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https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#1
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28714905/effects-of-eicosapentaenoic-acid-epa-and-docosahexaenoic-acid-dha-on-fetal-pulmonary-circulation-an-experimental-study-in-fetal-lambs
#2
Dyuti Sharma, Estelle Aubry, Thavarak Ouk, Ali Houeijeh, Véronique Houfflin-Debarge, Rémi Besson, Philippe Deruelle, Laurent Storme
Background: Persistent pulmonary hypertension of the newborn (PPHN) causes significant morbidity and mortality in neonates. n-3 Poly-unsaturated fatty acids have vasodilatory properties in the perinatal lung. We studied the circulatory effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fetal sheep and in fetal pulmonary arterial rings. Methods: At 128 days of gestation, catheters were placed surgically in fetal systemic and pulmonary circulation, and a Doppler probe around the left pulmonary artery (LPA)...
July 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28711967/fate-of-duct-dependent-discontinuous-pulmonary-arteries-after-arterial-duct-stenting
#3
Giuseppe Santoro, Giovanbattista Capozzi, Mario Giordano, Gianpiero Gaio, Maria Teresa Palladino, Carola Iacono, Heba Talat Mahmoud, Maria Giovanna Russo
Significant and balanced PA growth following arterial duct (AD) stenting has already been consistently reported in literature. However, to date, no data are available about the role of this approach as palliation of congenital heart disease with a duct-dependent discontinuous pulmonary artery (dPA). The aim of this study was to evaluate the fate of a dPA of ductal origin following trans-catheter AD stabilization. Angiographic PA evaluation was performed in seven patients submitted to neonatal AD stenting as palliative recruitment of dPA...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28708599/assessing-right-ventricular-function-in-pulmonary-hypertension-patients-and-the-correlation-with-the-new-york-heart-association-nyha-classification
#4
Xiaoke Shang, Shuna Xiao, Nianguo Dong, Rong Lu, Lijun Wang, Bin Wang, Yousan Chen, Liang Zhong, Mei Liu
This investigation aimed to compare the pressure-volume loop (PV loop) measurements in three less symptomatic categories (New York Heart Association classes , NYHA I, II, and III) of pulmonary hypertension (PH) patients since NYHA classification system performance is limited by the shortcomings discussed above.Thirty-six patients were enrolled in this study with PV loop measurement acquisition via micro-conductance catheters. Functional classification according to NYHA was determined with comprehensive assessing function and activity...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28708421/relationship-between-race-and-the-effect-of-fluids-on-long-term-mortality-after-acute-respiratory-distress-syndrome-secondary-analysis-of-the-nhlbi-fluid-and-catheter-treatment-trial
#5
Sarah E Jolley, Catherine L Hough, Gilles Clermont, Douglas Hayden, Suqin Hou, David Schoenfeld, Nicholas L Smith, Boyd Taylor Thompson, Gordon R Bernard, Derek C Angus
RATIONALE: Short-term follow up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction. OBJECTIVE: In a post-hoc analysis of FACTT including one-year follow up, we sought to estimate long-term mortality by race and test for an interaction between fluids and race. METHODS: Post-hoc analysis of FACTT and the Economic Analysis of Pulmonary Artery Catheters (EAPAC) study (included 655 of the 1000 FACTT patients with near complete one-year follow up)...
July 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#6
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28707021/the-response-to-trendelenburg-position-is-minimally-affected-by-underlying-hemodynamic-conditions-in-patients-with-aortic-stenosis
#7
Abraham Sonny, Daniel I Sessler, Jing You, Babak Kateby Kashy, Sheryar Sarwar, Akhil K Singh, Shiva Sale, Andrej Alfirevic, Andra E Duncan
PURPOSE: Trendelenburg positioning is commonly used to temporarily treat intraoperative hypotension. The Trendelenburg position improves cardiac output in normovolemic or anesthetized patients, but not hypovolemic or non-anesthetized patients. Therefore, the response to Trendelenburg positioning may vary depending on patient population or hemodynamic conditions. We thus tested the hypothesis that the effectiveness of the Trendelenburg position, as indicated by an increase in cardiac output, improves after replacement of a stenotic aortic valve...
July 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28706743/when-is-the-optimal-timing-of-surgical-intervention-for-severe-functional-tricuspid-regurgitation
#8
Nobuhiro Nakanishi, Masanobu Ishii, Koichi Kaikita, Ken Okamoto, Yasuhiro Izumiya, Eiichiro Yamamoto, Seiji Takashio, Seiji Hokimoto, Toshihiro Fukui, Kenichi Tsujita
Functional tricuspid regurgitation (TR) is a serious pathology to be noted for severe right heart failure (HF) and poor prognosis; however, the conventional assessment of TR has some limitations and the optimal timing of surgical intervention remains unclear. A 79-year-old Japanese female was admitted to our hospital to undergo cardiac surgery, because edema gradually got worse despite the increase in diuretics. She had a history of atrial fibrillation (AF) and chronic HF due to severe TR and had been treated with a furosemide for leg edema 4 years ago...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28705939/changes-in-pulmonary-exercise-haemodynamics-in-scleroderma-a-4-year-prospective-study
#9
Gabor Kovacs, Alexander Avian, Nora Wutte, Franz Hafner, Florentine Moazedi-Fürst, Sonja Kielhauser, Elisabeth Aberer, Marianne Brodmann, Winfried Graninger, Vasile Foris, Andrea Olschewski, Horst Olschewski
Pulmonary arterial hypertension (PAH) is a feared complication of systemic sclerosis. In this prospective cohort study, we monitored the changes in resting and exercise pulmonary haemodynamics of scleroderma patients without initial PAH over a mean follow-up period of ∼4 years.All patients underwent exercise echocardiography and cardiopulmonary exercise testing at baseline and follow-up. A subgroup underwent exercise right heart catheter (RHC) investigations. The primary end-point was the echocardiographic systolic pulmonary arterial pressure at 50 W exercise (sPAP50)...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28694355/peripheral-venous-pressure-measurements-in-patients-with-acute-decompensated-heart-failure-pvp-hf
#10
Brett W Sperry, Joseph Campbell, Marat Yanavitski, Samir Kapadia, W H Wilson Tang, Mazen Hanna
BACKGROUND: Accurate assessment of volume status is essential in diagnosis and guidance of decongestive therapy in patients with acute heart failure. We sought to compare peripheral venous pressure (PVP) with central venous pressure (CVP), as well as other invasive hemodynamic measurements, in patients hospitalized with an acute heart failure syndrome. METHODS AND RESULTS: PVP-HF (Peripheral Venous Pressure Measurements in Patients With Acute Decompensated Heart Failure) was a single-center prospective study, which enrolled patients admitted with acute heart failure, regardless of ejection fraction or disease pathogenesis...
July 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28687687/use-of-low-dose-thrombolytics-for-treatment-of-intracardiac-thrombus-and-massive-pulmonary-embolus-after-aborted-liver-transplant-leads-to-recovery-of-right-ventricular-function-and-redo-liver-transplantation
#11
Aarya Kafi, Oren Friedman, Irene Kim
This is a 61-year-old man with end-stage liver disease who experienced cardiac arrest secondary to a massive pulmonary embolus and intracardiac thrombus during cannulation for veno-venous extracorporeal membrane oxygenation (ECMO) in preparation for orthotopic liver transplantation (OLT). Surgery was aborted and the patient was taken back to the intensive care unit in cardiogenic shock on multiple vasopressors. The patient was unresponsive to heparin bolus and too high risk for systemic thrombolytics or embolectomy...
July 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28679970/clinical-significance-of-pulmonary-arterial-capacitance-calculated-by-echocardiography-in-patients-with-advanced-heart-failure
#12
Yuki Saito, Tomohito Ohtani, Hidetaka Kioka, Toshinari Onishi, Yasumasa Tsukamoto, Kei Nakamoto, Tatsunori Taniguchi, Satoshi Nakatani, Atsushi Hirayama, Yasushi Sakata
BACKGROUND: Advanced left heart failure (HF) often accompanies post-capillary pulmonary hypertension related to RV afterload. Although pulmonary arterial capacitance (PAC), a measure of pulmonary artery compliance, reflects right ventricular (RV) afterload, the clinical utility of PAC obtained by echocardiography (echo-PAC) is not well established in advanced HF.Methods and Results:We performed right heart catheterization in advanced HF patients (n=30), calculating echo-PAC as stroke volume/(tricuspid regurgitation pressure gradient-pulmonary regurgitation pressure gradient)...
July 4, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28669423/-influence-of-perfusion-status-on-central-and-mixed-venous-oxygen-saturation-in-septic-patients
#13
Simone Harumi Goto, Bruno Franco Mazza, Flávio Geraldo Resende Freitas, Flávia Ribeiro Machado
BACKGROUND AND OBJECTIVES: Although there is controversy regarding the role of venous oxygen saturation in the initial resuscitation of septic patients with hypoperfusion, these markers are still widely used. This study aimed to evaluate the correlation and concordance between central (SvcO2) and mixed (SvO2) oxygen saturation in septic shock patients with or without hypoperfusion, in addition to the impact of these differences in patient conduction. METHODS: Patients with septic shock were monitored with pulmonary artery catheter and the following subgroups of hypoperfusion were analyzed: 1) lactate>28mg/dL; 2) base excess ≤ -5 mmoL/L; 3) venoarterial CO2 gradient>6mmHg; 4) SvO2<65%; 5) SvcO2<70%; 6) lactate>28mg/dL and SvO2<70%; 7) lactate>28mg/dL and SvcO2<75%...
June 29, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28666664/young-infants-with-severe-tetralogy-of-fallot-early-primary-surgery-versus-transcatheter-palliation
#14
Travis J Wilder, Glen S Van Arsdell, Lee Benson, Eric Pham-Hung, Michael Gritti, Alexandra Page, Christopher A Caldarone, Edward J Hickey
BACKGROUND: Infants with severe tetralogy of Fallot may undergo (1) early primary surgical repair (EARLY) or (2) early transcatheter palliation (CATH) before delayed surgical repair. We compared these strategies with (3) elective single-stage tetralogy of Fallot repair (IDEAL). METHODS: From 2000 to 2012, 453 children underwent tetralogy of Fallot repair (excluding systemic-pulmonary shunts), including 383 in the IDEAL (75%), 42 in the EARLY (9%), and 28 in the CATH (6%) groups...
May 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28649087/acute-hemodynamic-and-tissue-effects-of-cryoballoon-ablation-on-pulmonary-vessels-the-ivus-cryo-study
#15
Jakub Baran, Paweł Lewandowski, Krzysztof Smarż, Agnieszka Sikorska, Beata Zaborska, Piotr Kułakowski
BACKGROUND: Cryoballoon-based pulmonary vein isolation (CB-PVI) has been widely used for the treatment of atrial fibrillation. Although generally safe and effective, the procedure may be associated with pulmonary vein (PV) stenosis and bronchial or esophageal injury. The mechanisms leading to these complications have not been studied in detail. Our aim was to examine acute effects of cryoballoon on the pulmonary vessel and right heart pressures as well as PV wall morphology. METHODS AND RESULTS: In 8 patients (5 men, mean age 55±14 years) undergoing CB-PVI, pressure in each PV was measured by catheter located inside the PV directly before and after CB-PVI...
June 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28647627/endovascular-retrieval-of-migrated-distal-end-of-vp-shunt-from-bilateral-pulmonary-arteries-a-technical-note
#16
Rimal Hanif Dossani, Tanmoy Kumar Maiti, Devi Prasad Patra, Anil Nanda, Hugo Cuellar
Ventriculoperitoneal (VP) shunting of cerebrospinal fluid is one of the most common procedures performed by neurosurgeons around the world. Migration of distal VP shunt catheter into bilateral segmental pulmonary arteries is an extremely rare complication of VP shunt placement. In present case, a 30-year-old male underwent VP shunting complicated by migration of distal VP shunt catheter into the bilateral pulmonary arteries. Despite manual attempt at externalizing the distal VP shunt catheter at the level of the clavicle, a small piece of distal VP shunt catheter in bilateral pulmonary arteries was noted on CT chest obtained following manual externalization...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28633268/surgical-interventional-hybrid-concept-in-a-newborn-with-borderline-left-heart
#17
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
#18
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
#19
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
#20
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
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