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Perioperative Echocardiography

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https://www.readbyqxmd.com/read/28794833/preoperative-cardiac-evaluation-with-transthoracic-echocardiography-before-non-cardiac-surgery
#1
REVIEW
Chi Young Shim
Transthoracic echocardiography has become increasingly popular in clinical practice. It is used for the functional evaluation of patients with various cardiovascular diseases. Its use has been extended further in routine screening for cardiovascular health and in preoperative risk assessment before non-cardiac surgery because it is non-invasive, easy to perform, reproducible, and cost-effective. When the results of preoperative echocardiography contain abnormalities, the findings must be interpreted to determine clinical relevance...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28758063/acquired-systemic-to-pulmonary-venous-shunt-or-persistent-left-superior-vena-cava-a-rare-right-to-left-shunt-case-based-discussion
#2
Alexandre Gamet, Pascale Raud-Raynier, Thomas Kerforne, Stéphane Velasco, Luc Christiaens
Cardiac shunts are often described in congenital or pediatric populations, but systemic-to-pulmonary venous shunts in adult patients are reported in literature in isolated case reports. We present the case of a 70-year-old female with a left superior vena cava (SVC) draining into the left atrium by the left superior pulmonary vein, with a complete right-to-left shunt of the superior venous circulation caused by a former catheter thrombosis in the right SVC. Diagnosis was suspected after a contrast echocardiography showing an exclusive perfusion of left heart after intravenous injection and confirmed by helical computed tomography with three-dimensional reconstruction...
July 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28757751/an-unusual-echocardiographic-presentation-of-left-atrial-dissection-following-cardiopulmonary-cerebral-resuscitation
#3
Chia-Ling Lee, Yi-Tso Cheng, Ming-Chon Hsiung, Chen-Fuh Lam
Left atrial dissection (LatD) is a relatively rare perioperative complication during mitral valve repair. Here, we report a 64-year-old man who developed LatD after cardiopulmonary resuscitation was needed due to an extensive myocardial infarction. Aggressive cardiac massage resulted in cardiac rupture and massive bloody pleura effusion. Intraoperative three-dimensional transesophageal echocardiography revealed posterior-medial papillary muscle ruptured and separation of the endocardium from the left atrial myocardium...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28755100/point-of-care-ultrasonography-in-canadian-anesthesiology-residency-programs-a-national-survey-of-program-directors
#4
Daniel Mok, Stephan K W Schwarz, Kevin Rondi
PURPOSE: Point-of-care ultrasonography (POCUS) is a useful tool with multiple perioperative applications relevant to the anesthesiologist. Nevertheless, the full scope of POCUS applications has yet to be formally incorporated into Canadian anesthesiology training. The purpose of this study was to determine the current state of POCUS training in Canadian anesthesiology residency programs. METHODS: We conducted a web-based survey of program directors from Royal College-accredited anesthesiology residency programs across Canada...
July 28, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28749796/irrigation-device-successfully-tests-valve-competence-during-minimally-invasive-mitral-valve-repair
#5
Tomoyuki Fujita, Satsuki Fukushima, Hiroki Hata, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Kizuku Yamashita, Junjiro Kobayashi
Minimally invasive mitral valve repair has become standard. We hypothesized that reproducible water testing with less air contaminations may help achieve successful repair and prevent air embolism. We used a long shaft irrigation device connected to an infuser pump to water test mitral valve repair in 104 consecutive patients with severe mitral regurgitation due to type II mitral valve dysfunction. All patients underwent mitral valve repair via small right thoracotomy. Water testing was performed by simultaneously monitoring root pressure to confirm valve competence and adequate leaflet coaptation with suitable pressure...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28745025/nonalcoholic-steatohepatitis-is-associated-with-cardiac-remodeling-and-dysfunction
#6
Tracey G Simon, Daniel G Bamira, Raymond T Chung, Rory B Weiner, Kathleen E Corey
OBJECTIVE: Preliminary data suggest that nonalcoholic fatty liver disease is associated with early heart failure (HF). However, whether nonalcoholic steatohepatitis (NASH) is directly associated with echocardiographic changes in cardiac structure or function remains unknown. METHODS: A retrospective cohort was identified of individuals (N = 65) without known heart disease, undergoing elective bariatric surgery with perioperative liver biopsy, and available recent transthoracic echocardiography (TTE)...
August 2017: Obesity
https://www.readbyqxmd.com/read/28743148/-impact-of-cardiac-anaesthesia-on-patient-outcome
#7
Martina Nowak-Machen
The perioperative management of complex patients in a highly technical and subspecialized environment is the domain of the cardiac anesthesiologist. Evidence suggests that hemodynamic management using goal directed hemodynamic therapy (GDHT) improves patient outcome. Organ protection remains a main concern during cardiac surgery using extracorporeal circulation. Mortality can be decreased when remote ischemic preconditioning techniques (RIPC) are being used. Neurological outcomes can be improved with near-infrared-spectometry (NIRS), volatile anesthetics increase myocardial protection through preconditioning and perioperative echocardiography increases overall patient survival...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28740625/pulmonary-valve-replacement-in-patients-with-corrected-tetralogy-of-fallot
#8
Fotios M Mitropoulos, Meletios A Kanakis, Christos Ntellos, Constantinos Loukas, Periklis Davlouros, Theophili Kousi, Andrew C Chatzis
Introduction: Development of pulmonary insufficiency in patients with surgically corrected tetralogy of Fallot (TOF) may lead to severe right heart failure with serious consequences. We herein present our experience with pulmonary valve replacement (PVR) in these patients. Methods: From 2005-2013, 99 consecutive patients (71 males/28 females, mean age 38±8 years), underwent PVR after 7 to 40 (mean 29 ± 8) years from the initial correction. Seventy nine of the symptomatic patients presented in NYHA II, 14 in III and 2 in IV...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#9
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#10
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28701611/the-utility-of-targeted-perioperative-transthoracic-echocardiography-in-managing-an-adult-patient-with-anomalous-origin-of-the-left-coronary-artery-pulmonary-artery-for-noncardiac-surgery
#11
Anudeep Jafra, Suman Arora, Aveek Jayant
Congenital coronary artery anomalies as a whole are uncommon. Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is probably the most common congenital coronary defect. An overwhelming majority of the patients with untreated ALCAPA do not survive to adulthood. As yet, there is no consensus on the management of adults with ALCAPA. We describe a patient with breast malignancy and incidentally detected ALCAPA; primacy was given to treatment of the oncologic condition as a first step...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28670776/myocardial-protective-effect-of-antegrade-cardioplegic-cardiac-arrest-versus-ventricular-fibrillation-during-cardiopulmonary-bypass-on-immediate-postoperative-and-mid-term-left-ventricular-function-in-right-ventricular-outflow-tract-surgery
#12
Sang Yoon Kim, Sungkyu Cho, Ji-Hyun Lee, Jin-Tae Kim, Woong-Han Kim
The objective of this study is to examine the myocardial protective effect of antegrade cardioplegic cardiac arrest (ACC) versus ventricular fibrillation (VF) on short-term and mid-term left ventricular (LV) function in right ventricular outflow tract (RVOT) surgery. RVOT operations conducted from January 2006 to December 2015 were reviewed. The numbers of cases using ACC and VF were 71 and 49, respectively. Postoperative mortality and morbidity were compared between the two groups. Before and after propensity score matching, left ventricular ejection fraction (LVEF) and left ventricular end-systolic/end-diastolic diameter (LVESD/LVEDD) in echocardiography were measured immediately after operation and at mid-term follow-up between postoperative 6 and 24 months...
July 2, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28647630/endovascular-repair-of-iatrogenic-iliocaval-fistula-causing-high-output-cardiac-failure-after-spine-fusion
#13
Seth Noland, Carlos A Espinoza, Jonathan D Dvorak, John D Rose, C Steven Powell
The case being presented is a 35-year-old female with a three-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventricle (LV) systolic function, enlarged right ventricle (RV), functional tricuspid regurgitation (TR) and moderate pulmonary hypertension. A computed tomography (CT) scan of the abdomen and pelvis demonstrated findings consistent with an arteriovenous fistula (AVF) between the right common iliac artery and the inferior vena cava (IVC)...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28592080/-complete-revascularization-for-multi-vessel-coronary-diseases-through-lower-ministernotomy-on-beating-heart-off-pump-surgery
#14
Z B Xiao, Y Zhang, J Z Guo, Y Y Li, Y P Zhang
Objective: To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy. Methods: Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#15
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28577847/short-term-and-midterm-follow-up-of-transthoracic-device-closure-of-atrial-septal-defect-in-infants
#16
Qiang Chen, Hua Cao, Gui-Can Zhang, Liang-Wan Chen, Fan Xu, Jia-Xin Zhang
BACKGROUND: The purpose of this study was to outline the safety and feasibility of transthoracic device closure of an atrial septal defect (ASD) with a domestic occluder in infants. METHODS: Sixty-eight infants underwent transthoracic device closure of an ASD at Union Hospital, Fujian Medical University, Fuzhou, China from January 2010 to January 2015. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography for 12 to 60 months after ASD closure, and telephone interviews were conducted with the infants' parents to evaluate the patients' clinical status further...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28543789/surgical-management-of-traumatic-tricuspid-insufficiency
#17
Zhiqi Zhang, Kanhua Yin, Lili Dong, Yongxin Sun, Changfa Guo, Yi Lin, Chunsheng Wang
BACKGROUND: This study reviews our experience with traumatic tricuspid insufficiency (TTI) following blunt chest trauma. METHODS: From January 2010 to June 2016, 10 patients (nine males, mean age 49.0 ± 12.4 years) underwent surgical treatment of TTI following blunt chest trauma. The mean intervals between trauma and diagnosis and between trauma and surgery were 74.1 and 81.8 months, respectively. Preoperatively, all patients exhibited severe tricuspid regurgitation...
June 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28540070/an-update-on-intraoperative-three-dimensional-transesophageal-echocardiography
#18
REVIEW
Lisa Qia Rong
Transesophageal echocardiography (TEE) was first used routinely in the operating rooms in the 1980s to facilitate surgical decision-making. Since then, TEE has evolved from the standard two-dimensional (2D) exam to include focused real-time three-dimensional (RT-3D) imaging both inside and outside the operating rooms. Improved spatial and temporal resolution due to technological advances has expedited surgical interventions in diseased valves. 3D imaging has also emerged as a crucial adjunct in percutaneous interventions for structural heart disease...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523177/systolic-anterior-motion-of-the-mitral-valve-the-mechanism-of-postural-hypotension-following-left-intrapericardial-pneumonectomy
#19
Javier D Lasala, January Tsai, Andrea Rodriguez-Restrepo, Scott Michael Atay, Boris Sepesi
Systolic anterior motion (SAM) is defined as displacement of the distal portion of the anterior leaflet of the mitral valve toward the left ventricular outflow tract obstruction. SAM can occur in patients without hypertrophic cardiomyopathy (HOCM) and is a well-recognized cause for unexplained sudden hypotension in perioperative settings. We present a case of persistent orthostatic hypotension caused by SAM following left intrapericardial pneumonectomy and mediastinal lymph node dissection for squamous cell carcinoma of the lung invading intrapericardial portion of the inferior pulmonary vein...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#20
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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