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Access Statistics 2015 | July-December | Issue 2

 

Review Article
Bahareh Khatibi, Nav Parkash Sandhu

Real-time Ultrasound-guided Axillary Vein Cannulation

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:42-47]


ABSTRACT

The axillary vein has been shown to be a safe and effective cannulation site for patients requiring central venous access. Compared to subclavian vein cannulation, axillary vein cannulation may reduce the rate of pneumothorax and hemothorax. Long-term complications, including the rate of infection or deep vein thrombosis, are comparable to internal jugular vein cannulation. The use of ultrasound for cannulation at traditional central vein sites, such as the internal jugular and femoral veins has been shown to aid in successful cannulation and potentially reduce complications. For axillary vein cannulation, however, when ultrasound is used only for localization of the axillary vein precannulation, it has not been shown to improve successful cannulation or decrease the rate of arterial puncture.
Real-time ultrasound-guided axillary vein cannulation has been described and may increase the rate of successful cannulation and decrease complications. Various techniques of real-time ultrasound-guided axillary vein cannulation have been studied over the past decade. They differ in various characteristics including technique for needle imaging (in-plane vs out-of-plane) and upper extremity positioning (neutral vs abducted). The in-plane technique, which images the axillary vein in longitudinal view and allows the needle to be visualized at all times, has been found to result in greater first-attempt success and easier overall placement than the transverse view technique. As for upper extremity positioning, 90° abduction may result a decreased risk of catheter misplacement after proximal axillary vein cannulation.
Ultrasound-guided axillary vein cannulation has many emerging uses, including use in oncology, cardiology, and nephrology.

Keywords: Axillary vein, Central venous access, Ultrasound.

How to cite this article: Khatibi B, Sandhu NP. Real-time Ultrasound-guided Axillary Vein Cannulation. J Perioper Echocardiogr 2015;3(2):42-47.

Source of support: Nil

Conflict of interest: None

1264

Case Report
Alok Kumar, V Rajkumar, Ajay Kumar, GD Puri

Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:58-61]


ABSTRACT

Systolic anterior motion (SAM) of the mitral leaflets can lead to hemodynamic instability in post bypass period. Perioperative transesophageal echocardiography (TEE) plays a crucial role in the management of SAM. Perioperative echocardiography helps to (a) identify cause of left ventricular outflow tract obstruction, (b) assess SAM and diagnose severity and (c) management of SAM. A case is presented illustrating identification and management of SAM in post bypass period.

Keywords: LVOT obstruction, Perioperative TEE, SAM.

How to cite this article: Kumar A, Rajkumar V, Kumar A, Puri GD. Role of Perioperative TEE in Diagnosing and Management of a Case of Dynamic LVOT Obstruction/SAM. J Perioper Echocardiogr 2015;3(2):58-61.

Source of support: Nil

Conflict of interest: None

643

Case Report
Pankaj Kumar, Suruchi Hasija, Usha Kiran

Unidirectional Valved Patch Closure of Ventricular Septal Defect with Eisenmenger Physiology

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:62-65]


ABSTRACT

Pulmonary hypertension in left-to-right shunt lesions, such as ventricular septal defect (VSD), patent ductus arteriosus, atrial septal defect (ASD) and atrioventricular canal defect is termed hyperkinetic pulmonary hypertension. Hyperkinetic pulmonary hypertension is usually reversible if the cause is treated before development of permanent changes in pulmonary arterioles. A unidirectional flap valve (UVP) VSD patch closure is a good alternative in children with large VSD with Eisenmenger physiology. The technique of unidirectional valved patch VSD closure obviates the need for extracorporeal membrane oxygenation and nitric oxide ventilation in patients who are at risk of pulmonary hypertensive crises postoperatively.

Keywords: Eisenmenger physiology, Pulmonary hypertension, Unidirectional valved patch, Ventricular septal defect.

How to cite this article: Kumar P, Hasija S, Kiran U. Unidirectional Valved Patch Closure of Ventricular Septal Defect with Eisenmenger Physiology. J Perioper Echocardiogr 2015;3(2):62-65.

Source of support: Nil

Conflict of interest: None

634

Case Report
Shrinivas Gadhinglajkar, Rupa Sreedhar, Pravin Lovhale, Thomas Mathew, Neeraj Tapdia

Iatrogenic Narrowing of Inferior Vena Cava after Atrial Septal Defect Closure: The Role of Intraoperative Echocardiography

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:48-51]


ABSTRACT

Single-patch closure of a superior sinus venosus atrial septal defect (SVASD) may be complicated with narrowing of inferior vena cava (IVC). If the pressure gradient across the narrowed portion of superior vena cava (SVC) exceeds 6 mm Hg, widening of SVC lumen is considered. No such guidelines are available in literature for narrowing of inferior vena cava in cardiac surgical patients. We describe an incident of inferior narrowing of inferior vena cava in a 10-year-old girl, who was operated for closure of an inferior type of ostium secundum ASD (OSASD). There was hepatic venous dilatation accompanied with gradient of 3 mm Hg at the junction of inferior vena cava and right atrium (RA). The cardiopulmonary bypass was reestablished and the surgical closure of the septal defect was revised to rectify the problem.

Keywords: Atrial septal defect, Inferior vena cava, Transesophageal echocardiography.

How to cite this article: Gadhinglajkar S, Sreedhar R, Lovhale P, Mathew T, Tapdia N. Iatrogenic Narrowing of Inferior Vena Cava after Atrial Septal Defect Closure: The Role of Intraoperative Echocardiography. J Perioper Echocardiogr 2015;3(2):48-51.

Source of support: Nil

Conflict of interest: None

628

Case Report
S Subash, Divya Gopal, Ashwini Thimmarayappa

Incidental Detection of Persistent Left Superior Vena Cava during Transvenous Pacing

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:52-54]


ABSTRACT

Patients with persistent left superior vena cava (PLSVC) are usually asymptomatic, but due to its anatomical defects, difficulties in establishing central venous access, pacemaker implantation and cardiothoracic surgery are common. We report a case of 65 years old patient who presented with complete heart block in cardiac critical care and, after emergency transvenous pacing, the chest X-ray showed unusual course of the transvenous pacing lead, which on further transthoracic echocardiographic (TTE) evaluation demonstrated dilated coronary sinus with PLSVC.

Keywords: Dilated coronary sinus, Persistent left superior vena cava, Transvenous pacing.

How to cite this article: Subash S, Gopal D, Thimmarayappa A. Incidental Detection of Persistent Left Superior Vena Cava during Transvenous Pacing. J Perioper Echocardiogr 2015; 3(2):52-54.

Source of support: Nil

Conflict of interest: None

487

Editorial
Rupa Sreedhar

Editorial

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:39-41]


ABSTRACT

Indications for transesophageal echocardiography (TEE) in patients with congenital heart disease (CHD) include.

484

Case Report
Sambhunath Das, Suruchi Ladha, Balram Airan

Role of Intraoperative Transesophageal Echocardiography in Evaluation of Fontan Conduit for Thrombosis

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:55-57]


ABSTRACT

The formation of thrombus after Fontan operation is a lifethreatening situation. The clinical manifestations by the patient may not reflect the true diagnosis of thrombosis. Transesophageal echocardiographic evaluation is an option to delineate the vena cava anastomosis and the Fontan conduit in different views. We used transesophageal echocardiography (TEE) to detect the thrombus site prior to surgery and guided for a successful removal of thrombus. The successful surgical revision of the anastomosis was confirmed by TEE.

Keywords: Fontan operation, Single ventricle, Thrombosis, Transesophageal echocardiography.

How to cite this article: Das S, Ladha S, Airan B. Role of Intraoperative Transesophageal Echocardiography in Evaluation of Fontan Conduit for Thrombosis. J Perioper Echocardiogr 2015;3(2):55-57.

Source of support: Nil

Conflict of interest: None

403

Photo Assay
Brett Cronin, Euqene Golts, Victor Pretorius

Unique Regurgitant Jet in a Patient with Takayasu Arteritis

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:28] [Pages No:66-67]


ABSTRACT

A 37-year-old female with a history of Takayasu arteritis was admitted for repair of a descending thoracic aortic aneurysm with penetrating ulcer and left ventricular outflow track (LVOT) pseudoaneurysm. A unique regurgitant jet was subsequently identified by transesophageal echocardiography after induction of anesthesia and endotracheal intubation.

Keywords: Left ventricular outflow track pseudoaneurysm, LVOT, Takayasu arteritis, TEE, Transesophageal echocardiography.

How to cite this article: Cronin B, Golts E, Pretorius V. Unique Regurgitant Jet in a Patient with Takayasu Arteritis. J Perioper Echocardiogr 2015;3(2):66-67.

Source of support: Nil

Conflict of interest: None

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