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Perioperative Echocardiography

Kanchi Muralidhar, Deepak Tempe, Yatin Mehta, Poonam Malhotra Kapoor, Chirojit Mukherjee, Thomas Koshy, Prabhat Tewari, Naman Shastri, Satyajeet Misra, Kumar Belani
During current medical care, perioperative transesophageal echocardiography (TEE) has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient's outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE...
October 2016: Annals of Cardiac Anaesthesia
Poonam Malhotra Kapoor, Kanchi Muralidhar, Navin C Nanda, Yatin Mehta, Naman Shastry, Kalpana Irpachi, Aditya Baloria
In 1980, Transesophageal Echocardiography (TEE) first technology has introduced the standard of practice for most cardiac operating rooms to facilitate surgical decision making. Transoesophageal echocardiography as a diagnostic tool is now an integral part of intraoperative monitoring practice of cardiac anaesthesiology. Practice guidelines for perioperative transesophageal echocardiography are systematically developed recommendations that assist in the management of surgical patients, were developed by Indian Association of Cardiac Anaesthesiologists (IACTA)...
October 2016: Annals of Cardiac Anaesthesia
K Muralidhar
No abstract text is available yet for this article.
October 2016: Annals of Cardiac Anaesthesia
Nikhil Kumar, Christopher A Troianos, Joshua S Baisden
In this report, we present the case of a patient with biventricular noncompaction cardiomyopathy, Ebstein anomaly, and a left atrial mass who required emergent placement of a left ventricular assist device. The noncompaction cardiomyopathy complicated the left ventricular assist device implantation procedure because the thickened, trabeculated myocardium made it difficult to place the inflow cannula. We discuss our perioperative management strategy, in which transesophageal echocardiography was used, to help the surgical team identify the proper cannula placement and provide a bridge to transplantation...
October 5, 2016: A & A Case Reports
Boyang Liu, Nicola C Edwards, Simon Ray, Richard P Steeds
Mitral regurgitation (MR) is the second most common form of valvular disease requiring surgery. Correct identification of surgical candidates and optimising the timing of surgery is key in management. For primary MR, this relies upon a balance between the perioperative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potential risk of irreversible left ventricular dysfunction if intervention is performed too late. For secondary MR, recognition that this is a highly dynamic condition where MR severity may change is key, although data on outcomes in determining whether concomitant valve intervention is performed with revascularisation has raised questions regarding timing of surgery...
October 13, 2016: Echo Research and Practice
Hugo Andr S Mantilla, Felix Ramón Montes, William F Amaya
Stress cardiomyopathy, or Takotsubo syndrome, is a widely recognized cardiac pathology with a clinical presentation similar to acute coronary syndrome and related to physical or emotional stress. Perioperatively, it is challenging to identify it given the variety of forms and scenarios in which it can present. We describe a 22-year-old patient with an atypical presentation of Takotsubo syndrome during anesthesia induction, which highlights the usefulness of transesophageal echocardiography for the initial diagnosis...
October 2016: Annals of Cardiac Anaesthesia
Deepak Prakash Borde, Antony George, Shreedhar Joshi, Suresh Nair, Thomas Koshy, Uday Gandhe, Murali Chakravarthy
CONTEXT: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). AIMS: We hypothesized that variations in practice of intraoperative TEE exist among centers and this survey aimed at analyzing them...
October 2016: Annals of Cardiac Anaesthesia
Garima Arora, Navin C Nanda
No abstract text is available yet for this article.
October 2016: Annals of Cardiac Anaesthesia
Vincent Chan, Olivier Levac-Martinho, Benjamin Sohmer, Elsayed Elmistekawy, Marc Ruel, Thierry G Mesana
BACKGROUND: Data comparing outcomes after repair versus replacement of chronic ischemic mitral regurgitation (MR) is evolving. Recent data suggest that repair is associated with recurrent MR, but not survival, when compared with replacement. However, it remains unclear when either surgical strategy should be applied based on preoperative mitral valve anatomy. METHODS: Between 2001 and 2013, 161 patients underwent repair or replacement of chronic ischemic MR. The mean age of these patients was 68...
September 22, 2016: Annals of Thoracic Surgery
Chantal A Boly, Etto C Eringa, R Arthur Bouwman, Rob F P van den Akker, Frances S de Man, Ingrid Schalij, Stephan A Loer, Christa Boer, Charissa E van den Brom
BACKGROUND: While most studies focus on cardiovascular morbidity following anesthesia and surgery in excessive obesity, it is unknown whether these intraoperative cardiovascular alterations also occur in milder forms of adiposity without type 2 diabetes and if insulin is a possible treatment to improve intraoperative myocardial performance. In this experimental study we investigated whether mild adiposity without metabolic alterations is already associated with cardiometabolic dysfunction during anesthesia, mechanical ventilation and surgery and whether these myocardial alterations can be neutralized by intraoperative insulin treatment...
2016: Cardiovascular Diabetology
Martina Nowak-Machen
Aortic disease, when left untreated, is still associated with major morbidity and mortality. Aortic dissection and aortic aneurysm are the main reasons for performing aortic surgery procedures in the adult. Imaging techniques such as computed tomography and magnetic resonance imaging play a key role in the preoperative evaluation. Transesophageal echocardiography (TEE) has become a safe and invaluable perioperative imaging tool for aortic disease over the past decade with high sensitivity and specificity. TEE can increase patient safety and improve overall patient outcome in aortic surgery...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Aly Ghoneim, Ismail Bouhout, Philippe Demers, Amine Mazine, Mary Francispillai, Ismail El-Hamamsy, Michel Carrier, Yoan Lamarche, Denis Bouchard
OBJECTIVE: Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging problem. The objective of this study was to compare 4 surgical approaches in terms of hemodynamics and perioperative outcomes. METHODS: A retrospective single-center study included 351 consecutive patients with a small aortic annulus (≤21 mm) who underwent aortic valve surgery between January 2007 and December 2014. Surgical techniques included standard AVR in 259 (74%) patients, aortic root enlargement in 20 (6%), implantation of a stentless bioprosthesis in 23 (6%), and sutureless AVR in 49 (13%)...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Cas Teunissen, Jesse Habets, Birgitta K Velthuis, Maarten J Cramer, Peter Loh
Prior to atrial fibrillation (AF) ablation, computed tomography angiography (CTA) is increasingly used for left atrial appendage (LAA) thrombus detection. LAA filling defects on CTA may represent thrombus or incomplete contrast mixing with blood. A pre-bolus of contrast material with delay before the CTA contrast bolus can help distinguish between thrombus and incomplete contrast mixing. We present results from a double-contrast, single-phase CTA protocol used in our daily clinical practice. In patients who underwent AF ablation between 2011 and 2015, double-contrast, single-phase CTA was performed prior to ablation...
September 6, 2016: International Journal of Cardiovascular Imaging
Michael J Plakke, Cory D Maxwell, Brandi A Bottiger
Surgical patients with pulmonary hypertension present a significant challenge to the anesthesiologist. Continuous perioperative monitoring of pulmonary artery (PA) pressure is recommended and most often accomplished with a PA catheter. Placement of a PA catheter may be difficult or contraindicated, and in these cases, transesophageal echocardiography is a useful alternative to monitor dynamic PA physiology. In this case, we used intraoperative transesophageal echocardiography to detect changes in peak PA pressure and guide clinical treatment in a patient with pulmonary hypertension and an extensive PA aneurysm undergoing partial nephrectomy...
September 1, 2016: A & A Case Reports
Ravi Raj, Goverdhan Dutt Puri, Aveek Jayant, Shyam Kumar Singh Thingnam, Rana Sandip Singh, Manoj Kumar Rohit
BACKGROUND: Right ventricular (RV) function alterations are invariably present in all patients after tetralogy of Fallot (TOF) repair. Unlike the developed world where most of the patients with TOF are corrected in infancy, average age of presentation and thus surgery for these patients in the developing world may be higher. We aimed to study the correlation between RV function parameters such as tricuspid annular peak systolic excursion (TAPSE), fractional area change (FAC), and tricuspid annular peak systolic velocity (S') with early outcome variables after intracardiac repair for TOF...
August 16, 2016: Echocardiography
Pelin Ayyildiz, Alper Güzeltaş, İbrahim Cansaran Tanidir, Taner Kasar, Erkut Öztürk, Yakup Ergül
BACKGROUND/AIM: The aim of this study was to evaluate the transesophageal echocardiography (TEE) findings of pediatric patients in a tertiary center where complex congenital heart surgery and interventional procedures have been performed. MATERIALS AND METHODS: All TEE studies performed between December 2009 and December 2014 were reviewed retrospectively. Patients were divided into 3 groups: perioperative, during interventional procedures, and due to other reasons...
2016: Turkish Journal of Medical Sciences
Yiorgos Alexandros Cavayas, Martin Girard, Georges Desjardins, André Y Denault
BACKGROUND: Acute deterioration in respiratory status commonly occurs in patients who cannot be transported for imaging studies, particularly during surgical procedures and in critical care settings. Transthoracic lung ultrasonography has been developed to allow rapid diagnosis of respiratory conditions at the bedside. Nevertheless, the thorax is not always accessible, especially in the perioperative setting. Transesophageal lung ultrasonography (TELU) can be used to circumvent this problem...
November 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Rohan Magoon, Amita Sharma, Suruchi Ladha, Poonam Malhotra Kapoor, Suruchi Hasija
With the growing requirement of echocardiography in the perioperative management, the anesthesiologists need to be well trained in transthoracic echocardiography (TTE). Lack of formal, structured teaching program precludes the same. The present article reviews the expanding domain of TTE, simulation-based TTE training, the advancements, current limitations, and the importance of simulation-based training for the anesthesiologists.
July 2016: Annals of Cardiac Anaesthesia
Naveen G Singh, P S Nagaraja, Divya Gopal, V Manjunath, K S Nagesh, N Manjunatha, Guru Police Patel, Satish Kumar Mishra
BACKGROUND: Abdominal complications being rare but results in high mortality, commonly due to splanchnic organ hypoperfusion during the perioperative period of cardiac surgery. There are no feasible methods to monitor intraoperative superior mesenteric artery blood flow (SMABF). Hence, the aim of this study was to evaluate the feasibility and to measure SMABF using transesophageal echocardiography (TEE) during cardiac surgery under hypothermic cardiopulmonary bypass (CPB). METHODOLOGY: Thirty-five patients undergoing elective cardiac surgery under CPB were enrolled...
July 2016: Annals of Cardiac Anaesthesia
Gregory J Latham, Faith J Ross, Michael J Eisses, Michael J Richards, Jeremy M Geiduschek, Denise C Joffe
BACKGROUND: Children with elastin arteriopathy (EA), the majority of whom have Williams-Beuren syndrome, are at high risk for sudden death. Case reports suggest that the risk of perioperative cardiac arrest and death is high, but none have reported the frequency or risk factors for morbidity and mortality in an entire cohort of children with EA undergoing anesthesia. AIM: The aim of this study was to present one institution's rate of morbidity and mortality in all children with EA undergoing anesthesia and to examine patient characteristics that pose the greatest risk...
September 2016: Paediatric Anaesthesia
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