Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perioperative transoesophageal echocardiography (TOE) was introduced from cardiology into cardiac anaesthesia in the 1980s. Initially TOE was used mainly as a monitor of left ventricular ischaemia, but now provides real-time dynamic information about the anatomy and physiology of the whole heart. TOE is of value in the management of patients undergoing procedures including cardiac valvular repair, surgery for endocarditis, surgery of the thoracic aorta, and may contribute useful information in a wide range of cardiac pathology. It is also useful in guiding therapy in haemodynamically unstable patients in the operating room and the intensive care unit. TOE is relatively cheap and non-invasive, but it should not be used as a stand alone device but as a tool which provides data in addition to the data acquired from other forms of monitoring. The use of TOE carries not only the benefits of a rapid and effective investigation, but also risks associated with the procedure itself and the burden of providing training and experience for practitioners. The establishment of TOE in perioperative cardiac anaesthetic care has resulted in a significant change in the role of the anaesthetist who, using TOE, can provide new information which may change the course and the outcome of surgical procedures.
 ...
PMID:Transoesophageal echocardiography (TOE) in the operating room. 1674 Jun 5

Techniques used to measure circulating hormone concentrations in avian species over extended periods routinely involve cannulation or multiple venipunctures under physical restraint, resulting in sepsis and stress. We adapted a method for serial blood sampling in chickens using a vascular access port (VAP) surgically implanted under the skin of the neck and connected to a catheter inserted in the right jugular vein. The system was used to measure circulating luteinizing hormone (LH) profiles in six, 21-mo-old broiler breeders at the end of their laying period. The VAP were implanted under general anesthesia, and, after a period of recovery, serial blood samples (every 10 min for 6 h) were collected using an extension line connected to a push-pull system. Birds were unrestrained and had free access to food and water. Red blood cells were recovered by centrifugation, reconstituted in saline solution, and returned to the donor bird through the VAP once every 90 min. Luteinizing hormone levels were subsequently measured in plasma by radioimmunoassay. With the exception of 1 hen that developed valvular endocarditis, no sign of disease or infection was observed throughout the study, and the VAP remained functional in all birds for at least 3 mo. Thus, our results suggest that VAP are a safe, reliable, and less stressful technique for serial blood sampling and long-term studies. Radioimmunoassay results revealed that in old birds, circulating LH levels followed a pulsatile pattern, with pulse amplitudes ranging from 1.35 to 2.02 ng/mL and pulse frequencies ranging from 5 to 6 peaks per 6 h. Although not significant, amplitude of LH pulses in out-of-lay hens appeared to be lower than in laying hens.
 ...
PMID:Use of a vascular access port for the measurement of pulsatile luteinizing hormone in old broiler breeders. 1697 50

Doxorubicin administered to rats induces a dose-dependent cardiomyopathy. Both doxorubicin administration and the presence of indwelling catheters have been associated with thrombus formation. We sought to determine feasibility of drug delivery and degree of thrombogenesis related to long-term indwelling catheter use in a cardiotoxicity model. Rats receiving doxorubicin or saline via jugular catheters coated with end-point immobilized heparin were compared to rats receiving similar treatments via direct jugular intravenous injection (venotomy). Onset of cardiotoxicity, defined by reduction in fractional shortening to 45% or less, was determined by echocardiography. Thrombogenesis was assessed by observation of atrial thrombi and pulmonary emboli as determined by post-mortem and histologic examination. Significantly more of the doxorubicin-treated and catheterized group (87.5%) developed cardiotoxicity relative to the doxorubicin-treated-venotomized group (28.6%), as indicated by an earlier and more precipitous decline in fractional shortening in the doxorubicin-treated-catheterized rats. Despite this change, rats from catheterized groups demonstrated improved weight maintenance relative to venotomy groups. Although the number of pulmonary emboli did not differ significantly between groups, 50% of the doxorubicin-treated-catheterized animals developed vegetative endocarditis. Despite alteration of the model-induced cardiac disease, we submit that the more reliable and early induction of the desired endpoint, in addition to improved weight maintenance, represent model refinements. The ease of drug delivery with minimal restraint and no anesthesia is an additional and important benefit. The development of vegetative endocarditis represents an opportunity to study the formation and prevention of this condition.
 ...
PMID:Validation of the use of long-term indwelling jugular catheters in a rat model of cardiotoxicity. 1699 48

Pregnancy results in dramatic changes in the cardiovascular system. Maternal heart disease complicates 0.2%-3% of pregnancies. Valvular heart disease in women of reproductive age is most commonly due to rheumatic heart disease, endocarditis, or congenital abnormalities. In general, regurgitant lesions are well tolerated during pregnancy because the increased plasma volume and lowered systemic vascular resistance result in increased cardiac output. In contrast, stenotic valvular disease is poorly tolerated with advancing pregnancy, owing to the inability to increase cardiac output in relation to the increased plasma volume preload. The choice of anesthesia depends on the lesion and its severity. Usually, regional anesthesia provides the least amount of alteration in hemodynamics, although general anesthesia for cesarean section can be equally safe when the abrupt changes associated with laryngoscopy, intubation, and extubation are blunted by the appropriate choice of pharmacological agents and anesthetic techniques.
 ...
PMID:Anesthesia for pregnant women with valvular heart disease: the state-of-the-art. 1745 55

An 82-year-old man with symptomatic bradycardia had infective endocarditis with tricuspid vegetation. The patient also had severe obstructive pulmonary disease, and endotracheal general anesthesia was contraindicated. Under satisfactory epidural anesthesia with catheterization at the T5/6 level, lower partial sternotomy was performed, and dual pacing electrodes were placed on the heart. Throughout the surgery, spontaneous breathing was maintained with a sufficient level of oxygenation. The postoperative course was uneventful. Although awake cardiac surgery under thoracic epidural anesthesia is challenging, this less invasive technique was useful for epicardial pacemaker implantation in this patient with severe pulmonary dysfunction.
 ...
PMID:Awake partial sternotomy pacemaker implantation under thoracic epidural anesthesia. 1977 90

Left ventricular noncompaction (LVNC), also known as spongiform cardiomyopathy, is a severe disease that has not previously been discussed with respect to general anesthesia. We treated a child with LVNC who experienced cardiac arrest. Dental treatment under general anesthesia was scheduled because the patient had a risk of endocarditis due to dental caries along with a history of being uncooperative for dental care. During sevoflurane induction, severe hypotension and laryngospasm resulted in cardiac arrest. Basic life support (cardiopulmonary resuscitation) was initiated to resuscitate the child, and his cardiorespiratory condition improved. Thereafter, an opioid-based anesthetic was performed, and recovery was smooth. In LVNC, opioid-based anesthesia is suggested to avoid the significant cardiac suppression seen with a volatile anesthetic, once intravenous access is established. Additionally, all operating room staff should master Advanced Cardiac Life Support/Pediatric Advanced Life Support (including intraosseous access), and more than 1 anesthesiologist should be present to induce general anesthesia, if possible, for this high-risk patient.
 ...
PMID:Transient cardiac arrest in patient with left ventricular noncompaction (spongiform cardiomyopathy). 2141 Mar 61

We report a 27 years old male who presented with a combination of both congenital and acquired cardiac defects. This syndrome complex includes congenital bicuspid aortic valve, Seller's grade II aortic regurgitation, juxta- subclavian coarctation, stenosis of ostium of left subclavian artery and ruptured sinus of Valsalva aneurysm without any evidence of infective endocarditis. This type of constellation is extremely rare. Neither coarctation of aorta with left subclavian artery stenosis nor the rupture of sinus Valsalva had a favorable pathology for percutaneus intervention. Taking account into morbidity associated with repeated surgery and anesthesia patient underwent a single stage surgical repair of both the defects by two surgical incisions. The approaches include median sternotomy for rupture of sinus of Valsalva and lateral thoracotomy for coarctation with left subclavian artery stenosis. The surgery was uneventful. After three months follow up echocardiography showed mild residual gradient across the repaired coarctation segment, mild aortic regurgitation and no residual left to right shunt. This patient is under follow up. This is an extremely rare case of single stage successful repair of coarctation and rupture of sinus of Valsalva associated with congenital bicuspid aortic valve.
 ...
PMID:A tetrad of bicuspid aortic valve association: A single-stage repair. 2262 35

A 54-year-old man with infective tricuspid endocarditis and an infective right coronary artery aneurysm was scheduled for simultaneous coronary artery aneurysmectomy and tricuspid valvulectomy. However, the tricuspid valve replacement and annuloplasty procedures could not be performed because vegetation was noted on all his tricuspid leaflets. Moreover, the infective right coronary artery aneurysm was located proximal to the annulus of the tricuspid valve. Complications of tricuspid valvulectomy include tricuspid regurgitation, right ventricular capacity load and right ventricular pressure load. In the present case, after the patient was weaned from cardiopulmonary bypass (CPB), transesophageal echocardiography (TEE) revealed severe tricuspid regurgitation and shifting of the interventricular septum toward the left ventricle at the telediastolic stage. We managed this condition on the basis of the TEE findings with fluid therapy and a nitroglycerin vasoactive agonist, and adjusted the ventilator setting to reduce pulmonary vascular resistance. In the present case of infective tricuspid endocarditis with infective right coronary artery aneurysm, the selection of the appropriate surgical method was important. Moreover, respiratory management which did not increase pulmonary vascular resistance and adequate fluid management based on TEE findings after weaning from CPB were equally important during anesthesia for tricuspid valvulectomy.
 ...
PMID:[Anesthesia management during coronary artery aneurysmectomy and tricuspid valvulectomy]. 2323 38

Maternal cardiac disease complicates approximately 1-2% of all pregnancies in the United States. Just as during the antepartum period, in the immediate period surrounding delivery, obstetrical patients with cardiac disease (both congenital and acquired) will have specialized needs, tailored to the patient and her specific lesion. While the basic principles of labor and delivery management protocols are relevant to this subgroup of patients, there are certain areas in which adjustments must be made. These include endocarditis prophylaxis, recent anticoagulation, fluid management, and the need for increased maternal cardiac monitoring. Awareness of the challenges of the intrapartum period combined with a multi-disciplinary approach from anesthesia, cardiology, and the obstetrical provider will optimize the patient for a safe delivery.
...
PMID:Intrapartum obstetric management. 2503 14

The anesthetic management of a patient with severe left ventricular (LV) dysfunction undergoing noncardiac surgery poses a challenge to the anesthesiologist as LV dysfunction is commonly complicated by progressive congestive heart failure and malignant arrhythmias. When the cause for LV dysfunction is postvalve replacement, additional complications such as intraoperative thrombosis, bleeding, and infective endocarditis need to be addressed perioperatively. In such situations, the anesthesiologist must have the knowledge hemodynamics, diagnostic evaluations, and treatment modalities, more so regarding various drugs used during anesthesia. We report a case of postmitral valve replaced patient with severe LV dysfunction posted for surgery of fracture of the femur and facial fractures managed successfully during anesthesia.
...
PMID:Perioperative management of poly-trauma in a postmitral valve replacement patient with severe left ventricular systolic dysfunction. 2588 34


<< Previous 1 2 3 4 5 6 Next >>