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Asymptomatic ventricular dysfunction preoperative

Anirudh Srinivasan, Ajay Bahl, Hemant Bhagat, Pinaki Dutta, Ashutosh Rai, Jagtar S Devgun, Rupinder Kaur, Kanchan Kumar Mukherjee
BACKGROUND: Patients with acromegaly have 2-3 times the expected mortality rates primarily due to cardiovascular risks. Echocardiographic studies showing improvement of cardiac function following transsphenoidal surgery (TSS) are limited. MATERIALS AND METHODS: All patients with acromegaly underwent preoperative echocardiography and tissue Doppler (Philips i33, 3D ECHO) for assessment of cardiac indices. In the prospective group of patients, echocardiography was repeated after 6 months of surgery...
November 2017: Neurology India
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
Taeha Ryu, Seok-Young Song
Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion...
February 2017: Korean Journal of Anesthesiology
Shruti R Tiwari, Prasun Mishra, Paola Raska, Benjamin Calhoun, Jame Abraham, Halle Moore, G Thomas Budd, Alicia Fanning, Stephanie Valente, Robyn Stewart, Stephen R Grobmyer, Alberto J Montero
BACKGROUND: Pertuzumab is FDA approved in the preoperative setting in combination with trastuzumab and chemotherapy, in women with nonmetastatic HER2 + breast cancer. The TRYPHAENA trial (n = 77) reported a pathologic complete response rate (pCR), i.e., ypT0ypN0, of 52 % in patients treated with neoadjuvant (docetaxel, carboplatin, trastuzumab, & pertuzumab) TCH-P. Aside from this study, there is limited information regarding the safety and efficacy of TCH-P in the neoadjuvant setting...
July 2016: Breast Cancer Research and Treatment
Deniz Gunay, Yucel Ozen, Davut Cekmecelioglu, Sabit Sarikaya, Eray Aksoy, Murat Bulent Rabus, Kaan Kirali
BACKGROUND: Due to ventricular compensatory mechanisms, patients with severe aortic regurgitation are generally asymptomatic. Severe left ventricular dysfunction develops annually in 20% of non-operated cases, and the prognosis in those cases is poor. Although surgery is recommend in patients with left ventricular dysfunction, surgeons are wary. We investigated the changes in ventricular and effort capacity after surgery in patients with normal and abnormal left ventricular function. METHODS: We retrospectively examined the data of patients with aortic regurgitation who underwent aortic valve replacement in our clinic between 1993 and 2013...
May 2016: Asian Cardiovascular & Thoracic Annals
Kusha Nag, Amrutha Bindu Nagella, V R Hemanth Kumar, Dewan Roshan Singh, M Ravishankar
A 60-year-old woman posted for percutaneous nephrolithotomy with ureterolithotripsy was found to have a history of hypertension and ischemic heart disease from past 6 months on regular treatment. Pulse rate was irregularly irregular in a range of 56-60/min, unresponsive to atropine, with a sinus pause on the electrocardiogram. Although the patient was asymptomatic, anticipating unmasking of the sick sinus syndrome during general anesthesia in the prone position, a temporary pacemaker was implanted at right ventricular outflow tract (RVOT) septum before the scheduled surgery...
September 2015: Anesthesia, Essays and Researches
Vincent Chan, Marc Ruel, Elsayed Elmistekawy, Thierry G Mesana
BACKGROUND: The evidence supporting early surgical intervention in patients with chronic asymptomatic mitral regurgitation (MR) is steadily accumulating. Although left ventricular (LV) enlargement and preoperative pulmonary hypertension are considered when deciding on surgical intervention, the threshold above which these factors influence clinical outcomes remains poorly defined. METHODS: One-hundred fifty asymptomatic patients of aged 59.3 ± 13.4 years underwent mitral valve repair of severe MR caused by myxomatous degeneration between 2001 and 2012...
January 2015: Annals of Thoracic Surgery
Joyce T Johnson, Aaron W Eckhauser, Nelangi M Pinto, Hsin-Yi Weng, L LuAnn Minich, Lloyd Y Tani
Based on outcome data, surgery is recommended for asymptomatic adults with chronic mitral regurgitation (MR) and systolic dysfunction, marked left ventricular (LV) dilation, pulmonary hypertension, atrial fibrillation, or high likelihood of successful repair; but indications for children are poorly defined. We sought to determine predictors of postoperative LV dysfunction in asymptomatic children with chronic MR. The surgical database was searched for all children who underwent mitral valve surgery for chronic MR (2000-2012)...
February 2015: Pediatric Cardiology
Minoru Tabata, Hitoshi Kasegawa, Tomoyuki Suzuki, Hiroyuki Watanabe, Toshihiro Fukui, Shuichiro Takanashi, Minoru Ono
BACKGROUND AND AIM OF THE STUDY: The long-term outcomes of early surgery in patients with asymptomatic severe chronic mitral regurgitation (MR) and the impact of preoperative left ventricular dysfunction, atrial fibrillation (AF) and/or pulmonary hypertension (PH) on outcomes in this patient group, were evaluated. METHODS: Between 1992 and 2007, a total of 212 patients (mean age 50 +/- 15 years) with asymptomatic severe chronic degenerative MR underwent early mitral valve surgery within 12 months after echocardiographic diagnosis at the authors' institution...
May 2013: Journal of Heart Valve Disease
Stanimir G Georgiev, Stojan D Lazarov, Ivajlo D Mitev, Alexandra Z Latcheva, Georgi A Christov, Ivan G Velkovski, Plamen D Mitev
BACKGROUND: The study evaluates the long-term results of surgery for anomalous left coronary artery from the pulmonary artery (ALCAPA) with special attention on the left ventricular (LV) function and mitral regurgitation. METHODS: Twenty-one children underwent surgery for ALCAPA over 23 years (1987-2010). All patients underwent establishment of a two-coronary system, by direct reimplantation (n = 13) or by intrapulmonary tunnel technique (n = 8), with concomitant mitral valve repair in one...
July 1, 2012: World Journal for Pediatric & Congenital Heart Surgery
Rebecca M Gerlach, Tarit K Saha, Rene V Allard, Rob C Tanzola
PURPOSE: We report a case of unrecognized cardiac tamponade diagnosed pre-induction by focused transthoracic echocardiography (TTE). The value of focused perioperative TTE, the anesthetic implications of Churg-Strauss syndrome, and the diagnosis of cardiac tamponade are discussed. CLINICAL FEATURES: A 58-yr-old man with a history of severe asymptomatic aortic stenosis presented for elective endoscopic sinus surgery for intractable nasal polyps with recurrent sinusitis...
August 2013: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Vito Mannacio, Anita Antignano, Vincenzo De Amicis, Luigi Di Tommaso, Raffaele Giordano, Gabriele Iannelli, Carlo Vosa
OBJECTIVES Left ventricular (LV) diastolic dysfunction after aortic valve replacement (AVR) carries a substantial risk of development of heart failure and reduced survival. In addition to echocardiography, B-type natriuretic peptide (BNP) provides a powerful incremental assessment of diastolic function. This study evaluates BNP as a marker of LV diastolic dysfunction in a cohort of patients with preserved LV ejection fraction who underwent AVR for pure aortic stenosis and the relationship between BNP values and the grade of LV diastolic dysfunction...
August 2013: Interactive Cardiovascular and Thoracic Surgery
M Aithoussa, Y Moutakiallah, A Abdou, M Bamous, F Nya, N Atmani, A Seghrouchni, C Selkane, B Amahzoune, F A Wahid, Y Elbekkali, M Drissi, N Berrada, H Azendour, A Boulahya
BACKGROUND: Aortic valve replacement improves clinical symptoms and left ventricular systolic function in patients with chronic aortic regurgitation despite a higher surgical risk. The objective of this study is to determine if left ventricular function will be normalized after surgery. PATIENTS AND METHOD: This retrospective study included 40 patients (nine females and 31 males) with chronic aortic regurgitation and left ventricular systolic dysfunction who were evaluated by echocardiography Doppler...
April 2013: Annales de Cardiologie et D'angéiologie
Biljana Obrenović-Kirćanski, Bojana Orbović, Mile Vraneš, Biljana Parapid, Nataša Kovačević-Kostić, Miloš Velinović, Stana Ristić
Atrial fibrillation occurs as a frequent complication after cardiac interventions. It can be found in 5% of all surgical patients, and it is far more common in cardiac (10% - 65% of patients) than in non-cardiac procedures. In a number of patients it remains asymptomatic, but may be accompanied by very severe symptoms of hypotension, heart failure, syncope, systemic or pulmonary embolism, perioperative myocardial infarction, cerebrovascular insult and increased operative mortality. Patients whose postoperative course is complicated by atrial fibrillation require longer hospitalization...
July 2012: Srpski Arhiv za Celokupno Lekarstvo
Sujatha Buddhe, Wei Du, Henry L Walters, Ralph Delius, Michael D Pettersen
OBJECTIVE: To identify the risk factors that could predict postoperative outcome after aortic valve replacement in pediatric patients with isolated aortic regurgitation (AR). BACKGROUND: There is controversy regarding the appropriate timing of surgery in asymptomatic or minimally symptomatic patients with isolated AR. In the pediatric age group, there are limited studies in this regard and most of them are on combined aortic valve stenosis and regurgitation. METHODS: All patients with biventricular physiology and morphologic left ventricle (LV) who underwent aortic valve surgery for AR from January 1988 to July 2010 were included in the study...
March 2013: Congenital Heart Disease
Takeshi Kitai, Yukikatsu Okada, Yu Shomura, Kazuaki Tanabe, Tomoko Tani, Toru Kita, Yutaka Furukawa
BACKGROUND AND AIM OF THE STUDY: It remains controversial whether early mitral valve (MV) repair should be performed for severe degenerative mitral regurgitation (MR) without symptoms, left ventricular (LV) dilatation or dysfunction, atrial fibrillation (AF) or pulmonary artery hypertension (PH), even at experienced surgical centers. The study aim was to reconsider the optimal timing of intervention for asymptomatic patients with severe degenerative MR at experienced surgical centers...
January 2012: Journal of Heart Valve Disease
Hiroshi Wakabayashi, Junichi Taki, Anri Inaki, Hisashi Sumiya, Hiroyuki Tsuchiya, Seigo Kinuya
BACKGROUND: Advancement in chemotherapy has significantly improved the prognosis of cancer patients. However, many anticancer drugs have serious cardiovascular side effects. We assessed doxorubicin-induced cardiac toxicity (DCT) during and after preoperative chemotherapy using gated (99m)Tc-hexakis-2-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) in patients with malignant bone and soft tissue tumors. METHODS AND RESULTS: Gated (99m)Tc-MIBI SPECT was performed before, and after the middle and final courses of preoperative chemotherapy...
2012: Circulation Journal: Official Journal of the Japanese Circulation Society
Maria Florescu, Diana Crina Ciresica Mihaela Benea, Roxana Cristina Rimbas, Gheorghe Cerin, Marco Diena, Guido Lanzzillo, Oana Aurelia Enescu, Mircea Cinteza, Dragos Vinereanu
AIMS: In asymptomatic patients with severe primary mitral regurgitation (PMR), early detection of left ventricular (LV) dysfunction indicates the optimal timing of mitral valve surgery; however, normal ejection fraction (EF) and end-systolic diameter (ESD) can mask significant LV impairment. METHODS: We studied 28 asymptomatic patients (59 ± 13 years, 18 male) with severe PMR, EF > 60%, and ESD < 45 mm, and 10 age-matched healthy subjects. All underwent echocardiography with tissue velocity imaging to assess LV geometry, EF, and longitudinal systolic function; and two-dimensional speckle tracking to assess longitudinal strain (LS) and longitudinal strain rate (LSR), and radial strain (RS) and radial strain rate (RSR)...
March 2012: Echocardiography
Mosaad Abdel-Aziz
Adenoid hypertrophy is the most common cause of pediatric upper airway obstruction, and it can lead to cardiopulmonary complications such as pulmonary hypertension, cor pulmonale, and even heart failure. The aim of this study was to detect the asymptomatic cardiopulmonary changes that could happen in children with adenoid hypertrophy.Eighty children with adenoid hypertrophy were included in this study. Chest x-ray was used to assess the cardiothoracic ratio, whereas echocardiography was used for measuring the pulmonary arterial pressures, right ventricular diastolic filling parameters, and right ventricular end-diastolic diameters...
July 2011: Journal of Craniofacial Surgery
Abdulaziz Al-Khaldi, Yasser Mohammed, Omar Tamimi, Abdulmohsen Alharbi
BACKGROUND: Arterial Tortuosity Syndrome (ATS) is an autosomal recessive connective tissue disease that can present with complex pulmonary arterial stenosis, causing right ventricular (RV) hypertension and dysfunction. In this study, we review our experience and early outcomes with single stage surgical repair. METHODS: From 2008 to 2010, 7 patients with ATS and severe bilateral pulmonary artery stenosis underwent surgical repair that involved extensive reconstruction of the pulmonary arterial tree bilaterally, including the central, lobar and segmental branches...
August 2011: Annals of Thoracic Surgery
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