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Intraoperative echocardiography

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https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#1
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#2
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28513189/transcatheter-aortic-valve-implantation-the-transaortic-approach
#3
Simon Cy Chow, Gary Sh Cheung, Alex Pw Lee, Eugene B Wu, Jacky Yk Ho, Micky Wt Kwok, Peter Sy Yu, Innes Yp Wan, Malcolm J Underwood, Randolph Hl Wong
Background Transcatheter aortic valve implantation has been established as a safe and effective treatment option for patients at high or prohibitive surgical risk. However, some patients may not be suitable for the transfemoral approach due to severe iliofemoral disease or aneurysmal disease of the thoracoabdominal aorta. The aim of this case series was to evaluate the feasibility and clinical outcomes of the transaortic approach. Methods From May 2015 to June 2016, 5 patients (mean age 78.4 ± 3.9 years) with severe symptomatic aortic stenosis underwent transaortic transcatheter aortic valve implantation after a heart team discussion...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28510739/comparison-of-preoperative-and-intraoperative-assessment-of-aortic-stenosis-severity-by-echocardiography
#4
Y Uda, B Cowie, R Kluger
Background: General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Methods: Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28497553/simultaneous-transcatheter-therapy-for-perimembranous-ventricular-septal-defect-combined-with-patent-ductus-arteriosus
#5
Qiguang Wang, Xianyang Zhu, Zhang Duanzhen, Po Zhang, Huoyuan Chen, Xiumin Han, Xiaotang Sheng, Lili Meng
OBJECTIVE: This study aims to assess the clinical efficiency and safety of simultaneous transcatheter interventional treatment for perimembranous ventricular septal defect (pmVSD) combined with patent ductus arteriosus (PDA). METHODS: Twenty-five patients with pmVSD and PDA treated with simultaneous transcatheter interventions from April 2004 to December 2015 were included in this study. The mean age was 9.80 ± 8.14 years and the mean weight was 29.76 ± 14...
May 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28481994/risk-factors-for-the-development-of-right-ventricular-failure-after-left-ventricular-assist-device-implantation-a-single-centre-retrospective-with-focus-on-deformation-imaging%C3%A2
#6
Nadia Boegershausen, Rashad Zayat, Ali Aljalloud, Giulia Musetti, Andreas Goetzenich, Lachmandath Tewarie, Ajay Moza, Andrea Amerini, Rüdiger Autschbach, Nima Hatam
OBJECTIVES: Right heart failure (RHF) after the implantation of a left ventricular assist device (LVAD) remains a dreaded postoperative complication. Using 2D speckle-tracking echocardiography, it is possible to acquire right ventricular global and regional function. The aim of our study was to assess whether speckle-tracking echocardiography values will better predict the RHF post-continuous-flow LVAD implantation. METHODS: From January 2014 to January 2016, 54 patients who underwent LVAD implantation were included and retrospectively analysed...
May 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28473968/utilization-of-intraoperative-real-time-three-dimensional-transoesophageal-echocardiography-to-objectively-assess-improvement-in-synchronization-and-regional-wall-motion-after-coronary-reperfusion
#7
Abhishek Karnwal, Clinton Z Kakazu, Sonia Shah, Bassim Omari, Charu Dutt Arora
It is well known that myocardial ischemia leads to Regional Wall Motion Abnormalities (RWMAs) and reversible depression of Left Ventricular (LV) systolic function. Transoesophageal Echocardiography (TEE) is an established tool for early diagnosis of new RWMAs. However, evaluation of RWMAs by echocardiography is largely qualitative and relies on visual assessment of wall segments. Evaluation of LV systolic function and Ejection Fraction (EF) is more reproducible and accurate with Real-Time 3D Echocardiography (RT3DE) as compared with two-dimensional and M-mode techniques...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28466690/a-unique-intracardiac-shunt-identifying-complex-anatomy-in-reoperative-adult-congenital-heart-disease
#8
Billie-Jean Martin, Ivan M Rebeyka, Jeffrey F Smallhorn, Dylan A Taylor, Isabelle F Vonder Muhll
Adult patients with repaired congenital heart disease are presenting with previously unseen types of residual lesions and consequences of prior repair. Patients with d-transposition of the great arteries repaired with atrial switch operations are returning with dysrhythmias and atrioventricular valve disease requiring intervention. We present the challenging case of a young adult with a residual shunt identified on preoperative three-dimensional transthoracic echocardiography, the precise anatomy of which was only characterized intraoperatively...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28465980/transesophageal-echocardiography-in-a-distal-aortopulmonary-window
#9
Subramanian Chellappan, Ashish Katewa, Yogesh C Sathe
Aortopulmonary window (APW) is a relatively rare cardiac lesion representing approximately 0.2%-0.4% of all cardiac malformation. It is a cardiac abnormality that results from abnormal communication between the proximal aorta and the main pulmonary artery in the presence of two normally separated aortic and pulmonary valves. In the past, the diagnostic and surgical approach to APW was almost always preceded by cardiac catheterization. With recent advances in noninvasive approach and techniques of two-dimensional echocardiography diagnosis of the defect and associated anomalies are facilitated without a cath study...
October 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28465979/isolated-double-chambered-right-ventricle-with-intact-interventricular-septum
#10
Subramanian Chellappan, Balaswaroop Sahu, Yogesh C Sathe
Double-chambered right ventricle (DCRV) is a developmental cardiac anomaly in which anomalous muscle bundles divide the right ventricular (RV) cavity into two chambers. It is usually associated with other congenital cardiac defects, of which ventricular septal defect is the most common association. Isolated DCRV with an intact interventricular septum is very rarely reported. It manifests itself usually in adolescence and adults as the obstruction progresses gradually. It is important to recognize this anomaly as it can progress to severe RV failure if unaddressed...
October 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28461798/transcatheter-aortic-valve-implantation-in-a-patient-with-unicuspid-aortic-valve
#11
Angelo Nascimbene, Pranav Loyalka, Igor D Gregoric, Ricardo Bellera, Maan Malahfji, Marija Petrovic, Biswajit Kar
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient. A 31-year-old woman with Turner syndrome-who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks-presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28459719/profound-obstructive-hypotension-from-prone-positioning-documented-by-transesophageal-echocardiography-in-patient-with-scoliosis-a-case-report
#12
Arnoley S Abcejo, Juan Diaz Soto, Courtney Castoro, Sarah Armour, Timothy R Long
In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28449514/left-ventricular-outflow-tract-obstruction-due-to-a-left-ventricular-myxoma-that-was-misidentified-as-an-accessory-mitral-valve-tissue
#13
Seung-Hoon Baek, Hee Young Kim, Hyae Jin Kim, Sang Wook Shin, Hye Jin Kim, Yun Mi Choi, Eun Ji Choi, Eunjung Chang, Hong-Sik Son
We report obstruction of the left ventricle outflow tract (LVOT) caused by cardiac myxoma that was misidentified as an accessory mitral valve tissue preoperatively. A 65-year-old woman presented with chest discomfort that persisted for 7 days. Transthoracic echocardiography (TTE) revealed a mobile, low-echogenic, balloon-shaped mass attached to the anterior mitral valve leaflet and papillary muscle, which was suspected to be an accessory mitral valve tissue. Because the mass caused LVOT obstruction and it could result in hemodynamic instability, emergency operation was performed...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28433951/transesophageal-echocardiography-in-the-evaluation-of-the-trauma-patient-a-trauma-resuscitation-transesophageal-echocardiography-exam
#14
REVIEW
Stefan W Leichtle, Andrew Singleton, Mandeep Singh, Matthew J Griffee, Joshua M Tobin
The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28431721/intra-aortic-missile-after-gunshot-wound-to-chest-an-interesting-case-of-traumatic-cardiac-injury
#15
Charles D Fraser, Lee Goeddel, Nishant D Patel, Said C Azoury, Joshua C Grimm, Rosanne B Sheinberg, Christopher M Sciortino
Missile embolus to the heart, although uncommon, is one of the most challenging scenarios in trauma. We describe a 36-year-old man who presented with a gunshot wound to the left chest and a chest x-ray revealing a foreign body in the mediastinum. A median sternotomy was performed and an injury to the left ventricle was identified. After intraoperative echocardiography and fluoroscopy confirmed a foreign body in the aortic root, cardiopulmonary bypass was implemented. A bullet was retrieved from the noncoronary sinus of the aortic valve...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28409217/-surgical-techniques-for-treatment-of-vestibular-schwannoma
#16
S Rosahl, D Eßer
BACKGROUND: Microsurgical resection of vestibular schwannomas is demanding, even if not all of these tumors represent a challenge for experienced surgeons. In order to make the right decisions when it comes to balancing the extent of tumor resection with preservation of function, the surgeon must possess detailed knowledge of the surgical techniques and also have mastered these. OBJECTIVE: The current article describes the state-of-the-art of the three major microsurgical techniques for resection of vestibular schwannomas, their pearls and their perils...
April 13, 2017: HNO
https://www.readbyqxmd.com/read/28393790/inverted-left-atrial-appendage-masquerading-as-a-left-atrial-mass
#17
Suresh Kumaran, Gladdy George, A V Varsha, Raj Sahajanandan
An inverted left atrial appendage after cardiac surgery is a rare finding and can be misinterpreted as a thrombus, mass, or vegetation. We report a case where intraoperative transesophageal echocardiography assisted in making an accurate diagnosis.
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393769/artificial-intelligence-in-mitral-valve-analysis
#18
Jelliffe Jeganathan, Ziyad Knio, Yannis Amador, Ting Hai, Arash Khamooshian, Robina Matyal, Kamal R Khabbaz, Feroze Mahmood
BACKGROUND: Echocardiographic analysis of mitral valve (MV) has become essential for diagnosis and management of patients with MV disease. Currently, the various software used for MV analysis require manual input and are prone to interobserver variability in the measurements. AIM: The aim of this study is to determine the interobserver variability in an automated software that uses artificial intelligence for MV analysis. SETTINGS AND DESIGN: Retrospective analysis of intraoperative three-dimensional transesophageal echocardiography data acquired from four patients with normal MV undergoing coronary artery bypass graft surgery in a tertiary hospital...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28391520/neonatal-repair-of-left-atrial-diverticulum-with-gigantic-thrombus-without-cardiopulmonary-bypass
#19
Akihiko Higashida, Takaya Hoashi, Heima Sakaguchi, Hajime Ichikawa
A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass...
April 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366705/defining-the-role-of-intraoperative-transesophageal-echocardiography-during-radical-nephrectomy-with-inferior-vena-cava-tumor-thrombectomy-for-renal-cell-carcinoma
#20
Megan P Kostibas, Vivek Arora, Michael A Gorin, Mark W Ball, Phillip M Pierorazio, Mohamad E Allaf, Daniel Nyhan, Mary Beth Brady
OBJECTIVE: To determine the impact of transesophageal echocardiography on the surgical management of patients undergoing nephrectomy and inferior vena cava tumor thrombectomy for renal cell carcinoma. MATERIALS AND METHODS: We retrospectively analyzed intraoperative records of 67 patients with renal cell carcinoma and level II-IV invasion of the inferior vena cava who underwent nephrectomy with tumor thrombectomy between 2007 and 2015. Based on preoperative imaging, patients were categorized according to vena cava thrombus level...
March 30, 2017: Urology
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