian, Yannis Amador, Ting Hai, Jelliffe Jeganathan, Maria Saraf, Eitezaz Mahmood, Robina Matyal, Kamal R Khabbaz, Massimo Mariani, Feroze Mahmood
OBJECTIVE: To provide (1) an overview of the aortic valve (AV) apparatus anatomy and nomenclature, and (2) data regarding the normal AV apparatus geometry and dynamism during the cardiac cycle obtained from three-dimensional transesophageal echocardiography (3D TEE). DESIGN: Retrospective feasibility study. SETTING: A single-center university teaching hospital. PARTICIPANTS: The study was performed on data of 10 patients with a nonregurgitant, nonstenotic aortic valve undergoing cardiac surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800985/assessment-of-paravalvular-leak-after-transcatheter-aortic-valve-replacement-transesophageal-echocardiography-compared-with-transthoracic-echocardiography
#15
Emily G Teeter, Claire Dakik, Mary Cooter, Zainab Samad, Kamrouz Ghadimi, J Kevin Harrison, Jeffery Gaca, Mark Stafford-Smith, Brandi A Bottiger
OBJECTIVES: Determine whether moderate or greater paravalvular leak (PVL) after transcatheter aortic valve replacement quantified using intraoperative transesophageal echocardiography (TEE) is associated with mortality and investigate the correlation between PVL grading using intraoperative TEE and postoperative transthoracic echocardiography (TTE). DESIGN: Retrospective, observational study. SETTING: Single academic institution. PARTICIPANTS: The study comprised adult patients undergoing elective transcatheter aortic valve replacement between April 2011 and February 2014...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28795442/protruding-coronary-stent-detected-by-transesophageal-echocardiography-changes-surgical-procedure
#16
David M Corda, Carl Dragstedt, Gary S Allen, Gregory M Janelle
This case describes an unusual intraoperative transesophageal echocardiogram (TEE) finding of an unknown sinus of Valsalva mass in a patient undergoing an off-pump coronary artery bypass procedure. The intraoperative TEE finding not only revealed a protruding right coronary ostial stent but also changed the surgical procedure to include an aortotomy that allowed successful removal of the stent. As interventional cardiologists begin exploring more techniques to manage difficult ostial lesions, this finding may be seen more commonly in the future...
August 9, 2017: Echocardiography
https://www.readbyqxmd.com/read/28762919/-effectiveness-of-extended-myectomy-in-patients-with-hypertrophic-cardiomyopathy-with-midventricular-obstruction
#17
A V Bogachev-Prokophiev, S I Zheleznev, M S Fomenko, R M Sharifulin, A V Afanasyev, O Yu Malakhova, A M Karaskov
PURPOSE: to assess effectiveness and safety of extended myectomy performed in patients with hypertrophic obstructive cardiomyopathy (HOCM) with midventricular obstruction. MATERIAL AND METHODS: Between 2010 and 2013 185 HOCM patients were operated for left ventricular outflow tract (LVOT) obstruction. Among these patients 32 had midventricular obstruction. Their age was 22-74 (mean 51.9+/-14.2) years. Mean peak gradient across LVOT was 89.1+/-20.4 mm Hg, thickness of interventricular septum was 26...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#18
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28651485/intraoperative-left-atrium-inversion-after-implantation-of-heartmate-iii-ventricular-assist-device
#19
Ayşegül Ozgök, Z Asli Demir, Gökçe Sert, Doğan Sert, Zehra Gölbaşı, Umit Kervan
We report here a case of left atrium inversion after implanting HeartMate III LVAD, which is known to be the first in literature. LVAD can be functional only if there is adequate inflow to the device. Parameters and filling of left ventricle can be assessed by TEE. In our case, initial examination with TEE showed thrombus like images. HeartMate III has a reliable algorithm that automatically reduces pump speed if 'suction effect' is detected. HeartMate III demonstrates clean flow properties and good surface wash...
June 27, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28631103/transesophageal-echocardiography-in-orthotopic-liver-transplantation-a-comprehensive-intraoperative-monitoring-tool
#20
REVIEW
Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli, Giorgio Della Rocca
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction...
December 2017: Critical Ultrasound Journal
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