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Assessment of the left ventricular outflow tract during cardiac anaesthesia with biplane transoesophageal echocardiography: An observational study
BACKGROUND Assessment of left ventricular outflow tract (LVOT) area is a key component of quantification of aortic stenosis and stroke volume. Current international guidelines recommend measurement of the LVOT diameter with two-dimensional (2D) echocardiography and assume a circle. This may lead to erroneous measures of aortic valve area and adversely affect peri-operative decision making. Multiplane orthogonal (biplane) and three-dimensional (3D) echocardiography imaging may allow more accurate calculation of LVOT, aortic valve area and stroke volume. OBJECTIVE To evaluate the shape and area of the LVOT with co...
Source: European Journal of Anaesthesiology - November 19, 2021 Category: Anesthesiology Tags: Haemodynamics Source Type: research

A Case of Successful Treatment of Cerebral Embolism Using Endovascular Thrombectomy Immediately After Transcatheter Aortic Valve Implantation
TRANSCATHETER aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement in high-risk patients with severe aortic stenosis. However, there are increasing concerns about the potential complications of TAVI now that its indications have been expanded to include patients with low-to-intermediate surgical risk.1,2 One of the serious complications of TAVI is stroke. It is known that there is an increase in 30-day mortality, rates of respiratory insufficiency and postprocedural delirium, and duration of hospital stay if stroke occurs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 17, 2019 Category: Anesthesiology Authors: Shunichi Murakami, Kazuyoshi Ishida, Hideyuki Ishihara, Takayuki Okamura, Tetsuro Oda, Ryo Suzuki, Atsuo Yamashita, Satoshi Yamashita, Hiroshi Kurazumi, Michiyasu Suzuki, Mishiya Matsumoto Tags: Case Report Source Type: research

Left Atrial Thrombus Formation in a Patient With Severe Non-rheumatic Mitral Stenosis After Mitral Valve Repair Receiving Dual Antiplatelet Therapy: A Clinical Challenge
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 10, 2019 Category: Anesthesiology Authors: Michael Essandoh, Amir Elhassan, Thomas J. Papadimos, Brandon Pruett, Gregory D. Rushing Tags: Diagnostic Dilemma Source Type: research

Goal-directed therapy during transthoracic oesophageal resection does not improve outcome: Randomised controlled trial
BACKGROUND Goal-directed therapy (GDT) is expected to be of highest benefit in high-risk surgery. Therefore, GDT is recommended during oesophageal resection, which carries a high risk of postoperative complications. OBJECTIVES The aim of this study was to confirm the hypothesis that GDT during oesophageal resection improves outcome compared with standard care. DESIGN A randomised controlled study. SETTING Two Swedish university hospitals, between October 2011 and October 2015. PATIENTS Sixty-four patients scheduled for elective transthoracic oesophageal resection were randomised. Exclusion criteria included c...
Source: European Journal of Anaesthesiology - January 9, 2019 Category: Anesthesiology Tags: Monitoring Source Type: research

Efficacy and Efficiency of Perioperative Stellate Ganglion Blocks in Cardiac Surgery: A Pilot Study
Nationally, postoperative atrial fibrillation (POAF) occurs in up to 40% of patients after coronary artery bypass grafting (CABG), 50% of patients after valve surgery, 64% of patients after mitral valve and CABG, and 49% after aortic valve replacement.1 Atrial fibrillation worsens a patient ’s hemodynamic status and increases the risk of congestive heart failure, embolic events, and longer intensive care unit stays, leading to increased patient morbidity and strain on financial resources. In the United States, POAF carries a higher risk of stroke, worsened survival, and an additional 4.9 days and $10,000 to $11,500 in hospital stay costs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 20, 2017 Category: Anesthesiology Authors: Christopher W. Connors, Wendy Y. Craig, Scott A. Buchanan, Justin M. Poltak, James B. Gagnon, Craig S. Curry Tags: Letter to the Editor Source Type: research

Double-Barrel Proximal Thoracic Aorta or Horrific Complication of Endocarditis?
A 76-YEAR-OLD man with hypertension, hyperlipidemia, and a recent embolic stroke was admitted to the authors’ institution for evaluation of progressive dyspnea. The patient’s past medical history was notable for an aortic valve replacement with a mechanical prosthesis. He did well for approximately 30 years after surgery before he presented to a community hospital with a non-ST segment elevation myocardial infarction that was treated with metoprolol and a bare metal stent (first obtuse marginal branch of the left circumflex coronary artery).
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 8, 2014 Category: Anesthesiology Authors: Andrew R. Schroeder, Joseph E. Strosin, Izabela Jugovac, Zahir A. Rashid, Paul S. Pagel Tags: Diagnostic DilemmasSection Editor? > Source Type: research

Basic Data From 176 Studies on the Immediate Outcome After Aortic Valve Replacement With or Without Coronary Artery Bypass Surgery
Objective: The aim of this study was to summarize the immediate outcome after aortic valve replacement (AVR) with or without coronary artery bypass grafting (CABG).Design: Systematic review and meta-analysis.Setting: University hospitals.Participants: Participants were 683,286 patients who underwent AVR with or without CABG. Patients undergoing other major cardiac procedures were excluded from this analysis.Interventions: AVR with or without CABG.Measurements and Main Results: Operative mortality after AVR with or without concomitant CABG was 4.3%, stroke 2.1%, pacemaker implantation 5.9%, and dialysis 2.2%. After isolated...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 2, 2013 Category: Anesthesiology Authors: Fausto Biancari, Marta Martin, Giulia Bordin, Elia Vettore, Giulia Vinco, Vesa Anttila, Juhani Airaksinen, Francesco Vasques Tags: Original Articles Source Type: research