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Intraoperative echocardiography

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https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#1
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
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/29121837/triple-outlet-right-ventricle-with-duplication-of-the-aortic-root-and-intrapericardial-ascending-aorta
#3
Ashish Katewa, Balswaroop Sahu, Vishal Jain, Robert H Anderson
We present a case of a highly unusual congenital cardiac malformation, namely, triple outlet right ventricle with duplication of the aortic root and the intrapericardial component of the ascending aorta. A girl, aged five, presented with complaints of cyanosis and effort intolerance and was diagnosed with double-outlet right ventricle and subpulmonary infundibular stenosis. Intraoperatively, we noted that the aortic root was guarded by two separate aortic valves, oriented anteroposteriorly relative to each other, and separated within the right ventricle by a muscle bar...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29116972/low-cardiac-output-syndrome-after-adult-cardiac-surgery-predictive-value-of-peak-systolic-global-longitudinal-strain
#4
Philippe Amabili, Sabeha Benbouchta, Laurence Roediger, Marc Senard, Marie Bernard Hubert, Anne-Françoise Donneau, Jean-François Brichant, Gregory A Hans
BACKGROUND: Peak systolic global longitudinal strain (GLS) is increasingly used to quantify left ventricular systolic function. The primary objective of this study was to assess whether GLS obtained during intraoperative transesophageal echocardiogram, performed before cardiopulmonary bypass, improves the prediction of postoperative low cardiac output syndrome (LCOS) after adult cardiac surgery. METHODS: GLS from 275 patients undergoing on-pump cardiac surgery was calculated retrospectively using two-dimensional- speckle tracking echocardiography (aCMQ module from Qlab software version 10...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29116970/assessment-of-tricuspid-annular-motion-by-speckle-tracking-in-anesthetized-patients-using-transesophageal-echocardiography
#5
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
#6
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/29092770/avalon-catheters-in-pediatric-patients-requiring-ecmo-placement-and-migration-problems
#7
Marcus D Jarboe, Samir K Gadepalli, Joseph T Church, Meghan A Arnold, Ronald B Hirschl, George B Mychaliska
PURPOSE: The Avalon dual-lumen venovenous catheter has several advantages, but placement techniques and management have not been adequately addressed in the pediatric population. We assessed our institutional outcomes and complications using the Avalon catheter in children. METHODS: We reviewed all pediatric patients who had Avalon catheters placed for respiratory failure at our institution, excluding congenital heart disease patients, from April 2009 to March 2016...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29092124/post-coital-acute-rupture-of-a-fenestrated-aortic-valve
#8
Aurélien Roumy, Xavier Jeanrenaud, René Pretre, Matthias Kirsch
Fenestrated aortic valve is a frequent condition which is, for most of the time, asymptomatic and generally has no influence on aortic valve competence. However, aortic valve regurgitation could occur, especially in the case of fibrous strand rupture. In this situation, acute aortic regurgitation is poorly tolerated and requires urgent surgical correction. Herein is presented the case of a 70-year-old patient who was admitted as an emergency for acute heart failure after coital exertion. Echocardiography revealed severe acute aortic regurgitation due to leaflet prolapse...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29067708/preliminary-study-of-the-application-of-transthoracic-echocardiography-guided-three-dimensional-printing-for-the-assessment-of-structural-heart-disease
#9
Yanbo Zhu, Jianshi Liu, Lianqun Wang, Xin Guan, Yongjuan Luo, Jie Geng, Qingguo Geng, Yunjia Lin, Lixia Zhang, Xixue Li, Yaping Lu
OBJECTIVE: To investigate the feasibility and diagnostic value of a preoperative transthoracic echocardiography-guided three-dimensional printed model (TTE-guided 3DPM) for the assessment of structural heart disease (SHD). METHODS: Fourty-four patients underwent cardiac surgery at Tianjin Chest Hospital. The patients were preoperatively assessed using TTE-guided 3DPM, which was compared to conventional three-dimensional transthoracic echocardiography (3DTTE) along with direct intraoperative findings, which were considered the "gold standard...
October 25, 2017: Echocardiography
https://www.readbyqxmd.com/read/29049675/combined-perventricular-septal-defect-closure-and-patent-ductus-arteriosus-ligation-via-the-lower-ministernotomy-approach
#10
Alexey Voitov, Alexander Omelchenko, Yuriy Gorbatykh, Alexander Bogachev-Prokophiev, Alexander Karaskov
Over the past decade, minimally invasive approaches have been advocated for surgical correction of congenital defects to reduce costs related to hospitalization and for improved cosmesis. Minimal skin incisions and partial sternotomy reduce surgical trauma, however these techniques might not be successful in treating a number of congenital pathological conditions, particularly for combined congenital defects. We focused on cases with a combined presentation of ventricular septal defect and patent ductus arteriosus...
September 25, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29030366/role-of-transoesophageal-echocardiography-in-renal-cell-carcinoma-a-brief-review
#11
Chitra Rajeswari Thangaswamy, Ramanitharan Manikandan, Sai Chandran Bathala Vedagiri
Transoesophageal echocardiography (TOE) is regularly used in cardiac and also increasingly in non-cardiac surgeries. It has a leading role in the perioperative management of renal cell carcinoma with tumour extension into inferior vena cava. We report two cases in which TOE was of immense help for patient management. This report highlights the two cases where intraoperative TOE was of immense help to establish diagnosis, to modify surgical plan, to guide the surgeon during clamp placement, to monitor cardiac function, to rule out tumour embolism and to confirm the complete removal of tumour thrombus...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29026892/prompt-diagnosis-of-st-elevation-myocardial-infarction-with-papillary-muscle-rupture-by-point-of-care-ultrasound-in-the-emergency-department
#12
Koon Ho Cheung, Colin Graham Alexander
A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture...
September 2017: Clinical and Experimental Emergency Medicine
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
#13
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/28992750/acute-hypotension-after-mitraclip-implantation-due-to-acute-left-ventricular-failure
#14
Adam A Dalia, Michael Essandoh
The MitraClip is a percutaneously implanted device approved for the treatment of symptomatic organic mitral regurgitation in poor surgical candidates. Despite its proven efficacy and safety for mitral regurgitation treatment, the MitraClip may unmask the true afterload of the left ventricle by removing the low-pressure left atrial system and may cause acute left ventricular systolic failure (afterload mismatch). Rapid diagnosis and treatment of afterload mismatch is crucial to ensure optimal patient outcomes...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28991113/pearls-of-wisdom-for-high-risk-laser-lead-extractions-a-focused-review
#15
Lilibeth Fermin, Ralf E Gebhard, Ryan Azarrafiy, Roger Carrillo
Due to new indications and improved technology, the incidence of laser lead extraction (LLE) has significantly increased over the past years. While LLE has been well studied and proven to be safe and effective, only few studies are geared toward the anesthesiologist's role during high-risk LLEs. This article utilized both a focused review and authors' experience to investigate anesthetic protocols during LLEs. Through this review, we recommend best practices for the anesthesiologist including appropriate procedure location, onsite availability of a cardiac surgeon, availability of a cardiopulmonary bypass machine, and intraoperative use of echocardiography to detect and address potential complications during high-risk LLEs...
October 5, 2017: Anesthesia and Analgesia
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
#16
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/28944177/isolated-septal-myectomy-for-hypertrophic-obstructive-cardiomyopathy-an-update-on-the-toronto-general-hospital-experience
#17
Rachel D Vanderlaan, Anna Woo, Anthony Ralph-Edwards
BACKGROUND: Isolated septal myectomy is considered the gold standard for refractory left ventricular outflow tract (LVOT) obstruction at centers with dedicated hypertrophic obstructive cardiomyopathy (HOCM) surgeons. In this paper, we provide an update on the Toronto General Hospital (TGH) experience for isolated septal myectomy and comment on the safety and efficacy of myectomy in patients with thin basal septal thickness at our institution. METHODS: We retrospectively reviewed all patients undergoing surgical myectomy at our institution from January 2012 to August 2016...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28944171/current-state-of-the-art-and-future-of-myectomy
#18
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
#19
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
#20
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
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