Annemarie Thompson

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

Jeffrey L. Anderson, MD, FACC, FAHA, Chair Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect Nancy M. Albert, PhD, RN, FAHA Biykem Bozkurt, MD, PhD, FACC, FAHA Ralph G. Brindis, MD, MPH, MACC Lesley H. Curtis, PhD, FAHA David DeMets, PhD[¶¶][1] Lee A. Fleisher, MD, FACC, FAHA Samuel

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery: Executive Summary

Preamble 2216 1. Introduction 2217 2. Clinical Risk Factors: Recommendations 2220 3. Approach to Perioperative Cardiac Testing 2221 4. Supplemental Preoperative Evaluation: Recommendations 2221 5. Perioperative Therapy: Recommendations 2224 6. Anesthetic Consideration and Intraoperative Management: Recommendations 2228 7. Surveillance and Management for Perioperative MI: Recommendations 2229 8. Future Research Directions 2230 Appendix 1. Author Relationships With Industry and Other Entities (Relevant) 2237 Appendix 2. Reviewer Relationships With Industry and Other Entities (Relevant) 2239 Appendix 3. Related Recommendations From Other CPGs 2244 References 2230 The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients. Since 1980, the ACC and AHA have shared a responsibility to translate scientific evidence into clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health. These CPGs, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality …

The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management: Executive Summary: This document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS)

a t C r a t a R The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management This document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS)

2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery

A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines Developed inCollaborationWith theAmericanCollege of Surgeons, American Society of Anesthesiologists, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Anesthesiologists, and Society of Vascular Medicine Endorsed by the Society of Hospital Medicine

The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management: Executive Summary

a t C r a t a R The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the Perioperative Management of Patients with Implantable Defibrillators, Pacemakers and Arrhythmia Monitors: Facilities and Patient Management This document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS)

Takotsubo Cardiomyopathy and Coronary Vasospasm During Orthotopic Liver Transplantation: Separate Entities or 'Common Mechanism?

l AKOTSUBO CARDIOMYOPATHY (idiopathic or transient left ventricular apical ballooning syndrome [ABS]) is reversible condition frequently precipitated by a stressful rigger that clinically mimics an acute ST-elevation myocardial nfarction.1 Characteristically, hypokinesis or akinesis occurs in he mid and apical segments of the left ventricle in the absence f epicardial coronary lesions. Preserved (or hyperdynamic) unction of the basal myocardial segments results in apical allooning, assuming the shape of a Japanese pot used to catch ctopus (a takotsubo). This syndrome has been reported in the perioperative setting fter both minor and major (eg, orthotopic liver transplantation) urgical procedures.2-4 Intraoperatively, ABS manifests as cariogenic shock and is displayed as ST-elevation on an electroardiogram (ECG) without angiographic evidence of coronary cclusion.5 Coronary vasospasm has also been described as a eparate entity during liver transplantation, with similar clinical igns also representative of an acute myocardial infarction.2,6,7 he authors report a patient presenting intraoperatively with imultaneous severe right coronary artery (RCA) vasospasm nd ABS during liver transplant surgery.

Percutaneous closure of aortic prosthetic paravalvular regurgitation with two amplatzer septal occluders.

We report the transesophageal echocardiography (TEE) findings of percutaneous closure of an aortic paravalvular defect with two Amplatzer septal occluder devices (AGA Medical Corporation, Plymouth, MN). The patient was an 82-year-old male who underwent an aortic valve replacement with a Mosaic bioprosthetic valve 5 mo before admission. He presented with increasing shortness of breath, and transthoracic echocardiography revealed partial dehiscence of the aortic bioprosthetic valve with severe paravalvular regurgitation. Because the patient failed medical therapy and repeat aortic valve surgery, which is associated with significant morbidity, the patient opted for percutaneous closure of the paravalvular defect.

Anesthetic Evolution in Transcatheter Aortic Valve Replacement: Expert Perspectives From High-Volume Academic Centers in Europe and the United States

Cite this article as: Prakash A. Patel, Abraham M. Ackermann, John G.T. Augoustides, Joerg Ender, Jacob T. Gutsche, Jay Giri, Prashanth Vallabhajosyula, Nimesh D. Desai, Megan Kostibas, Mary Beth Brady, Eun J. Eoh, Jeffrey G. Gaca, Annemarie Thompson and Michael G. Fitzsimons, Anesthetic Evolution In Transcatheter Aortic Valve Replacement: Expert Perspectives From High-Volume Academic Centers In Europe And The United S t a t e s , Journal of Cardiothoracic and Vascular Anesthesia, http://dx.doi.org/10.1053/j.jvca.2017.02.051

Perioperative management of cardiovascular implantable electronic devices: what every anesthesiologist needs to know.

1titled “Perioperative Pacemaker-Mediated Tachycardia in the Patient with a Dual Chamber Implantable Cardioverter-Defibrillator.” The authors describe the management of a patient who undergoes hip surgery with ischemic cardiomyopathy and an implantable cardioverter-defibrillator (ICD) inserted for primary prevention of sudden cardiac death. This case report is an excellent demonstration of classic pacemakermediated tachycardia (PMT) in a patient with an ICD. PMT is seen in patients with a dual chamber pacemaker, whose conduction is anterograde via the pacemaker with retrograde conduction via the atrioventricular node where the activation of the atria is outside the programmed postventricular atrial refractory period (PVARP). As in this case, a premature ventricular contraction is conducted in a retrograde fashion and is improperly interpreted by the atrial channel of the pacemaker as a native atrial impulse, which initiates a paced ventricular beat. The authors correctly emphasize the difference in acute management of PMT depending on whether the device is a pacemaker or an ICD. If the device is a pacemaker, a magnet applied to the generator will result in asynchronous pacing of the heart (DOO), thus eliminating the atrial tracking and timing of a ventricular impulse. An ICD cannot be placed in asynchronous mode by applying a magnet; its pacemaker (bradycardia therapy) can only be altered by using a manufacturer-specific programmer. Extending the PVARP interval such that the atrial channel does not sense any retrograde conduction from the ventricles will also terminate a PMT. Many of the current cardiac implantable electronic devices (CIEDs) have a specialized algorithm that allows the PVARP to be automatically extended in the presence of premature ventricular contraction.

Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

OBJECTIVE In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. DESIGN A retrospective study. SETTINGS A single institutional university hospital. PARTICIPANTS Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. MEASUREMENTS AND MAIN RESULTS Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. CONCLUSIONS In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications.