Intervention in Massive Pulmonary Embolus: Catheter Thrombectomy/Thromboaspiration versus Systemic Lysis versus Surgical Thrombectomy

This article will review the current medical management as well as catheter-directed therapies and surgical embolectomy in the treatment of patients with massive PE. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Seminars in Interventional Radiology - Category: Radiology Authors: Tags: Review Article Source Type: research

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Publication date: Available online 22 July 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Christian Schmidt, Astrid Ellen Berggreen, Matthias HeringlakeThe clinical usefulness of the so-called “static” cardiac filling pressures - central (CVP) and pulmonary-artery-occlusion-pressure (PAOP) – has come into question for guiding hemodynamic therapy due to their poor ability to predict fluid responsiveness in comparison with other monitoring modalities such as transpulmonary thermodilution-derived volumetric measurements, dynamic variables for assessing fluid responsiveness, and th...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 22 July 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Christian Schmidt, Astrid Ellen Berggreen, Matthias HeringlakeAbstractThe clinical usefulness of the so-called “static” cardiac filling pressures - central (CVP) and pulmonary-artery-occlusion-pressure (PAOP) – has come into question for guiding hemodynamic therapy due to their poor ability to predict fluid responsiveness in comparison with other monitoring modalities like transpulmonary thermodilution derived volumetric measurements, dynamic variables for assessing fluid responsiveness, a...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Editor ’s PerspectiveWhat We Already Know about This TopicAfter pulmonary artery occlusion (mimicking a pulmonary embolism), perfusion is redistributed to the rest of the lung tissue, but the distribution of ventilation is uncertain.What This Article Tells Us That Is NewData from anesthetized pigs (uninjured lungs) indicate that the perfusion is redistributed as suspected. Similarly, ventilation is redistributed from nonperfused to perfused lung tissue. This limits the increase in dead space and is accompanied by less density in the occluded lung.Background Acute unilateral pulmonary arterial occlusion causes ventila...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 24 April 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Frederic Michard, Matthieu Biais, Suzana M. Lobo, Emmanuel FutierSummaryPostoperative complications within 30 days represent the third leading cause of death in the world. Multiple solutions have been proposed to tackle the clinical and economic burden of postoperative complications. They include the optimal fluid and hemodynamic management of patients undergoing major surgery. A better understanding of cardiovascular physiology and technological improvements are responsible for the evolution of perioperat...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Conclusion: 5-HMF treatment decreased P50, improved SaO2, and mitigated increases in PAP in this swine model of NH. Introduction The reduction of barometric pressure at altitude is associated with reduced partial pressure of ambient Oxygen (PO2). With lower ambient PO2, it can be anticipated that alveolar (PAO2), arterial O2 (PaO2) and blood O2 content (CaO2) will decrease accordingly, resulting in a widely recognized decrease in maximal O2 consumption (VO2) (Dill and Adams, 1972; Lucas et al., 2011). In humans, with acute exposure to altitude, maximal VO2 decrements are measurable at elevations even as low as 580 ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Discussion of Figure-1: As per Dr. Smith — ECG #1 showed marked sinus tachycardia at ~140/minute — with diffuse ST segment elevation.I often find it difficult to determine the precise amount of ST elevation when the heart rate is very fast. For clarity — I ’ve added short horizontal RED lines in Figure-1 to show what I took as the “baseline” for assessing the amount of J-point ST elevation for the 2 ECGs in this figure.It may be especially difficult when there is marked tachycardia to identify the J-point that defines the number of millim...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 23 March 2019Source: Revista Portuguesa de Cardiologia (English Edition)Author(s): Maria Emanuel Amaral, Pedro Epifânio, Natália Noronha, António Pires, Paula Martins, Vanda Azevedo, Eduardo Castela, Manuel J. AntunesAbstractAnomalous origin of the left coronary artery from the pulmonary artery is a rare congenital heart defect and a cause of myocardial ischemia during childhood. Most undiagnosed cases die in the first year of life as an extensive collateral network is essential for survival. The diagnosis requires a high index of clinical suspicion. The authors presen...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
Rationale: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with a poor prognosis, characterized by chronic thromboembolic obstruction of the pulmonary arteries and pulmonary hypertension. Balloon pulmonary angioplasty (BPA) is a newly emergent treatment for CTEPH, which may substitute pulmonary endarterectomy, the standard but more invasive treatment for CTEPH. Here, we report the case of a CTEPH patient who underwent 2 noncardiac surgeries without complications after preoperative intervention of BPA. Patient concerns: A 79-year-old man presented with severe osteoarthritis of bilateral knees, with a...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSION:: The combination of pulmonary artery flotation catheter hemodynamic monitoring and pump-controlled retrograde trial off can increase the possibility of veno-arterial extracorporeal membrane oxygenation successful decannulation. PMID: 30736715 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Publication date: February 2019Source: The Annals of Thoracic Surgery, Volume 107, Issue 2Author(s): Lukas Lannemyr, Gudrun Bragadottir, Anders Hjärpe, Bengt Redfors, Sven-Erik RickstenBackgroundCardiac surgery with cardiopulmonary bypass (CPB) is associated with acute kidney injury, and the risk increases with low oxygen delivery during CPB. We hypothesized that renal oxygenation could be improved at higher than normal CPB flow rates.MethodsAfter ethical approval and informed consent, 17 patients with normal serum creatinine undergoing normothermic CPB were included and received pulmonary artery and renal vein cathet...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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