Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2013
Clinical significance of the cross-sectional area of the internal jugular vein.
The aim of this study was to compare the cross-sectional area (CSA) of the right internal jugular vein (IJV) with that of the left IJV and to evaluate the anatomic location of the IJV in relation to the common carotid artery, utilizing computed tomography scans of the neck. ⋯ This study suggested one advantage of using the right IJV compared with the left for central venous cannulation. However, anatomic variations of the IJV, such as a small CSA and a medial or posterior position, are not associated with demographic data. Although right-handedness was well-correlated with a larger ipsilateral IJV, a possibility of a larger contralateral IJV should be considered. Therefore, central venous cannulation with ultrasonography is recommended to avoid complications and repeated needling.
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J. Cardiothorac. Vasc. Anesth. · Aug 2013
The use of TEE simulation in teaching basic echocardiography skills to senior anesthesiology residents.
The authors evaluated the educational benefits of using a first-generation HeartWorks simulator to teach senior anesthesiology residents basic echocardiography skills. ⋯ Virtual reality TEE simulation technology was endorsed strongly by residents, produced a statistically significant improvement in knowledge of normal echocardiographic anatomy, and could be effective for teaching basic echocardiography to anesthesiology residents.
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J. Cardiothorac. Vasc. Anesth. · Aug 2013
Is real time 3D transesophageal echocardiography a feasible approach to detect coronary ostium during transapical aortic valve implantation?
Transapical aortic valve implantation (TAVI) may lead to obstruction of coronary arteries during deployment. To prevent this, it is essential to determine the distance of the coronary ostium to the aortic annulus prior to valve placement. Multidetector computed tomography (MDCT) commonly is used to determine these measurements, but even marginal exposure to contrast agents can result in acute kidney injury in this high-risk group of multi-morbid patients. The aim of the study was to determine the feasibility of real-time 3D transesophageal echocardiography (RT 3D TEE) as the first-choice technique for noninvasive evaluation of the coronary ostium during TAVI. ⋯ The observations showed that RT 3D TEE reliably can measure the coronary ostium distance from the aortic annulus. It is feasible and an alternative method for evaluating these measurements and thereby preventing contrast exposure during MDCT, which may jeopardize the safety of patients with pre-existing renal disease.