Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function. We report a 45-year-old female patient with mild mitral and moderate-to-severe mitral regurgitation who presented to the Khoula Hospital, Muscat, Oman, in 2016 following a ruptured anterior communicating artery aneurysm requiring urgent surgical intervention. As highlighted in this case, the VolumeView EV1000™ (Edwards Lifesciences, Irvine, California, USA) system is a minimially invasive haemodynamic monitor that can help immensely in the perioperative management of such patients.
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http://dx.doi.org/10.18295/squmj.2017.17.03.015 | DOI Listing |
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China. Electronic address:
Objective: To comprehensively explore the prognostic significance of transthoracic echocardiography (TTE) and three-dimensional speckle-tracking echocardiography (3D STE) parameters in AIS and their role in distinguishing cardioembolic stroke.
Methods: 301 acute ischemic stroke (AIS) patients were enrolled. TTE and 3D STE were employed to evaluate cardiac function and structure, also left atrial strain.
Curr Opin Cardiol
December 2024
Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada.
Purpose Of Review: Management of tricuspid regurgitation and annular dilation during mitral valve repair remains controversial. We review the latest evidence on indications to repair the tricuspid valve during mitral valve repair and discuss surgical strategies and complications.
Recent Findings: Concomitant tricuspid valve repair of moderate tricuspid regurgitation is effective in reducing tricuspid regurgitation progression at 2 years, but has not shown benefit to late survival, quality of life, or functional benefit, and is associated with increased permanent pacemaker implantation (PPM) rates, which is associated with reduced late survival.
Eur Heart J Case Rep
January 2025
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-amamiya, Aoba Ward, Sendai, Miyagi 9810914, Japan.
Background: Transcatheter edge-to-edge mitral valve repair (M-TEER) using the MitraClip system is primarily performed using the transfemoral approach. However, when this approach is not feasible, the transjugular approach can be used as an alternative.
Case Summary: A 57-year-old man presented with heart failure and persistent New York Heart Association class IV symptoms, refractory to guideline-directed medical therapy, intravenous therapy, and intra-aortic balloon pumping.
Eur Heart J Case Rep
January 2025
HerzZentrum Hirslanden, 8032 Zurich, Switzerland.
Background: Mitral annular calcification (MAC) is characterized by severe calcification of mitral annulus and might be associated with both mitral regurgitation and stenosis. It is technically challenging for both surgical and percutaneous approach and is burdened by high mortality.
Case Summary: The present case report describes a complex case of mitral steno-insufficiency (baseline transvalvular gradient = 5 mmHg, effective regurgitant orifice area 0.
J Psychiatr Res
December 2024
Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Patients with schizophrenia have a high risk of cardiovascular death. Increased cardiac left ventricular (LV) mass has been reported to be associated with heart failure and cardiac mortality. However, few studies have used echocardiographic imaging to evaluate the associations between cardiac LV mass and the clinical characteristics of schizophrenia.
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