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https://www.readbyqxmd.com/read/29054907/secondary-aortoduodenal-fistula-and-the-unrecognised-herald-bleed
#1
Francesc Simó Alari, Esther Molina González, Israel Gutierrez, Aïcha Ahamdanech-Idrissi
A 65-year-old man with history of aortobifemoral surgery 4 years ago was admitted to hospital after sudden abdominal pain. Initially misdiagnosed as renal colic, he was treated with analgesics, and while on observation he started with haematemesis, rapidly responding to volume infusion. Upper gastrointestinal endoscopy showed fresh blood in the stomach with no visible active bleeding. CT scan showed an important contrast extravasation from the aorta to the third duodenal portion, restarting haemodynamic instability and a cardiac arrest...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054851/changes-in-the-venous-pulse-waveform-in-pericardial-effusion-revealed-by-doppler-echocardiography-of-the-superior-vena-cava
#2
Benoy N Shah, Dhrubo J Rakhit
Doppler echocardiography has become the imaging technique of choice for urgent bedside assessment of the haemodynamic significance of pericardial effusion. However, classical findings such as respiratory variation in trans-mitral and trans-tricuspid velocities and plethoric inferior vena cava are not pathognomonic of tamponade and may be seen in non-cardiac diseases such as obesity and obstructive airways disease. Thus, ancillary findings are sometimes of clinical value. This case illustrates the classical changes seen in the flow profile of the superior vena cava, which reflect the changes seen in the jugular venous pulse waveform, before and after pericardiocentesis...
October 20, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29051269/management-and-long-term-outcomes-of-sarcoidosis-associated-pulmonary-hypertension
#3
Athénaïs Boucly, Vincent Cottin, Hilario Nunes, Xavier Jaïs, Abdelatif Tazi, Grégoire Prévôt, Martine Reynaud-Gaubert, Claire Dromer, Catherine Viacroze, Delphine Horeau-Langlard, Christophe Pison, Emmanuel Bergot, Julie Traclet, Jason Weatherald, Gérald Simonneau, Dominique Valeyre, David Montani, Marc Humbert, Olivier Sitbon, Laurent Savale
Studies reporting the effects of modern strategies with pulmonary arterial hypertension (PAH)-targeted therapies in sarcoidosis-associated pulmonary hypertension (S-APH) are limited.Clinical and haemodynamic data from newly diagnosed patients with severe S-APH (mean pulmonary artery pressure (mPAP) >35 mmHg or mPAP 25-35 mmHg with cardiac index <2.5 L·min(-1)·m(-2)) were collected from the French Pulmonary Hypertension Registry between 2004 and 2015.Data from 126 patients with severe S-APH were analysed (mean±sd age 57...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29051132/how-should-i-treat-a-rupture-of-the-interatrial-septum-with-haemodynamically-relevant-right-to-left-shunt-during-mitraclip-implantation
#4
Tobias Schmidt, Hannes Alessandrini, Felix Kreidel, Tobias Spangenberg, Michael Schlüter, Jochen Kannmacher, Ralf Bader, Thomas Thielsen, Karl-Heinz Kuck, Christian Frerker, Ivan P Casserly, Miles W H Behan, Anne Scott, Ajay Yerramasu, Alan Japp, Renzo Pessotto, David B Northridge
No abstract text is available yet for this article.
October 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#5
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049819/treatment-of-a-degenerated-sutureless-sorin-perceval%C3%A2-valve-using-an-edwards-sapien-3
#6
Norman Mangner, David Holzhey, Martin Misfeld, Axel Linke
Valve-in-valve implantation is an alternative to reoperation for patients with degenerated bioprostheses. This case report presents a 75-year-old woman presenting with worsening dyspnoea according New York Heart Association (NYHA) Class III after she had received a Sorin Perceval® S sutureless valve due to severe aortic valve stenosis 5 years ago. Echocardiography revealed a degenerated Perceval valve with severe valvular aortic regurgitation and stenosis. After exclusion of acute infective endocarditis, an Edwards SAPIEN 3 was implanted leading to an immediate haemodynamic improvement...
October 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049796/surgical-strategy-for-aortic-arch-reconstruction-after-the-norwood-procedure-based-on-numerical-flow-analysis
#7
Shohei Miyazaki, Kagami Miyaji, Keiichi Itatani, Norihiko Oka, Shinji Goto, Masanori Nakamura, Tadashi Kitamura, Tetsuya Horai, Koichi Sughimoto, Yuki Nakamura, Naoki Yoshimura
OBJECTIVES: Inefficient aortic flow after the Norwood procedure is known to lead to the deterioration of ventricular function due to an increased cardiac workload. To prevent the progression of aortic arch obstruction, arch reconstruction concomitant with second-stage surgery is recommended. The aim of this study was to determine the indications for reconstruction based on numerical simulation and to reveal the morphology that affects the haemodynamic parameters. METHODS: Fifteen patients who underwent the Norwood procedure or arch repair and Damus-Kaye-Stansel anastomosis were enrolled...
October 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049794/a-novel-approach-to-treating-a-post-sternotomy-internal-mammary-artery-pseudoaneurysm
#8
Yassir Al-Radhi, Vivek Shrivastava
Pseudoaneurysms of the internal mammary artery are a rare complication of median sternotomy. They may clinically present as a pulsatile mass or with signs of rupture and haemodynamic instability. In stable patients, percutaneous thrombin injection of the pseudoaneurysm is a safe and minimally invasive procedure to treat the pseudoaneurysm and avoid further surgery. We present a case of a pseudoaneurysm of a branch of the right internal mammary artery post-median sternotomy with no signs or symptoms of haemodynamic instability...
August 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049749/transvalvular-pressure-gradients-for-different-methods-of-mitral-valve-repair-only-neochordoplasty-achieves-native-valve-gradients
#9
Silje Ekroll Jahren, Samuel Hurni, Paul Philipp Heinisch, Bernhard Winkler, Dominik Obrist, Thierry Carrel, Alberto Weber
OBJECTIVES: Many surgical and interventional methods are available to restore patency for patients with degenerative severe mitral valve regurgitation. Leaflet resection and neochordoplasty, which both include ring annuloplasty, are the most frequently performed techniques for the repair of posterior mitral leaflet flail. It is unclear which technique results in the best haemodynamics. In this study, we investigated the effect of different mitral valve reconstruction techniques on mitral valve haemodynamics and diastolic transvalvular pressure gradient in an ex vivo porcine model...
October 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049673/incidence-and-echocardiographic-predictors-of-early-postoperative-right-ventricular-dysfunction-following-left-ventricular-assist-implantation-in-paediatric-patients
#10
Mathias Redlin, Oliver Miera, Helmut Habazettl, Joachim Photiadis, María Irene Carísimo-Cresta, Mathias Hommel, Benjamin O'Brien, Marian Kukucka
OBJECTIVES: Left ventricular assist device implantation is an established therapy for paediatric patients with end-stage heart failure. Early right ventricular dysfunction (RVD) after implantation still remains a challenge in the postoperative period. This study sought to determine the incidence of RVD and to identify echocardiographic predictors of RVD in paediatric patients, as well describing associated clinical outcome. METHODS: Prospectively collected preoperative echocardiographic, haemodynamic, demographic and biochemical data from 48 patients scheduled for left ventricular assist device implantation were evaluated...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049662/flexible-mechanoprosthesis-made-from-woven-ultra-high-molecular-weight-polyethylene-fibres-proof-of-concept-in-a-chronic-sheep-model
#11
Amir Basir, Remco B Grobben, Maarten Jan Cramer, Joost A van Herwaarden, Aryan Vink, Gerard Pasterkamp, Jolanda Kluin, Paul F Gründeman
OBJECTIVES: Ultra-high-molecular-weight polyethylene (UHMWPE) fibres are flexible, have high tensile strength, and platelet and bacterial adhesion is low. Therefore, UHMWPE may overcome limitations of current mechanical valves and bioprostheses. In this study, the biocompatibility and functionality of prototype handmade stented valves from woven UHMWPE (U-valve) was assessed in a chronic sheep model with acetylsalicylic acid monotherapy. METHODS: Native pulmonary valves of 23 sheep were replaced by U-valves ( n  = 18) or Perimount bovine bioprostheses (reference group, n  = 5)...
July 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049563/red-cell-distribution-width-is-a-prognostic-marker-of-perioperative-stroke-in-patients-undergoing-cardiac-valve-surgery
#12
Piotr Duchnowski, Tomasz Hryniewiecki, Mariusz Kusmierczyk, Piotr Szymanski
OBJECTIVES: Numerous studies have shown that elevated red cell distribution width (RDW) is associated with poor outcomes in patients with cardiovascular diseases such as coronary artery disease, peripheral artery disease or stroke. The usefulness of the RDW as a predictor of perioperative stroke in patients with valve disease undergoing valve surgery is currently unknown. The aim of the study was to evaluate the prognostic value of RDW for stroke in the early postoperative period in patients undergoing valve replacement or repair surgery...
July 7, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049549/transapical-cardioscopic-mitral-annuloplasty-a-short-term-survival-study-in-a-porcine-model
#13
Thang Duc Vu, Min Zin Oo, Duc-Viet Nguyen, Ervin Marquez Ocampo, Yilin Ong, Suganya Cheyyatraivendran-Arularasu, Lian-Kah Ti, Mark A Richards, Theo Kofidis
OBJECTIVES: The transapical approach provides concurrent surgical access to the mitral and the aortic valves, the root of the aorta and the left atrium. We previously showed the feasibility of transapical cardioscopic (TAC) surgery in a non-survival porcine model. However, reproducibility and feasibility of ring implantation using TAC have not been reported. Therefore, in this study, we hypothesized that implantation of a mitral annuloplasty ring can be feasibly and safely carried out endoscopically via the apex of the heart...
August 30, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049537/bilateral-bidirectional-glenn-outcome-of-off-pump-technique
#14
Ashraf A H El Midany, Ezzeldin A Mostafa, Sherif A Mansour, Mohammed Saffan, Mahmoud Zalat, Ismail N El-Sokkary, Ahmed M E Aletreby
OBJECTIVES: Off-pump bilateral bidirectional Glenn (b-BDG) poses a surgical challenge and may add complexity to the postoperative outcome especially regarding uniformity of the anastomosis and central pulmonary artery growth. Herein, we report early- and mid-term outcomes after off-pump b-BDG without using superior vena cava decompression techniques. METHODS: Ninety-seven consecutive patients, between 2009 and 2014, were included in this prospective study. All patients had complete pre- and postoperative clinical and detailed neurological assessments...
June 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049525/impact-of-the-haga-braincare-strategy-on-the-burden-of-haemodynamic-and-embolic-strokes-related-to-cardiac-surgery
#15
Friso Duynstee, Ruud W M Keunen, Agnes van Sonderen, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Erik Teeuws, Jan W K van Alphen, Dénes L J Tavy, Arne Mosch, Sebastiaan F T M de Bruijn, Hans van Overhagen, Frank E E Treurniet, Lucas C van Dijk, Paulien M van Kampen
OBJECTIVES: This study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals. METHODS: The HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry...
June 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048215/sauna-exposure-leads-to-improved-arterial-compliance-findings-from-a-non-randomised-experimental-study
#16
Earric Lee, Tanjaniina Laukkanen, Setor K Kunutsor, Hassan Khan, Peter Willeit, Francesco Zaccardi, Jari A Laukkanen
Background Heat therapy has been suggested to improve cardiovascular function. However, the effects of hot sauna exposure on arterial compliance and the dynamics of blood flow and pressure have not been well documented. Thus, we investigated the short-term effects of sauna bathing on arterial stiffness and haemodynamics. Design The design was an experimental non-randomised study. Methods There were 102 asymptomatic participants (mean age, 51.9 years) who had at least one cardiovascular risk factor. Participants were exposed to a single sauna session (duration: 30 min; temperature: 73℃; humidity: 10-20%)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#17
Julia Riebandt, Thomas Haberl, Dominik Wiedemann, R Moayedifar, Thomas Schloeglhofer, Stéphane Mahr, Kamen Dimitrov, Philipp Angleitner, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29045598/prognostic-value-of-pulmonary-blood-volume-by-first-pass-contrast-enhanced-cmr-in-heart-failure-outpatients-the-prove-hf-study
#18
F Ricci, A Barison, G Todiere, C Mantini, A R Cotroneo, M Emdin, R De Caterina, S Galllina, G D Aquaro
Aims: Pulmonary blood volume (PBV) is a novel clinical application of cardiovascular magnetic resonance (CMR) imaging for the quantitative grading of haemodynamic congestion. In this study, we aimed to assess the prognostic value of PBV in a cohort of outpatients with chronic heart failure (HF). Methods and results: One hundred and twelve consecutive patients (91 men, 67 ± 12 years) and 53 age- and sex-matched healthy controls underwent echocardiography and contrast-enhanced CMR...
October 17, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29045596/the-relationship-between-cardiovascular-magnetic-resonance-imaging-measurement-of-extracellular-volume-fraction-and-clinical-outcomes-in-adults-with-repaired-tetralogy-of-fallot
#19
Kate Hanneman, Andrew M Crean, Bernd J Wintersperger, Paaladinesh Thavendiranathan, Elsie T Nguyen, Camilla Kayedpour, Rachel M Wald
Aims: Our aims were to explore cardiac magnetic resonance quantification of myocardial extracellular volume (ECV) in adults with repaired tetralogy of Fallot (rTOF) when compared with healthy controls and to investigate the association between ECV and major adverse cardiovascular outcomes. Methods and results: We prospectively recruited adults with rTOF (n = 44, 59% male, 32.9 ± 13.6 years) and evaluated right ventricular (RV) and left ventricular (LV) ECV by pre/post-gadolinium T1 measurements (modified Look-Locker inversion recovery technique) on a 1...
October 17, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29043398/oral-paracetamol-for-patent-ductus-arteriosus-rescue-closure
#20
Pramod Pharande, Hadley Watson, Kenneth Tan, Arvind Sehgal
The objective of this study was to ascertain the efficacy of oral paracetamol in closing a symptomatic patent ductus arteriosus (PDA) when used as 'rescue' option. After obtaining ethics approval, a retrospective appraisal of the data from April 2014 to July 2015 was performed. Infants who were administered oral paracetamol either after unsuccessful therapy with ibuprofen or where it was considered contraindicated were included. A previously published echocardiographic scoring schema to stratify for ductal disease severity was used...
October 17, 2017: Pediatric Cardiology
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