Anesthetic management of a patient with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation: Early postinterventional period and anesthetic considerations

2001 ◽  
Vol 15 (3) ◽  
pp. 362-363
Author(s):  
Takashi Kita ◽  
Ken Nakata ◽  
Tadanori Mammoto ◽  
Yoshihiko Kishi
HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Aliki Tympa ◽  
Kassiani Theodoraki ◽  
Athanassia Tsaroucha ◽  
Nikolaos Arkadopoulos ◽  
Ioannis Vassiliou ◽  
...  

Background. Hazards of liver surgery have been attenuated by the evolution in methods of hepatic vascular control and the anesthetic management. In this paper, the anesthetic considerations during hepatic vascular occlusion techniques were reviewed. Methods. A Medline literature search using the terms “anesthetic,” “anesthesia,” “liver,” “hepatectomy,” “inflow,” “outflow occlusion,” “Pringle,” “hemodynamic,” “air embolism,” “blood loss,” “transfusion,” “ischemia-reperfusion,” “preconditioning,” was performed. Results. Task-orientated anesthetic management, according to the performed method of hepatic vascular occlusion, ameliorates the surgical outcome and improves the morbidity and mortality rates, following liver surgery. Conclusions. Hepatic vascular occlusion techniques share common anesthetic considerations in terms of preoperative assessment, monitoring, induction, and maintenance of anesthesia. On the other hand, the hemodynamic management, the prevention of vascular air embolism, blood transfusion, and liver injury are plausible when the anesthetic plan is scheduled according to the method of hepatic vascular occlusion performed.


1998 ◽  
Vol 31 (2) ◽  
pp. 252-258 ◽  
Author(s):  
Hubert Seggewiss ◽  
Ulrich Gleichmann ◽  
Lothar Faber ◽  
Dieter Fassbender ◽  
Henning K Schmidt ◽  
...  

2018 ◽  
Vol 22 (4) ◽  
pp. 383-394 ◽  
Author(s):  
Benjamin Kloesel ◽  
Martina Richtsfeld ◽  
Mojca Konia ◽  
John L. Bass

The term “coronary artery anomalies” encompasses a large and heterogeneous group of disorders that may affect origin, intrinsic anatomy, course, location, and termination of the coronary arteries. With these different anatomies, presentation, symptoms, and outcomes are heterogeneous as well. While significant efforts are directed toward improving diagnosis and risk-stratification, best evidence-guided practices remain in evolution. Data about anesthetic management of patients with coronary anomalies are lacking as well. This review aims to provide the anesthesiologist with a better understanding of an important subgroup of coronary artery anomalies: anomalous aortic origin of a coronary artery. We will discuss classification, pathophysiology, incidence, evaluation, management, and anesthetic implications of this potentially fatal disease group.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Dai ◽  
N Iguchi ◽  
I Takamisawa ◽  
M Takayama ◽  
M Nanasato ◽  
...  

Abstract Background Functional follow-up modalities of hypertrophic obstructive cardiomyopathy (HOCM) subjected to percutaneous transluminal septal myocardial ablation (PTSMA) are limited mainly to echocardiography and catheterization. Recent advancements in four-dimensional (4D) flow magnetic resonance imaging (MRI) have enabled us to assess patients from the perspective of fluid dynamics by visualising blood flow and calculating quantitative parameters such as wall shear stress and energy loss within cardiac chambers or blood vessels. Several reports have demonstrated that the intra-cardiac energy loss decreased along with improvement of cardiac function achieved by treatment of cardiac diseases. Whether changes in energy loss occur along with PTSMA in HOCM patients and the underlying mechanism remain unknown. Purpose This study sought to investigate the influence of PTSMA in patients with HOCM on energy loss in the left ventricle (LV) and aortic root measured by 4D flow MRI. Methods We retrospectively recruited HOCM patients who underwent PTSMA at a referral centre from May to November 2019. Patients who underwent 4D flow MRI both before and after PTSMA were included. We collected demographic and clinical data from electronic health records. MRI scans implemented two-dimensional phase-contrast imaging of the three-chamber plane with three-directional velocity, using a 1.5 T scanner. Furthermore, 4D blood flow analysis was performed on off-line saved data, using iTFlow version 1.9. We assessed energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root (area surrounded by the LV endocardium, sinotubular junction, and mitral annulus). Results This study finally included 12 patients, whose mean age was 66±12 years, and 5 (42%) of whom were men. The pressure gradient between the LV apex and ascending aorta was 81±32 mmHg before and 20±22 mmHg immediately after PTSMA (P<0.005, paired). Before PTSMA, 6 patients were in New York Heart Association functional class III and the other 6 in class II. However, after PTSMA, 10 patients improved to class I and 2 to class II. PTSMA reduced energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root, from 79±36 mJ/m to 55±19 mJ/m (P=0.001, paired). Conclusions PTSMA in patients with HOCM reduced energy loss within the LV and aortic root, indicating significant decrease with cardiac workload. Four-dimensional flow MRI of the three-chamber plane to assess energy loss within the LV and aortic root is a time-efficient and reproducible quantitative method to evaluate the effects of PTSMA. Given its non-invasive nature, it also enables to sequentially follow-up HOCM patients who underwent PTSMA. Periprocedural changes of energy loss Funding Acknowledgement Type of funding source: None


2019 ◽  
Vol 35 (5) ◽  
pp. 647-654
Author(s):  
Yoichi Imori ◽  
Hitoshi Takano ◽  
Mitsunobu Kitamura ◽  
Rie Aoyama ◽  
Hideto Sangen ◽  
...  

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