Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2019
Review Case ReportsLate Clinical Presentation of Prosthesis-Patient Mismatch Following Transcatheter Aortic Valve Replacement.
Prosthesis-patient mismatch (PPM) is relatively common after aortic valve replacement (AVR) and generally is associated with reduced regression of left ventricular (LV) mass. PPM after valve-in-valve transcatheter aortic valve replacement (TAVR) was reported to be 38%. PPM generally is manifested clinically by dyspnea and echocardiographically by high transvalvular gradients. In this E-Challenge, the authors will review a case of a late clinical presentation of PPM 1-year following a valve-in-valve TAVR.
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J. Cardiothorac. Vasc. Anesth. · Jan 2019
Observational StudyThe Evolution of Echocardiographic Type and Anesthetic Technique for Transcatheter Aortic Valve Replacement at a High-Volume Transcatheter Aortic Valve Replacement Center.
Describe the change in intraoperative transcatheter aortic valve replacement (TAVR) care by examining the utilization of transesophageal echocardiography (TEE) versus transthoracic echocardiography (TTE) and general anesthesia (GA) versus conscious sedation (CS) over time. ⋯ Although TAVR initially was conducted exclusively under GA with TEE, nearly two-thirds of TAVR procedures now are performed using CS and TTE at the authors' institution. STS scores were significantly lower in patients having CS and TTE.
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J. Cardiothorac. Vasc. Anesth. · Jan 2019
Observational StudyThe Sum of Early Diastolic Annulus Velocities in the Mitral and Tricuspid Valve Can Predict Adverse Events After Cardiac Surgery.
To assess whether a tissue Doppler imaging (TDI)-based parameter consisting of the sum of early diastolic velocities of the mitral annulus (Me') and tricuspid annulus (Te') can serve as a predictor of adverse outcomes after cardiac surgery. ⋯ Compared with Me' and E/Me', which traditionally are used for assessing diastolic function, Me' plus Te' showed better prognostic ability for both short- and long-term outcomes of cardiac surgery.