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Intraoperative Transesophageal Echocardiography

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https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#1
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/28465980/transesophageal-echocardiography-in-a-distal-aortopulmonary-window
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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/28409217/-surgical-techniques-for-treatment-of-vestibular-schwannoma
#8
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
#9
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
#10
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/28366705/defining-the-role-of-intraoperative-transesophageal-echocardiography-during-radical-nephrectomy-with-inferior-vena-cava-tumor-thrombectomy-for-renal-cell-carcinoma
#11
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
https://www.readbyqxmd.com/read/28359486/intraoperative-bioprosthetic-valve-dysfunction-causing-severe-mitral-regurgitation
#12
Philip Y K Pang, Susan Garwood, Sabet W Hashim
Structural degeneration of bioprosthetic valves usually occurs gradually over time. Failure of a bioprosthetic valve immediately after implantation is extremely rare. Possible causes include obstruction of valve leaflets from preserved subvalvular tissue during chordal-sparing mitral valve replacement (MVR) or strut entrapment by suture loops. We report 2 cases of acute bioprosthetic mitral valve (MV) dysfunction involving newly implanted Perimount Theon (Edwards Lifesciences, Irvine, CA) bioprostheses, causing severe transvalvular mitral regurgitation (MR)...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28302715/late-thrombosis-of-a-mitral-bioprosthetic-valve-with-associated-massive-left-atrial-thrombus
#13
Preetham Muskula, Rigoberto Ramirez, A Michael Borkon, Michael L Main
An 84-year-old man presented 5 years following bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg) was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (> 4 cm in diameter) (see Figures 1A-D, and video files 1-4)...
March 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28293002/-dehiscence-of-the-pericardial-patch-after-surgical-treatment-of-active-infective-aortic-valve-endocarditis-with-reconstruction-of-the-aortic-annulus-using-a-glutaraldehyde-treated-autologous-pericardium
#14
Kazufumi Yoshida, Naoto Fukunaga, Shigeki Koizumi, Kenta Nishiya, Yasuhiro Matsuda, Masanosuke Ishigami, Atsushi Nagasawa, Ryuzo Sakata, Tadaaki Koyama
A 50-year-old man was admitted with fever and chill sensation 6 months ago. Transthoracic echocardiography (TTE) showed left and right coronary cusp prolapses and a thickened tissue of the aortic curtain. Congestive heart failure due to active infective aortic valve endocarditis was diagnosed, and he underwent aortic valve replacement. The aortic annulus was reconstructed using a glutaraldehydetreated autologous pericardium. Six months after surgery, TTE showed severe aortic regurgitation and saccular change in the aortic annulus...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28290168/early-results-of-rheumatic-mitral-valve-repair
#15
Giuseppe Petrone, Panagiotis Theodoropoulos, Prakash P Punjabi
BACKGROUND: Mitral valve repair (MVr) in rheumatic heart disease (RHD) remains challenging. The present authors' surgical experience of MVr in 56 patients with RHD operated in between January 2011 and September 2014 is reported. METHODS: Among the patients (mean age 32 ± 11 years), 11 were in NYHA functional class II, 32 in class III, and seven in class IV. An adequate or oversized autologous pericardial patch was sutured to extend the coaptating edge of both the anterior leaflet (in 18 patients) and the posterior leaflet (in 30 patients)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28268005/feasibility-of-intraoperative-water-testing-in-aortic-valve-repair-direct-visualization-from-left-ventricle-with-a-videoscope
#16
Shunsuke Miyahara, Takanori Oka, Hiroaki Takahashi, Takeshi Inoue, Masamichi Matsumori, Hiroshi Tanaka, Yutaka Okita
OBJECTIVE: We describe a simple method to assess the aortic valve using a videoscope inserted in the left ventricle (LV-VS) during valve-sparing root replacement. The aim of this study was to evaluate the feasibility of this technique by comparing it with the findings of postoperative transesophageal echocardiography (TEE). METHODS: Thirty-six patients (29 male, mean age 45.4 ± 20.1 years) undergoing aortic root reimplantation were assessed intraoperatively with LV-VS...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#17
Arman Kilic, Mary A Siki, Wilson Y Szeto, Joseph E Bavaria, Saif Anwaruddin, Nimesh D Desai
An 87-year-old woman with severe aortic stenosis underwent a transfemoral transcatheter aortic valve replacement (TAVR). Intraoperative transesophageal echocardiography demonstrated a well-seated valve with no paravalvular leak; however, a new acute type B aortic dissection was identified. Endografts were delivered through the TAVR sheath and deployed, effectively treating the dissection. The patient did well postoperatively, with imaging at 2 years demonstrating a well-functioning aortic valve and no migration or endoleak of the thoracic endografts...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28151822/clinical-significance-of-portal-hypertension-diagnosed-with-bedside-ultrasound-after-cardiac-surgery
#18
André Y Denault, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Roberto Eljaiek, Ismail El-Hamamsy, Yoan Lamarche, Alexandra Chronopoulos, Jean Lambert, Josée Bouchard, Georges Desjardins
BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients undergoing cardiac surgery. METHODS: This is a case series performed in patients undergoing cardiac surgery between February 2014 and February 2015 in which portal and/or splenic venous flows were assessed by the attending anesthesiologist during surgery or by the intensivist after surgery using transthoracic echography in 9 patients or transesophageal echocardiography in 5 patients...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28114154/mitral-inflow-obstruction-resulting-from-a-dilated-coronary-sinus-role-of-intraoperative-transesophageal-echocardiography-in-diagnosis-and-surgical-repair-a-case-report
#19
Saravana Babu, Shrinivas V Gadhinglajkar, Muthu Kumar, Subin Sukesan, Baiju S Dharan, Rupa Sreedhar, Neelam Aggarwal
Mitral inflow obstruction caused by dilated coronary sinus is a rare congenital cardiac anomaly that must be differentiated from other causes of left ventricular inflow obstruction such as cor triatriatum, supramitral membrane, and supramitral ridge, because their surgical repair is different. Although preoperative transthoracic echocardiography is the primary imaging modality for diagnosis, intraoperative transesophageal echocardiography has a higher sensitivity and specificity over transthoracic echocardiography in differentiating these lesions...
April 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28100984/intraoperative-transesophageal-echocardiography-accurately-identifies-sinus-of-valsalva-aneurysm-in-a-27-year-old-man
#20
Ahmet Dolapoglu, Samuel J Hankins, David A Ott
No abstract text is available yet for this article.
December 2016: Texas Heart Institute Journal
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