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Intraoperative Transesophageal Echocardiography

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
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
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
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
Andrea Colli, Laura Besola, Matteo Montagner, Nicola Soriani, Erica Manzan, Eleonora Bizzotto, Fabio Zucchetta, Danila Azzolina, Roberto Bellu, Cristiano Sarais, Demetrio Pittarello, Gino Gerosa
OBJECTIVES: Our aim is to investigate the acute intraoperative effects of the NeoChord repair procedure on mitral valve (MV) annular geometry and LV function and the impact of these changes on MR at 1-year follow-up. BACKGROUND: Recently transapical off-pump mitral valve repair with NeoChord implantation has been demonstrated to be safe and effective in patients with degenerative mitral regurgitation (DMR). METHODS: We retrospectively analyzed baseline and early postoperative 3-dimensional transesophageal echocardiography of 66 patients who underwent NeoChord repair for isolated posterior leaflet MV disease using semiautomatic off-line analysis software...
January 25, 2018: International Journal of Cardiology
John Baer, Matthew M Wyatt, Kenneth R Kreisler
OBJECTIVE: Pulmonary artery catheters (PACs) have routinely been positioned by wedging into the pulmonary artery before pulling back 1-2 centimeters or advancing the PAC several centimeters after achieving a pulmonary artery waveform. A rare, major complication is pulmonary artery rupture. This study presents transesophageal echocardiography (TEE) for PAC placement by leaving the catheter tip at the one o'clock position, upper window short-axis view of the ascending aorta at the bifurcation of the pulmonary artery (TEE distance)...
January 22, 2018: Echocardiography
Anupam Das, Ummed Singh, Palleti Rajashekar
Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation...
January 2018: Annals of Cardiac Anaesthesia
James Taylor Herbert, Miklos David Kertai
The increasing use of endovascular interventions coupled with the large number of published case series detailing complications attest to the likelihood that anesthesiologists will encounter a case of intravascular foreign body embolization during their careers. Transesophageal echocardiography is essential to the diagnosis and management of traumatic and intravascular foreign bodies embolized to the heart because it can identify not only the foreign body but also hemodynamically significant lesions to radiolucent anatomic structures prior to and during surgical exploration...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Karin Graeser, Mikhail Zemtsovski, Klaus F Kofoed, Matilde Winther-Jensen, Jens C Nilsson, Jesper Kjaergaard, Hasse Møller-Sørensen
BACKGROUND: Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract...
January 9, 2018: Anesthesia and Analgesia
Keerthi Chigurupati, Subin Sukesan, Pravin S Lovhale, Baiju S Dharan, Thomas Koshy
Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) accounts for 0.4% of the congenital heart diseases. Comprehensive 2D and 3D transesophageal echocardiographic imaging of a well-collateralized subset of ALCAPA is described. A nonstandard short-axis view of both aorta and pulmonary arteries showed the origin of left coronary artery from the posterior sinus of the pulmonary artery and right coronary artery in its usual position. Pulse-wave interrogation of the coronary arteries showed the direction of flow in opposite directions...
January 11, 2018: Echocardiography
Ju Deok Kim, Ilsoon Son, Won Kyoung Kwon, Tae Yun Sung, Hanafi Sidik, Karam Kim, Hyun Kang, Jiyon Bang, Gwi Eun Yeo, Dong Kyu Lee, Tae Yop Kim
BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1...
January 22, 2018: Journal of Korean Medical Science
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