Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2015
Changes in Left Ventricular Torsion Early Postoperatively after Aortic Valve Replacement and at Long-Term Follow-up.
In patients with aortic stenosis, left ventricular systolic torsion (pT) is increased to overcome excessive afterload. This study assessed left ventricular torsion before and immediately after surgical valve replacement and tested the instant effect of fluid loading. ⋯ pT decreased early after aortic valve replacement but remained elevated despite elimination of aortic stenosis. After 2.5 years, torsion had returned to preoperative levels.
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J. Cardiothorac. Vasc. Anesth. · Aug 2015
Can Intraoperative Transesophageal Echocardiography Predict Postoperative Aortic Insufficiency in Patients Receiving Implantable Left Ventricular Assist Devices?
Aortic insufficiency (AI) develops in 25% of patients after left ventricular assist device (LVAD) insertion. The objective of this study was to evaluate the occurrence of new-onset AI upon initiation of cardiopulmonary bypass (CPB) required for LVAD insertion and the potential ability of this new-onset AI to predict development of post-LVAD insertion AI. ⋯ One in 5 patients undergoing LVAD insertion will demonstrate an increase in AI severity at CPB initiation without changes in aortic root measurements. None of the information obtained from intraoperative TEE seemed to predict development of at least moderate postoperative AI.
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J. Cardiothorac. Vasc. Anesth. · Aug 2015
Observational StudyEffect of Preload Alterations on Left Ventricular Systolic Parameters Including Speckle-Tracking Echocardiography Radial Strain During General Anesthesia.
Frequently used parameters for evaluation of left ventricular systolic function are load-sensitive. However, the impact of preload alterations on speckle-tracking echocardiographic parameters during anesthesia has not been validated. Therefore, two-dimensional (2D) speckle-tracking echocardiography radial strain (RS) was assessed during general anesthesia, simulating 3 different preload conditions. ⋯ Alterations in preload did not result in clinically relevant changes of RS, FS, or FAC. Observed changes for RS were smallest; however, the variation of RS was larger than that of FS or FAC.