RESUMO
This article is the eighth in an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr Kaplan, and the editorial board for the opportunity to continue this series. In most cases, these will be research articles targeted at the perioperative echocardiographic diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, the articles will target the use of perioperative echocardiography in general.
RESUMO
THIS SPECIAL article is part of an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the Editorial Board for the opportunity to continue this series, which focuses on the past year's research highlights that pertain to perioperative echocardiography in relation to cardiothoracic and vascular anesthesia. The major selected themes for 2022 include (1) updates on mitral valve assessments and interventions, (2) training and simulation updates, (3) outcomes and complications of transesophageal echocardiography, and (4) point-of-care cardiac ultrasound. The themes selected for this special article are just a sample of the advances in perioperative echocardiography during 2022. An appreciation and understanding of these highlights will help to ensure and improve the perioperative outcomes for patients with cardiovascular disease undergoing cardiac surgery.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Assistência Perioperatória , Humanos , Ecocardiografia , Ecocardiografia Transesofagiana , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Valva Mitral/diagnóstico por imagemRESUMO
Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients1-4. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness5-11, and existing wearable cardiac devices can only capture signals on the skin12-16. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.
Assuntos
Ecocardiografia , Desenho de Equipamento , Coração , Dispositivos Eletrônicos Vestíveis , Humanos , Débito Cardíaco , Ecocardiografia/instrumentação , Ecocardiografia/normas , Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Volume Sistólico , Dispositivos Eletrônicos Vestíveis/normas , PeleRESUMO
This article is the sixth of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series. In most cases, these were research articles that were targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; but, in some cases, these articles targeted the use of perioperative echocardiography in general.
Assuntos
Anestesia , Anestesiologia , Ecocardiografia , Ecocardiografia Transesofagiana , HumanosRESUMO
This article is the fifth of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank Editor-in-Chief Dr. Kaplan and the editorial board for the opportunity to continue this series. In most cases, these will be research articles that are targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, these articles will target the use of perioperative echocardiography in general.
Assuntos
Anestesia , Anestesiologia , Ecocardiografia , Ecocardiografia Transesofagiana , HumanosRESUMO
This article is the fourth of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board, for the opportunity to continue this series. In most cases, these were research articles that were targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, these articles targetted the use of perioperative echocardiography in general.
Assuntos
Anestesia , Anestesiologia , Insuficiência da Valva Tricúspide , Ecocardiografia , HumanosRESUMO
This article is the third of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series. In most cases, these will be research articles targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, these articles will target the use of perioperative echocardiography in general.
Assuntos
Ecocardiografia/métodos , Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Assistência Perioperatória/métodos , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Ecocardiografia/tendências , Implante de Prótese de Valva Cardíaca/tendências , Humanos , Insuficiência da Valva Mitral/cirurgia , Assistência Perioperatória/tendências , Resultado do Tratamento , Insuficiência da Valva Tricúspide/cirurgiaRESUMO
This article is the second of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to start this series. In most cases, these will be research articles that are targeted at the perioperative echocardiography diagnosis and treatment of patients after cardiothoracic surgery; however, in some cases, these articles will target the use of perioperative echocardiography in general.
Assuntos
Anestesiologistas , Doenças Cardiovasculares/diagnóstico por imagem , Ecocardiografia Transesofagiana/métodos , Assistência Perioperatória/métodos , Guias de Prática Clínica como Assunto , Sociedades Médicas , Anestesiologistas/tendências , Doenças Cardiovasculares/terapia , Ecocardiografia Transesofagiana/tendências , Humanos , Assistência Perioperatória/tendências , Sociedades Médicas/tendênciasAssuntos
Ventrículos do Coração/diagnóstico por imagem , Assistência Perioperatória/tendências , Disfunção Ventricular Direita/diagnóstico por imagem , Ecocardiografia Transesofagiana/tendências , Ventrículos do Coração/fisiopatologia , Humanos , Assistência Perioperatória/métodos , Volume Sistólico/fisiologia , Disfunção Ventricular Direita/fisiopatologiaRESUMO
Aortic rupture and transection are constituents of the acute aortic syndrome. Injury to the thoracic aorta during motor vehicle crashes is associated with blunt chest trauma and rapid deceleration mechanisms. Type A dissections and/or rupture of the aorta at the level of the aortic isthmus are the more common presentations of aortic injuries associated with motor vehicle crashes. We present the case of atypical echocardiographic findings of a nearly complete circumferential transection of the proximal ascending aorta injury after a motorcycle crash.
Assuntos
Aorta Torácica/diagnóstico por imagem , Aorta Torácica/lesões , Ruptura Aórtica/diagnóstico , Ecocardiografia Doppler em Cores/métodos , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Acidentes de Trânsito , Ruptura Aórtica/etiologia , Angiografia por Tomografia Computadorizada , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Torácicos/diagnóstico , Ferimentos não Penetrantes/diagnósticoRESUMO
OBJECTIVE: To evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. SETTING: One university hospital. PARTICIPANTS: One hundred ninety-five patients scheduled for transvenous lead extraction. INTERVENTIONS: A multidisciplinary approach to transvenous lead extraction involving cardiac surgery, electrophysiology, perfusion, and cardiac anesthesiology. MEASUREMENTS AND MAIN RESULTS: A case series of 351 lead extractions performed in 195 patients over a 42-month period. Indications, success rates, and complication rates were tracked and retrospectively evaluated and reported. Indications for lead extraction included 53.3% because of lead malfunction, 36.9% because of infection, with the remaining 9.7% from other categories such as venous stenosis. The lead extraction rate was 99.7%, with complete removal in 97.7%. The overall major complication rate was 3.08%. After an initial 1-year period of performing lead extractions, the overall major complication rate reduced to 1.23%. CONCLUSIONS: Transvenous lead extraction generally is a safe procedure, but not without complications. A multidisciplinary approach involving cardiac surgery, electrophysiology, and cardiac anesthesiology allows for successful management and the ability to rapidly manage major complications.
