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Intraoperative echocardiography

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
Carlos M Mery, R Michael Nieto, Luis E De León, Shaine A Morris, Wei Zhang, John L Colquitt, Iki Adachi, Lauren C Kane, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser
BACKGROUND: Predictors for single ventricle palliation (SVP) or successful biventricular repair (BVR) in patients with borderline left-side heart structures are not well defined. The goal was to evaluate the role of echocardiography and intracardiac exploration in determining feasibility of BVR. METHODS: All neonates surgically treated from 1995 to 2015 with mitral valve (MV), aortic valve, or left ventricle end-diastolic dimension z score of -2 or less for whom management was controversial were included...
October 4, 2016: Annals of Thoracic Surgery
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
Mingjia Ma, Mohamed Abdulkadir, Yang Li, Xiang Wei
INTRODUCTION: Blindly punching between aorta and right atrium is dangerous. In that case, there is concerned about leakage between the two referred isolate parts. Besides, as the routine imaging techniques (echocardiography or computer tomography) are incompetent to detect this particular anatomic structure preoperatively, the intraoperative inspection appears necessary. Our method is useful for identifying this innate fusion plane. CASE REPORT: The thrombosis surrounding prosthesis was detected in the first ultrasound examination after the operation, which was considered to be an indication of successful hemostasis...
July 27, 2016: Medical Archives
Joon Hwa Hong, Hartzell V Schaff, Rick A Nishimura, Martin D Abel, Joseph A Dearani, Zhuo Li, Steve R Ommen
BACKGROUND: Incidence and outcome of mitral valve (MV) surgery are unknown in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing extended transaortic septal myectomy. OBJECTIVES: This study sought to define indications and suitable operative strategy for mitral regurgitation (MR) in patients with HOCM. METHODS: A total of 2,107 septal myectomy operations performed in adults from January 1993 to May 2014 at Mayo Clinic in Rochester, Minnesota, were retrospectively reviewed...
October 4, 2016: Journal of the American College of Cardiology
Chantal A Boly, Etto C Eringa, R Arthur Bouwman, Rob F P van den Akker, Frances S de Man, Ingrid Schalij, Stephan A Loer, Christa Boer, Charissa E van den Brom
BACKGROUND: While most studies focus on cardiovascular morbidity following anesthesia and surgery in excessive obesity, it is unknown whether these intraoperative cardiovascular alterations also occur in milder forms of adiposity without type 2 diabetes and if insulin is a possible treatment to improve intraoperative myocardial performance. In this experimental study we investigated whether mild adiposity without metabolic alterations is already associated with cardiometabolic dysfunction during anesthesia, mechanical ventilation and surgery and whether these myocardial alterations can be neutralized by intraoperative insulin treatment...
2016: Cardiovascular Diabetology
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
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
C O Tan, R T C Hu, I Harley, L Weinberg
For accurate spectral Doppler valvular evaluation, intraoperative sonographers must use transoesophageal echocardiographic (TOE) views that offer optimal incident angles. We hypothesised that views added to the 2013 American Society of Echocardiography/Society of Cardiovascular Anesthesiologists (ASE/SCA) standard views and other novel views we have described of the tricuspid (TV) and pulmonary valves (PV) offered superior incident angles to those included in the original 1999 ASE/SCA recommendations for comprehensive intraoperative TOE examination...
September 2016: Anaesthesia and Intensive Care
Abraham Sonny, Shiva Sale, Nicholas G Smedira
No abstract text is available yet for this article.
September 7, 2016: Anesthesia and Analgesia
Michael J Plakke, Cory D Maxwell, Brandi A Bottiger
Surgical patients with pulmonary hypertension present a significant challenge to the anesthesiologist. Continuous perioperative monitoring of pulmonary artery (PA) pressure is recommended and most often accomplished with a PA catheter. Placement of a PA catheter may be difficult or contraindicated, and in these cases, transesophageal echocardiography is a useful alternative to monitor dynamic PA physiology. In this case, we used intraoperative transesophageal echocardiography to detect changes in peak PA pressure and guide clinical treatment in a patient with pulmonary hypertension and an extensive PA aneurysm undergoing partial nephrectomy...
September 1, 2016: A & A Case Reports
Young-Jin Moon, Ji Hyun Park, JongEun Oh, Sooho Lee, Gyu-Sam Hwang
INTRODUCTION: As a common morphological change of aging heart, sigmoid ventricular septum is frequently found during routine preoperative evaluation, but often disregarded because of its little clinical importance. However, in this report, we describe a 70-year old patient with sigmoid ventricular septum who developed severe hemodynamic deterioration during liver transplantation because of its unique morphology of heart. METHODS: During the course of reperfusion of the graft, patient's hemodynamics were closely monitored using transesophageal echocardiography...
August 2016: Medicine (Baltimore)
Francisco Diniz Affonso da Costa, Daniele de Fátima Fornazari Colatusso, Ana Claudia Brenner Affonso da Costa, Eduardo Mendel Balbi Filho, Vinicius Nesi Cavicchioli, Sergio Augusto Veiga Lopes, Andrea Dumsch de Aragon Ferreira, Claudinei Collatusso
INTRODUCTION: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. METHODS: From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males...
April 2016: Brazilian Journal of Cardiovascular Surgery
Hee Young Kim, Seung-Hoon Baek, Ji Uk Yoon, Dong Hoon Lee, Gyeong-Jo Byeon, Ji Hye Ahn
We report cardiac arrest due to obstruction of the right ventricular outflow tract (RVOT) caused by an RVOT mass that was not identified preoperatively. A 62-year-old woman with renal cell carcinoma (RCC) experienced deteriorating hypotension and bradycardia during radical nephrectomy. Hemodynamic stability was maintained on extracorporeal membrane oxygenation, and after surgery, she was transferred to the intensive care unit. On postoperative day 3, transthoracic echocardiography showed an intracardiac mass obstructing the RVOT, which caused severe functional pulmonary stenosis and moderate resting pulmonary hypertension...
September 2016: Journal of Clinical Anesthesia
Neal S Gerstein, Ran Zhang, Michael S Davis, Harish Ram
Renal cell carcinoma (RCC) is the most common primary renal neoplasm and is associated with the intraluminal growth into the venous system with possible extension into the inferior vena cava or even right heart. Intraoperative pulmonary embolism is a complication of resection of RCC, which may be mitigated by the use of the cardiopulmonary bypass with or without deep hypothermic circulatory arrest. We present a case of unexpected pulmonary embolism diagnosed during RCC surgery. The case highlights the central importance of intraoperative transesophageal echocardiography use and the need for proper preoperative planning for the use of cardiopulmonary bypass...
October 15, 2016: A & A Case Reports
Mattia Glauber, Simon C Moten, Eugenio Quaini, Marco Solinas, Thierry A Folliguet, Bart Meuris, Antonio Miceli, Peter J Oberwalder, Manfredo Rambaldini, Kevin H T Teoh, Gopal Bhatnagar, Michael A Borger, Denis Bouchard, Olivier Bouchot, Stephen C Clark, Otto E Dapunt, Matteo Ferrarini, Theodor J M Fischlein, Guenther Laufer, Carmelo Mignosa, Russell Millner, Philippe Noirhomme, Steffen Pfeiffer, Xavier Ruyra-Baliarda, Malakh Lal Shrestha, Rakesh M Suri, Giovanni Troise, Borut Gersak
OBJECTIVE: To define the benefit of sutureless and rapid deployment valves in current minimally invasive approaches in isolated aortic valve replacement. METHODS: A panel of 28 international experts with expertise in both minimally invasive aortic valve replacement and rapid deployment valves was constituted. After thorough literature review, the experts rated evidence-based recommendations in a modified Delphi approach. RESULTS: No guideline could be retrieved...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular 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
Inez J Wijdh-den Hamer, Wobbe Bouma, Eric K Lai, Melissa M Levack, Eric K Shang, Alison M Pouch, Thomas J Eperjesi, Theodore J Plappert, Paul A Yushkevich, Judy Hung, Massimo A Mariani, Kamal R Khabbaz, Thomas G Gleason, Feroze Mahmood, Michael A Acker, Y Joseph Woo, Albert T Cheung, Matthew J Gillespie, Benjamin M Jackson, Joseph H Gorman, Robert C Gorman
OBJECTIVES: Repair for ischemic mitral regurgitation with undersized annuloplasty is characterized by high recurrence rates. We sought to determine the value of pre-repair 3-dimensional echocardiography over 2-dimensional echocardiography in predicting recurrence at 6 months. METHODS: Intraoperative transesophageal 2-dimensional echocardiography and 3-dimensional echocardiography were performed in 50 patients undergoing undersized annuloplasty for ischemic mitral regurgitation...
September 2016: Journal of Thoracic and Cardiovascular Surgery
Lindsay R Freud, Gerald R Marx, Audrey C Marshall, Wayne Tworetzky, Sitaram M Emani
OBJECTIVES: Mitral valve replacement (MVR) in young children is limited by the lack of small prostheses. Our institution began performing MVR with modified, surgically placed, stented jugular vein grafts (Melody valve) in 2010. We sought to describe key echocardiographic features for pre- and postoperative assessment of this novel form of MVR. METHODS: The pre- and postoperative echocardiograms of 24 patients who underwent Melody MVR were reviewed. In addition to standard measurements, preoperative potential measurements of the mitral annulus were performed whereby dimensions were estimated for Melody sizing...
July 25, 2016: Journal of Thoracic and Cardiovascular Surgery
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