By International Anesthesia Research Society
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Extra resources for Anesthesia & Analgesia Vol 110 Issue 1 Jan 2010
Rehfeldt, and Nikolaos J. Skubas: • The spectrum of pathology associated with aortic valve endocarditis includes vegetations, leaflet perforations, and abscesses, which often extend to adjacent intracardiac structures. A unique feature of this case was extension of an aortic periannular abscess to the right ventricular outflow tract. • Transesophageal echocardiogram examination is more sensitive than transthoracic echocardiography for detection of a thickened aortic annulus and pathologic, fluid-filled cavities and fistulous tracts; structures adjacent to the aortic annulus should be examined in the midesophageal short-axis and long-axis aortic valve views with stepwise angulation of the transducer.
Echocardiographic features of an aortic root abscess include abnormal thickening of the aortic annulus with echo-dense texture. 4 RVOT obliteration (using 2dimensional and M-mode ultrasound) and flow aliasing in the RVOT (using color Doppler) are important qualitative echocardiographic findings consistent with RVOT obstruction. When present, further quantification by spectral Doppler examinations should be considered. The gradient can be determined using a pulmonary artery catheter to measure the systolic pulmonary artery pressure.
1, January 2010 21. Socher I, Kroll H, Jorks S, Santoso S, Sachs UJ. Heparinindependent activation of platelets by heparin-induced thrombocytopenia antibodies: a common occurrence. J Thromb Haemost 2008;6:197–200 22. Walenga JM, Jeske WP, Prechel MM, Bakhos M. Newer insights on the mechanism of heparin-induced thrombocytopenia. Semin Thromb Hemost 2004;30(suppl 1):57– 67 23. Williams RT, Damaraju LV, Mascelli MA, Barnathan ES, Califf RM, Simoons ML, Deliargyris EN, Sane DC. Anti-platelet factor 4/heparin antibodies: an independent predictor of 30-day myocardial infarction after acute coronary ischemic syndromes.
Anesthesia & Analgesia Vol 110 Issue 1 Jan 2010 by International Anesthesia Research Society