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https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#1
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#2
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27898500/patterns-and-trends-of-transcatheter-aortic-valve-implantation-in-italy-insights-from-rispeva
#3
Arturo Giordano, Nicola Corcione, Giuseppe Biondi-Zoccai, Sergio Berti, Anna Sonia Petronio, Carlo Pierli, Patrizia Presbitero, Pietro Giudice, Gennaro Sardella, Antonio L Bartorelli, Roberto Bonmassari, Ciro Indolfi, Alfredo Marchese, Elvis Brscic, Alberto Cremonesi, Luca Testa, Nedy Brambilla, Francesco Bedogni
AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#4
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27887855/regional-anesthesia-as-the-anesthetic-of-choice-for-high-risk-surgical-patients-undergoing-repair-of-juxtarenal-aortic-aneurysms-with-fenestrated-stent-grafts
#5
Jesse Manunga, Jessica Titus
Juxtarenal aortic aneurysms (JAAs) have been conventionally treated using open repair with excellent results. Recent approval of fenestrated stent grafts by the United States Food and Drug Administration has given patients with JAAs an alternative for repair. However, most of these procedures are still performed under general anesthesia, making some surgeons reluctant to offer repair to a subset of patients deemed too high risk for general anesthesia. We present three patients with JAAs at high surgical risk, including one patient with a ruptured aneurysm, who were successfully treated using a fenestrated stent graft under regional anesthesia...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27883975/evaluation-of-current-practices-in-transcatheter-aortic-valve-implantation-the-written-worldwide-tavi-experience-survey
#6
Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers. METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867460/percutaneous-dual-valve-intervention-in-a-high-risk-patient-with-severe-aortic-and-mitral-stenosis
#7
Blaz Mrevlje, Mohamad Aboukura, Christoph A Nienaber
Aortic stenosis is the most frequent and mitral stenosis is the least frequent native single-sided valve disease in Europe. Patients with the combination of severe symptomatic degenerative aortic and mitral stenosis are very rare. Guidelines for the treatment of heart valve diseases are clear for single-valve situations. However, there is no common agreement or recommendation for the best treatment strategy in patients with multiple valve disease and severe concomitant comorbidities. A 76-year-old female patient with the combination of severe degenerative symptomatic aortic and mitral stenosis and several comorbidities including severe obesity, who was found unsuitable surgical candidate by the heart team and unsuitable for two-time general anesthesia in the case of two-step single-valve percutaneous approach by anesthesiologists, underwent successful percutaneous dual-valve single-intervention (transcatheter aortic valve implantation and percutaneous mitral balloon commissurotomy)...
July 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27865218/-percutaneous-endovascular-aortic-repair-with-local-anesthesia-one-day-surgery
#8
Joel Sousa, Daniel Brandão, Paulo Barreto, Joana Ferreira, José Almeida Lopes, Armando Mansilha
INTRODUCTION: To evaluate the results of the abdominal aortic aneurism endovascular treatment (EVAR), percutaneously and with local anesthesia, according to the concept of one day surgery. MATERIAL AND METHODS: Unicentric, retrospective analysis of patients with aorto-iliac aneurysmal disease, consecutively treated by EVAR with percutaneous access trough the Preclose technique (pEVAR), according to the outpatient criteria, with one overnight stay in the hospital...
June 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27853448/a-novel-mutation-in-abca1-gene-causing-tangier-disease-in-an-italian-family-with-uncommon-neurological-presentation
#9
Marco Ceccanti, Chiara Cambieri, Vittorio Frasca, Emanuela Onesti, Antonella Biasiotta, Carla Giordano, Sabina M Bruno, Giancarlo Testino, Marco Lucarelli, Marcello Arca, Maurizio Inghilleri
Tangier disease is an autosomal recessive disorder characterized by severe reduction in high-density lipoprotein cholesterol and peripheral lipid storage. We describe a family with c.5094C > A p.Tyr1698* mutation in the ABCA1 gene, clinically characterized by syringomyelic-like anesthesia, demyelinating multineuropathy, and reduction in intraepidermal small fibers innervation. In the proband patient, cardiac involvement determined a myocardial infarction; lipid storage was demonstrated in gut, cornea, and aortic wall...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27821785/anesthetic-considerations-for-surgery-on-the-aortic-arch
#10
REVIEW
Barbara J Wilkey, Nathaen S Weitzel
Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist's perspective, with particular emphasis on transesophageal echo evaluation and coagulation management.
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27816175/-transfemoral-tavi-procedure-in-women-minimally-invasive-technique
#11
H Benamer, B Chevalier, A Roy, M A Bouzid, C Perdrix, P Garot, T Hovasse, T Unterseeh, S Champagne, T Lefèvre
Demographic data point to a substantial proportion of women in the population of elderly patients with an increasing prevalence of aortic stenosis. Implantation of an aortic bioprosthesis via an endovascular approach known as Transcatheter aortic valve implantation (TAVI) in patients presenting with a symptomatic tight aortic stenosis (severe aortic stenosis) (AS) is an alternative therapeutic option to surgical aortic valve replacement in patients at high surgical risk or ineligible for surgery. The literature has shown that this technique seems to be particularly beneficial in female patients...
November 2, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27793402/one-year-outcomes-of-transcatheter-aortic%C3%A2-valve-implantation-using-the-direct%C3%A2-aortic%C3%A2-approach
#12
Giuseppe Bruschi, Marian Branny, Molly Schiltgen, Federica Ettori, Bertrand Marcheix, Hafid Amrane, Hasan Bushnaq, M Erwin S H Tan, Uday Trivedi, Piotr Branny, Silvio Klugmann, Giuseppe Coletti, Nicolas Dumonteil, Fabiano Porta, Anna Nordell, Neil Moat
BACKGROUND: The direct aortic (DA) approach allows for transcatheter aortic valve implantation (TAVI) in patients with difficult peripheral vascular anatomy. The CoreValve ADVANCE Direct Aortic (ADVANCE DA) study was performed to assess the outcomes of DA TAVI with the CoreValve System (Medtronic, Minneapolis, MN) in routine practice. METHODS: Patients were selected for the DA approach by local cardiac surgical teams, and TAVI was performed with patients under general anesthesia...
October 25, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27778056/-unilateral-spinal-anesthesia-literature-review-and-recommendations
#13
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27774967/trans-subclavian-aortic-valve-replacement-with-various-bioprosthetic-valves-single-center-experience
#14
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27771771/survival-after-intravenous-thrombin-prior-to-cardiopulmonary-bypass
#15
Vance G Nielsen, Samata R Paidy, Camron A Meek, Tiffany K Thornton, Scott D Lick
We present a case of a patient undergoing aortic valve replacement being inadvertently administered 5000 U of bovine thrombin instead of heparin for anticoagulation for cardiopulmonary bypass. The labeling error was made within the operating room pharmacy. The key to survival of this patient was a rapid diagnosis, administration of antithrombin and heparin, and removal of cardiac and great vessel thrombi. It is recommended that point of care anesthesia providers `prepare heparin for cardiopulmonary bypass anticoagulation, as thrombin is not used in anesthetic practice and is not contained within anesthesia cabinet medication drawers...
October 22, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27765304/transcarotid-transcatheter-aortic%C3%A2-valve%C3%A2-replacement-general-or-local-anesthesia
#16
Nicolas Debry, Cédric Delhaye, Alexandre Azmoun, Ramzi Ramadan, Sahbi Fradi, Philippe Brenot, Arnaud Sudre, Mouhamed Djahoum Moussa, Didier Tchetche, Said Ghostine, Darren Mylotte, Thomas Modine
OBJECTIVES: The study sought to assess the safety and efficacy of a minimally invasive strategy (MIS) (local anesthesia and conscious sedation) compared to general anesthesia (GA) among the largest published cohort of patients undergoing transcarotid transcatheter aortic valve replacement (TAVR). BACKGROUND: Transcarotid TAVR has been shown to be feasible and safe. There is, however, no information pertaining to the mode anesthesia in these procedures. METHODS: Between 2009 and 2014, 174 patients underwent transcarotid TAVR at 2 French centers...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27738457/the-effect-of-steroid-therapy-on-postoperative-inflammatory-response-after-endovascular-abdominal-aortic-aneurysm-repair
#17
Kazuto Maruta, Atsushi Aoki, Tadashi Omoto, Hirofumi Iizuka, Hiroyuki Kawaura
Objectives: Unexpected systemic inflammatory response with high fever and increase in C-reactive protein (CRP) occurred frequently after endovascular abdominal aortic aneurysm repair (EVAR). This excessive inflammatory response affects the postoperative course. We evaluated the effects of steroid on the postoperative inflammatory response after EVAR. Methods: Steroid therapy, intravenous infusion of methylprednisolone 1000 mg just after the anesthesia induction, was started since December 2012. After induction of the steroid therapy, 25 patients underwent EVAR with steroid therapy (Group S)...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27731519/thoracoscopy-with-concurrent-esophagoscopy-for-persistent-right-aortic-arch-in-9-dogs
#18
Sarah Townsend, Michelle L Oblak, Ameet Singh, Michele A Steffey, Jeffrey J Runge
OBJECTIVE: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs with suspected PRAA (n=9). METHODS: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included...
November 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27720490/a-retrospective-analysis-of-the-influence-of-ventricular-morphology-on-the-perioperative-outcomes-after-fontan-surgery
#19
Mineto Kamata, Corey Stiver, Aymen Naguib, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: The objectives of this study were to evaluate the effect of ventricular morphology on perioperative outcomes during Fontan surgery. DESIGN: Retrospective cohort study. SETTING: Single standing, not-for-profit pediatric hospital. PARTICIPANTS: A total of 72 patients who underwent Fontan surgery using cardiopulmonary bypass without aortic cross-clamp between January 1, 2009 and December 31, 2014. INTERVENTIONS: None...
July 19, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27694213/effects-of-various-types-of-anesthesia-on-hemodynamics-cardiac-function-and-glucose-and-lipid-metabolism-in-rats
#20
Yusuke Sano, Shogo Ito, Mamoru Yoneda, Kai Nagasawa, Natsumi Matsuura, Yuichiro Yamada, Ayako Uchinaka, Yasuko K Bando, Toyoaki Murohara, Kohzo Nagata
Anesthesia can affect respiratory, circulatory, and endocrine systems but is necessary for certain experimental procedures such as echocardiography and blood sampling in small animals. We have now investigated the effects of four types of anesthesia [pentobarbital sodium (PENT), ketamine-xylazine (K/X), and low- or high-dose isoflurane (ISO)] on hemodynamics, cardiac function, and glucose and lipid metabolism in Sprague-Dawley rats. Aortic pressure, heart rate, and echocardiographic parameters were measured at various time points up to 45 min after the induction of anesthesia, and blood was then collected for measurement of parameters of glucose and lipid metabolism...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
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