Preload Sensitivity in Cardiac Assist Devices
In this review, we stratify the preload sensitivity of 17 implantable cardiac assist devices relative to the native heart and discuss the effect of preload sensitivity on left ventricular volume unloading, levels of cardiac support, and the future development of continuous-flow total artificial heart technology.
Minimal-Access Aortic Valve Replacement with Concomitant Aortic Procedure: A 9-Year Experience
Minimal-access approaches through upper hemisternotomy is an established technique for aortic valve replacement (AVR) and aortic surgery in our institution. We assessed the outcome of undergoing AVR with concomitant aortic surgery through upper hemisternotomy.
Isolated Aortic Valve Replacement in Patients with Small Aortic Annulus-A High-Risk Group on Long-Term Follow-Up
Patients with small aortic annulus undergoing isolated aortic valve replacement face an often underestimated surgical risk. We describe initial clinical results and long-term follow-up of this particular high-risk group.
Prognostic Value of Cardiac Magnetic Resonance Imaging in Patients with Aortic Regurgitation
These results demonstrate a potential role for CMR for risk stratification of patients with asymptomatic moderate or severe AR, given the ability of CMR to accurately quantify AR and LV volumes. Based on the data presented, it is possible that we may be waiting too long to offer surgery in patients with severe AR.
Tirone David Valve-Sparing Aortic Root Replacement and Cusp Repair for Bicuspid Aortic Valve Disease
The durability of valve-sparing aortic root replacement with or without cusp repair in patients with bicuspid aortic valve (BAV) disease is questioned. We analyzed the results of 75 patients with a BAV undergoing Tirone David reimplantation valve-sparing aortic root replacement.
Clinical Outcome of Mechanical Circulatory Support for Refractory Cardiogenic Shock in the Current Era
Mortality for refractory cardiogenic shock (RCS) remains high. However, with improving mechanical circulatory support device (MCSD) technology, the treatment options for RCS patients are expanding. We report on a recent 5-year single-center experience with MCSD for treatment of RCS.
Conduits for Coronary Bypass: Internal Thoracic Artery
Thus widespread adaption of the ITA as the conduit of choice for the anterior descending required another decade and bilateral use is only now expanding to more than 5% of patients in the US and somewhat faster in other countries.
Successful Intraoperative Reversal of Heparin With Factor VII in a Patient With Protamine Reaction
We report the case of a patient who developed intractable bleeding after a severe protamine reaction following emergency repair of type A aortic dissection and was successfully treated with factor VII.
Alternative Access in Transcatheter Aortic Valve Implantation: Brachiocephalic Artery Access
The direct brachiocephalic access can be obtained with or without partial upper sternotomy, depending on the anatomy, which should be evaluated by preprocedural angiographic computed tomography scan.
Marfan Syndrome: Correct Diagnosis Can Save Lives
Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the body. However, the most serious complication in patients with Marfan syndrome is progressive enlargement of the aortic root, which may lead to aortic dissection, rupture, or aortic regurgitation.
Methylene Blue to Treat Vasoplegia Due to a Severe Protamine Reaction: A Case Report
A review of the pathophysiologic characteristics associated with vasoplegia and the pharmacodynamics of methylene blue will potentially enable anesthesia providers to utilize this lifesaving drug when needed.
Methylene Blue and Vasoplegia: Who, When, and How
Vasoplegia has been observed in all age groups and in various clinical settings, such as anaphylaxis (including protamine reaction), sepsis, hemorrhagic shock, hemodialysis, and cardiac surgery.