Right ventricular functional assessment by three-dimensional transesophageal echocardiography is useful for withdrawal from a right ventricular assist device: a case report.

Right ventricular assist device (RVAD) implantation is one type of surgical treatment used for right heart failure. It is important to assess right ventricular (RV) function precisely when RVAD withdrawal is considered. Although assessment of RV function is difficult due to its complicated shape and contraction pattern, the volumetric analysis method of three-dimensional (3D) transesophageal echocardiography (TEE) has been developed and is useful for this task.

Unexpected bioprosthetic mitral valve thrombus during left ventricular assist device implantation.

Acute bioprosthetic valve thrombosis can occur after surgery and sometimes cause hemodynamic instability and cardiogenic shock. Risk factors for bioprosthetic valve thrombosis are hypercoagulability, atrial fibrillation, atrial dilatation, low cardiac function, and lack of anticoagulation therapy. The authors present a case of severe mitral stenosis due to bioprosthetic valve thrombus.

Choice of desflurane or propofol for the maintenance of general anesthesia does not affect the risk of periprocedural myocardial damage in patients undergoing transfemoral transcatheter aortic valve implantation.

Purpose: This study aimed to reveal whether the occurrence of periprocedural myocardial damage (PMD) decreases in patients who received volatile anesthetics to maintain general anesthesia compared with those who received propofol during transcatheter aortic valve implantation (TAVI).

Methods: We included one hundred and forty adult patients who underwent transfemoral TAVI under general anesthesia from January 2015 to March 2017 in this single-center retrospective review. We compared the rate of patients who developed PMD between those who received desflurane (Group D, n = 72) and propofol (Group P, n = 68) for anesthetic maintenance.

Perioperative factors related to the severity of vocal cord paralysis after thoracic cardiovascular surgery: A retrospective review.

Background: Vocal cord paralysis (VCP) is a rare complication of thoracic cardiovascular surgery. In severe cases, life-threatening airway obstruction may occur.

Objective: To evaluate the incidence and severity of VCP among patients who underwent thoracic cardiovascular surgery and to identify possible risk factors.

[Massive Air Inflow into the Left Ventricle Detected by Transesophageal Echocardiography during Rastelli Coduit Re-replacement].

We present a case of massive air inflow into the left ventricle from the right ventricle through a small intraventricular shunt detected by transesophageal echocardiography (TEE). This case suggests that TEE plays an important role in the right ventricle-pulmo- nary artery conduit re-replacement.

[Comparison of Aortic Valve Replacement Combined with Coronary Artery Bypass Grafting and Transcatheter Aortic Valve Implantation Combined with Off-pump Coronary Artery Bypass Grafting].

Background: The purpose of this study was to compare the perioperative management of aortic valve replacement combined with coronary artery bypass grafting (AVR+CABG) and transcatheter aortic valve implantation combined with off-pump coronary artery bypass grafting (TAVI+OPCAB).

Methods: A retrospective analysis was performed on patients who had undergone either AVR+CABG or TAVI+OPCAB for AS and CAD in Osaka Univer- sity Medical Hospital from January to October, 2014.

Results: AVR+CABG was performed in 11 pa- tients (group A) and TAVI+OPCAB was performed in 4 patients (group T) in this period.

A longer total duration of rapid ventricular pacing does not increase the risk of postprocedural myocardial injury in patients who undergo transcatheter aortic valve implantation.

Rapid ventricular pacing (RVP) is used during transcatheter aortic valve implantation (TAVI). RVP disturbs myocardial oxygen balance, and when prolonged, it may cause procedure-related myocardial injury (PMI). This study investigated whether a longer duration of RVP increased the occurrence of PMI or worsened long-term mortality after TAVI.

[Anesthetic Management of Off-pump Coronary Artery Bypass Grafting in a Patient with Adrenal Pheochromocytoma].

A 64-year-old male patient with pheochromocytoma underwent an off-pump coronary artery bypass graft- ing. Determination of order of surgeries, preoperative medical management and intraoperative hemodynamic management are important in these cases. Al- though bolus administration of phenylephrine showed poor response, the surgery was uneventful and the patient remained hemodynamically stable throughout the procedure and perioperative period.

[Anesthetic Management for Removal of Right Atrial Tumor: 2 Case Reports].

Primary cardiac tumors are extremely rare. We experienced the management of anesthesia for removal of right atrial tumors in two cases. The removal of cardiac tumors is associated with various risks such as embolism, obstructive symptoms of organs and ar- rhythmia.

[Anesthetic Management for Heart-Lung Transplantation Report of 2 Cases from Japan].

Heart and lung transplantation (HLT) is the surgical procedure for congenital heart disease and cardiomy- opathy with pulmonary hypertension. HLT is rare in the world and has been performed only twice until October, 2014 at our hospital in Japan. We report the anesthetic management for HLT.

[The effects of the employment of physical therapists and occupational therapists on the gait function of adult day service users after 1 year].

Objective: The present study aimed to investigate the effects of the presence or absence of physical therapists (PTs) and occupational therapists (OTs) in an adult day service on the users' gait function, and to generalize the format of an effective service aimed at the preventing the exacerbation of the gait function and at promoting self-reliance in activities and participation.

Methods: The study population included 830 elderly day service users (mean age, 83.7±6.

Risk of Hematoma in Patients With a Bleeding Risk Undergoing Cardiovascular Surgery With a Paravertebral Catheter.

Objective: This study aimed to determine the risk of hematoma associated with thoracic paravertebral block (TPVB) in patients undergoing cardiovascular surgery.

Design: Retrospective analysis.

Setting: Single university hospital.

[Anesthesia for Transcatheter Aortic Valve Implantation and Off-pump Coronary Artery Bypass Grafting in a Patient with Total Occlusion of Right Common Carotid Artery].

Transcatheter aortic valve implantation (TAVI) is a novel treatment option for inoperative high-risk pa- tients with severe aortic stenosis (AS). However, there is a risk of cerebral ischemia by the two times of rapid ventricular pacing (RVP) procedure during valvulo- plasty and prosthesis implantation. An 86-year-old man was diagnosed with old myocardial infarction and severe AS, and was scheduled to undergo TAVI and off-pump coronary artery bypass grafting (OPCAB).

Pain Management With Bilateral Continuous Thoracic Paravertebral Block in a Patient With Fontan-Associated Hepatocellular Carcinoma Undergoing Hepatectomy.

Objective: We report a case of perioperative management of a single-ventricle patient with Fontan-associated liver disease undergoing hepatectomy.

Case Report: A 12-year-old boy with Fontan circulation was scheduled for partial hepatectomy to remove a liver mass in segment 6. He received stent implantation to relieve conduit stenosis 6 months before the operation.

[Anesthetic Management of a Patient with Quasi-moyamoya Disease Undergoing Total Thyroidectomy for Graves' Disease].

Quasi-moyamoya disease defined as moyamoya disease combined with autoimmune diseases such as Graves' disease is rare. We report anesthetic management of a patient with quasi-moyamoya disease undergoing total thyroidectomy for Graves' disease resistant to medical therapy. This disease is characterized by the aggravation of cerebral ischemic symptoms with hyperthyroidism.

Paravertebral block decreases opioid administration without causing hypotension during transapical transcatheter aortic valve implantation.

Paravertebral block (PVB) is feasible for postoperative analgesia in patients who undergo cardiac surgery with unilateral thoracotomy. Postoperative continuous PVB is as effective as thoracic epidural anesthesia and is less likely to cause hypotension. However, the intraoperative utility and safety of PVB remains unclear.

Intraoperative Right Ventricular Fractional Area Change Is a Good Indicator of Right Ventricular Contractility: A Retrospective Comparison Using Two- and Three-Dimensional Echocardiography.

Objective: Intraoperative two-dimensional echocardiography is technically challenging, given the unique geometry of the right ventricle (RV). It was hypothesized that the RV fractional area change (RVFAC) could be used as a simple method to evaluate RV function during surgery. Therefore, the correlation between the intraoperative RVFAC and the true right ventricular ejection fraction (RVEF), as measured using newly developed three-dimensional (3D) analysis software, was evaluated.

Anesthesia for aortic reconstruction in a child with PHACE syndrome.

PHACE syndrome is a neurocutaneous syndrome characterized by the association of large cutaneous hemangiomas and the cardiac and cerebral vascular anomalies. We report a 6-year-old female with PHACE syndrome presented with left facial hemangiomas, cystic lesion in the cerebral posterior fossa, coarctation of the aorta, aplasia of the left vertebral artery and stenosis of the left internal carotid artery. Surgical repair of the aorta with left heart bypass under beating heart was scheduled.

[Sugammadex reversal after extubation under muscle relaxation to prevent cough reflex in a patient with intractable spontaneous pneumothorax].

A 40-year-old man (168 cm tall and weighing 71 kg) with intractable pneumothorax was operated for resection of a bulla in the left lung. After insertion of epidural catheter via T 5-6 interspace, general anesthesia was induced and maintained with propofol, remifentanil and rocuronium. The duration of surgery was 1h 48 min and rocuronium given during surgery was 110 mg.

[Acute subdural hematoma secondary to cerebrospinal fluid drainage during thoracic endovascular aortic repair (TEVAR): A case report].

We report a case of acute subdural hematoma which occurred following cerebrospinal fluid (CSF) drainage during thoracic endovascular aortic repair (TEVAR) surgery. A 63-year-old woman was scheduled to receive TEVAR for thoracic-abdominal aneurysm extending from the descending aorta (T10) to 15 mm above the celiac trunk. Before the TEVAR operation, a lumbar cerebrospinal drain was inserted at L4-5.