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Preoperative tee

Deepak Prakash Borde, Antony George, Shreedhar Joshi, Suresh Nair, Thomas Koshy, Uday Gandhe, Murali Chakravarthy
CONTEXT: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). AIMS: We hypothesized that variations in practice of intraoperative TEE exist among centers and this survey aimed at analyzing them...
October 2016: Annals of Cardiac Anaesthesia
Hyun Ju Jung, Won-Kyoung Kwon, Sung Jun Lee, Nazri Mohamed, Bo-Mi Shin, Jinyoung Lee, Tae-Yop Kim
BACKGROUND: This study reports the efficacy of intraoperative transesophageal echocardiography (TEE) for evaluation of high take-off coronary ostia and proximal coronary arterial flows as an alternative to preoperative coronary angiography. CASE PRESENTATION: In a 65-year old male undergoing the bicuspid aortic valve (BAV) repair and the extensive remodeling of dilated sinus and tubular junction, and preoperative coronary angiography were unsuccessfully completed due to an allergic reaction to the contrast medium...
October 4, 2016: BMC Anesthesiology
Martina Nowak-Machen
Aortic disease, when left untreated, is still associated with major morbidity and mortality. Aortic dissection and aortic aneurysm are the main reasons for performing aortic surgery procedures in the adult. Imaging techniques such as computed tomography and magnetic resonance imaging play a key role in the preoperative evaluation. Transesophageal echocardiography (TEE) has become a safe and invaluable perioperative imaging tool for aortic disease over the past decade with high sensitivity and specificity. TEE can increase patient safety and improve overall patient outcome in aortic surgery...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Peng Liu, Rijing Liu, Yan Zhang, Yingfeng Liu, Xiaoming Tang, Yanzhen Cheng
AIMS AND OBJECTIVES: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. BACKGROUND: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion...
August 19, 2016: Cardiology
Cesare Quarto, Simon Davies, Alison Duncan, Alistair Lindsay, Georg Lutter, Lucian Lozonschi, Neil Moat
OBJECTIVE: A small number of transcatheter mitral valve implants (TMVIs) have been reported using devices designed to treat secondary mitral regurgitation (MR). However, MR has many etiologies, and patients have a broad spectrum of annular size, geometry, and lesions. There are a number of technical challenges for TMVI including left ventricular outflow tract obstruction and paravalvular MR. Thirty days' outcome of first-in-man implants with a novel TMVI device is reported. METHODS: The Tendyne TMVI system consists of a porcine pericardial valve in a tethered nitinol frame...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
George Whitener, Joseph Sivak, Igor Akushevich, Zainab Samad, Madhav Swaminathan
OBJECTIVE: The authors hypothesized that average precardiopulmonary bypass (pre-CPB) transesophageal echocardiographic (TEE) mean gradient (PGm) and aortic valve area (AVA) values would be significantly different from preoperative transthoracic (TTE) values in the same patients and that these changes would affect pre-CPB TEE grading of aortic stenosis (AS). DESIGN: Retrospective, observational design. SETTING: Single university hospital. PARTICIPANTS: The study comprised 92 patients who underwent aortic valve replacement with or without coronary artery bypass grafting between 2000 and 2012 at Duke University Hospital and who had PGm and AVA values recorded in both pre-CPB TEE and preoperative TTE reporting databases...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Takao Imai, Suetaka Nishiike, Kazuo Oshima, Hidenori Tanaka, Yukinori Tsuruta, Yoichiro Tomiyama
OBJECTIVE: The aim of this study was to evaluate part of the area of the posterior wall of the external auditory canal (EAC) that is resected during transcanal endoscopic ear surgery (TEES) for cholesteatomas that extend to the mastoid cavity, and to determine whether TEES is a minimally invasive surgical procedure for cholesteatoma. METHODS: This was a retrospective study involving 25 patients with cholesteatoma that extended to the mastoid cavity, and who underwent surgery between October 2014 and October 2015...
June 23, 2016: Auris, Nasus, Larynx
Erika Fagman, Agneta Flinck, Ulrika Snygg-Martin, Lars Olaison, Odd Bech-Hanssen, Gunnar Svensson
OBJECTIVES: The aim of this study was to investigate the value of electrocardiogram (ECG)-gated computed tomography (CT) in the surgical decision-making and preoperative evaluation in patients with aortic prosthetic valve endocarditis (PVE). METHODS: Sixty-eight prosthetic valves in 67 patients with aortic PVE were prospectively evaluated with ECG-gated CT and transoesophageal echocardiography (TEE). Imaging findings considered indications for surgery were as follows: (i) abscess/pseudoaneurysm formation; (ii) prosthetic valve dehiscence; (iii) valve destruction with valvular regurgitation; (iv) large vegetations (>1...
May 30, 2016: European Journal of Cardio-thoracic Surgery
Kazumi Ono, Hidekuni Hidaka, Yusuke Koyama, Kenzo Ishii, Shinya Taguchi, Mako Kosaka, Nobuki Okazaki, Wakana Tanimoto, Akira Katayama
Recent publications provided controversial results indicating that perioperative heparin bridging anticoagulation (HBA) increased the bleeding risk without decreasing the thromboembolic risk in patients undergoing minor surgery. To investigate if this is also the case in high-risk patients undergoing major abdominal malignancy surgery, we retrospectively collected data of 3268 patients over a 10-year period. After the interruption of preoperative antithrombotic agents, HBA was initiated with a prophylactic-dose of unfractionated heparin in 133 patients (HBA group), and 62 patients did not receive HBA (non-HBA group)...
August 2016: Journal of Anesthesia
Kazumi Ono, Hidekuni Hidaka, Yusuke Koyama, Kenzou Ishii, Chiharu Tanaka, Shinya Taguchi, Nobuki Okazaki, Wakana Tanimoto, Akira Katayama
BACKGROUND: Controversies still exist whether to continue or withdraw aspirin (ASA) perioperatively. This study was performed to determine whether patients on preoperative antiplatelet therapy (APT) benefit from continuing ASA in terms of thrombotic and bleeding risk prevention. METHODS: Among 307 consecutive patients who were on APT preoperatively for the secondary prevention of cardiovascular disease and who underwent elective major abdominal malignancy surgery, 148 patients had all the preoperative APT withdrawn and the remaining 159 patients continued only ASA...
April 2016: Masui. the Japanese Journal of Anesthesiology
Neil L Duplantier, Michael Couch, Logan Emory, Joseph M Zavatsky
STUDY DESIGN: This is a case report. OBJECTIVE: Describe the occurrence of cardiac emboli recorded on transesophageal echocardiogram (TEE) after the injection of a topical hemostatic agent into a vertebra prior to performing a pedicle subtraction osteotomy (PSO). SUMMARY OF BACKGROUND DATA: Hemostasis during spinal surgery is critical for adequate visualization and to reduce the risk of perioperative complications. Adult spinal deformity surgery can involve performing PSOs which are useful in cases of fixed spinal deformities and are associated with increased blood loss secondary to epidural and cancellous bleeding...
May 2016: Spine
Farideh Roshanali, Mohammad Naderan, Saeed Shoar, Ali Vedadian, Saleh Sandoughdaran, Nasrin Shoar, Mohammad Hossein Mandegar
OBJECTIVES: The aim of the present study was to ascertain whether the length of anterior mitral leaflet second-order chordae (SOC) could be considered as a predictor of the incidence of post-repair systolic anterior motion (SAM) and left ventricular outflow tract obstruction (LVOTO) in patients with myxomatous mitral valve disease. METHODS: With the implementation of preoperative transoesophageal echocardiography (TEE), the length of anterior mitral leaflet SOC, anterior leaflet (AL) and posterior leaflet (PL) as well as the distance from the coaptation point to the septum (C-S distance) before and after mitral valve repair (MVR) surgery were measured in 190 patients, comprising 12 who developed SAM and 178 who did not...
August 2016: Interactive Cardiovascular and Thoracic Surgery
Abdulraouf M Z Jijeh, Ahmad S Omran, Hani K Najm, Riyadh M Abu-Sulaiman
BACKGROUND: Intraoperative transesophageal echocardiography (TEE) has a major role in detecting residual lesions during and/or after pediatric cardiac surgery. METHODS: All pediatric patients who underwent cardiac surgery between July 2001 and December 2008 were reviewed. The records of surgical procedure, intraoperative TEE, and predischarge transthoracic echocardiograms were reviewed to determine minor and major residual cardiac lesions after surgical repair. RESULTS: During the study period, a total of 2268 pediatric cardiac patients were operated in our center...
April 2016: Journal of the Saudi Heart Association
Neelam Aggarwal, Shrinivas Gadhinglajkar, Rupa Sreedhar, Baiju S Dharan, Keerthi Chigurupati, Saravana Babu
OBJECTIVE: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. DESIGN: A retrospective observational case series. METHODOLGY: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperative events were recorded from the medical records...
April 2016: Annals of Cardiac Anaesthesia
Jacob B Hunter, M Geraldine Zuniga, Alex D Sweeney, Natalie M Bertrand, George B Wanna, David S Haynes, Christopher T Wootten, Alejandro Rivas
OBJECTIVES: (1) To describe and review a single center's pediatric endoscopic cholesteatoma experience, including surgical and audiologic outcomes. (2) To assess the most common locations of residual cholesteatoma following endoscopic removal. STUDY DESIGN: Case series with chart review. SETTING: Tertiary otologic referral center. SUBJECTS: Patients <19 years of age who underwent cholesteatoma removal with either endoscopic or microscopic visualization...
June 2016: Otolaryngology—Head and Neck Surgery
Kongkiat Chaikriangkrai, Dimitrios Maragiannis, Tatiana Belousova, Stephen Little, Faisal Nabi, John Mahmarian, Su Min Chang
BACKGROUND: Transesophageal echocardiography (TEE) is recommended for diagnosis in patients suspected of prosthetic valve dysfunction, but could be limited in its ability to identify the etiology of these dysfunctions and to assess extracardiac structures. Our objective is to examine the usefulness of multidetector computed tomography (MDCT) in establishing the etiology of the dysfunctions and its clinical utility in preoperative assessment in these patients. METHODS: Twenty-two prosthetic heart valves from 20 consecutive patients who had a preoperative MDCT and underwent redo prosthetic valve procedures from December 2008 to February 2013 were examined retrospectively...
March 2016: Journal of Cardiac Surgery
George Whitener, Jeff McKenzie, Igor Akushevich, William D White, Ishwori B Dhakal, Alina Nicoara, Madhav Swaminathan
BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) ≤1.0 cm by the continuity equation and mean gradient (ΔPm) ≥ 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approximately one-third of patients with normal ejection fraction and severe AS by AVA have nonsevere AS by ΔPm when measured by preoperative transthoracic echocardiography (TTE). Given the use of positive pressure ventilation and general anesthesia in the pre-cardiopulmonary bypass (pre-CPB) period, we hypothesized that discordance between ΔPm and AVA during pre-CPB transesophageal echocardiography (TEE) would be higher than previously reported by TTE...
April 2016: Anesthesia and Analgesia
Hiroshi Tsuneyoshi, Tatsuhiko Komiya, Takeshi Shimamoto
OBJECTIVE: Accurate preprocedural quantification of the aortic annulus diameter is crucial for the operative success of the aortic valve surgery and especially transcatheter aortic valve replacement (TAVR). We conducted a prospective study to compare the accuracy of preoperative aortic annulus measurements using different imaging methods and direct measurements for aortic valve surgery. METHODS: We enrolled 52 patients who underwent open aortic valve surgery between March 2012 and March 2014...
January 2016: Journal of Cardiac Surgery
Feridoun Sabzi, Donya Khosravi
We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE) confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer...
July 2015: Acta Medica Iranica
Jagadeesh N Vaggar, Shrinivas Gadhinglajkar, Vivek Pillai, Rupa Sreedhar, Roshith Cahndran, Suddhadeb Roy
We report an incident of detection of a free-floating thrombus in the left ventricle (LV) using intraoperative two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE) during proximal coronary artery bypass graft anastomosis. A 58-year-old man presented to us with a 6-month history of chest pain without any history suggestive of myocardial infarction or transient ischemic attacks. His preoperative echocardiography revealed the systolic dysfunction of LV, mild hypokinesia of basal and mid-anterior wall, and the absence of an aneurysm...
October 2015: Annals of Cardiac Anaesthesia
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