Facilitating transesophageal echocardiography probe placement by esophageal bougie in an anesthetized patient.

The reported adverse effects of perioperative transesophageal echocardiography (TEE) are mostly associated with the insertion and manipulation of the TEE probe. Recent data suggest that blind probe insertion may be associated with greater morbidity than reported previously. Although this morbidity appears to be subclinical with unknown effects on patient outcome, evaluation of strategies for insertion is warranted.

Robotic mammary artery harvest and anastomotic device allows minimally invasive mitral valve repair and coronary bypass.

We report the case of a 60-year-old man requiring combined mitral valve repair and coronary artery bypass grafting. A unique minimally invasive approach was used combining robotic internal mammary artery harvesting, partial lower sternotomy, and single vessel coronary artery bypass grafting using an automated distal coronary artery anastomotic device. Issues in approaching the commonly encountered patient with mitral valve disease and coronary artery disease using minimally invasive techniques are discussed.

Fentanyl or dexmedetomidine combined with desflurane for bariatric surgery.

Study Objective: Because fentanyl has ventilatory depressing effects, alternative methods for analgesia may be beneficial for management of bariatric surgery. We evaluated whether dexmedetomidine infusion could replace fentanyl for facilitation of open gastric bypass surgery.

Design: Randomized, single blinded, open label.