A multiparameter algorithm to guide repair of degenerative mitral regurgitation.

Purpose: Degenerative mitral regurgitation repair using a measured algorithm could increase the precision and reproducibility of repair outcomes.

Methods: Direct and echocardiographic measurements guide the repair to achieve a coaptation length of 5 to 10 mm and minimize the risk of systolic anterior motion. Leaflet reconstruction restored the normal 2 to 1 ratio of anterior to posterior leaflet length without residual prolapse or restriction.

Anesthetic Considerations in Transplant Recipients for Nontransplant Surgery.

As solid organ transplantation increases and patient survival improves, it will become more common for these patients to present for nontransplant surgery. Recipients may present with medical problems unique to the transplant, and important considerations are necessary to keep the transplanted organ functioning. A comprehensive preoperative examination with specific focus on graft functioning is required, and the anesthesiologist needs pay close attention to considerations of immunosuppressive regimens, blood product administration, and the risk benefits of invasive monitoring in these immunosuppressed patients.

United States practice patterns in the use of transesophageal echocardiography during adult liver transplantation.

Objective: To characterize contemporary practice patterns in the use of transesophageal echocardiography during adult liver transplantation and to identify factors preventing more frequent use.

Design: Online questionnaire.

Setting: Liver transplantation centers in the United States performing 12 or more adult liver transplants in 2011.

The successful use of low-dose recombinant tissue plasminogen activator for treatment of intracardiac/pulmonary thrombosis during liver transplantation.

Intracardiac thrombosis and pulmonary embolism are uncommon complications during liver transplantation but carry a high mortality rate. We report the successful use of low-dose recombinant tissue plasminogen activator (0.5-4 mg) administration in 4 patients.