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https://www.readbyqxmd.com/read/29154747/disseminated-methicillin-susceptible-staphylococcus-aureus-infection
#1
David R Perkins, James A Hall, Lisa M Lopez, Lizbeth Janice Cahuayme-Zuniga
INTRODUCTION: When clinicians think about Staphylococcus aureus bacteria, what comes to the mind of most is the dreaded methicillin-resistant form. However, clinicians should not forget the methicillin-susceptible type, which is just as virulent. CASE PRESENTATION: The authors present the case of a 20-year-old woman who was admitted with septic shock and multi-organ failure and was found to have disseminated methicillin-susceptible Staphylococcus aureus (MSSA) infection...
November 20, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29151509/in-paroxysmal-atrial-fibrillation-patients-the-neutrophil-to-lymphocyte-ratio-is-related-to-thrombogenesis-and-more-closely-associated-with-left-atrial-appendage-contraction-than-with-the-left-atrial-body-function
#2
Yukihiro Fukuda, Mitsunori Okamoto, Shunsuke Tomomori, Hiroya Matsumura, Takehito Tokuyama, Yukiko Nakano, Yasuki Kihara
Objective The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that can be used to detect atrial inflammatory changes, which may contribute to a reduced left atrial (LA) function and thrombosis. Our study aimed to determine whether or not the association of NLR with the LA appendage (LAA) function in relation to thrombogenesis differs from the association with the LA body function in paroxysmal atrial fibrillation (PAF) patients. Methods A total of 183 PAF patients were studied. The LA volume index, mitral flow velocity (A), and mitral annular motion velocity (A') were examined using transthoracic echocardiography...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29151480/the-refinement-of-risk-stratification-for-atrial-thrombus-or-spontaneous-echo-contrast-in-nonvalvular-atrial-fibrillation
#3
Wenna Ning, Yang Li, Chunyan Ma, Liangxian Qiu, Bo Yu
As for nonvalvular atrial fibrillation (NVAF) patients with left atrial thrombus or spontaneous echo contrast (LAT/SEC), we evaluated the additional predictive value of serum uric acid (SUA) and Left atrial diameter (LAD) for CHADS2 and CHA2DS2-VASc, and explored the influence from the level of SUA and LAD to LAT/SEC in moderate risk group. Thus, we put forward the concept of a borderline high risk group to guide clinical anticoagulant therapy in patients with NVAF.A total of 284 NVAF patients without the history of anticoagulant prior to hospitalization were enrolled...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#4
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#5
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29147150/localized-aortic-root-dissection-with-a-superior-mesenteric-artery-aneurysm
#6
Akihiko Ikeda, Tomomi Nakajima, Yuji Hiramatsu, Tomoaki Jikuya
In this study, the case of a 46-year-old female patient with localized aortic root dissection and a superior mesenteric artery (SMA) aneurysm is described. Computed tomographic angiography could not clearly delineate an intimal flap in the aortic root, but it detected SMA aneurysm, which implied the presence of a vulnerability of the aortic wall. Finally, transesophageal echocardiography (TEE) evidently showed the intimal flap localized in the aortic root. The present case suggests that TEE is of paramount importance for detecting localized aortic root dissection...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147130/mobile-mass-in-the-aortic-arch-a-case-report
#7
Fatemeh Ghani-Dehkordi, Rostam Esfandiyari-Bakhtiyari, Firoozeh Alirezaee-Shahraki
BACKGROUND: The finding of a floating mass in the aortic arch is rare and the management remains controversial. CASE REPORT: We describe a 42-year-old woman with an embolic infarction in whom transesophageal echocardiography revealed a mobile mass in the aortic arch that was characterized as atherothrombi with an evidence of embolic infarction in the territory of the middle cerebral artery. Treatment with antiplatelet and anticoagulants failed to resolve the mass and is surgically resected...
July 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#8
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142815/multifactorial-genesis-of-a-seeming-case-of-pulmonary-hypertension
#9
Rita Leonarda Musci, Lucrezia De Michele, Carlo D'Agostino, Paolo Colonna
Herein, we report the case of a 44-year-old female with end-stage renal disease on hemodialysis. She was admitted to our hospital to evaluate if she was eligible for a kidney transplant. Transthoracic echocardiography showed a markedly dilated coronary sinus and an unexpected finding of increased right ventriculoatrial gradient. A saline contrast echocardiography to confirm the presence of persistent left superior vena cava (PLSVC) was not performed because of arteriovenous fistula (FAV) for hemodialysis on the left forearm...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142814/a-membranous-septal-aneurysm-causing-right-ventricular-outflow-tract-obstruction-in-an-adult
#10
Fiorella Privitera, Ines Paola Monte, Antonino Indelicato, Corrado Tamburino
We describe a case of a 69-year-old female referred for the evaluation of exertional dyspnea, with a small membranous ventricular septal defect (VSD) and right ventricle (RV) outflow tract obstruction. Using transthoracic echo was diagnosed VSD with left to right shunting and transesophageal echo (TEE) was used to a better anatomical characterization. TEE showed a perimembranous subaortic VSD that developed a high-velocity flow in RV. Pulmonary valve appears normal and right ventricular infundibular hypertrophy or double-chambered RV was excluded from the study...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#11
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29134434/fluoroscopy-free-af-ablation-using-transesophageal-echocardiography-and-electroanatomical-mapping-technology
#12
Benjamin O'Brien, Damian C Balmforth, Ross J Hunter, Richard J Schilling
PURPOSE: Guidelines recommend that radiation exposure during AF catheter ablation procedures should be 'as low as reasonably achievable' (ALARA), particularly since many patients may have multiple procedures. Consequently, avoiding radiation exposure altogether must, if safe to do so, be the ultimate goal. The primary objective was to determine the feasibility and efficacy of fluoroscopy-free AF ablation compared to the fluoroscopy-assisted procedure. METHODS: Patients underwent AF ablation using commercially available technology with no routine pre-procedural imaging...
November 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29132805/feasibility-of-the-use-of-transesophageal-echocardiography-as-a-surface-probe-for-puncturing-and-catheterization-of-the-internal-jugular-vein-a-randomized-controlled-pilot-study
#13
Yi Teng, Mengchan Ou, Hai Yu
OBJECTIVE: To compare the transesophageal echocardiography (TEE) probe as a surface probe with the vascular probe for guiding internal jugular vein (IJV) catheterization. DESIGN: Prospective, randomized, controlled pilot study. SETTING: University hospital. PARTICIPANTS: One hundred cardiac surgery patients, including 50 adult and 50 pediatric patients. INTERVENTIONS: Patients in the TEE probe group received right IJV catheterization using the TEE probe, while the vascular probe group used the vascular probe for catheterization...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29131286/conscious-sedation-for-transcatheter-implantation-of-atrial-septal-occluders-with-the-2d-and-3d-transesophageal-echocardiography-guidance-the-feasibility-and-safety-study
#14
Piotr Lipiec, Dawid Miśkowiec, Jan Z Peruga, Michał Plewka, Ewa Szymczyk, Paulina Wejner-Mik, Karolina Kupczyńska, Jarosław D Kasprzak
BACKGROUND: General anesthesia may have negative impact on patients mortality and morbidity, as well as overall procedure costs in atrial septal occluders (ASO) implantation. AIM: We sought to evaluate the safety, efficacy and feasibility of conscious sedation for transcatheter implantation of ASO. METHODS: 122 patients (pts) referred for transcatheter implantation of ASO were included. Mean patients' age was 51±15 years, 43 patients were male (35%)...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#15
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29128482/aortic-valve-cusp-coaptation-surface-area-using-3-dimensional-transesophageal-echocardiography-correlates-with-severity-of-aortic-valve-insufficiency
#16
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/29128265/atrial-flutter-has-less-left-atrial-spontaneous-contrast-and-higher-left-atrial-appendage-emptying-velocity-compared-with-atrial-fibrillation
#17
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. There are clear guidelines in anticoagulation management of patient's with atrial fibrillation, however, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography (TEE); thereby possibly leading to a lower stroke risk...
November 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#18
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29121724/noacs-and-atrial-fibrillation-incidence-and-predictors-of-left-atrial-thrombus-in-the-real-world
#19
Emanuele Bertaglia, Matteo Anselmino, Alessandro Zorzi, Vincenzo Russo, Elisabetta Toso, Francesco Peruzza, Antonio Rapacciuolo, Federico Migliore, Fiorenzo Gaita, Umberto Cucchini, Marcello De Divitiis, Sabino Iliceto, Giuseppe Stabile
AIMS: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2DS2-VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118891/systolic-anterior-motion-of-mitral-valve-subchordal-apparatus-a-rare-echocardiographic-pattern-in-non-obstructive-hypertrophic-cardiomyopathy
#20
Jezreel L Taquiso, Stephanie Martha O Obillos, Joerelle V Mojica, Lauro L Abrahan, Elleen C Cunanan, Jaime Alfonso M Aherrera, Jose Donato A Magno
Systolic anterior motion (SAM) of the mitral valve or chordate is one characteristic seen in hypertrophic cardiomyopathy (HCM) either in obstructive or non-obstructive phenotypes. More often than not, the obstruction is caused by valvular rather than chordal SAM. We describe the role of echocardiography in identifying the actual anatomical location of the mitral valve apparatus involved in SAM and in assessing consequent left ventricular outflow tract (LVOT) obstruction in an otherwise asymptomatic patient...
October 2017: Cardiology Research
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