scholarly journals Transoesophageal echocardiography: What a neuroanaesthesiologist should know?

2015 ◽  
Vol 02 (01) ◽  
pp. 003-014 ◽  
Author(s):  
Minati Choudhury
Keyword(s):  
Surgical Procedures ◽  
Imaging Modality ◽  
Air Embolism ◽  
Transoesophageal Echocardiography ◽  
Haemodynamic Instability ◽  
Anaesthetic Care ◽  
New Information ◽  
Neurosurgical Patients ◽  
Echocardiographic Examination ◽  
And Function

AbstractTransoesophageal echocardiography (TEE) is a semi invasive imaging modality rapidly gained credence and popularity in the cardiothoracic centers worldwide by mid 1990s. It has also been found to be useful in some noncardiac surgical procedures, in particular in the management of neurosurgical patients and haemodynamically unstable patients in intensive care units (ICUs). The principal goal of basic transoesophageal echocardiographic examination encompass a broad range of anatomic imaging including the diagnosis of air embolism, causes of haemodynamic instability, ventricular size and function, volume status, and complications from invasive procedures, as well as the clinical impact or etiology of pulmonary dysfunction in ICU. TEE is relatively cheap and semi-invasive, but it should not be used as a stand-alone device but as a tool which provides data in addition to the data acquired from other forms of monitoring. The establishment of TEE in perioperative neuro anaesthetic care though recent, may result in a significant change in the role of the anaesthetsiologist who, using TEE can provide new information which may change the course and the outcome of surgical procedures.

Right ventricular dilatation and function

2016 ◽  
Author(s):  
Petros Nihoyannopoulos ◽  
Gustavo Restrepo Molina ◽  
André La Gerche
Keyword(s):  
Right Ventricular ◽  
Quantitative Methods ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Qualitative Assessment ◽  
Thin Wall ◽  
Echocardiographic Examination ◽  
Three Dimensional Echocardiography ◽  
The Right ◽  
And Function

Assessing the right ventricle by any imaging modality is a challenge because of the thin wall and crescent shape that wraps around the left ventricle. Structured echocardiographic examination using two-dimensional imaging provides a detailed regional and global qualitative assessment for routine evaluation. Quantitation is possible using one or more methods including tricuspid annulus plane systolic excursion, fractional area change, and myocardial performance index but speckle tracking deformation imaging and three-dimensional echocardiography are emerging as more robust quantitative methods. Right ventricular pressures should also be estimated routinely as long as a clear tricuspid regurgitant jet is identified.

Right ventricular morphology and function undergo complex changes after cardiac surgery

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Wejner-Mik ◽  
J.D Kasprzak ◽  
E Szymczyk ◽  
K Wdowiak-Okrojek ◽  
A Ammer ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Right Ventricular ◽  
Artery Bypass ◽  
Public Institution ◽  
Transverse Diameter ◽  
Funding Source ◽  
Longitudinal Function ◽  
Echocardiographic Examination ◽  
And Function ◽  
Rv Function

Abstract Background An impairment of certain echocardiographic parameters of right ventricular (RV) function, such as tricuspid annular peak systolic excursion (TAPSE), is a known phenomenon in patients undergoing cardiac surgery. However, little is known about significance of these alterations with regard to other aspects of RV function. The aim of our study was to clarify this issue using parameters based on 3D echocardiography and speckle tracking technique. Methods The study population comprised 122 patients (92 men, mean age 65±11 years), referred for coronary artery bypass grafting and/or replacement of mitral or aortic valve. Patients undergoing tricuspid annuloplasty and with baseline suboptimal image quality were excluded from the study group. Transthoracic echocardiographic examination was performed on average 2±2 days prior to surgery (TTE1), and 7±4 days after surgery (TTE2), whereas follow-up TTE (TTE3) was performed on average 12±2months after the surgery. Parameters measured during these examinations included both standard and advanced indices of RV size and function (such as TAPSE, systolic velocity of tricuspid annulus (S'), fractional area change (FAC), RV ejection fraction (EF) and RV global longitudinal systolic strain (GLS), as well as a new parameter introduced by our team - RV shortening fraction (RV SF), calculated as the change in mid RV transverse diameter. Results Echocardiographic measurements were completed for TTE1, TTE2 and TTE3 in 95% of patients. We noticed a significant postoperative (TTE2) impairment of parameters of RV longitudinal function (TAPSE, S' and GLS; p<0,0001). However, neither RV size assessed by both 2D and 3D technique changed, nor the global RV function measured with the use of FAC and EF. Additionally during the postoperative period an increase in the value of a RV SF by 12.85% was observed. After 12 months (TTE3) we observed an improvement in the parameters of the longitudinal RV function. Conclusion Cardiac surgery results in an impairment of the longitudinal systolic RV function, with no influence on the global RV function. The preservation of global function results from increased RV SF. After 12 months, an improvement of the longitudinal function can be observed. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Grant Polish Cardiac Society

scholarly journals Evolutionary Conservation of Reactions in Translation

2002 ◽  
Vol 66 (3) ◽  
pp. 460-485 ◽  
Author(s):  
M. Clelia Ganoza ◽  
Michael C. Kiel ◽  
Hiroyuki Aoki
Keyword(s):  
Molecular Mechanisms ◽  
Tertiary Structure ◽  
Evolutionary Conservation ◽  
Initiation Factor ◽  
Structural Studies ◽  
X Ray Diffraction ◽  
X Ray ◽  
Common Features ◽  
New Information ◽  
And Function

SUMMARY Current X-ray diffraction and cryoelectron microscopic data of ribosomes of eubacteria have shed considerable light on the molecular mechanisms of translation. Structural studies of the protein factors that activate ribosomes also point to many common features in the primary sequence and tertiary structure of these proteins. The reconstitution of the complex apparatus of translation has also revealed new information important to the mechanisms. Surprisingly, the latter approach has uncovered a number of proteins whose sequence and/or structure and function are conserved in all cells, indicating that the mechanisms are indeed conserved. The possible mechanisms of a new initiation factor and two elongation factors are discussed in this context.

scholarly journals Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

2021 ◽  
Vol 9 (B) ◽  
pp. 417-425
Author(s):  
Ted Trajcheski ◽  
Lulzim Brovina ◽  
Biljana Zafirova ◽  
Lada Trajceska
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Heart Valves ◽  
Heart Diseases ◽  
Imaging Modality ◽  
Gadolinium Contrast ◽  
Myocardial Perfusion Study ◽  
Imaging Tool ◽  
Gadolinium Contrast Agent ◽  
And Function

BACKGROUND: Cardiac magnetic resonance (CMR) as advanced diagnostic tool for the heart has been introduced in our institution since September 2019. AIM: We report on the first fifty consecutive patients using this imaging modality. METHODS AND MATERIALS: Strict protocol for CMR procedure, imaging quality assessment, contraindications, and informed consent were established. Patients selected for CMR were enrolled in a prospective registry. Visualizing the heart chambers, heart muscle and heart valves, resulted in acquiring complex imaging of the heart structure and function. When applicable, patients received gadolinium contrast agent for Late Gadolinium Enhancement (LGE). Adenosine was used for stress induced myocardial perfusion study. In this study, we report on the initial CMR procedures in the first 15 months. RESULTS: The age of the patients ranges from 17 to 82 and the number of male and female patients was well balanced. No absolute contraindications were met in any patient. Relative contraindications were noted but did not prevent from performing the scan. Different cardiac pathologies were encountered in the examined patients. Most common was the ischemic heart disease – 19 (38%). We had 15 (30%) out of 46 (92%) CMR procedures with LGE showing fibrotic scaring. Quality image assessment was scaled from poor to excellent. Most of the assessments were graded very good and good (46% and 48%), no poor, and very poor noted. CONCLUSION: CMR has been successfully introduced in Kosovo as excellent imaging tool for diagnosing and characterizing a nearly exhaustive spectrum of heart diseases.

scholarly journals Rescue transoesophageal echocardiography for refractory haemodynamic instability during transvenous lead extraction

2014 ◽  
Vol 15 (8) ◽  
pp. 926-932 ◽  
Author(s):  
J. N. Hilberath ◽  
P. S. Burrage ◽  
S. K. Shernan ◽  
D. J. Varelmann ◽  
K. Wilusz ◽  
...  
Keyword(s):  
Transoesophageal Echocardiography ◽  
Lead Extraction ◽  
Haemodynamic Instability

Salvage Procedures

2018 ◽  
pp. 307-322
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Surgical Technique ◽  
Surgical Procedures ◽  
Glenohumeral Joint ◽  
Resection Arthroplasty ◽  
Successful Management ◽  
The Many ◽  
And Function ◽  
Surgical Option

The many surgical procedures summarized in previous chapters allow successful management of most shoulder conditions and result in improved pain, motion, and function. However, salvage procedures that sacrifice the glenohumeral joint or the scapulothoracic joint represent the best surgical option for a few patients. These salvage procedures are uncommon, but shoulder surgeons need to be familiar with their indications, surgical technique, and reported outcomes. This chapter addresses glenohumeral arthrodesis, scapulothoracic arthrodesis, and glenohumeral resection arthroplasty.

Aortic regurgitation

2015 ◽  
pp. 141-147
Author(s):  
Raphael Rosenhek
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Cardiac Computed Tomography ◽  
Transoesophageal Echocardiography ◽  
Left Ventricular ◽  
Disease Aetiology ◽  
Echocardiographic Parameters ◽  
And Function

The workup of patients with aortic regurgitation is routinely based on echocardiography and includes a detailed morphologic assessment of the aortic valve with the determination of disease aetiology. The quantification of aortic regurgitation is based on an integration of qualitative and quantitative parameters. Haemodynamic consequences of aortic valve disease on left ventricular size, hypertrophy, and function, as well as potentially coexisting valve lesions, are assessed. Predictors of outcome and indications for surgery are substantially defined by echocardiographic parameters. Cardiac magnetic resonance has become an important complementary technique, both for the quantification of regurgitant severity and for the assessment of ventricular function. While the proximal parts of the ascending aorta are routinely visualized by transthoracic echocardiography, transoesophageal echocardiography (TOE) and in particular cardiac magnetic resonance (CMR) and cardiac computed tomography (CT) allow a more comprehensive assessment of the thoracic aorta.

Transoesophageal: Chambers and vessels

2020 ◽  
pp. 493-542
Keyword(s):  
Left Atrial ◽  
Thoracic Aortic Aneurysm ◽  
Pulmonary Veins ◽  
Transoesophageal Echocardiography ◽  
Pleural Space ◽  
Intramural Haematoma ◽  
Left And Right ◽  
Aortic Transection ◽  
And Function ◽  
Right Atria

This chapter covers the chambers and vessels in transoesophageal echocardiography. It includes the left and right ventricles (size, mass, and function); the left and right atria, including the left atrial appendage; the pulmonary veins; the coronary sinus; the interatrial and interventricular septa; the pericardium and pericardial effusion; cardiac tamponade; the aorta (size, atherosclerosis, and dissection); intramural haematoma; aortic transection; thoracic aortic aneurysm; masses; pleural space and lungs; and implanted devices.

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