Systolic Anterior Motion of the Mitral Valve Post-Heart Transplant Secondary to an Unusual Mechanism.

In this case report, we discuss the critical interdependence of structure and function in demonstrating systolic anterior motion (SAM) of the mitral valve after repeat heart transplantation, where residual apical tissue of the explanted heart remained in place. The resulting conformational changes led to anterior displacement of the mitral valve and persistent SAM.

Perioperative Considerations in Alpha-Gal Syndrome: A Review.

Galactose-⍺-1, 3-galactose (alpha-gal) is an oligosaccharide found in mammalian tissues that causes allergic reactions in patients with alpha-gal syndrome (AGS). AGS is a hypersensitivity reaction notable for both immediate and delayed allergic and anaphylactic symptoms. As a tick-based disease, AGS has gained increasing prevalence across the United States and can have a significant influence on which medications are safe for patients.

Bedside Clinician's Guide to Pulmonary Artery Catheters.

Background: Pulmonary artery catheters provide important information about cardiac function, mixed venous oxygenation, and right-sided pressures and potentially provide temporary pacing ability.

Objective: To provide bedside clinicians with guidance for techniques to insert right heart monitors and devices, describe risk factors for difficult insertion and contraindications to placement, and provide updates on new technologies that may be encountered in the intensive care unit.

Methods: An extensive literature review was performed.

Heparin Insensitivity and Thrombotic Risk Associated With Sequential Uses of Prothrombin Complex Concentrate and Andexanet Alfa for Apixaban Reversal During Acute Type A Aortic Dissection Repair: A Case Report.

The management of patients on direct oral anticoagulants (DOACs) who require emergent cardiac surgery is slowly evolving. The introduction of andexanet alfa, a novel antidote for apixaban and rivaroxaban, added a specific reversal agent to our armamentarium, but its safety and efficacy are still being investigated. We report 2 patients on DOAC treatment who required emergency cardiac surgery.

Outcomes of heparinized adult veno-arterial extracorporeal membrane oxygenation patients managed with low and high activated partial thromboplastin time targets: A systematic review and meta-analysis.

Introduction: There are no randomized controlled trials comparing low and high activated partial thromboplastin time (aPTT) targets in heparinized adult veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) patients. Our systematic review and meta-analysis summarized complication rates in adult VA ECMO patients treated with low and high aPTT targets.

Methods: Studies published from January 2000 to May 2022 were identified using Pubmed, Embase, Cochrane Library, and LILACS (Latin American and Caribbean Health Sciences Literature).

Aortic Dissection.

Acute aortic dissection is a highly morbid condition with high mortality that requires emergent surgical evaluation and repair. The intraoperative management of acute aortic dissection requires the anesthesiologist to do far more than administer anesthesia and begins before the patient arrives at the operative theater. High-fidelity communication with the surgeon, knowledge of the surgical plan, knowledge of the anatomy of the dissection, and a nuanced understanding of aortic dissection pathophysiology are all critical aspects of anesthetic management.

The Era of Mass Casualty Events: Perspectives on Care Paradigms from a Critical Care Anesthesiologist.

The modern era has brought the concept of preparedness for mass casualties and disasters to the forefront of every health systems' concerns as one of their most urgent needs. Anesthesiologists, and the components of their departments, are vital to include in organizing and coordinating clinical and administrative services for an effective and comprehensive plan of action.

The Use of Point-of-Care Ultrasonography in Trauma Anesthesia.

Caring for the trauma patient requires an in-depth knowledge of the pathophysiology of trauma, the ability to rapidly diagnose and intervene to reverse the derangements caused by shock states, and an aptitude for the use of advanced monitoring techniques and perioperative point-of-care ultrasonography (P-POCUS) to assist in diagnosis and delivery of care. Historically, anesthesiology has lagged behind in wholly embracing this technology. P-POCUS has the potential to allow the trauma anesthesiologist to diagnose numerous injuries, quickly guide the placement of central vascular catheters and invasive monitors, and assess the efficacy of interventions.

Safety of percutaneous injection of bovine dermal crosslinked collagen for glottic insufficiency.

Objective: Our aim was to review the safety of percutaneous injection laryngoplasty using bovine crosslinked collagen, focusing specifically on two often-stated concerns: injecting patients who are taking the anticoagulant medication warfarin, and injecting patients without prior skin hypersensitivity testing.

Study Design And Setting: Retrospective chart review of injection laryngoplasty performed between 1997 and 2006 at the University of California, Los Angeles.

Results: The study group consisted of 895 patients who underwent 1290 injection laryngoplasty procedures.