Análisis del Ventrículo derecho / Analysis of the right ventricle

Resumen El ventrículo derecho, históricamente, ha sido en gran medida olvidado e y la gran mayoría de las técnicas diagnósticas,los abordajes terapéuticos y las investigaciones clínicas están dirigidas al ventrículo izquierdo. Con una anatomía y fisiologíamuy diferente a su contraparte izquierda, el ventrículo derecho dispone de limitadas opciones terapéuticas cuando éste falla, lo cual empeora enormemente el pronóstico del paciente. La presente revisión pretende hacer un análisis de la anatomía, fisiología, fisiopatología, estudios de imagen y tratamiento de la falla ventricular derecha con el fin de retomar su importancia en la cardiología actual.

Abstract The right ventricle has been, historically, largely forgotten and the vast majority of diagnostic techniques, therapeutic approaches and clinical research are directed to the left ventricle. With a very different anatomy and physiology from its left counterpart, the right ventricle has limited therapeutic options when it fails, which greatly worsens the patient's prognosis. The present review intends to analyze the anatomy, physiology, physiopathology, imaging studies and treatment of right ventricular failure in order to resume its importance in current cardiology.

Intracardiac Foreign Body Formation from Bone Cement Material Following Total Hip Replacement: A Case Report

A linear intracardiac foreign body was identified following a total hip replacement (THR) on chest CT and transesophageal echocardiography in a 60-year-old woman with rheumatoid arthritis. Leakage and migration of bone cement during arthroplasty is a possible explanation for this rare complication. Therefore, adequate preparation and handling of cement using biplane fluoroscopy are recommended during arthroplasty.

Hemodynamic Evaluation of Atracurium or Cis-atracurium by Transesophageal Echocardiography under N2O-Enflurane Anesthesia / 대한마취과학회지

BACKGREOUND: Several studies have demonstrated that atracurium produced cardiovascular response by releasing histamine but cis-atracurium has no any singnificant cardiovascular effect. However, evaluation of hemodynamic response of atracurium or cis-atracurium by using TEE has not yet to be reported. Accordingly, we evaluated the effect of atracurium or cis-atracurium on the left ventricular function of surgical patients using TEE. METHODS: Twenty adult patients were studied. Patients were intubated with thiopental sodium (4mg/kg), fentanyl (100 microgram) and succinylcholine (1.5 mg/kg) and anesthesia was maintained with enflurane (0.8%) and nitrous oxide (50%) and oxygen (50%). The patients were randomly assigned to give the neuromuscular blocking equipotent (2 x ED95) doses of atracurium or cis-atracurium. The transesophageal echocardiographic probe was inserted properly to measure the end-diastolic diameter, end-systolic diameter, end-diastolic area and end-systolic area. The stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), fractional shortening (FS), and fractional area change (FAC) were calculated. Heart rate (HR) and mean arterial pressures (MAP) were recorded and all data were collected just before, and 1, 2, 3, 5 and 10 minutes after injection of atracurium (0.5 mg/kg) or cis-atracurium (0.1 mg/kg). RESULTS: The MAP, SVI, CI, EF, FS, and FAC did not show any statistically significant changes after the drug administration in either groups and did not show any statistically significant difference between the two groups when compared at same time points. HR at 5 and 10 minutes after injection of cis- atracurium is significantly decreased than the control. CONCLUSIONS: Two times of ED95 dose of atracurium or cis-atracurium had no significant effects on left ventricular function in healthy adult patients during the general anesthesia with N2O-enflurane.