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Superior septal approach

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https://www.readbyqxmd.com/read/30077562/echocardiographic-applications-of-m-mode-ultrasonography-in-anesthesiology-and-critical-care
#1
REVIEW
Gabriel Prada, Antoine Vieillard-Baron, Archer K Martin, Antonio Hernandez, Farouk Mookadam, Harish Ramakrishna, Jose L Diaz-Gomez
Proficiency in echocardiography and lung ultrasound has become essential for anesthesiologists and critical care physicians. Nonetheless, comprehensive echocardiography measurements often are time-consuming and technically challenging, and conventional 2-dimensional images do not permit evaluation of specific conditions (eg, systolic anterior motion of the mitral valve, pneumothorax), which have important clinical implications in the perioperative setting. M-mode (motion-based) ultrasonographic imaging, however, provides the most reliable temporal resolution in ultrasonography...
June 30, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29709577/endocardial-ablation-of-ventricular-ectopic-beats-arising-from-the-basal-inferoseptal-process-of-the-left-ventricle
#2
Anthony Li, Zia Zuberi, Jason S Bradfield, John K Zarif, David E Ward, Robert H Anderson, Kalyanam Shivkumar, Magdi M Saba
BACKGROUND: Idiopathic ventricular ectopy (VE) shows predilection to sites within the left ventricular (LV) base such as the outflow tract/aortic sinuses, LV summit, and areas adjacent to the aortomitral continuity. We characterize VE arising from the inferior septum of the LV base that was successfully managed by LV endocardial ablation from the inferoseptal recess of the LV. OBJECTIVE: The purpose of this study was to determine the incidence, electrocardiographic (ECG) findings, electrophysiological findings, and anatomical features associated with VE arising from the basal inferoseptal process of the LV (ISP-LV) ablated using an LV endocardial approach via the inferoseptal recess of the LV...
April 28, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29501668/endocardial-left-ventricular-pacing-across-the-interventricular-septum-for-cardiac-resynchronization-therapy-clinical-results-of-a-pilot-study
#3
James H P Gamble, Neil Herring, Matthew R Ginks, Kim Rajappan, Yaver Bashir, Tim R Betts
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for selected patients with heart failure, but it can be limited by the inability to place the left ventricular (LV) lead via the coronary sinus. OBJECTIVE: The purpose of this study was to develop an alternative approach, placing the LV lead endocardially via an interventricular septal puncture, and to assess the feasibility and safety of this technique. METHODS: All patients were anticoagulated with warfarin (international normalized ratio 2...
July 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29454717/superior-approach-for-supracardiac-total-anomalous-pulmonary-venous-connection
#4
Rong Liufu, Guocheng Shi, Fang Zhu, Yongmei Guan, Zhaohui Lu, Weimin Chen, Zhongqun Zhu, Huiwen Chen
BACKGROUND: Studies on the outcomes of surgical repair for supracardiac total anomalous pulmonary venous connection through the superior approach are uncommon. METHODS: From January 2004 to January 2016, 198 patients with supracardiac total anomalous pulmonary venous connection underwent side-to-side anastomosis between the common pulmonary vein and left atrium through the superior approach. Kaplan-Meier curve was used to demonstrate the survival estimates. Cox proportional hazard model and competing risk regression model were used to identify risk factors for death and postoperative pulmonary venous obstruction...
May 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29337012/expanding-the-limits-of-endoscopic-intraorbital-tumor-resection-using-3-dimensional-reconstruction
#5
Luciano Lobato Gregorio, Nicolas Y Busaba, Marcel M Miyake, Suzanne K Freitag, Benjamin S Bleier
INTRODUCTION: Endoscopic orbital surgery is a nascent field and new tools are required to assist with surgical planning and to ascertain the limits of the tumor resectability. OBJECTIVE: We purpose to utilize three-dimensional radiographic reconstruction to define the theoretical lateral limit of endoscopic resectability of primary orbital tumors and to apply these boundary conditions to surgical cases. METHODS: A three-dimensional orbital model was rendered in 4 representative patients presenting with primary orbital tumors using OsiriX open source imaging software...
December 26, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29305627/antagonism-at-the-nr2b-subunit-of-nmda-receptors-induces-increased-connectivity-of-the-prefrontal-and-subcortical-regions-regulating-reward-behavior
#6
Natalia Gass, Robert Becker, Markus Sack, Adam J Schwarz, Jonathan Reinwald, Alejandro Cosa-Linan, Lei Zheng, Christian Clemm von Hohenberg, Dragos Inta, Andreas Meyer-Lindenberg, Wolfgang Weber-Fahr, Peter Gass, Alexander Sartorius
RATIONALE: Evidence indicates that ketamine's rapid antidepressant efficacy likely results from its antagonism of NR2B-subunit-containing NMDA receptors (NMDAR). Since ketamine equally blocks NR2A- and NR2B-containing NMDAR, and has affinity to other receptors, NR2B-selective drugs might have improved therapeutic efficiency and side effect profile. OBJECTIVES: We aimed to compare the effects of (S)-ketamine and two different types of NR2B-selective antagonists on functional brain networks in rats, in order to find common circuits, where their effects intersect, and that might explain their antidepressant action...
April 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29232303/totally-endoscopic-cardiac-surgery-for-atrial-septal-defect-repair-on-beating-heart-without-robotic-assistance-in-25-patients
#7
Quang-Huy Dang, Ngoc-Thanh Le, Cong-Huu Nguyen, Dac-Dai Tran, Do-Hung Nguyen, Trung-Hieu Nguyen, Thi-Hai-Linh Ngo
OBJECTIVE: The aim of the study was to investigate the effectivity and safety of totally endoscopic cardiac surgery without robotic assistance for atrial septal defect (ASD) closure on beating hearts. METHODS: Twenty-five patients (adults/children: 15/10) underwent ASD closure using nonrobotically assisted totally endoscopic approach on beating heart. Three 5-mm trocars and one 12-mm trocar were used, only the superior vena cava is snared, filling the pleural and pericardial cavities with CO2, and the heart was beating during the surgery...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29016788/isolation-of-the-superior-vena-cava-from-the-right-atrial-posterior-wall-a-novel-ablation-approach
#8
Carola Gianni, Javier E Sanchez, Sanghamitra Mohanty, Chintan Trivedi, Domenico G Della Rocca, Amin Al-Ahmad, J David Burkhardt, G Joseph Gallinghouse, Patrick M Hranitzky, Rodney P Horton, Luigi Di Biase, Andrea Natale
Aims: Superior vena cava (SVC) isolation might be difficult to achieve because of the vicinity of the phrenic nerve (PN) and sinus node. Based on its embryogenesis, we hypothesized the presence of preferential conduction from the right atrial (RA) posterior wall, making it possible to isolate the SVC antrally, sparing its anterior and lateral aspect. Methods and results: This is a descriptive cohort study of 105 consecutive patients in which SVC isolation was obtained with radiofrequency ablation, starting in the septal aspect of the SVC-RA junction and continued posteriorly and inferiorly targeting sites of early activation until electrical isolation was obtained...
September 15, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28974283/is-mesocardia-with-left-sided-caval-vein-draining-to-coronary-sinus-a-contraindication-for-a-percutaneous-pulmonary-valve-implantation-a-case-description
#9
Marinos Kantzis, Christoph M Happel, Nikolaus A Haas
Introduction Although the right jugular vein approach for percutaneous pulmonary valve implantation is well described, there are no reports that describe a percutaneous pulmonary valve implantation through a left superior caval vein to coronary sinus pathway. Case A 14-year-old female with tetralogy of Fallot, mesocardia, left superior caval vein draining into the coronary sinus, and hemiazygos continuation of the inferior caval vein underwent ventricular septal defect closure, with homograft insertion from the right ventricle to the pulmonary artery, patch augmentation of the left pulmonary artery, and creation of an atrial communication...
February 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/28774381/first-in-human-closed-chest-transcatheter-superior-cavopulmonary-anastomosis
#10
Kanishka Ratnayaka, John W Moore, Rodrigo Rios, Robert J Lederman, Sanjeet R Hegde, Howaida G El-Said
BACKGROUND: In the care of patients with congenital heart disease, percutaneous interventional treatments have supplanted many surgical approaches for simple lesions, such as atrial septal defect. By contrast, complex congenital heart defects continue to require open-heart surgery. In single-ventricle patients, a staged approach is employed, which requires multiple open-heart surgeries and significant attendant morbidity and mortality. A nonsurgical transcatheter alternative would be attractive...
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28528053/transcatheter-mustard-revision-using-endovascular-graft-prostheses
#11
Diego Porras, Dimitrios Mitsouras, Michael Steigner, Andreas A Giannopoulos, Tatiana Kelil, Audrey C Marshall, Matthew T Menard
We describe the use of percutaneously inserted, transcatheter endovascular graft prostheses to exclude large Mustard baffle leaks in a high-surgical-risk patient. We used 3-dimensional-printed models to determine feasibility and to plan the procedure. Telescoping thoracic and abdominal graft extensions were placed in the inferior and superior limbs of the systemic venous pathways. An atrial septal defect occluder device was also used to close a separate leak not covered by the endovascular graft prostheses...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#12
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28390741/treatment-options-for-the-closure-of-secundum-atrial-septal-defects-a-systematic-review-and-meta-analysis
#13
REVIEW
Pedro A Villablanca, David A Briston, Josep Rodés-Cabau, David F Briceno, Gaurav Rao, Mohammed Aljoudi, Aman M Shah, Divyanshu Mohananey, Tanush Gupta, Mohammed Makkiya, Harish Ramakrishna, Mario J Garcia, Robert H Pass, Giles Peek, Ali N Zaidi
BACKGROUND: Secundum atrial septal defects (ASDs) are treated by surgical closure (SC) or transcatheter device closure (TCC). Due to a scarcity of data directly comparing these approaches, it remains unclear which is superior. This meta-analysis compares the clinical outcomes of the two treatment options. METHODS: A literature search was performed in MEDLINE, Embase, PubMed, Google Search, and Cochrane databases for studies directly comparing SC and TCC of ASDs...
August 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28374333/how-to-approach-difficult-cases-of-avnrt
#14
REVIEW
Darpan S Kumar, Thomas A Dewland, Seshadri Balaji, Charles A Henrikson
Our approach to the ablation of atrioventricular nodal reciprocating tachycardia (AVNRT), the most common supraventricular tachycardia, is as follows: We first attempt ablation in the right atrial posteroseptum anterior to the coronary sinus ostium with a 4-mm non-irrigated tip catheter. If ablation within the triangle of Koch is unsuccessful with radiofrequency (RF), we switch to cryoablation and target a more superior (mid septal) region. We also utilize cryoablation if RF ablation produces transient VA block (absence of retrograde conduction during junctional rhythm) or a fast junctional rhythm (<350 msec)...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28138196/superior-septal-approach-versus-left-atrial-approach-for-mitral-valve-replacement-a-retrospective-cohort-study
#15
Tooba Ansar, Taimur Asif Ali, Saneeha Shahid, Saulat Hasnain Fatimi, Ghulam Murtaza
OBJECTIVE: To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28097430/how-i-do-it-the-mononostril-endonasal-transethmoidal-paraseptal-approach
#16
Robert Reisch, Hans Rudolf Briner, Anne-Katrin Hickmann
BACKGROUND: The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach. METHODS: The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27943499/prenatal-diagnosis-and-prognosis-of-accelerated-idioventricular-rhythm
#17
J-C Fouron, A McNeal-Davidson, S Abadir, A Fournier, J-L Bigras, C Boutin, M Brassard, M-J Raboisson, N van Doesburg, A Berger, S Brisebois, R Gendron
OBJECTIVES: As postnatal identification of accelerated idioventricular rhythm (AIVR) relies on specific electrocardiographic patterns, prenatal diagnosis of this condition is challenging and its true incidence is unknown. The objectives of this study were to evaluate the performance of prenatal ultrasonography in identifying intrauterine cardiocirculatory events linked to specific electrocardiographic signs of postnatal AIVR, including left or right ventricular origin, and to assess the prenatal prognosis of this arrhythmia...
November 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27591768/ct-pulmonary-angiography-based-scoring-system-to-predict-the-prognosis-of-acute-pulmonary-embolism
#18
COMPARATIVE STUDY
Kanako K Kumamaru, Sachin S Saboo, Ayaz Aghayev, Phoebe Cai, Carlos Gonzalez Quesada, Elizabeth George, Zoha Hussain, Tianrun Cai, Frank J Rybicki
BACKGROUND: The purpose is to develop a comprehensive risk-scoring system based on CT findings for predicting 30-day mortality after acute pulmonary embolism (PE), and to compare it with PE Severity Index (PESI). MATERIALS AND METHODS: The study included consecutive 1698 CT pulmonary angiograms (CTPA) positive for acute PE performed at a single institution (2003-2010). Two radiologists independently assessed each study regarding clinically relevant findings and then performed adjudication...
November 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27549549/minimally-invasive-periareolar-approach-to-unroofed-coronary-sinus-atrial-septal-defect-repair
#19
Sabin J Bozso, Aaron Grant, Ivan Iglesias, Michael W A Chu
Less invasive techniques are commonly used to treat patients with anatomically suitable secundum atrial septal defects; however, repair of more complex atrial septal defects are still performed through sternotomy. Cosmetically appealing periareolar incisions have been used in breast reconstructive surgery and may provide an esthetically superior alternative to the anterolateral minithoracotomy incision used in minimally invasive cardiac surgery. We describe a patient with an unroofed coronary sinus atrial septal defect who underwent successful minimally invasive, endoscopic repair of this defect with autologous pericardial baffle reconstruction of the coronary sinus roof and closure of the interatrial communication through a periareolar approach...
September 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27194540/differential-effect-of-ganglionic-plexi-ablation-in-a-patient-with-neurally-mediated-syncope-and-intermittent-atrioventricular-block
#20
Masato Fukunaga, Dan Wichterle, Petr Peichl, Bashar Aldhoon, Robert Čihák, Josef Kautzner
AIMS: In patients with severe neurally mediated syncope (NMS), radiofrequency catheter ablation (RFA) of ganglionic plexi (GP) has been proposed as a new therapeutic approach. Cardio-inhibitory response during NMS is usually related to the sinoatrial (SA) and less frequently to atrioventricular (AV) node. Differential effect of GP ablation on SA and AV node is poorly understood. METHODS AND RESULTS: We report a case of a 35-year-old female with frequent symptomatic episodes of advanced AV block treated by anatomically guided RFA at empirical sites of GPs...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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