Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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   2016| October  | Volume 19 | Issue 5  
    Online since October 19, 2016

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Left ventricular global systolic function assessment by echocardiography
Suresh Chengode
October 2016, 19(5):26-34
DOI:10.4103/0971-9784.192617  PMID:27762246
The left ventricle, with its thickened myocardial walls, unlike the right ventricle has no measurable geometric shape. It has a conical apex and its function quantification, needs intensive, 2D, 3D and M mode transesophageal echocardiography, which is described in this review.
  6,601 556 -
Echo for diastology
Candice Morrissey
October 2016, 19(5):12-18
DOI:10.4103/0971-9784.192585  PMID:27762243
Diastolic dysfunction ranging from impaired relaxation of the left ventricle to heart failure with preserved ejection fraction (HFpEF) is a common finding in the cardiac surgery population. It is important for the peri-operative echocardiographer to have a developed understanding of the pathophysiology of diastolic dysfunction and the echocardiographic features that determine where on the spectrum of diastolic function and dysfunction a patient lies
  4,980 374 -
An update on transesophageal echocardiography views 2016: 2D versus 3D tee views
Poonam Malhotra Kapoor, Kanchi Muralidhar, Navin C Nanda, Yatin Mehta, Naman Shastry, Kalpana Irpachi, Aditya Baloria
October 2016, 19(5):56-72
DOI:10.4103/0971-9784.192624  PMID:27762249
In 1980, Transesophageal Echocardiography (TEE) first technology has introduced the standard of practice for most cardiac operating rooms to facilitate surgical decision making. Transoesophageal echocardiography as a diagnostic tool is now an integral part of intraoperative monitoring practice of cardiac anaesthesiology. Practice guidelines for perioperative transesophageal echocardiography are systematically developed recommendations that assist in the management of surgical patients, were developed by Indian Association of Cardiac Anaesthesiologists (IACTA). This update relates to the former IACTA practice guidelines published in 2013 and the ASE/EACTA guidelines of 2015. The current authors believe that the basic echocardiographer should be familiar with the technical skills for acquiring 28 cross sectional imaging planes. These 28 cross sections would provide also the format for digital acquisition and storage of a comprehensive TEE examination and adds 5 more additional views, introduced for different clinical scenarios in recent times. A comparison of 2D TEE views versus 3D TEE views is attempted for the first time in literature, in this manuscript. Since, cardiac anaesthesia variability exists in the precise anatomic orientation between the heart and the oesophagus in individual patients, an attempt has been made to provide specific criteria based on identifiable anatomic landmarks to improve the reproducibility and consistency of image acquisition for each of the standard cross sections.
  4,190 499 -
Transesophageal echocardiography evaluation of the thoracic aorta
TA Patil, Arno Nierich
October 2016, 19(5):44-55
DOI:10.4103/0971-9784.192623  PMID:27762248
Transesophageal echocardiography (TEE) can be used to identify risk factors such as aortic atherosclerosis [2] before any sort of surgical manipulations involving aorta and its related structures. TEE has become an important noninvasive tool to diagnose acute thoracic aortic pathologies. TEE evaluation of endoleaks helps early detection and immediate corrective interventions. TEE is an invaluable imaging modality in the management of aortic pathology. TEE has to a large extent improved the patient outcomes.
  4,079 364 -
Three-dimensional transesophageal echocardiography: Principles and clinical applications
Annette Vegas
October 2016, 19(5):35-43
DOI:10.4103/0971-9784.192622  PMID:27762247
A basic understanding of evolving 3D technology enables the echocardiographer to master the new skills necessary to acquire, manipulate, and interpret 3D datasets. Single button activation of specific 3D imaging modes for both TEE and transthoracic echocardiography (TTE) matrix array probes include (a) live, (b) zoom, (c) full volume (FV), and (d) color Doppler FV. Evaluation of regional LV wall motion by RT 3D TEE is based on a change in LV chamber subvolume over time from altered segmental myocardial contractility. Unlike standard 2D TEE, there is no direct measurement of myocardial thickening or displacement of individual segments.
  2,558 327 -
Transesophageal echocardiography evaluation of tricuspid and pulmonic valves
Aneeta Bhatia
October 2016, 19(5):21-25
DOI:10.4103/0971-9784.192616  PMID:27762245
The tricuspid is the lost valve and the pulmonary being the most anterior, is not visualized well on TEE; The Pulmonary valve is a semilunar valve that separates the right ventricle from the pulmonary artery. It is situated anterior and superior to the aortic valve, almost at right angle to the aortic valve and parallel to the beam of the ultrasound.
  2,106 269 -
Guidelines of the Indian Association of Cardiovascular and Thoracic Anaesthesiologists and Indian College of Cardiac Anaesthesia for perioperative transesophageal echocardiography fellowship examination
Kanchi Muralidhar, Deepak Tempe, Yatin Mehta, Poonam Malhotra Kapoor, Chirojit Mukherjee, Thomas Koshy, Prabhat Tewari, Naman Shastri, Satyajeet Misra, Kumar Belani
October 2016, 19(5):73-78
DOI:10.4103/0971-9784.192626  PMID:27762250
During current medical care, perioperative transesophageal echocardiography (TEE) has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient's outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE. The provision of "Fellowship" is by way of conducting IACTA - TEE fellowship (F-TEE) examination. This has been done annually for the past 7 years using well-established curriculums by accredited national and international societies. Now, with the transformation and reconstitution of IACTA education and research cell into the newly formed Indian College of Cardiac Anaesthesia, F-TEE is bound to meet international standards. To ensure that the examinations are conducted in a transparent and foolproof manner, the guideline committee (formulated in 2010) of IACTA has taken the onus of formulating the guidelines for the same. These guidelines have been formally reviewed and updated since 2010 and are detailed here to serve as a guide to both the examinee and examiner ensuring standardization, efficiency, and competency of the IACTA F-TEE certification process.
  2,016 331 -
Utility of perioperative transesophageal echocardiography
K Muralidhar
October 2016, 19(5):2-5
DOI:10.4103/0971-9784.192573  PMID:27762241
  1,346 230 -
The utility of live video capture to enhance debriefing following transcatheter aortic valve replacement
David P Seamans, Boshra F Louka, F David Fortuin, Bhavesh M Patel, John P Sweeney, Louis A Lanza, Patrick A DeValeria, Kim M Ezrre, Harish Ramakrishna
October 2016, 19(5):6-11
DOI:10.4103/0971-9784.192576  PMID:27762242
Background: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm. Aims: We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing. Setting and Design: B-Line Medical's LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system. Results and Conclusions: An illustrative case is presented that resulted in long-term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.
  1,419 92 -
Perioperative management of left ventricular assist devices
OP Sanjay
October 2016, 19(5):19-20
DOI:10.4103/0971-9784.192604  PMID:27762244
The use of mechanical circulatory support for patients with severe heart failure is on the rist. The poeoperative, intraoperative and postoperative challenges the anaesthesiologists skills. These are discussed in this review.
  1,214 287 -
"TEE or not to TEE?"
Mukul Kapoor
October 2016, 19(5):1-1
DOI:10.4103/0971-9784.192571  PMID:27762240
  1,136 122 -