60-something y/o male patient who isn’t physically active but does ADLs. Scheduled for CABG but has AI, PVD, EF 40%, HTN, HLD. Would you suggest an AVR or not…. along with the CABG?
What would you suggest?
Tag: hearts
Transcatheter Mitral Valve Replacement
Our hospital will be partaking in the Medtronic APOLLO study.
The data so far from other hospitals in an easy to read format.
Echo in mitral valve intervention. ESC 2012.
Transcatheter Mitral Valve Intervention, An Issue of Interventional Cardiology Clinics, E-Book.
Transcatheter Mitral Valve Repair. Summer 2014Volume 19, Issue 2, Pages 219–237.
Ventricular Assist Devices: Impella
“There’s an emergent case coming for impella placement.”
Impella? I’ve read about these devices and I’m familiar with managing patients on LVADs as well as providing anesthesia for LVAD placement. But, I’ve never done an Impella on a critically unstable patient.
YouTube video describing the purpose and placement of the Impella
Cath Lab Digest: Overview of Impella 5.0
YouTube video similar to our axillary artery conduit (we had to go left sided bc of a prior AICD in the patient’s right chest) for Impella 5.0
The basic CABG (coronary artery bypass graft) #cardiac #anesthesia #hearts
This article is quite a bit antiquated, but touches on some good basic points in cardiac anesthesia for CABG.
Teeny Tiny Hearts
Nov 21, 2010
Pediatric cardiac anesthesiologists are pretty much the Gods of anesthesia. What do I mean by this? Well, putting kids to sleep and finding IVs and managing their little airways can be tricky. Now, let’s take that and make it more complex by giving them funky heart anatomy and connections and we’ve got some real tricky anesthesia!
Picture tiny babies, 1-2kg (for the U.S.: 2-4lbs), with teeny tiny hearts…who only have a fightin’ chance in this world with corrective heart surgery. These tiny hearts are beating away…with some type of pathology that will kill them oftentimes before they reach adulthood.
Sick kids + general anesthesia = possible scary scenario. Throw in a really good pediatric cardiac anesthesiologist (and pedi heart surgeon)… and that could mean many more years of happy memories! I’m not sure how these amazing physicians sleep at night (high stress!), but they’re outstanding and certainly have earned my respect!
Some of the cases that I’ve come across: division of vascular ring; bidirectional Glenn; Fontan; Tetralogy of Fallot repair (extracardiac); hypoplastic aortic arch repair; PDA ligations; modified Blalock-Taussig shunts; AV canal repair; Aortic valve replacement; tricuspid valve repair; mitral valve repair; Repair of Coarctation.
Some of the pathology I’ve seen: Tetralogy of Fallot, hypoplastic left heart syndrome, coarctation, bicuspid aortic valve, mitral valve prolapse, tricuspid valve prolapse, heterotaxy, unbalanced AV canal, complete vascular ring, patients who were s/p Norwood-Sano, double outlet RV
All I can say is that rotating through pedi hearts for a month was an outstanding experience… one that all adult cardiac anesthesiologists should do.
Sleepy Time 