Surgical Approaches to Hypertrophic Cardiomyopathy and Implications for Perioperative Management

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Source: International Anesthesiology Clinics - Category: Anesthesiology Tags: Review Articles Source Type: research

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Source: Anesthesiology - Category: Anesthesiology Source Type: research
Costello syndrome is a rare genetic disorder characterized by mental and growth retardation and distinctive coarse facies. A significant proportion of patients with Costello syndrome have hypertrophic cardiomyopathy, papillomata, and malignant tumors. General anesthesia practice, especially airway and cardiac management, in patients with Costello syndrome may be complicated by anatomical features and cardiac abnormalities. There have been several reports on the anesthetic management of children with Costello syndrome, but few have reported on the anesthetic management of adults with Costello syndrome. In adults, careful pr...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
We report our use of angiotensin II infusion for vasoplegic shock in a combined heart and liver transplantation recipient with hypertrophic cardiomyopathy and systolic anterior motion of the mitral leaflet (SAM). A 34-year-old woman (60 kg) with complex congenital heart disease, failing Fontan physiology dependent on pharmacologic inotropy, and cardiac cirrhosis underwent combined orthotopic heart and deceased-donor liver transplantation. The cause of death in the donor was aneurysmal subarachnoid hemorrhage.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health probl...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Ranjith K Sivakumar, Sakthirajan Panneerselvam, Subashree Das, Priya RudingwaIndian Journal of Anaesthesia 2019 63(4):321-323
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
ConclusionsPatients with aortic stenosis most often develop symmetric hypertrophy; however, a small subset has asymmetric septal hypertrophy leading to left ventricular outflow tract obstruction. In cases of severe aortic stenosis, however, evidence of left ventricular outflow tract obstruction via both symptoms and echocardiographic findings may be minimized due to extremely high afterload on the left ventricle. Diagnosing a left ventricular outflow tract obstruction as the cause of hemodynamic instability during transcatheter aortic valve replacement, in the absence of abnormal findings on echocardiogram preoperatively, ...
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
In this report, we managed general anesthesia for a 74-year-old male patient with nonobstructive HCM who developed circulatory instability intraoperatively. Severe bradycardia measuring 35 beats/min and hypotension measuring 78 mm Hg systolic were observed during surgery. Using stroke volume variation and stroke volume from the FloTrac as indices, successful circulatory management was performed with dopamine. The hypotension and bradycardia were thought to be the result of methyldigoxin and possibly associated with our perioperative management. Cardiology consult should have been obtained. We demonstrated that the FloTrac ...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
M-mode echocardiogram in left ventricular dysfunction M-mode echocardiogram is commonly used to measure left ventricular dimensions and ejection fraction. Ejection fraction is indicative of the left ventricular systolic function. In this case left ventricular systolic function is grossly depressed, with a left ventricular ejection fraction (EF) of only 31.1%. Usually the left ventricular cavity is also significantly dilated when there is severe left ventricular dysfunction. But here it is within the normal range. IVSd: Interventricular septal septum, diastolic; LVIDd: Left ventricular internal diameter, diastolic; LVPWd: ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Uncategorized Spherical formula for calculation of ejection fraction Teichholz formula Source Type: blogs
We present a case where intraoperative transesophageal echocardiography played a crucial role in defining the etiology of LVOT obstruction that subsequently helped in deciding the surgical plan. PMID: 30052226 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
HYPERTROPHIC CARDIOMYOPATHY (HCM) has been described since the 1800s, but it was not until the mid-1960s that the first cases were reported in the literature.1 Characterized by hypertrophy, HCM is a heterogenous disease of all age groups2 that develops in absence of a physiological cause. The disease carries a wide array of manifestations and hemodynamic alterations.3 Even though some patients present with the usual symptoms (fatigue, dyspnea, chest pain, palpitations, or syncope), other patients are asymptomatic with an incidental diagnosis made on echocardiographic findings.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
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