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Intraoperative echocardiography

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https://www.readbyqxmd.com/read/29327650/transesophageal-echocardiography-use-in-diagnosis-and-management-of-embolized-intravascular-foreign-bodies
#1
James Taylor Herbert, Miklos David Kertai
The increasing use of endovascular interventions coupled with the large number of published case series detailing complications attest to the likelihood that anesthesiologists will encounter a case of intravascular foreign body embolization during their careers. Transesophageal echocardiography is essential to the diagnosis and management of traumatic and intravascular foreign bodies embolized to the heart because it can identify not only the foreign body but also hemodynamically significant lesions to radiolucent anatomic structures prior to and during surgical exploration...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#2
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29324489/comparing-methods-for-cardiac-output-intraoperatively-doppler-derived-cardiac-output-measured-with-3-dimensional-echocardiography-is-not-interchangeable-with-cardiac-output-by-pulmonary-catheter-thermodilution
#3
Karin Graeser, Mikhail Zemtsovski, Klaus F Kofoed, Matilde Winther-Jensen, Jens C Nilsson, Jesper Kjaergaard, Hasse Møller-Sørensen
BACKGROUND: Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29323747/comprehensive-intraoperative-transesophageal-echocardiography-of-anomalous-left-coronary-artery-from-pulmonary-artery-what-to-look-for-and-where-to-look
#4
Keerthi Chigurupati, Subin Sukesan, Pravin S Lovhale, Baiju S Dharan, Thomas Koshy
Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) accounts for 0.4% of the congenital heart diseases. Comprehensive 2D and 3D transesophageal echocardiographic imaging of a well-collateralized subset of ALCAPA is described. A nonstandard short-axis view of both aorta and pulmonary arteries showed the origin of left coronary artery from the posterior sinus of the pulmonary artery and right coronary artery in its usual position. Pulse-wave interrogation of the coronary arteries showed the direction of flow in opposite directions...
January 11, 2018: Echocardiography
https://www.readbyqxmd.com/read/29318795/isoflurane-s-effect-on-intraoperative-systolic-left-ventricular-performance-in-cardiac-valve-surgery-patients
#5
Ju Deok Kim, Ilsoon Son, Won Kyoung Kwon, Tae Yun Sung, Hanafi Sidik, Karam Kim, Hyun Kang, Jiyon Bang, Gwi Eun Yeo, Dong Kyu Lee, Tae Yop Kim
BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1...
January 22, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29297248/book-review-intraoperative-and-interventional-echocardiography-atlas-of-transesophageal-imaging-oxorn-donald-c-otto-catherine-m-2017-intraoperative-and-interventional-echocardiography-atlas-of-transesophageal-imaging-second-edition-philadelphia-pa-elsevier
#6
https://www.readbyqxmd.com/read/29285810/von-willebrand-factor-revisited
#7
Senan J Yasar, Obai Abdullah, William Fay, Sudarshan Balla
Degenerative aortic valve stenosis is the most common valvular heart disease seen in developed countries. Since the implementation of transcatheter aortic valve replacement, there has been a surge of efforts to improve procedural technique as well as reduce mortality. Until recently, the mainstay method of assessment of valve implantation as well as paravalvular regurgitation has relied heavily on imaging techniques including transesophageal echocardiography and aortic root angiography. There has been a lot of scientific inquiry to identify biomarkers in the management of patients with aortic stenosis...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29284365/echocardiographic-guidance-for-surgical-excision-of-the-intracardiac-component-of-a-pheochromocytoma
#8
Dinesh J Kurian, Angela X Li, Srikar Rao, Agathoklis Konstantinidis, Sanziana A Roman, Miklos D Kertai
Pheochromocytomas are rare neuroendocrine tumors, with published incidence of 2 to 8 cases per million patients per year. The extension of these tumors into the vena cava and right atrium is rarely seen. Transesophageal echocardiography may be invaluable to delineate tumor extent and characteristics, which in turn may provide a useful tool to guide intraoperative surgical approach to these uncommon masses. In the case presented in this article, we describe the role of transesophageal echocardiography in guiding a safe and complete, excision of an invasive pheochromocytoma without embolization of tumor components...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29274676/-determination-of-residual-mass-in-left-ventricle-by-intraoperative-transesophageal-echocardiography-after-a-giant-and-floating-left-atrial-myxoma-resection
#9
Ali Sait Kavakli, Nilgun Kavrut Ozturk
Atrial myxoma is a benign tumor of the heart that occurs primarily in the left atrium. Floating or large left atrial myxomas frequently cause functional mitral stenosis, may also affect mitral valve structure and flow, and lead to mitral regurgitation. Systemic embolization occurs in around 30% of cases either from tumor fragmentation or complete tumor detachment hence it should be removed as soon as it is detected. Intraoperative transesophageal echocardiography has a vital importance in the surgery. After resection of myxoma, intraoperative transesophageal echocardiography must be performed to rule out residual mass...
December 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29249790/-ascending-aorta-replacement-and-extended-myectomy-for-acute-aortic-dissection-and-coexistent-hypertrophic-obstructive-cardiomyopathy-report-of-a-case
#10
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29246546/surgical-unroofing-of-intramural-anomalous-aortic-origin-of-a-coronary-artery-in-pediatric-patients-single-center-perspective
#11
Shagun Sachdeva, Michele A Frommelt, Michael E Mitchell, James S Tweddell, Peter C Frommelt
BACKGROUND: Intramural anomalous aortic origin of a coronary artery (AAOCA) is associated with an increased risk of sudden cardiac death. This is amenable to surgical coronary unroofing, but outcomes studies are lacking. OBJECTIVE: To perform a comprehensive review of our institutional experience with pediatric patients with AAOCA who underwent surgical repair with unroofing of the intramural segment, focusing on preoperative and postoperative course and testing as well as intraoperative findings...
November 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29246545/severity-of-tricuspid-regurgitation-is-associated-with-long-term-mortality
#12
Brian J Kelly, Jamahal Maeng Ho Luxford, Carolyn Goldberg Butler, Chuan-Chin Huang, Kerry Wilusz, Julius I Ejiofor, James D Rawn, John A Fox, Stanton K Shernan, Jochen Daniel Muehlschlegel
OBJECTIVES: To determine the association between intraoperative/presurgical grade of tricuspid regurgitation (TR) and mortality, and to determine whether surgical correction of TR correlated with an increased chance of survival compared with patients with uncorrected TR. METHODS: The grade of TR assessed by intraoperative transesophageal echocardiography (TEE) before surgical intervention was reviewed for 23,685 cardiac surgery patients between 1990 and 2014. Cox proportional hazard regression models were used to determine association between grade of TR and the primary endpoint of all-cause mortality...
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29241961/management-of-neonates-with-right-sided-aortic-arch-and-esophageal-atresia-international-survey-on-ipeg-and-espes-members%C3%A2-experience
#13
REVIEW
Monserrat Aguilera-Pujabet, Jose Andres Molino Gahete, Gabriela Guillén, Sergio López-Fernández, Marta Patricia Martin-Giménez, Josep Lloret, Manuel López
AIM: The optimum surgical approach of neonates with right-sided aortic arch (RAA) and esophageal atresia (EA)/tracheoesophageal fistula (TEF) is still an unsolved question. In order to propose an operative algorithm in the era of endoscopic surgery, we performed an international survey to know the current practice between pediatric endoscopic surgeons. Two of the most important societies in endoscopic pediatric surgery were queried: the International Pediatric Endosurgery Group (IPEG) and the European Society of Paediatric Endoscopic Surgeons (ESPES)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29233364/epicardial-15-mhz-echocardiography-for-effective-repair-of-coronary-arteriovenous-fistula
#14
Masashi Komeda, Hirotomo Uchiyama, Sakurako Nakamura, Takashi Kusunose, Shoji Fujiwara, Toshimi Ujiie
In the era of catheter intervention, the surgical repair of coronary arteriovenous fistula needs to be free from residual shunt. Intraoperative epicardial 15-MHz echocardiography helps to find the residual shunt after ligation or obliteration of anomalous vessels. Here we report our method of the echo-assisted surgical repair of coronary arteriovenous fistula in 7 adult patients. The method made the operation for coronary arteriovenous fistula free from residual shunt, but care should be taken to the development of new vessels after the operation...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29231093/the-utility-of-simulation-in-the-management-of-patients-with-congenital-heart-disease-past-present-and-future
#15
Ali Subat, Andrew Goldberg, Samuel Demaria, Daniel Katz
Significant advancements have been made in the diagnosis and management of congenital heart disease (CHD). As a result, a higher percentage of these patients are surviving to adulthood. Despite this improvement in management, these patients remain at higher risk of morbidity and mortality, particularly in the perioperative setting. One new area of interest in these patients is the implementation of simulation-based medical education. Simulation has demonstrated various benefits across high-acuity scenarios encountered in the hospital...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217244/intraoperative-transesophageal-and-postoperative-transthoracic-echocardiographic-evaluation-of-a-mechanical-heart-valve-prosthesis-implanted-at-aortic-position
#16
Saravana Babu, Rupa Sreedhar, Shrinivas V Gadhinglajkar, Prasanta Kumar Dash, Subin Sukesan, Vivek Pillai, Varghese T Panicker, Lovhale Pravin Shriram, Neelam Aggarwal
OBJECTIVE: The aims of this study were to evaluate the intraoperative transesophageal echocardiographic (iTEE) characteristics and Doppler flow profile of aortic Chitra heart valve prosthesis (CHVP) under stable hemodynamic and loading conditions, and to compare and correlate the iTEE data with the postoperative transthoracic echocardiography (TTE) data obtained at 48 hours (TTE1) and 3 months (TTE2) after the surgery. DESIGN: Prospective, observational study. SETTING: University-level tertiary referral hospital...
September 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217240/the-role-of-intraoperative-transesophageal-echocardiography-in-identifying-a-fenestrated-occlusion-of-the-inferior-vena-cava-during-pulmonary-thromboendarterectomy
#17
Thomas Chloros, Christiana Burt, John Dunning
No abstract text is available yet for this article.
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217238/feasibility-and-impact-of-focused-intraoperative-transthoracic-echocardiography-on-management-in-thoracic-surgery-patients-an-observational-study
#18
Thomas Kratz, Sarah Holz, Thorsten Steinfeldt, Maik Exner, Marco Campo dell'Orto, Caroline Kratz, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Intraoperative focused transthoracic echocardiography (TTE) is feasible and has an effect on the management of hemodynamically unstable surgical patients. Furthermore, in noncardiac thoracic surgery, TTE might provide additional information for hemodynamic treatment. Transthoracic accessibility during thoracic surgical interventions is assumed to be difficult. For patients positioned on their right side, a modified subcostal transthoracic view might be helpful. DESIGN: A prospective observational study...
September 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29207816/non-catheter-related-perioperative-superior-vena-cava-syndrome-following-surgical-vsd-closure-role-of-transesophageal-echocardiography
#19
Tanveer Singh Kundra, Divya Gopal, Manasa Dhananjaya
Unintentional iatrogenic surgical complications can complicate the operative and postoperative courses of paediatric cardiac surgery patients. Unless recognized and treated early, it's possible, these complications may lead to a prolonged hospital stay, increased treatment cost, morbidity, and even death. Ventricular Septal Defect (VSD) is the most common congenital heart defect in children, occurring in 50% of all children with congenital heart disease and in 20% as an isolated lesion. Herein, we discuss the development of Superior Vena Cava (SVC) syndrome following surgical repair of VSD in a nine-month-old child...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29204888/initial-robotic-assistance-in-the-surgical-management-of-renal-cell-carcinoma-with-level-4-cavoatrial-thrombus
#20
Isaac Palma-Zamora, Deepansh Dalela, Ravi Barod, Linda Hsu, Mani Menon, Craig G Rogers
We report a case of left-sided renal cell carcinoma (RCC) with level 4 cavoatrial tumor thrombus where robotic assistance was used to achieve hemostasis around the kidney in order to minimize coagulopathic hemorrhage from the nephrectomy bed during subsequent open completion nephrectomy and cavoatrial thrombectomy under extracorporeal circulation and hypothermic circulatory arrest. Robotic assistance allowed for meticulous dissection and ligation of parasitic and arterial vessels to the kidney, release of renal attachments, and exposure of the inferior vena cava...
December 4, 2017: Journal of Robotic Surgery
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