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Perioperative Echocardiography

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https://www.readbyqxmd.com/read/29337842/perioperative-coagulation-management-in-liver-transplant-recipients
#1
Dmitri Bezinover, Daniel Dirkmann, James Findlay, Cosmin Guta, Matthias Hartmann, Ramona Nicolau-Raducu, Ahmed M Mukhtar, Marina Moguilevitch, Evan Pivalizza, David Rosenfeld, Fuat Saner, Christopher Wray, Gebhardt Wagener, James West
We review contemporary coagulation management for patients undergoing liver transplantation. A better understanding of the complex physiologic changes that occur in patients with end-stage liver disease has resulted in significant advances in anesthetic and coagulation management. A group of internationally recognized experts have critically evaluated current approaches for coagulopathy detection and management. Strategies for blood component and factor replacement have been evaluated and recommended therapies proposed...
January 15, 2018: Transplantation
https://www.readbyqxmd.com/read/29336405/looking-inside-the-third-generation-left-ventricular-assist-device-using-color-doppler-transesophageal-echocardiography
#2
Ankit Jain, Frederick C Cobey
HeartWare is a third-generation continuous flow left ventricular assist device (LVAD) and generates centrifugal pattern of blood flow. In the perioperative setting, interrogating the HeartWare devices is very difficult due to the interference of the Doppler by the impeller frequency and generation of the waterfall artifact. We present a case where using color Doppler a view "inside" the impeller can be seen which corresponds to the centrifugal flow of blood. With time, these images can be looked into in pathological states such as pump thrombosis, to come to a more meaningful conclusion regarding the flow of blood within the centrifugal chamber...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29336392/transesophageal-echocardiography-evaluation-of-the-aortic-arch-branches
#3
REVIEW
Thimmangouda A Patil, Santosh Kumar Ambli
Visualization of aortic arch branches by transesophageal echocardiography has been technically challenging. Visualizing these vessels helps in identifying the extent of dissection of the aorta, assessing the severity of carotid artery stenosis, presence of atheromatous plaques, patency of the left internal mammary artery graft, confirmation of subclavian artery cannulation, confirming holodiastolic flow reversal in the left subclavian artery by spectral Doppler imaging in case of severe aortic regurgitation, and confirming the optimal position of the intraaortic balloon perioperatively...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29317977/stemi-due-to-big-ostial-left-main-thrombus-extending-into-aorta-challenging-situation-with-no-clear-guidelines
#4
Mohammady Shahin, Oliver Gaemperli, Patrick Siegrist, Jasmina Alibegovic
Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29310938/evaluation-of-the-clinical-utility-of-transesophageal-echocardiography-and-invasive-monitoring-to-assess-right-ventricular-function-during-and-after-pulmonary-endarterectomy
#5
Thomas P Sullivan, James E Moore, Andrew A Klein, David P Jenkins, Lynne K Williams, Andrew Roscoe, Wendy Tsang
OBJECTIVE: Patients undergoing pulmonary endarterectomy (PEA) have impaired right ventricular function. The authors sought to assess the clinical utility of commonly used perioperative echocardiographic and right heart catheter measurements in patients undergoing PEA. DESIGN: A single-center prospective observational study. SETTING: The study was conducted in a quaternary care cardiac surgical center in the United Kingdom. PARTICIPANTS: Patients undergoing PEA between April 2015 and January 2016...
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29310598/assessing-cardiovascular-risk-in-chronic-kidney-disease-patients-prior-to-kidney-transplantation-clinical-usefulness-of-a-standardised-cardiovascular-assessment-protocol
#6
Robin Ramphul, Maria Fernandez, Sam Firoozi, Juan C Kaski, Rajan Sharma, Debasish Banerjee
BACKGROUND: Despite pre-kidney-transplant cardiovascular (CV) assessment being routine care to minimise perioperative risk, the utility of such assessment is not well established. The study reviewed the evaluation and outcome of a standardised CV assessment protocol. METHODS: Data were analysed for 231 patients (age 53.4 ± 12.9 years, diabetes 34.6%) referred for kidney transplantation between 1/2/2012-31/12/2014. One hundred forty-three patients were high-risk (age > 60 years, diabetes, CV disease, heart failure, peripheral vascular disease) and offered dobutamine stress echocardiography (DSE); 88 patients were low-risk and offered ECG and echocardiography with/without exercise treadmill test...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29283917/anesthetic-management-and-procedural-outcomes-of-patients-undergoing-off-pump-transapical-implantation-of-artificial-chordae-to-correct-mitral-regurgitation-case-series-of-76-patients
#7
Robertas Stasys Samalavicius, Ieva Norkiene, Agne Drasutiene, Arturas Lipnevicius, Vilius Janusauskas, Karolis Urbonas, Diana Zakarkaite, Audrius Aidietis, Kestutis Rucinskas
BACKGROUND: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure. METHODS: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29277303/modified-tricuspid-annular-plane-systolic-excursion-using-transesophageal-echocardiography-and-its-utility-to-predict-postoperative-course-in-heart-transplantation-and-left-ventricular-assist-device-implantation
#8
Yoshihisa Morita, Tura Lencho, Sharadhadevi Gunasekaran, Raj Modak
OBJECTIVES: Perioperative right ventricular (RV) function is important for determining the postoperative course in heart transplantation (HT) and left ventricular assist device (LVAD) implantation. The authors describe a modified tricuspid annular plane systolic excursion (m-TAPSE) using transesophageal echocardiography and assessed its clinical utility in HT and LVAD. DESIGN: Retrospective medical record review. SETTING: A single tertiary-care medical center...
November 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29249790/-ascending-aorta-replacement-and-extended-myectomy-for-acute-aortic-dissection-and-coexistent-hypertrophic-obstructive-cardiomyopathy-report-of-a-case
#9
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29241961/management-of-neonates-with-right-sided-aortic-arch-and-esophageal-atresia-international-survey-on-ipeg-and-espes-members%C3%A2-experience
#10
REVIEW
Monserrat Aguilera-Pujabet, Jose Andres Molino Gahete, Gabriela Guillén, Sergio López-Fernández, Marta Patricia Martin-Giménez, Josep Lloret, Manuel López
AIM: The optimum surgical approach of neonates with right-sided aortic arch (RAA) and esophageal atresia (EA)/tracheoesophageal fistula (TEF) is still an unsolved question. In order to propose an operative algorithm in the era of endoscopic surgery, we performed an international survey to know the current practice between pediatric endoscopic surgeons. Two of the most important societies in endoscopic pediatric surgery were queried: the International Pediatric Endosurgery Group (IPEG) and the European Society of Paediatric Endoscopic Surgeons (ESPES)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29234970/aortic-valve-reconstruction-using-autologous-pericardium-ozaki-procedure-for-active-infective-endocarditis-a-case-report
#11
Kimiaki Okada, Yoshito Inoue, Hirofumi Haida, Satoru Suzuki
Approximately one-third of patients with infective endocarditis require surgical treatment, but the ideal procedure that prevents infection ensures long durability and maintains quality of life remains unclear. A 21-year-old man who was diagnosed with aortic active infective endocarditis was referred to our hospital for surgical treatment. Echocardiography showed bicuspid aortic valve, severe aortic regurgitation, a large vegetation, and a paravalvular abscess. We planned to perform elective surgical treatment after antibiotic therapy; however, progression to heart failure required urgent operation...
December 12, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29231093/the-utility-of-simulation-in-the-management-of-patients-with-congenital-heart-disease-past-present-and-future
#12
Ali Subat, Andrew Goldberg, Samuel Demaria, Daniel Katz
Significant advancements have been made in the diagnosis and management of congenital heart disease (CHD). As a result, a higher percentage of these patients are surviving to adulthood. Despite this improvement in management, these patients remain at higher risk of morbidity and mortality, particularly in the perioperative setting. One new area of interest in these patients is the implementation of simulation-based medical education. Simulation has demonstrated various benefits across high-acuity scenarios encountered in the hospital...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217238/feasibility-and-impact-of-focused-intraoperative-transthoracic-echocardiography-on-management-in-thoracic-surgery-patients-an-observational-study
#13
Thomas Kratz, Sarah Holz, Thorsten Steinfeldt, Maik Exner, Marco Campo dell'Orto, Caroline Kratz, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Intraoperative focused transthoracic echocardiography (TTE) is feasible and has an effect on the management of hemodynamically unstable surgical patients. Furthermore, in noncardiac thoracic surgery, TTE might provide additional information for hemodynamic treatment. Transthoracic accessibility during thoracic surgical interventions is assumed to be difficult. For patients positioned on their right side, a modified subcostal transthoracic view might be helpful. DESIGN: A prospective observational study...
September 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29207816/non-catheter-related-perioperative-superior-vena-cava-syndrome-following-surgical-vsd-closure-role-of-transesophageal-echocardiography
#14
Tanveer Singh Kundra, Divya Gopal, Manasa Dhananjaya
Unintentional iatrogenic surgical complications can complicate the operative and postoperative courses of paediatric cardiac surgery patients. Unless recognized and treated early, it's possible, these complications may lead to a prolonged hospital stay, increased treatment cost, morbidity, and even death. Ventricular Septal Defect (VSD) is the most common congenital heart defect in children, occurring in 50% of all children with congenital heart disease and in 20% as an isolated lesion. Herein, we discuss the development of Superior Vena Cava (SVC) syndrome following surgical repair of VSD in a nine-month-old child...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29199051/noninvasive-evaluation-of-native-valvular-regurgitation-a-review-of-the-2017-american-society-of-echocardiography-guidelines-for-the-perioperative-echocardiographer
#15
REVIEW
Shane V Cherry, Pankaj Jain, Yiliam F Rodriguez-Blanco, Michael Fabbro
No abstract text is available yet for this article.
October 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29198631/elective-david-i-procedure-has-excellent-long-term-results-20-year-single-center-experience
#16
Malakh L Shrestha, Erik Beckmann, Firas Abd Alhadi, Heike Krueger, Fiona Meyer-Bockenkamp, Sebastian Bertele, Nurbol Koigeldiyev, Tim Kaufeld, Felix Fleissner, Wilhelm Korte, Jan Schmitto, Serghei Cebotari, Wolfgang Harringer, Axel Haverich, Andreas Martens
BACKGROUND: We present our results after elective, isolated David I procedures over the past 20 years. METHODS: Between 1993 and 2015, 197 patients (mean age 46 ± 17 years, 73% men) underwent isolated aortic valve reimplantation using straight tube grafts (David I procedure). Sixty patients (31%) had Marfan syndrome, and 24 (12%) had a bicuspid aortic valve. Twenty-four patients (12%) were operated through upper mini-sternotomy. RESULTS: There were no perioperative deaths...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29187656/-perioperative-safety-of-tibetan-children-with-congenital-heart-disease-undergoing-cardiac-surgery-and-anesthesia-in-low-altitude-area
#17
Yundan Pan, Jiaojiao Niu, Gang Qin, Lu Wang, Fan Zhang, E Wang
To observe the clinical parameters and short-term prognosis of Tibetan high-altitude area children with congenital heart disease undergoing surgery and anaesthesia in low-altitude area, and to investigate the perioperative safety of the treatment.
 Methods: From January, 2016 to December, 2016, 14 children with congenital heart disease who underwent surgery were assigned into 2 groups (n=7 each): the high-altitude area group (X group, children from Tibetan Autonomous Region) and the low-altitude area group (H group, children from Hunan Province)...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29184618/off-pump-coronary-artery-bypass-surgery-in-a-patient-with-dextrocardia-and-situs-inversus-anesthetic-surgical-consideration-and-role-of-transesophageal-echocardiography
#18
S Subash, Parimala Prasanna Simha, N Manjunatha
Coronary artery bypass surgery (CABG) in dextrocardia with situs inversus patients is reported less in literature. Due to abnormal looping and associated other congenital anomalies, anesthetic implications and surgical difficulties become challenging in these patients. Transesophageal echocardiography examination (TEE) needs multiplane angle adjustments compared to normal heart to obtain the images. Here, we describe a 53-year-old female patient having dextrocardia with situs inversus who underwent CABG and discuss the perioperative management and multiplane adjustments during TEE examination...
July 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29165758/therapeutic-strategy-for-multiple-vsd-combined-with-mvsd-in-infants-and-young-children
#19
Y-B Hu, J-Q Zou, L Wang, G-Y Liu
OBJECTIVE: To investigate the therapeutic strategy for the multiple ventricular septal defects (VSD) combined with a muscular ventricular septal defect (MVSD) in the infants and young children. PATIENTS AND METHODS: We analyzed clinical data of 63 child patients with multiple VSD who received the treatment between January 2009 and April 2013 in our hospital. There were 33 males and 30 females, the patients aged from 6 to 28 (10 ± 6) months and weighed between 5...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#20
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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