Anne Rother - Academia.edu (original) (raw)
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ISCTE - University Institute of Lisbon (ISCTE-IUL)
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Papers by Anne Rother
Anesthesia & Analgesia, Aug 1, 2000
Anesthesiologists are routinely required to evaluate cardiac valvular function by using transesop... more Anesthesiologists are routinely required to evaluate cardiac valvular function by using transesophageal echocardiography (TEE) after valve replacement or repair. In addition to assessing the surgically corrected valve, evaluation of adjacent cardiac structures by using TEE is necessary to exclude iatrogenic surgical complications. Complications of mitral valve (MV) surgery that may be diagnosed by using TEE include injury to the ventricular septum, left ventricular outflow tract, and aortic valve (AV) (1–4). We report a case of acute AV insufficiency diagnosed by using TEE after MV repair. A 46-yr-old man with severe mitral regurgitation presented for elective MV surgery. Intraoperative TEE of the MV before cardiopulmonary bypass (CPB) revealed myxomatous leaflet degeneration, annular dilation, and ruptured posterior leaflet chordae tendineae. The AV was structurally normal (Fig. 1A) and without evidence of insufficiency. MV repair was subsequently performed by quadrangular resection of the posterior leaflet, sliding valvuloplasty, and placement of a 36-mm Carpentier-Edwards Physio annuloplasty ring (Baxter Healthcare Corp., Irvine, CA). TEE examination of the MV after CPB demonstrated only trace mitral regurgitation. However, the post-CPB TEE examination of the AV revealed a nonmobile left coronary cusp (Fig. 1B) and moderate insufficiency (Fig. 2). Surgical exploration of the aortic root revealed that a MV annuloplasty ring suture had perforated and tethered the AV left coronary cusp. Despite release of the tethering suture, the damaged AV leaflet was surgically unrepairable, necessitating AV replacement. This case highlights the importance of thoroughly examining adjacent cardiac structures by TEE after valvular surgery so that iatrogenic surgical complications may be diagnosed in a timely fashion.
Best Practice & Research Clinical Anaesthesiology, 2001
Anesthesia & Analgesia, 2000
ndoluminal stenting, a recently introduced, less invasive approach to abdominal aortic aneurysm (... more ndoluminal stenting, a recently introduced, less invasive approach to abdominal aortic aneurysm (AAA) repair, is an attractive alternative to open repair in high-risk patients with severe coexisting medical disease (1). We report a case of endoluminal AAA repair complicated by accidental intracardiac guidewire placement and massive hemorrhage, which illustrates the potential for the occurrence of major procedure-specific complications. It also confirms the value of intraoperative transesophageal echocardiography (TEE) in the rapid evaluation of acute hypotension in a critically ill patient.
Anesthesia & Analgesia, 2000
Anesthesia & Analgesia, Aug 1, 2000
Anesthesiologists are routinely required to evaluate cardiac valvular function by using transesop... more Anesthesiologists are routinely required to evaluate cardiac valvular function by using transesophageal echocardiography (TEE) after valve replacement or repair. In addition to assessing the surgically corrected valve, evaluation of adjacent cardiac structures by using TEE is necessary to exclude iatrogenic surgical complications. Complications of mitral valve (MV) surgery that may be diagnosed by using TEE include injury to the ventricular septum, left ventricular outflow tract, and aortic valve (AV) (1–4). We report a case of acute AV insufficiency diagnosed by using TEE after MV repair. A 46-yr-old man with severe mitral regurgitation presented for elective MV surgery. Intraoperative TEE of the MV before cardiopulmonary bypass (CPB) revealed myxomatous leaflet degeneration, annular dilation, and ruptured posterior leaflet chordae tendineae. The AV was structurally normal (Fig. 1A) and without evidence of insufficiency. MV repair was subsequently performed by quadrangular resection of the posterior leaflet, sliding valvuloplasty, and placement of a 36-mm Carpentier-Edwards Physio annuloplasty ring (Baxter Healthcare Corp., Irvine, CA). TEE examination of the MV after CPB demonstrated only trace mitral regurgitation. However, the post-CPB TEE examination of the AV revealed a nonmobile left coronary cusp (Fig. 1B) and moderate insufficiency (Fig. 2). Surgical exploration of the aortic root revealed that a MV annuloplasty ring suture had perforated and tethered the AV left coronary cusp. Despite release of the tethering suture, the damaged AV leaflet was surgically unrepairable, necessitating AV replacement. This case highlights the importance of thoroughly examining adjacent cardiac structures by TEE after valvular surgery so that iatrogenic surgical complications may be diagnosed in a timely fashion.
Best Practice & Research Clinical Anaesthesiology, 2001
Anesthesia & Analgesia, 2000
ndoluminal stenting, a recently introduced, less invasive approach to abdominal aortic aneurysm (... more ndoluminal stenting, a recently introduced, less invasive approach to abdominal aortic aneurysm (AAA) repair, is an attractive alternative to open repair in high-risk patients with severe coexisting medical disease (1). We report a case of endoluminal AAA repair complicated by accidental intracardiac guidewire placement and massive hemorrhage, which illustrates the potential for the occurrence of major procedure-specific complications. It also confirms the value of intraoperative transesophageal echocardiography (TEE) in the rapid evaluation of acute hypotension in a critically ill patient.
Anesthesia & Analgesia, 2000