Non ‐femoral TAVR: Time to stratify alternative vascular approaches
Key Points Although transfemoral transcatheter aortic valve replacement (TAVR) is the gold standard, this approach is not be feasible in approximately 15% of the patients. Trans ‐carotid TAVR may be less invasive than transthoracic routes for TAVR, and has been associated with encouraging results. Further prospective studies comparing alternative access routes in patients with whom transfemoral TAVR is not feasible are warranted, to propose an evidence‐based algorithm g uiding the physician decision.
Authors: Erbel R Abstract The progress in cardiology during the last 50 years can best be studied by looking at the diagnostics and treatment of patients with aortic valve stenosis. Previously, the clinical examination, electrocardiography (ECG) and chest X‑ray were used before heart catheterization, which included a transseptal puncture to complete the indications for surgery in young patients. Nowadays, echocardiography, often combined with a dobutamine stress test, is the primary diagnostic tool to which computed tomography for quantification of valve calcification and cardiac magnetic resonance...
In conclusion, a hemodynamic ramp test with simultaneous echocardiography and RHC was useful for the evaluation of the causal relationship between AI and low CO, and for selection of surgical treatment for AI in a patient with CF-LVAD.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) commonly is used to manage cardiogenic shock after cardiac surgery, transcatheter aortic valve replacement,1,2 cardiac catheterization procedures, and cardiac arrest.3,4 Anesthesiologists often are involved in the management of these patients both in the operating room and in critical care settings. However, its use raises many medical, ethical, and economic challenges.5,6 Several articles,7-14 editorials,15,16 and a pro/con debate17,18 related to ECMO after cardiac surgery have appeared this year in this Journal of Cardiothoracic and Vascular Anesthesia.
Purpose of review The number of complex procedures performed in the cardiac catheterization laboratory (CCL) is rapidly increasing. Because of their complexity, they frequently require the assistance of an anesthesiologist. The CCL is primarily designed to facilitate a percutaneous cardiac intervention; therefore, it might be a challenging workplace for an anesthesiologist. The aim of this review is to briefly present tasks and challenges of providing anesthesia in the CCL and to provide a concise description of common cardiac procedures performed there. Recent findings Recent literature indicates that many complicate...
AbstractA 43 ‐year‐old gentleman was transferred for management of acute on chronic cardiogenic shock (left ventricular ejection fraction
ConclusionThe COVID ‐19 pandemic has impacted on the delivery of TAVI services to patients in Asia. This expert recommendation on best practices may be a useful guide to help TAVI teams during this period until a COVID‐19 vaccine becomes widely available.
ConclusionsIn case of accidental Impella dislodgement and fast deterioration of the patient's hemodynamic status, rapid pacing may be an option to “open” the aortic valve thus aiding quick replacement of Impella 5.0 through the aortic valve into the left ventricle under TEE guidance.
We present a case of right coronary artery dissection leading to type ‐A aortic dissection suffered during diagnostic coronary catheterization. This required emergency supracoronary replacement of the ascending aorta with an aortic interposition tube graft and venous grafts to coronary arteries.
AbstractAimsThe PREPARE ‐MVR study (PRediction of Early PostoperAtive Right vEntricular failure in Mitral Valve repair (MVR) and to explore the associations between/Repair patients) sought to investigate the alterations of right ventricular (RV) contraction pattern in patients undergoing mitral valve replacement/repair ( MVR) and to explore the associations between pre‐operative RV mechanics and early post‐operative RV dysfunction (RVD).Methods and resultsWe prospectively enrolled 42 patients (63 ± 11 years, 69% men) undergoing open‐heart MVR. Transthoracic three‐dimensional (3D) echocardio...
CONCLUSIONS: BAV is an effective treatment modality for AS in children of all age groups, which postpones the need for surgical treatment. Late follow-up reveals progression of AR. A greater reduction in PGmax is a risk factor for at least moderate AR directly post BAV, which results in the progression of AR at late follow-up and the need for performing heart surgery sooner. PMID: 32207700 [PubMed - as supplied by publisher]