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https://www.readbyqxmd.com/read/28633268/surgical-interventional-hybrid-concept-in-a-newborn-with-borderline-left-heart
#1
Stefan Rupp, Josef Thul, Kerstin Gummel, Markus Khalil, Hakan Akintuerk, Dietmar Schranz
Through a series of complex surgical and interventional procedures including downsizing of an unrestricted atrial septal defect, aortic arch reconstruction, pulmonary artery banding, reversed Potts shunt, and Melody valve in a mitral position, biventricular conversion was successfully achieved in a patient with a distinct borderline left ventricle. By use of these interventional steps, flow-mediated and load-mediated growth of a small left ventricle was observed, highlighting the plasticity of hearts in growing children...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#2
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28605442/perioperative-goal-directed-therapy-with-uncalibrated-pulse-contour-methods-impact-on-fluid-management-and-postoperative-outcome
#3
F Michard, M T Giglio, N Brienza
Previous meta-analyses suggest that perioperative goal-directed therapy (GDT) is useful to decrease postoperative morbidity. Most GDT studies analysed were done with pulmonary artery catheters, oesophageal Doppler and calibrated pulse contour methods. Uncalibrated pulse contour (uPC) techniques are an appealing alternative but their accuracy has been questioned. The effects of GDT on fluid management (volumes and volume variability) remain unclear. We performed a meta-analysis of randomized controlled trials investigating the effects of GDT with uPC methods on postoperative outcome...
June 11, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28598912/cardiac-output-measurements-based-on-the-pulse-wave-transit-time-and-thoracic-impedance-exhibit-limited-agreement-with-thermodilution-method-during-orthotopic-liver-transplantation
#4
Aurora Magliocca, Emanuele Rezoagli, Thomas Anthony Anderson, Sara Maria Burns, Fumito Ichinose, Hovig Vatche Chitilian
BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending ability of CO estimation obtained noninvasively using pulse wave transit time (estimated continuous cardiac output [esCCO; Nihon Kohden, Tokyo, Japan]) or thoracic bioimpedance (ICON; Osypka Medical GmbH, Berlin, Germany) to thermodilution cardiac output (TDCO) measured with a pulmonary artery catheter...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597797/percutaneous-intervention-for-central-shunts-new-routes-new-strategies
#5
Bjorn Cools, Stephen C Brown, Derize E Boshoff, Benedicte Eyskens, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
Introduction In traditional locations, the standard Blalock-Taussig shunt presents numerous technical difficulties for percutaneous intervention. We changed our strategy to a central type shunt (Laks-type) with end-to-side pulmonary and side-to-side aortic anastomosis. The aim of this study was to determine whether this modified strategy would allow easier percutaneous manipulation in patients with small pulmonary arteries. Methods All children with a stretchable central vascular graft who required any form of percutaneous intervention were prospectively enrolled in the study...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597755/assessment-of-microrna-and-gene-dysregulation-in-pulmonary-hypertension-by-endoarterial-biopsy
#6
Abraham Rothman, Humberto Restrepo, Valeri Sarukhanov, William N Evans, Robert G Wiencek, Roy Williams, Nicole Hamburger, Kylie Anderson, Jasmine Balsara, David Mann
MicroRNAs (miRNAs) may regulate a number of genes, each of which may have a variety of functions. We utilized an endoarterial biopsy catheter to assess the dysregulation of miRNAs in a porcine shunt model of pulmonary hypertension (PH). Two Yucatan micropigs underwent surgical anastomosis of the left pulmonary artery to the descending aorta. Endoarterial biopsy samples were obtained at baseline, and at regular intervals during the progression of PH. RNA, isolated from biopsy samples, was analyzed by Illumina miRNA expression microarrays (containing ∼1200 human miRNAs), Affymetrix Porcine GeneChips, Bioconductor, and GeneSpring...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28595621/transthoracic-echocardiography-an-accurate-and-precise-method-for-estimating-cardiac-output-in-the-critically-ill-patient
#7
Pablo Mercado, Julien Maizel, Christophe Beyls, Dimitri Titeca-Beauport, Magalie Joris, Loay Kontar, Antoine Riviere, Olivier Bonef, Thierry Soupison, Christophe Tribouilloy, Bertrand de Cagny, Michel Slama
BACKGROUND: Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28593267/national-trends-in-use-and-outcomes-of-pulmonary-artery-catheters-among-medicare-beneficiaries-1999-2013
#8
Kevin Ikuta, Yun Wang, Austin Robinson, Tariq Ahmad, Harlan M Krumholz, Nihar R Desai
Importance: Recent studies have observed an increase in the rate of pulmonary artery catheter (PAC) use in heart failure admissions. Little is known about the national trends in other previously common indications for PAC placement, PAC use overall, or outcomes associated with PAC placement. Objective: To determine national trends in PAC use overall as well as across sociodemographic groups and key clinical conditions, including acute myocardial infarction, heart failure, and respiratory failure...
June 7, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28591467/the-effect-of-impella-cp-on-cardiopulmonary-physiology-during-venoarterial-extracorporeal-membrane-oxygenation-support
#9
Hoong Sern Lim
Left ventricle (LV) distension is a complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. The effects of Impella on the pulmonary circulatory physiology were studied in a single-center study of six consecutive patients on VA-ECMO support who had LV unloading with Impella. Right ventricular stroke volume, pulmonary hemodynamics, and partial pressure of end-tidal CO2 (PETCO2 ) were measured on echocardiogram, pulmonary artery catheter, and capnography, respectively. The addition of Impella CP increased total blood flow and reduced pulmonary artery wedge pressure...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28589405/drug-coated-balloon-angioplasty-a-novel-treatment-for-pulmonary-artery-in-stent-stenosis-in-a-patient-with-williams-syndrome
#10
Jennifer L Cohen, Julie S Glickstein, Matthew A Crystal
A 20-month-old boy with Williams syndrome had undergone multiple surgical and catheter-based interventions for resistant peripheral pulmonary arterial stenoses with eventual bilateral stent placement and conventional balloon angioplasty. He persistently developed suprasystemic right ventricular (RV) pressure. Angioplasty with a drug-coated balloon (DCB) was performed for in-stent restenosis and to remodel his distal pulmonary vessels bilaterally. This resulted in immediate improvement in the in-stent stenosis and resultant decrease in RV pressure...
June 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#11
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
OBJECTIVE: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28585685/pulmonary-artery-a-pivotal-site-for-catheter-ablation-in-idiopathic-rvot-ventricular-arrhythmias
#12
REVIEW
Chunmiao Wang, Yawen Zhang, Fangde Hong, Ying Huang
In patients without associated myocardial diseases, characterized by left bundle branch block (LBBB) and inferior axis morphologies, repetitive idiopathic right ventricular tachycardias (VTs) and ventricular premature contractions (VPCs) typically arise from right ventricular outflow tract (RVOT). Accumulated evidences have shown that radiofrequency catheter ablation (RFCA) is a useful treatment for patients with RVOT ventricular arrhythmias (VAs). Interestingly, several medical centers have showed that pulmonary artery (PA) is a potential novel site for catheter ablation in RVOT-like VAs, particularly in patients where termination of RVOT VAs at the usual site fails...
June 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28584440/overestimation-of-cardiac-output-by-bent-pulmonary-artery-catheter
#13
Monish S Raut, Sibashankar Kar, Arun Maheshwari, Moloy Rajkhowa, Sumir Dubey, Ganesh Shivnani, Himanshu Arora
No abstract text is available yet for this article.
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28583617/totally-implantable-intravenous-treprostinil-therapy-in-pulmonary-hypertension-assessment-of-the-implantation-procedure
#14
Aaron B Waxman, Hugh T McElderry, Mardi Gomberg-Maitland, Martin C Burke, Edgar L Ross, Malcolm M Bersohn, Sanjog S Pangarkar, James H Tarver, Diane L Zwicke, Jeremy P Feldman, Murali M Chakinala, Robert P Frantz, Geoffrey B Thompson, Fernando Torres, Richard L Rauck, Kathy Clagg, Louise Durst, Pei Li, Marty Morris, Kara L Southall, Leigh Peterson, Robert C Bourge
BACKGROUND: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable intravenous infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. This analysis describes the findings related to the implant procedure. METHODS: Patients (n=64) with PAH (WHO Group 1) receiving stable intravenous treprostinil were enrolled...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28580610/acute-and-long-term-effects-of-endovascular-debanding-of-pulmonary-arteries-in-a-swine-model
#15
Michael Perez, Tk Susheel Kumar, Deepthi Hoskoppal, Yada Akkhawattanangkul, Kimberly Allen, Christopher J Knott-Craig, Benjamin Rush Waller, Shyam Sathanandam
OBJECTIVES: The primary objective of this study was to demonstrate that pulmonary artery (PA) debanding via cardiac catheterization using balloon angioplasty is feasible and safe in swine. The secondary objectives were to determine the acute and long-term effects of this therapy. DESIGN: This is a chronic survival experimental study in newborn swine. BACKGROUND: PA bands are used in infants for transient palliation of congenital heart defects with excessive pulmonary blood flow...
May 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28577412/postmortem-computed-tomography-evaluation-of-fatal-gas-embolism-due-to-connection-of-an-intravenous-cannula-to-an-oxygen-supply
#16
Yoichiro Takahashi, Rie Sano, Akiyuki Yasuda, Eri Kuboya, Keiko Takahashi, Rieko Kubo, Yoshihiko Kominato, Hiroyuki Takei, Susumu Kobayashi, Takehiro Shimada, Sachiko Awata, Hiroyuki Tokue, Satoshi Hirasawa
An 84-year-old man who had suffered from chronic obstructive pulmonary disease accompanied by moderate pneumonia as well as gastric cancer with liver metastasis was found dead by a nurse, who noticed that the patient's intravenous catheter in the left forearm had been erroneously connected to an oxygen supply in his hospital room, leading to infusion of oxygen into a vein. Postmortem CT scanning demonstrated multiple accumulations of gas in the pulmonary artery, the right atrium and ventricle, as well as the left subclavian and brachiocephalic veins, corresponding to the route that the infused gas would have taken to the heart and pulmonary artery...
May 26, 2017: Legal Medicine
https://www.readbyqxmd.com/read/28575079/comparison-of-forced-air-and-water-circulating-warming-for-prevention-of-hypothermia-during-transcatheter-aortic-valve-replacement
#17
Benjamin Rohrer, Emily Penick, Farhad Zahedi, Hocine Tighiouart, Brian Kelly, Frederick Cobey, Stefan Ianchulev
INTRODUCTION: Transcatheter Aortic Valve Replacement (TAVR) procedures at our institution were complicated by perioperative hypothermia despite use of the standard of care forced-air convective warming device (the BairHugger, Augustine Medical Inc, Eden Prairie, MN, USA). To remedy this problem, we initiated a quality improvement process that investigated the use of a conductive warm water-circulating device (the Allon ThermoWrap, Menen Medical Corporation, Trevose, PA, USA), and hypothesized that it would decrease the incidence of perioperative hypothermia...
2017: PloS One
https://www.readbyqxmd.com/read/28554716/acute-hemodynamic-effects-of-intra-aortic-balloon-counterpulsation-pumps-in-advanced-heart-failure
#18
Shiva K Annamalai, Lyanne Buiten, Michele L Esposito, Vikram Paruchuri, Andrew Mullin, Catalina Breton, Robert Pedicini, Ryan O'Kelly, Kevin Morine, Benjamin Wessler, Ayan R Patel, Michael S Kiernan, Richard H Karas, Navin K Kapur
BACKGROUND: The utility of intra-aortic balloon counterpulsation pumps (IABPs) in low cardiac output states is unknown and no studies have explored the impact of IABP therapy on ventricular workload in patients with advanced HF. For these reasons, we explored the acute hemodynamic effects of IABP therapy in patients with advanced HF. METHODS: We prospectively studied 10 consecutive patients with Stage D HF referred for IABP placement prior to LVAD surgery and compared to five control patients with preserved left ventricular (LV) ejection fraction (EF) who did not receive IABP therapy...
May 26, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28554711/scimitar-syndrome-anaesthetic-management-for-pulmonary-resection-of-the-unaffected-lung
#19
B Fernández-Torres, A Fernández-López, M Congregado
Scimitar syndrome is a rare congenital anomaly characterized by anomalous drainage of the right pulmonary veins in the inferior vena cava, frequently associated with right lung and pulmonary artery hypoplasia, dextrocardia and abnormal systemic arterial supply to the lower lobe. Pulmonary resection surgery on healthy lung is exceptional, and there are no published records of it, as far as we know. A man with scimitar syndrome diagnosed with a lung nodule with malignant features in the contralateral lung. This situation implies huge anaesthetic complexity, mainly for intraoperative ventilation...
May 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#20
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
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