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Cardiac surgery and echocardiography

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https://www.readbyqxmd.com/read/28217069/can-ultrasound-guided-subcostal-transverse-abdominis-plane-block-be-used-as-sole-anesthetic-technique
#1
Pooja Bihani, Pradeep Bhatia, Swati Chhabra, Pradeepika Gangwar
Subcostal transverse abdominis plane (TAP) block anesthetizes area of the abdomen with cutaneous innervation of T6-T10 dermatomes. These abdominal field blocks become very advantageous when cardiac patient presents for noncardiac surgeries as sole anesthetic or as a part of multimodal anesthesia. A 58-year-male came for open surgical repair of subxiphoid incisional hernia developed post coronary artery bypass grafting (CABG). Echocardiography showed hypokinesia of left ventricle (LV) in the left anterior descending (LAD) artery territory, dilated LV, and ejection fraction of 30%, and coronary angiography after 6 months of CABG showed 70% stenosis of LAD...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217062/anesthetic-management-of-a-case-of-gilbert-s-syndrome-for-mitral-and-aortic-valve-replacement-role-of-transesophageal-echocardiography
#2
P S Nagaraja, Naveen G Singh, S Subash, N Manjunatha, C G Prabhushankar, N Sathish
Gilbert's syndrome (GS) is an autosomal inherited disorder characterized by relative deficiency of glucuronyl transferase and poor uptake of unconjugated bilirubin by hepatocytes. Cardiac surgery on cardiopulmonary bypass (CPB) in these patients triggers further hepatic dysfunction. Transesophageal echocardiography (TEE) and Doppler assessment of hepatic vein help in assessing hepatic blood flow (HBF) during cardiac surgery. Here, we discuss anesthetic management and role of TEE in maintaining HBF perioperatively in a 25-year-old male patient with GS undergoing double valve replacement with tricuspid valve plasty...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28214967/increased-atrial-%C3%AE-adrenergic-receptors-and-grk-2-gene-expression-can-play-a-fundamental-role-in-heart-failure-after-repair-of-congenital-heart-disease-with-cardiopulmonary-bypass
#3
Marcela Silva Oliveira, Fabio Carmona, Walter V A Vicente, Paulo H Manso, Karina M Mata, Mara Rúbia Celes, Erica C Campos, Simone G Ramos
Surgeries to correct congenital heart diseases are increasing in Brazil and worldwide. However, even with the advances in surgical techniques and perfusion, some cases, especially the more complex ones, can develop heart failure and death. A retrospective study of patients who underwent surgery for correction of congenital heart diseases with cardiopulmonary bypass (CPB) in a university tertiary-care hospital that died, showed infarction in different stages of evolution and scattered microcalcifications in the myocardium, even without coronary obstruction...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28208930/precautionary-measures-for-successful-open-heart-surgery-in-g6pd-deficient-patient-a-case-report
#4
Rupesh Kumar
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is among the most common enzymatic disorders of red blood cells. Cardiac surgeries on this group of individuals are associated with an additional risk in terms of impaired oxygenation, prolonged ventilation and increased risk of haemolysis. These patients have a very low threshold for haemolysis due to oxidative stress. Many commonly used drugs also predispose the individual for haemolysis when they are subjected to surgery. Here we present a known case of G6PD deficient patient with symptoms of breathlessness for the last nine years who was taken for surgery with pre-planned precautionary measures to avoid unnecessary haemolysis...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205629/mechanisms-of-chinese-medicine-xinmailong-s-protection-against-heart-failure-in-pressure-overloaded-mice-and-cultured-cardiomyocytes
#5
Jianyong Qi, Juan Yu, Yafang Tan, Renshan Chen, Wen Xu, Yanfen Chen, Jun Lu, Qin Liu, Jiashin Wu, Weiwang Gu, Minzhou Zhang
Patients with heart failure (HF) have high mortality and mobility. Xinmailong (XML) injection, a Chinese Medicine, is clinically effective in treating HF. However, the mechanism of XML's effectiveness on HF was unclear, and thus, was the target of the present study. We created a mouse model of pressure-overload-induced HF with transverse aortic constriction (TAC) surgery and compared among 4 study groups: SHAM (n = 10), TAC (n = 12), MET (metoprolol, positive drug treatment, n = 7) and XML (XML treatment, n = 14)...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28205344/utility-of-a-standardized-postcardiopulmonary-bypass-epicardial-echocardiography-protocol-for-stage-i-norwood-palliation
#6
Kenan W D Stern, Kimberlee Gauvreau, Sitaram Emani, Tal Geva
OBJECTIVE: Stage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known...
February 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#7
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#8
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196823/cor-triatriatum-sinistrum-presentation-of-syncope-and-atrial-tachycardia
#9
Malcolm Avari, Sunil Nair, Zofia Kozlowska, Samer Nashef
We present a rather unusual cause for syncope associated with atrial tachycardia. A man aged 39 years presented with an episode of syncope and narrow complex tachycardia. Further investigations, including transoesophageal echocardiography, identified cor triatriatum sinistrum (CTS), a rare congenital abnormality characterised by the atrium being divided by a fibrous membrane. Although it is rare, there has been an increase in diagnosis due to developments in diagnostic imaging techniques. Symptoms are related to the size of fenestrations within the fibrous membrane...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28185701/immediate-increase-of-cardiac-output-after-percutaneous-mitral-valve-repair-pmvr-determined-by-echocardiographic-and-invasive-parameters-patzelt-increase-of-cardiac-output-after-pmvr
#10
Johannes Patzelt, Yingying Zhang, Harry Magunia, Rezo Jorbenadze, Michal Droppa, Miriam Ulrich, Shanglang Cai, Henning Lausberg, Tobias Walker, Tobias Wengenmayer, Peter Rosenberger, Juergen Schreieck, Peter Seizer, Meinrad Gawaz, Harald F Langer
BACKGROUND: Successful percutaneous mitral valve repair (PMVR) in patients with severe mitral regurgitation (MR) causes changes in hemodynamics. Echocardiographic calculation of cardiac output (CO) has not been evaluated in the setting of PMVR, so far. Here we evaluated hemodynamics before and after PMVR with the MitraClip system using pulmonary artery catheterization, transthoracic (TTE) and transesophageal (TEE) echocardiography. METHODS: 101 patients with severe MR not eligible for conventional surgery underwent PMVR...
January 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28168077/a-case-of-neonatal-marfan-syndrome-a-management-conundrum-and-the-role-of-a-multidisciplinary-team
#11
Elliott J Carande, Samuel J Bilton, Satish Adwani
Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1 gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28153348/cardiac-magnetic-resonance-imaging-versus-transthoracic-echocardiography-for-prediction-of-outcomes-in-chronic-aortic-or-mitral-regurgitation
#12
Andrew W Harris, Eric V Krieger, Minkyu Kim, Peter J Cawley, David S Owens, Christian Hamilton-Craig, Jeffrey Maki, Catherine M Otto
In subjects with aortic regurgitation (AR) or mitral regurgitation (MR), transthoracic echocardiography (TTE) is recommended for surveillance. Few prospective studies have directly compared the ability of TTE and cardiac magnetic resonance (CMR) to predict clinical outcomes in AR and MR. We hypothesized that, given its higher reproducibility, CMR would predict the need for valve surgery or heart failure (HF) hospitalization better than TTE. Quantitative TTE and CMR were performed on the same day for 51 subjects: 29 with chronic AR and 22 with chronic, primary MR for quantification of valve regurgitation...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28151822/clinical-significance-of-portal-hypertension-diagnosed-with-bedside-ultrasound-after-cardiac-surgery
#13
André Y Denault, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Roberto Eljaiek, Ismail El-Hamamsy, Yoan Lamarche, Alexandra Chronopoulos, Jean Lambert, Josée Bouchard, Georges Desjardins
BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients undergoing cardiac surgery. METHODS: This is a case series performed in patients undergoing cardiac surgery between February 2014 and February 2015 in which portal and/or splenic venous flows were assessed by the attending anesthesiologist during surgery or by the intensivist after surgery using transthoracic echography in 9 patients or transesophageal echocardiography in 5 patients...
February 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28151505/-a-late-diagnosis-of-left-atrial-myxoma-how-to-gain-time
#14
Ferdinando Maria Massari, Tatiana Tonella, Giuseppe Pomè, Alessandra Di Mauro, Claudio Clemente, Federico Lombardi
A 56-year-old man presented to the Outpatient Cardiology Unit for dyspnea that had been lasting 6 months and an occasional episode of cold perspiration on climbing a flight of stairs. In the suspicion of coronary artery disease, he was prescribed a complete blood panel, an echocardiogram and a treadmill stress test. The echocardiogram, performed as late as 78 days after the first evaluation and only by chance scheduled 2 days before the stress test, enabled a diagnosis of left atrial myxoma for which the patient successfully underwent cardiac surgery...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28150060/rupture-of-the-right-upper-pulmonary-vein-and-left-atrium-caused-by-blunt-chest-trauma
#15
Motoo Osaka, Ryo Nagai, Tadashi Koishizawa
A 49-year-old man was transferred to our hospital by ambulance due to blunt chest trauma sustained in a car accident. Echocardiography and enhanced computed tomography showed hemopericardium without other vital organ damage. Emergent surgery was performed under strong suspicion of traumatic cardiac rupture. Careful inspection showed a rupture of the right upper pulmonary vein at the junction of the left atrium, a laceration of the inferior vena cava, and a left-side pericardium rupture, and they were repaired with running 4-0 polypropylene suture...
February 1, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28129939/2d-echocardiographic-evaluation-of-right-ventricular-function-correlates-with-3d-volumetric-models-in-cardiac-surgery-patients
#16
Harry Magunia, Eckhard Schmid, Jan N Hilberath, Leo Häberle, Christian Grasshoff, Christian Schlensak, Peter Rosenberger, Martina Nowak-Machen
OBJECTIVES: The early diagnosis and treatment of right ventricular (RV) dysfunction are of critical importance in cardiac surgery patients and impact clinical outcome. Two-dimensional (2D) transesophageal echocardiography (TEE) can be used to evaluate RV function using surrogate parameters due to complex RV geometry. The aim of this study was to evaluate whether the commonly used visual evaluation of RV function and size using 2D TEE correlated with the calculated three-dimensional (3D) volumetric models of RV function...
November 14, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28129367/differences-in-aortic-valve-and-left-ventricular-parameters-related-to-the-severity-of-myocardial-fibrosis-in-patients-with-severe-aortic-valve-stenosis
#17
Inyoung Song, Sung Min Ko, Jeong Geun Yi, Hyun Keun Chee, Jun Seok Kim
OBJECTIVE: This study investigated the morphological and functional characteristics of the aortic valve and the left ventricular (LV) systolic functional parameters and myocardial mass related to the severity of myocardial fibrosis (MF) in patients with severe aortic valve stenosis (AS). MATERIALS AND METHODS: We retrospectively enrolled 81 patients (48 men; mean age: 59±12 years) with severe AS who underwent transthoracic echocardiography (TTE), cardiac computed tomography (CCT), and cardiovascular magnetic resonance (CMR) within 1 month and subsequent aortic valve surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28127033/advanced-imaging-in-valvular-heart-disease
#18
REVIEW
Jeroen J Bax, Victoria Delgado
Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery...
January 27, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28123737/cardiac-metastasis-of-squamous-cell-carcinoma-of-the-thyroid-gland-with-severe-disseminated-intravascular-coagulation-a-case-report
#19
Tomoyasu Yoshihiro, Kenji Tsuchihashi, Hitoshi Kusaba, Torahiko Nakashima, Teppei Obara, Kenta Nio, Kotoe Takayoshi, Hiroyuki Kodama, Nobuhiro Tsuruta, Hideyuki Kiyohara, Kaori Asai, Eiji Harada, Kenjiro Kamezaki, Takeshi Arita, Masanobu Sato, Hidetaka Yamamoto, Shuji Arita, Hiroshi Ariyama, Keita Odashiro, Yoshinao Oda, Koichi Akashi, Eishi Baba
Distant metastasis of primary squamous cell carcinoma (SCC) of the thyroid gland is rare and, to the best of our knowledge, cardiac metastasis has not been reported to date. A 57-year-old man underwent surgery and adjuvant chemoradiotherapy for stage IVA SCC of the thyroid gland. After 3 months, the patient was admitted to the Kyushu University Hospital (Fukuoka, Japan) with subcutaneous hematomas of the left thigh and lower leg, and he was diagnosed with cardiac and mediastinal lymph node metastases of SCC of the thyroid gland with severe disseminated intravascular coagulation (DIC)...
January 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28120157/subclinical-markers-of-cardiovascular-disease-predict-adverse-outcomes-in-chronic-kidney-disease-patients-with-normal-left-ventricular-ejection-fraction
#20
Samir Sulemane, Vasileios F Panoulas, Athanasios Bratsas, Julia Grapsa, Edwina A Brown, Petros Nihoyannopoulos
Emerging cardiovascular biomarkers, such as speckle tracking echocardiography (STE) and aortic pulse wave velocity (aPWV), have recently demonstrated the presence of subclinical left ventricular dysfunction and arterial stiffening in patients with chronic kidney disease (CKD) and no previous cardiovascular history. However, limited information exists on the prognostic impact of these biomarkers. We aimed to investigate whether STE and aPWV predict major adverse cardiac events (MACE) in this patient population...
January 24, 2017: International Journal of Cardiovascular Imaging
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