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Intraoperative echocardiography

Anna Cavigelli-Brunner, Maja I Hug, Hitendu Dave, Oskar Baenziger, Christoph Buerki, Dominique Bettex, Vincenzo Cannizzaro, Christian Balmer
OBJECTIVES: Dobutamine and milrinone are commonly used after open-heart surgery to prevent or treat low cardiac output syndrome. We sought to compare efficacy and safety of these drugs in pediatric patients. DESIGN: Prospective, single-center, double-blinded, randomized clinical pilot study. SETTING: Tertiary-care university children's hospital postoperative pediatric cardiac ICU. PATIENTS: After written consent, 50 consecutive patients (age, 0...
March 13, 2018: Pediatric Critical Care Medicine
Luke Lamers, Erick E Jimenez, Catherine Allen, Derreck Hoyme, Entela Bua Lushaj, Petros V Anagnostopoulos
The purpose of this study was to assess the diagnostic capabilities of transesophageal echocardiography (TEE) compared to completion angiography for detection of residual post-operative pulmonary artery lesions. This is a retrospective review of 19 consecutive surgical cases involving the pulmonary arteries that had post-operative TEE and completion angiography from 2014 to 2017. The echocardiograms were reviewed by 2 blinded examiners and categorized as adequate or inadequate visualization of the surgical repair...
March 10, 2018: Pediatric Cardiology
Robert D Kale, Muhammad F Sarwar, Andrew Sopchak
No abstract text is available yet for this article.
February 2, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Masahide Komagamine, Nobuyuki Furukawa, Jan Gummert, Jochen Börgermann
Transapical transcatheter aortic valve implantation is a well-established alternative in patients at a high risk for conventional aortic valve replacement. We performed transapical transcatheter aortic valve implantation on an 83-year-old woman with symptomatic severe aortic stenosis. Intraoperative transoesophageal echocardiography (TOE) after transcatheter aortic valve implantation showed mild mitral regurgitation without intracardiac structural injury. In the intensive care unit, the patient gradually had haemodynamic instability; TOE revealed severe mitral regurgitation with A2 and A3 prolapse due to rupture of the posterior papillary muscle...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Yangyang Li, Teng Ye, Qianru Gu, Lei Dong, Guorong Chen, Shanshan Lu
RATIONALE: Primary cardiac osteosarcoma is a rare tumor. To our knowledge, only 15 cases have been reported in the literature in the past 10 years. We describe a case of primary, cardiac, fibroblastic osteosarcoma in a 42-year-old woman. PATIENT CONCERNS: A 42-year-old woman with a 10-day history of chest pain. Intraoperatively, a mass was found originating from the ostium of the left inferior pulmonary vein in the left atrium, extending to the mitral orifice. Histologically, the tumor contained variable amounts of spindle cells and osseous differentiation in different areas...
January 2018: Medicine (Baltimore)
Yanhui Li, Xiaodong Li, Xiaocong Wang, Liping Chen
RATIONALE: Myxoma is the most common type of primary benign cardiac tumor in adults. The left atrium is the most frequent site of origin followed by the right atrium. Biatrial myxoma is extremely rare. PATIENT CONCERNS: We present a case of a 60-year-old woman with biatrial myxoma, who presented with palpitations for one month. DIAGNOSES: Echocardiography revealed an irregular homogeneous mass in the left atrium and in the right atrium, and were connected via the fossa ovalis suspiciously...
January 2018: Medicine (Baltimore)
Robert G Nampiaparampil, Daniel G Swistel, Michael Schlame, Muhamed Saric, Mark V Sherrid
Transesophageal echocardiography is essential in guiding the surgical approach for patients with obstructive hypertrophic cardiomyopathy. Septal hypertrophy, elongated mitral valve leaflets, and abnormalities of the subvalvular apparatus are prominent features, all of which may contribute to left ventricular outflow tract obstruction. Surgery aims to alleviate the obstruction via an extended myectomy, often with an intervention on the mitral valve and subvalvular apparatus. The goal of intraoperative echocardiography is to assess the anatomic pathology and pathophysiology in order to achieve a safe intraoperative course and a successful repair...
March 2018: Journal of the American Society of Echocardiography
Olivia K Ginty, John M Moore, Yuanwei Xu, Wenyao Xia, Satoru Fujii, Daniel Bainbridge, Terry M Peters, Bob B Kiaii, Michael W A Chu
OBJECTIVE: Planned mitral repair strategies are generally established from preoperative echocardiography; however, specific details of the repair are often determined intraoperatively. We propose that three-dimensional printed, patient-specific, dynamic mitral valve models may help surgeons plan and trial all the details of a specific patient's mitral repair preoperatively. METHODS: Using preoperative echocardiography, segmentation, modeling software, and three-dimensional printing, we created dynamic, high-fidelity, patient-specific mitral valve models including the subvalvular apparatus...
February 22, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
B A Akselrod, L A Tolstova, T A Pshenichniy, S V Fedulova
BACKGROUND: Estimated continuous cardiac output (esCCOTM) based on pulse wave transit time is one of alternative non-invasive CO measurement techniques. METHODS: Randomized study included 23 scheduled patients operated upon due to cardiovascular diseases. Cardiac index (CI) was measured Comparative analyses of esCCO and others CO measurement methods used intraoperative was carried out. In the first group (n = 9) esCCO was compared with transpulmonary thermodilution (PiCCO-plus); in the second group (n = 8) - with pulmonary artery thermodilution; in the third group (n = 6) - with transoesophageal echocardiography (velocity-time integral)...
September 2017: Anesteziologiia i Reanimatologiia
Xiao-Dong Li, Yang Bai, Xiu-Mei Duan, Xiao-Cong Wang
Mitral valve myxoma is a very rare entity. Multiple myxomas with extensive involvement of the anterior and posterior leaflets of the mitral valve are exceedingly rare. We report a 58-year-old man who was admitted as sudden syncope. Thoracic echocardiography showed several masses adherent to the anterior and posterior leaflets and the mitral annulus with obvious mobility. Intraoperative probing revealed multiple tumors attached to the mitral annulus, valve leaflets, and tendinous cords. Mechanical mitral valve replacement was performed...
February 20, 2018: Annals of Thoracic and Cardiovascular Surgery
Piotr Lipiec, Janusz Bąk, Wojciech Braksator, Marcin Fijałkowski, Andrzej Gackowski, Zbigniew Gąsior, Jarosław D Kasprzak, Anna Klisiewicz, Mirosław Kowalski, Tomasz Kukulski, Katarzyna Mizia-Stec, Edyta Płońska-Gościniak, Piotr Pruszczyk, Bożena Sobkowicz, Piotr Szymański, Andrzej Szyszka, Olga Trojnarska, Andrzej Wysokiński, Piotr Hoffman
This document presents current Polish guidelines on the clinical use of transesophageal echocardiography, including guidance of percutaneous procedures and intraoperative echocardiography, in adult patients. The authors present recommendations regarding indications and contraindications, staff and equipment requirements, patient preparation and information, examination protocol, reporting and reimbursement.
2018: Kardiologia Polska
Ashraf Fayad, Sasha Shillcutt, Massimiliano Meineri, Terrence D Ruddy, Mohammed Toseef Ansari
Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Hythem M Nawaytou, Laura Mercer-Rosa, Alexandra Channing, Meryl S Cohen
BACKGROUND: Intraoperative transesophageal echocardiography (iTEE) is used to assess for residual left ventricular outflow tract obstruction (LVOTO) after surgical resection of subaortic membrane causing subaortic stenosis (sub-AS). We aimed to identify the iTEE features associated with recurrence of LVOTO. METHODS: We conducted a retrospective study of children undergoing sub-AS resection from June 2006 to June 2014. Doppler assessment of the flow velocity and the anatomical features of the left ventricular outflow tract were analyzed from stored echocardiograms...
February 13, 2018: Echocardiography
Amanda M Kleiman, Lindsay M Harding, Allison J Bechtel
Masses in and near the interatrial septum may be either benign or malignant. The most common mass near the interatrial septum is lipomatous atrial septal hypertrophy (LASH). LASH can be present in patients with intracardiac malignancies, myxomas, lipomas, or other cardiac masses. It is important to recognize the transesophageal echocardiography (TEE) characteristics of these pathologies to arrive at an accurate diagnosis with an appropriate plan for intraoperative resection. At the authors' institution, patients have been referred for surgery due to a finding of significant LASH masquerading as a left atrial myxoma...
February 11, 2018: Echocardiography
Vikas Saini, Tanvir Samra, Gurpreet Kaur
A 25-year-old female with congenitally corrected transposition of great arteries (CCTGAs), atrial septal defect, and severe pulmonary stenosis underwent lower segment cesarean section at 34 weeks of gestation using combined spinal epidural anesthesia (CSEA). We used transthoracic echocardiography (TTE) for intraoperative monitoring of the cardiovascular system because these patients are reported to have a high prevalence of myocardial perfusion defects, regional wall motion abnormalities, and impaired ventricular contractility...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Harendra Arora, Priya Ajit Kumar
A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a bicuspid aortic valve (BAV). In addition, he was noted to have a dilated thoracic aorta concerning for a dissection, severe aortic insufficiency (AI), and both a pericardial and pleural effusion. Magnetic resonance imaging revealed a Type A ascending aortic dissection. He was taken emergently to the operating room for repair...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
A A Vitin, M W Pennington, T A Bowdle, S C Rayhill, L Sibulesky, J D Reyes, J M McCabe
A case of stress (takotsubo) cardiomyopathy (TC) that occurred intraoperatively during liver transplantation surgery was identified by transesophageal echocardiography. Only a few cases of TC occurring during liver transplantation have been reported to date. Unlike other cases reported, TC occurred during the anhepatic stage of the liver transplantation, with subsequent complete recovery. Notwithstanding the large number of cases of TC in the perioperative settings reported worldwide, the exact reasons of this syndrome occurring intraoperatively as well as precipitating factors and conditions remain mostly unknown...
January 2018: Transplantation Proceedings
Asad Ikram, Hafsa Mohiuddin, Aisha Zia, Hafiz Umair Siddiqui, Hoda Javadikasgari, Marijan Koprivanac, Sajjad Raza, Atif Zafar
Although the occurrence of stroke in patients undergoing coronary artery bypass grafting (CABG) is decreasing, it remains an important concern. Therefore, it is important to identify and adopt strategies that can decrease the incidence of stroke in these patients. One of the strategies that have demonstrated the potential to decrease the rate of post-CABG stroke is an assessment of aorta for atherosclerosis before surgery and changing the surgical plan accordingly to minimize the stroke risk. This assessment can be done through palpation of the aorta, transesophageal echocardiography (TEE), and epiaortic ultrasound scanning (EAS)...
February 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Neelam Aggarwal, Rupa Sreedhar, Shrinivas V Gadhinglajkar, Baiju S Dharan, Saravana Babu, Manjusha N Pillai, Sabarinath Menon
No abstract text is available yet for this article.
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
McKenzie Hollon, Kathyrn Glas, Michele Sumler
Carcinoid heart disease is a rare form of heart disease due to secretion of vasoactive compounds, including serotonin, from gastrointestinal tumors. This E-challenge examines the case of a patient with advanced carcinoid heart disease who presented to the operating room (OR) for a tricuspid valve replacement. Once the patient was in the OR, intraoperative transesophageal echocardiography was used to discover a patent foramen ovale and involvement of all 4 valves with regurgitant lesions. The patient underwent tricuspid valve replacement, pulmonic valve replacement, right ventricular outflow tract reconstruction, and patent foramen closure in the OR and experienced subsequent fulminant right heart failure...
October 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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