Subject(s)
Aortic Valve Stenosis , Aortic Valve , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/instrumentation , Aortic Valve Stenosis/surgery , Aortic Valve/surgery , Aortic Valve/diagnostic imaging , Heart Valve ProsthesisSubject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Aortic Valve/surgery , Risk , Aortic Valve Stenosis/surgery , Aortic Valve Stenosis/etiology , Transcatheter Aortic Valve Replacement/adverse effects , Heart Valve Prosthesis Implantation/adverse effects , Risk Factors , Treatment Outcome , Risk AssessmentSubject(s)
Calcinosis , Heart Defects, Congenital , Heart Valve Diseases , Heart Valve Prosthesis Implantation , Mitral Valve Insufficiency , Humans , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Heart Valve Diseases/complications , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/surgery , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/surgery , Calcinosis/complications , Calcinosis/diagnostic imaging , Calcinosis/surgery , Treatment OutcomeSubject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis Implantation , Pulmonary Disease, Chronic Obstructive , Transcatheter Aortic Valve Replacement , Humans , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/surgery , Aortic Valve Stenosis/complications , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Treatment Outcome , Retrospective StudiesSubject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Anesthesiologists , Echocardiography, Transesophageal , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Treatment Outcome , Prosthesis DesignSubject(s)
Aortic Valve Stenosis , Bicuspid Aortic Valve Disease , Heart Valve Diseases , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Constriction, Pathologic , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Heart Valve Diseases/surgery , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Treatment OutcomeSubject(s)
Cardiac Surgical Procedures , Nerve Block , Humans , Paraspinal Muscles , Pain, PostoperativeABSTRACT
Significant mitral regurgitation (MR) is the most common valvular disease in the United States in patients older than 75. However, many patients with severe MR are at a high risk for surgical repair due to other significant comorbidities. Over the past decade, many transcatheter mitral valve devices have been studied that address the different mechanisms of MR, but only a few have received a Conformité Européene (CE) mark or United States Food and Drug Administration (FDA) approval. The Carillon, Cardioband, and Mitralign all received CE marking for percutaneous mitral annuloplasty, while the Tendyne and SAPIEN 3 received a CE mark and FDA approval, respectively, for transcatheter mitral valve replacement. Finally, the NeoChord DS 1000 received a CE mark for transcatheter chordal repair. Each of these devices is reviewed in detail, including device indications, performance in clinical trials, anesthetic management, intraprocedural imaging guidance, and postprocedural complications. Although percutaneous devices will appear and disappear from use, understanding the procedural considerations remains highly relevant, as these key principles will apply to the next generation of transcatheter valve interventions.
Subject(s)
Heart Valve Prosthesis Implantation , Mitral Valve Annuloplasty , Mitral Valve Insufficiency , Cardiac Catheterization/methods , Heart Valve Prosthesis Implantation/methods , Humans , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Mitral Valve Annuloplasty/methods , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/surgery , Treatment OutcomeABSTRACT
Transesophageal echocardiography (TEE) use has become widespread in cardiac surgical operating rooms over the last 2 decades. Surgical and medical decision-making often are guided by the findings of the TEE examination, rendering TEE an invaluable tool both inside and outside the operating room. TEE has become ubiquitous in some parts because it is considered safe and relatively noninvasive. However, it is imperative for clinicians to understand that TEE can cause severe and possibly life-threatening complications, and the risks of TEE must be balanced against its benefits as a diagnostic tool. Upper gastrointestinal (UGI) injuries are the most commonly described complications of TEE; however, the relative infrequency of injuries and lack of uniform reporting make it difficult to definitively identify potential risk factors. Some large retrospective trials suggested that patient factors (age, body mass index, anatomic abnormalities), comorbid conditions (previous stroke), and procedural variables (procedure time, cardiopulmonary bypass time, etc.) are associated with TEE-related injuries. In this narrative review of complications from TEE, the authors focus on the incidence of UGI injuries, the spectrum of injuries associated with TEE, risk factors that may contribute to UGI injuries, as well as diagnosis and management options. Lastly, the discussion focuses on the prevention of injuries as TEE use continues to become more prevalent.