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https://www.readbyqxmd.com/read/28923694/outcomes-of-transcatheter-aortic-valve-replacement-using-a-minimalist-approach
#1
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Karen Ringsred, Annette Lawton, Brenda Thooft, Julie Wagner, Santiago Garcia
BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) is increasingly performed using a minimalist approach under monitored anesthesia care (MAC). The safety of this approach remains controversial and adoption has been low in the US. METHODS: The study cohort was comprised of 130 patients (98% male) who underwent TAVR between 4/2015 and 4/2017 at the Minneapolis VA. We compared the outcomes of 81 patients who underwent TAVR using a standard approach (standard TAVR) and 49 who underwent TAVR using a minimalist approach (minimalist TAVR)...
August 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#2
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#3
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28911827/single-site-robot-assisted-laparoscopic-staging-surgery-for-presumed-clinically-early-stage-ovarian-cancer
#4
Ji Geun Yoo, Woo Jin Kim, Keun Ho Lee
STUDY OBJECTIVE: To present the demonstration of Robotic-assisted laparoendoscopic single-site(R-LESS) staging surgery in presumed clinically early stage ovarian cancer. DESIGN: A step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING: A university hospital. INTERVENTION: A 29-year-old woman was referred from a local clinic for an 8x6cm sized left ovarian tumor suggesting malignancy...
September 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#5
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28893433/effects-of-remote-ischemic-preconditioning-in-patients-with-concentric-myocardial-hypertrophy-a-randomized-controlled-trial-with-molecular-insights
#6
Young Song, Jong Wook Song, Sak Lee, Ji-Hae Jun, Young-Lan Kwak, Jae-Kwang Shim
BACKGROUND: Efficacy of remote ischemic preconditioning (RIPC) for cardioprotection in cardiac surgery is controversial. We aimed to evaluate the clinical and molecular effects of RIPC on the concentrically hypertrophied myocardium. METHODS: Seventy-two aortic stenosis patients receiving aortic valve replacement (AVR) under sevoflurane anesthesia were randomly allocated to RIPC (3cycles of 5-min inflation [300mmHg] and deflation on the left arm) or control (deflated cuff placement) group...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#7
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887255/forced-air-warming-in-patients-undergoing-endovascular-procedures-comparison-between-two-thermal-blanket-models
#8
Frederico L J Monteiro, Helio Halpern, Fernando Bortoli, Lucia Kataoka, Cristina Marumo, Mariângela Ribeiro, Matheus Castellassi, Cynthia Mendes, Nelson Wolosker
STUDY OBJECTIVE: The purpose of this study was to compare the efficiency between two thermal blanket models: the upper blanket and the underbody blanket in patient heating and hypothermia prevention during endovascular surgery. DESIGN: Prospective randomized study SETTING: Operating room PATIENTS: 50 patients, ASA 2-4 physical status, receiving endovascular surgery repair of infrarenal abdominal aortic aneurysm or lower limb angioplasty by endovascular technique were studied...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887248/positive-impact-of-an-aortic-center-designation
#9
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Brad Johnson, Karl A Illig, Bruce Zwiebel, Lawrence S Grundy, Robert Hooker, Christiano Caldeira, Martin A Back, Murray L Shames
BACKGROUND: In January 2015 we created a multidisciplinary Aortic Center with the collaboration of Vascular Surgery, Cardiac Surgery, Interventional Radiology, Anesthesia and Hospital Administration. We report the initial success of creating a Comprehensive Aortic Center. METHODS: All aortic procedures performed from January 1, 2015 until December 31, 2016 were entered into a prospectively collected database and compared with available data for 2014. Primary outcomes included the number of all aortic related procedures, transfer acceptance rate, transfer time and proportion of elective/emergent referrals...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28886850/transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-lower-surgical-risk-patients-with-chronic-obstructive-pulmonary-disease
#10
Vincent Auffret, Victor Becerra Munoz, Aurélie Loirat, Eric Dumont, Hervé Le Breton, Jean-Michel Paradis, Daniel Doyle, Robert De Larochellière, Siamak Mohammadi, Jean-Philippe Verhoye, François Dagenais, Marc Bedossa, Dominique Boulmier, Guillaume Leurent, Lluis Asmarats, Ander Regueiro, Chekrallah Chamandi, Tania Rodriguez-Gabella, Emile Voisine, Anne-Sophie Moisan, Martin Thoenes, Mélanie Côté, Rishi Puri, Pierre Voisine, Josep Rodés-Cabau
Respiratory complications are a major factor contributing to postoperative morbidity and mortality, especially in patients with chronic obstructive pulmonary disease (COPD). Our objective was to compare the rate of respiratory complications in patients with COPD with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR). Low-to-intermediate surgical-risk patients with moderate or severe COPD who underwent TAVI or SAVR at 2 tertiary centers were included in this study...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28874243/central-regional-anaesthesia-in-patients-with-aortic-stenosis-a-systematic-review
#11
Sofia Johansson, Morten Nikolaj Lind
INTRODUCTION: Aortic stenosis is a valvular lesion that poses several haemodynamic challenges for the anaesthesiologist. The use of central regional anaesthesia is traditionally regarded as contraindicated in patients with severe aortic stenosis due to its sympatholytic effect, potentially causing loss of vascular tone and ultimately diminished cardiac output. The aim of this paper was to review current literature to find evidence for or against the use of neuroaxial blockade in patients with aortic stenosis...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#12
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28860786/risk-factors-and-early-outcomes-of-acute-renal-injury-after-thoracic-aortic-endograft-repair-for-type-b-aortic-dissection
#13
Songyuan Luo, Huanyu Ding, Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become an emerging treatment modality for acute type B aortic dissection (TBAD) patients in recent years. The risk factors and impacts of acute kidney injury (AKI) after percutaneous TEVAR, however, have not been widely established. METHODS: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28852473/evaluation-of-operating-room-reverse-trendelenburg-positioning-and-its-effect-on-postoperative-hypoxemia-aspiration-and-length-of-stay-a-retrospective-study-of-consecutive-patients
#14
C Michael Dunham, Barbara M Hileman, Amy E Hutchinson, Tamara Antonaccio, Elisha A Chance, Gregory S Huang, Gregory Szmaj, Kristen Calabro, Cynthia Bishop, Tyson T Schrickel
BACKGROUND: In 2014, this group published an investigation of surgical patients from 2012 who had substantial rates of postoperative hypoxemia (POH) and perioperative pulmonary aspiration (POPA). Therefore, we investigated whether intraoperative reverse Trendelenburg positioning (RTP) decreases POH and POPA rates. METHODS: Consecutive ASA I-IV surgical patients who had preoperative pulmonary stability requiring general anesthesia with endotracheal intubation were evaluated...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#15
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28828046/modern-use-of-echocardiography-in-transcatheter-aortic-valve-replacement-an-up-date
#16
Cristina Caldararu, Serban Balanescu
Echocardiography is the cornerstone in the diagnosis of any valvular heart disease. The accurate diagnosis of aortic stenosis, the left ventricle function and the other heart valves evaluation are currently done by ultrasound alone. Prosthetic valve choice and dimensions prior to implantation can be done solely by proper use of echocardiography. The emergence of new methods to cure aortic stenosis such as trans-catheter aortic valve replacement (TAVR) emphasized the diagnostic value of cardiac ultrasound. The usefulness of echocardiography in TAVR can be divided in the baseline assessment (common to patients treated by conventional surgery), intra-procedural guidance of valve deployment and post-procedural follow-up...
December 2016: Mædica
https://www.readbyqxmd.com/read/28821337/intraoperative-cerebral-perfusion-disturbances-during-transcatheter-aortic-valve-replacement
#17
Jonathon P Fanning, Darren L Walters, Allan J Wesley, Chris Anstey, Samuel Huth, Judith Bellapart, Caroline Collard, Ivan L Rapchuk, Sarvesh Natani, Michael Savage, John F Fraser
BACKGROUND: Transcatheter aortic valve replacement entails profound and unavoidable hemodynamic perturbations that may contribute to the neurological injury associated with the procedure. METHODS: Thirty-one patients were monitored with cerebral oximetry as a surrogate marker of perfusion while undergoing transcatheter aortic valve replacement via a transfemoral approach under general anesthesia to detect intraoperative hypoperfusion insult. Serial neurologic, cognitive, and cerebral magnetic resonance imaging assessments were administered to objectively quantify perioperative neurologic injury and ascertain any association with significant cerebral oximetry disturbances...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28820420/alterations-in-placenta-redox-status-during-experimental-model-of-hypoxia-induced-preeclampsia
#18
A Sharashenidze, L Panchulidze, T Sanikidze
An important pathogenetic link of preeclampsia (PE) is hypoxia of uterine-placental tissues, accompanied by damage of the vascular endothelium and the release of vasoactive mediators, violate vascular tone and microcirculation in the maternal organism and placenta and development of a number of pathological processes in the mother's and fetus body. The aim of the study was to establish metabolic abnormalities of oxidative metabolism of the placenta during experimental model of PE (uterine/placental hypoxia)...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28781880/acute-aortic-occlusion-due-to-tumor-embolism-in-a-patient-with-lung-malignancy
#19
Stella Lioudaki, Nikolaos Kontopodis, Stefanos Palioudakis, Anastasios V Koutsopoulos, Ioannis Drositis, Christos V Ioannou
OBJECTIVES: Acute lower limb ischemia caused by tumor embolization is rare, despite the fact that cancer is a common cause of hypercoagulability predisposing to venous thrombosis. Arterial embolization is mostly associated with intracardiac tumors while lung malignancies are the second most common cause of tumor embolism. METHODS: In this report, we present a male patient who developed acute bilateral lower limb ischemia in the immediate postoperative period after a thoracotomy for attempted left upper lobe resection for lung cancer...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28747079/endovascular-repair-of-a-thoracoabdominal-aortic-aneurysm-with-a-patient-specific-fenestrated-branched-stent-graft
#20
Bernardo C Mendes, Lawrence E Greiten, Gustavo S Oderich
PURPOSE: To describe the technical aspects of a thoracoabdominal aortic aneurysm (TAAA) repair using a patient-specific fenestrated-branched stent-graft. TECHNIQUE: The technique is demonstrated in a 69-year-old man with a 6.2-cm asymptomatic type III TAAA. A patient-specific fenestrated-branched stent-graft was designed with 2 down-going directional branches for the celiac and superior mesenteric arteries and 2 reinforced fenestrations for the renal arteries. The procedure was performed under general anesthesia and included sequential stenting of the celiac, superior mesenteric, and bilateral renal arteries...
July 1, 2017: Journal of Endovascular Therapy
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