The role of echocardiography in the management of structural valve degeneration of transcatheter valves.

Transcatheter valve implantation in patients with aortic stenosis has evolved as an acceptable alternative to surgical aortic valve replacement in a subset of patients at excessively high risk from surgery. The structural valve degeneration (SVD) is a known phenomenon in catheter-based valves too, which was hitherto seen with surgical bioprosthetic valves. Echocardiography plays a pivotal role not only in early detection but also in the management of SVD of Transcatheter valves.

Superior Mesenteric Artery Thrombosis for Emergency Laparotomy in Covid-19 Patient: A Case Report.

The novel coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. The most common symptoms include fever, cough, and shortness of breath (predominantly involving pulmonary function). However, there are lesser-known presentations that affect other systems too.

Intraoperative 2D and 3D transesophageal echocardiographic assessment of cor triatriatum with ostium secundum atrial septal defect in an adult patient.

Cor triatriatum is a rare congenital cardiac anomaly. Majority of the cases present in the childhood with an incidence of 0.4%.

Watch out for left atrial roof thrombus.

Rheumatic mitral stenosis is often associated with thrombus formation in the left atrium (LA), especially in patients with atrial fibrillation. Although thrombus can occur anywhere within the LA, the most common site is the left atrial appendage. Therefore, it is important to carefully screen the entire LA during perioperative transesophageal echocardiography to exclude thrombus.

Prophylactic preoperative levosimendan for off-pump coronary artery bypass grafting in patients with left ventricular dysfunction: Single-centered randomized prospective study.

Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients.

Aim And Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery.

Materials And Methods: After Institutional Ethics Committee approval, 60 patients posted for elective OPCAB surgery were randomly divided into two groups (n = 30 each).

Pulmonary hypertension and cardiac anesthesia: Anesthesiologist's perspective.

Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis.

Conscious sedation using dexmedetomidine for percutaneous transcatheter closure of atrial septal defects: A single center experience.

Objective: The aim of this study is to determine safety and feasibility of conscious sedation using dexmedetomidine for transcatheter atrial septal defect (ASD) device closure.

Material And Methods: A retrospective institutional review of transcatheter ASD device closure without endotracheal intubation over 18 months. The protocol included topical oropharyngeal anesthesia using lignocaine followed by dexmedetomidine bolus 1 μg/kg intravenously over 10 min and maintenance dose 0.

Cardioversion: What to choose? Etomidate or propofol.

Context: Electrical cardioversion is a short painful procedure to regain normal sinus rhythm requiring anaesthesia for haemodynamic stability, sedation, analgesia and early recovery.

Aims: To compare propofol and etomidate as sedatives during cardioversion.

Settings And Design: Single centred, prospective and randomized single blind study comprising 60 patients.

A simple quality assurance test tool for the visual verification of light and radiation field congruent using electronic portal images device and computed radiography.

Background: The radiation field on most megavoltage radiation therapy units are shown by a light field projected through the collimator by a light source mounted inside the collimator. The light field is traditionally used for patient alignment. Hence it is imperative that the light field is congruent with the radiation field.