Scholars@Duke
Alina Nicoara

Alina Nicoara

Professor of Anesthesiology
Anesthesiology, Cardiothoracic

Selected Publications

Challenges and opportunities in assessing right ventricular structure and function: a Roadmap for standardization, clinical implementation and research.

Journal Article Nat Rev Cardiol · January 2026 Given its crucial role in determining patient symptoms and outcomes in various cardiopulmonary diseases, the thorough and accurate assessment of right ventricular function is essential for both diagnosis and ongoing patient monitoring. In the era of precis ... Full text Link to item Cite

Impact of left ventricular assist device implantation on right ventricular-pulmonary arterial coupling assessed by high-fidelity hemodynamics.

Journal Article J Heart Lung Transplant · December 2, 2025 BACKGROUND: Postoperative right ventricular (RV) adaptation to left ventricular assist device (LVAD) implantation remains poorly characterized. RV-pulmonary artery (PA) coupling, defined as the ratio of end-systolic to arterial elastance (Ees/Ea), provides ... Full text Link to item Cite

Percutaneous Coronary Sinus Catheter Placement and Management With Transesophageal Echocardiography for Robotic Mitral Valve Surgery.

Journal Article Echocardiography · November 2025 INTRODUCTION: Placement of a percutaneous coronary sinus catheter (CSC) for retrograde cardioplegia delivery in minimally invasive cardiac surgery has been implemented at various centers. While several techniques have been described for catheter placement, ... Full text Link to item Cite

Right Ventricle-Pulmonary Artery Coupling and Major Morbidity and Operative Mortality After Cardiac Surgery.

Journal Article Anesth Analg · October 1, 2025 BACKGROUND: The right ventricle-pulmonary artery (RV-PA) coupling ratio provides an assessment of RV function indexed to PA afterload. A low preoperative RV-PA ratio has been associated with increased mortality after transcatheter procedures. In patients u ... Full text Link to item Cite

Right Ventricular Function and Echocardiographic Pressure-Volume Loops: Overview and Perioperative Clinical Implications.

Journal Article J Cardiothorac Vasc Anesth · October 2025 Right ventricular (RV) mechanics have critical roles in cardiovascular physiology, yet their assessment remains challenging owing to the right ventricle's complex geometry and unique interaction with the pulmonary vascular system. This review explores RV s ... Full text Link to item Cite

Aortic Root Thrombus in a Left Ventricular Assist Device Patient as a Cause for Intractable Ventricular Tachycardia.

Journal Article Ann Thorac Surg Short Rep · September 2025 Aortic root thrombosis (ART) is an uncommon complication after left ventricular assist device implantation. We describe a unique postoperative presentation of intractable ventricular tachycardia as a result of an aortic root thrombus extending into the lef ... Full text Link to item Cite

Considerations of Intraoperative Transesophageal Echocardiography During Adult Cardiac Surgery: A Scientific Statement From the American Heart Association.

Journal Article Circulation · July 15, 2025 Intraoperative transesophageal echocardiography is used with increasing frequency in cardiac surgery for monitoring and diagnostic purposes. Recent data have shown the impact of improved outcomes in patients undergoing cardiac surgery and the use of intrao ... Full text Link to item Cite

Late follow-up for a randomized trial of surgical treatment of tricuspid valve regurgitation in patients undergoing left ventricular assist device implantation.

Journal Article J Thorac Cardiovasc Surg · July 2025 BACKGROUND: We previously reported that concurrent tricuspid valve surgery (TVS) was not associated with a lower incidence of early right heart failure (RHF) in patients undergoing durable left ventricular assist device (LVAD) implantation. This follow-up ... Full text Link to item Cite

The Impact of Minimally Invasive Surgery in Patients with Colorectal Cancer and Type 2 Diabetes Mellitus.

Journal Article Chirurgia (Bucur) · February 2025 Background: Laparoscopic surgery is now widely recognized as a very safe and effective standard treatment for colorectal cancer as compared with laparotomy. Diabetes causes significant mortality and morbidity in the general population, and in particular in ... Full text Link to item Cite

The Odyssey of Diastolic Function: No Time to Relax.

Journal Article Anesth Analg · January 1, 2025 Full text Link to item Cite

Tricuspid Regurgitation after Orthotopic Heart Transplantation: Trajectories and Association With Mortality.

Journal Article Clin Transplant · January 2025 BACKGROUND: Tricuspid regurgitation (TR) is common immediately after orthotopic heart transplantation (OHT), though the expected outcomes of TR over time remain undefined. In this study, we examined the natural trajectory of TR in the first 120 days post-t ... Full text Link to item Cite

Echocardiography for short-term mechanical circulatory support: a trans-Atlantic practical guide.

Journal Article Eur Heart J Imaging Methods Pract · January 2025 Short-term mechanical circulatory support (stMCS) devices are increasingly utilized for haemodynamic stabilization in patients with cardiogenic shock. Echocardiography plays a pivotal role across the continuum of stMCS use-from patient selection and device ... Full text Link to item Cite

Intraoperative right ventricular end-systolic pressure-volume loop analysis in patients undergoing cardiac surgery: A proof-of-concept methodology.

Journal Article JTCVS Open · December 2024 BACKGROUND: Perioperative right ventricular (RV) dysfunction is associated with increased morbidity and mortality in cardiac surgery patients. This study aimed to demonstrate proof of concept in generating intraoperative RV pressure-volume (PV) loops and c ... Full text Link to item Cite

Transmitral Pressure Gradients in Patients With Degenerative Mitral Regurgitation After Robotic Mitral Valve Repair With Leaflet Preservation Techniques.

Journal Article Echocardiography · October 2024 INTRODUCTION: The hemodynamic effects of mitral valve repair (MVr) with respect to transmitral pressure gradients (TMPGs) have not been described well in patients undergoing leaflet preservation techniques. In a population of patients undergoing robotic MV ... Full text Link to item Cite

Artificial intelligence-enabled reconstruction of the right ventricular pressure curve using the peak pressure value: a proof-of-concept study.

Journal Article Eur Heart J Imaging Methods Pract · October 2024 AIMS: Conventional echocardiographic parameters of right ventricular (RV) function are afterload-dependent. Therefore, incorporating RV pressures may enable the formulation of new parameters that reflect intrinsic RV function accurately. Accordingly, we so ... Full text Link to item Cite

The International Society for Heart and Lung Transplantation (ISHLT): 2024 infection definitions for durable and acute mechanical circulatory support devices.

Journal Article J Heart Lung Transplant · July 2024 Infections remain a significant concern in patients receiving mechanical circulatory support (MCS), encompassing both durable and acute devices. This consensus manuscript provides updated definitions for infections associated with durable MCS devices and n ... Full text Link to item Cite

Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions.

Journal Article Curr Cardiol Rep · June 2024 PURPOSE OF REVIEW: This review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease. RECENT FIN ... Full text Link to item Cite

Surgical Treatment of Tricuspid Valve Regurgitation in Patients Undergoing Left Ventricular Assist Device Implantation: Interim analysis of the TVVAD trial.

Journal Article J Thorac Cardiovasc Surg · May 2024 OBJECTIVES: Right heart failure remains a serious complication of left ventricular assist device therapy. Many patients presenting for left ventricular assist device implantation have significant tricuspid regurgitation. It remains unknown whether concurre ... Full text Link to item Cite

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: Intraoperative Echocardiography Reporting.

Journal Article J Cardiothorac Vasc Anesth · May 2024 OBJECTIVES: To identify trends in the reporting of intraoperative transesophageal echocardiographic (TEE) data in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) and the Adult Cardiac Anesthesiology (ACA) module by period, prac ... Full text Link to item Cite

Early Outcomes in Patients With LVAD Undergoing Heart Transplant via Use of the SherpaPak Cardiac Transport System.

Journal Article Circ Heart Fail · May 2024 BACKGROUND: Heart transplant (HT) in recipients with left ventricular assist devices (LVADs) is associated with poor early post-HT outcomes, including primary graft dysfunction (PGD). As complicated heart explants in recipients with LVADs may produce longe ... Full text Link to item Cite

Practical Considerations for Obtaining Perioperative Transesophageal Echocardiography Accreditation: Collective Experiences at Early-Adopting Centers.

Journal Article J Cardiothorac Vasc Anesth · March 2024 The Intersocietal Accreditation Commission (IAC) is a nonprofit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It comprises a collaboration of stakeholders spanning numerous medical professionals an ... Full text Link to item Cite

Abstract 14318: Right Ventriculo- Arterial Coupling Assessment by High-Fidelity Hemodynamic Measurements in Patients Undergoing Left Ventricular Assist Device Implantation

Conference Circulation · November 7, 2023 Background: The changes in RV function after LVAD placement are not fully understood. RV- PA coupling, defined as the ratio of RV end-systolic to arterial elastances (E ES Full text Cite

The Role of Recipient Thyroid Hormone Supplementation in Primary Graft Dysfunction After Heart Transplantation: A Propensity-Adjusted Analysis.

Journal Article J Cardiothorac Vasc Anesth · November 2023 OBJECTIVES: To investigate whether recipient administration of thyroid hormone (liothyronine [T3]) is associated with reduced rates of primary graft dysfunction (PGD) after orthotopic heart transplantation. DESIGN: Retrospective cohort study. SETTING: Sing ... Full text Link to item Cite

Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery.

Journal Article Circulation · October 24, 2023 BACKGROUND: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-sel ... Full text Open Access Link to item Cite

Health care resource utilization and clinical outcomes for adult heart transplant recipients with primary graft dysfunction.

Journal Article Clin Transplant · October 2023 INTRODUCTION: The advent of new technologies to reduce primary graft dysfunction (PGD) and improve outcomes after heart transplantation are costly. Adoption of these technologies requires a better understanding of health care utilization, specifically the ... Full text Link to item Cite

Pulmonary Vein Systolic Flow Reversal Seen With Severe Tricuspid Regurgitation.

Journal Article CASE (Phila) · July 2023 • Systolic PVF reversal is specific to severe MR. • We report systolic PVF reversal with severe TR and TS. • This may be caused by interatrial dependence due to elevated RAP. ... Full text Link to item Cite

Ruptured sinus of Valsalva aneurysm with dynamic aortic regurgitation.

Journal Article Echocardiography · January 2023 The ruptured sinus of Valsalva aneurysm (SVA) can present with dynamic aortic regurgitation (AR). Hemodynamic changes elicited by induction of general anesthesia can lead to dynamic AR in setting of ruptured SVA. Perioperative echocardiography is critical ... Full text Link to item Cite

Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Journal Article J Cardiothorac Vasc Anesth · October 2022 OBJECTIVES: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support ... Full text Link to item Cite

Transesophageal Echocardiography-Guided Percutaneous Aspiration of a Large Tricuspid Valve Vegetation in a Patient with Infective Endocarditis.

Journal Article CASE (Phila) · September 2022 • Right-sided IE is associated with IVDU. • Percutaneous debulking of TV vegetations can be a therapeutic option. • TEE can help guide debulking. • TEE can be used to monitor for and prevent complications. ... Full text Link to item Cite

Cerebral Oximetry During Adult Cardiac Surgery Is Associated With Improved Postoperative Outcomes.

Journal Article J Cardiothorac Vasc Anesth · September 2022 OBJECTIVE: To examine the association/effect of intraoperative cerebral oximetry (CeOx) on major organ morbidity and mortality (MOMM) after adult cardiac surgery. DESIGN: A retrospective, multicenter cohort study. SETTING: Patients treated at any hospital ... Full text Link to item Cite

Imaging for Temporary Mechanical Circulatory Support Devices.

Journal Article J Cardiothorac Vasc Anesth · July 2022 Heart failure is an important cause of mortality and morbidity in the world. Changes in organ allocation for solid thoracic (lung and heart) transplantation has increased the number of patients on mechanical circulatory support. Temporary mechanical suppor ... Full text Link to item Cite

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2021 Update on Echocardiography.

Journal Article Ann Thorac Surg · January 2022 The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) is the world's premier clinical outcomes registry for adult cardiac surgery and a driving force for quality improvement in cardiac surgery. Echocardiographic data provide a wealth ... Full text Link to item Cite

Renal-Resistive Index for Prediction of Acute Kidney Injury in the Setting of Aortic Insufficiency.

Journal Article J Cardiothorac Vasc Anesth · December 2021 Acute kidney injury (AKI) is a common postoperative complication after cardiac surgery with cardiopulmonary bypass (CPB), and leads to significant morbidity, mortality, and cost. Although early recognition and management of AKI may reduce the burden of ren ... Full text Link to item Cite

In reply to: "Intra-aortic balloon pump protects against hydrostatic pulmonary oedema during peripheral venoarterial-extracorporeal membrane oxygenation".

Journal Article Eur Heart J Acute Cardiovasc Care · March 5, 2021 Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized life-saving measure. However, left-ventricular distention from inadequate left-ventricular off-loading can lead to unwanted pulmonary and cardiac complications. We are ... Full text Link to item Cite

Of Heights, Lengths, and Distances.

Journal Article J Am Soc Echocardiogr · January 2021 Full text Link to item Cite

Transesophageal Echocardiographic Evaluation of Novel Extracellular Matrix Valve for Tricuspid Valve Endocarditis.

Journal Article CASE (Phila) · October 2020 • Intravenous drug abuse is a common cause of infective TV endocarditis. • The use of a novel ECM valve is a surgical alternative to TV replacement. • TEE evaluation is a useful tool to evaluate the unique valve appearance and function. ... Full text Link to item Cite

Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.

Journal Article Transpl Int · August 2020 Acute kidney injury (AKI) and primary graft dysfunction (PGD) are serious complications after heart transplantation (HT). The relationship between AKI and PGD is poorly understood. We sought to examine the incidence of AKI and identify risk factors associa ... Full text Link to item Cite

Lead Extraction for Cardiovascular Implantable Electronic Device Infection in Patients With Left Ventricular Assist Devices.

Journal Article JACC Clin Electrophysiol · June 2020 OBJECTIVES: The goal of this study was to assess the utility of transvenous lead extraction for cardiovascular implantable electronic device (CIED) infection in patients with a left ventricular assist device (LVAD). BACKGROUND: The use of transvenous lead ... Full text Link to item Cite

Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach: From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons.

Journal Article J Am Soc Echocardiogr · June 2020 Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the management of patients undergoing an entire spectrum of cardiac surgical procedures, ranging from "routine" surgical coronary revascularization to ... Full text Link to item Cite

Specific Considerations for the Protection of Patients and Echocardiography Service Providers When Performing Perioperative or Periprocedural Transesophageal Echocardiography during the 2019 Novel Coronavirus Outbreak: Council on Perioperative Echocardiography Supplement to the Statement of the American Society of Echocardiography Endorsed by the Society of Cardiovascular Anesthesiologists.

Journal Article J Am Soc Echocardiogr · June 2020 • TEE carries a high risk for SARS-CoV-2 spread. • TEE should be performed when clinical benefits outweigh the risks. • Proper handling and cleaning of equipment is critical. • Airborne precautions should be used in patients suspected or confirmed COVID-19 ... Full text Link to item Cite

Intraoperative renal resistive index threshold as an acute kidney injury biomarker.

Journal Article J Clin Anesth · May 2020 STUDY OBJECTIVE: The lag in creatinine-mediated diagnosis of cardiac surgery-associated acute kidney injury (AKI) may be impeding the development of renoprotection therapies. Postoperative renal resistive index (RRI) measured by transabdominal Doppler ultr ... Full text Link to item Cite

Impact of Tricuspid Valve Repair for Moderate Tricuspid Regurgitation at the Time of Left Ventricular Assist Device Implantation on the Occurrence of Right Heart Failure

Conference The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · April 1, 2020 PURPOSE: Significant tricuspid regurgitation (TR) in patients undergoing durable left ventricular assist device (LVAD) implantation has been associated with increased incidence of right heart failure (RHF). There is great surgical practice variability rela ... Full text Cite

EUROMACS-RHF Risk Score and 3D Echocardiography as Predictors of Right Heart Failure after Left Ventricular Assist Device Implantation

Conference The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · April 1, 2020 PURPOSE: Right heart failure (RHF) after LVAD implantation is associated with significant morbidity and mortality. Recently, the EUROMACS-RHF risk score was developed to predict postoperative RHF in this setting. In a single-center analysis, we assessed th ... Full text Cite

Durability and Efficacy of Tricuspid Valve Repair in Patients Undergoing Left Ventricular Assist Device Implantation.

Journal Article JACC Heart Fail · February 2020 OBJECTIVES: This study sought to determine the durability of tricuspid valve repair (TVr) performed concurrently with left ventricular assist device (LVAD) implantation and its association with the development of late right heart failure (RHF). BACKGROUND: ... Full text Open Access Link to item Cite

The Added Power of the Third Dimension.

Journal Article J Cardiothorac Vasc Anesth · December 2019 Full text Link to item Cite

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation.

Journal Article Semin Cardiothorac Vasc Anesth · June 2019 Publications of note from 2018 are reviewed for the cardiothoracic transplant anesthesiologist. Strategies to expand the availability of donor organs were highlighted, including improved donor management, accumulating experience with increased-risk donors, ... Full text Link to item Cite

Frailty in the End-Stage Lung Disease or Heart Failure Patient: Implications for the Perioperative Transplant Clinician.

Journal Article J Cardiothorac Vasc Anesth · May 2019 The syndrome of frailty for patients undergoing heart or lung transplantation has been a recent focus for perioperative clinicians because of its association with postoperative complications and poor outcomes. Patients with end-stage cardiac or pulmonary f ... Full text Open Access Link to item Cite

Right Ventricular Function in Left Heart Disease.

Journal Article Semin Cardiothorac Vasc Anesth · March 2019 Right ventricular (RV) function is an independent prognostic factor for short- and long-term outcomes in cardiac surgical patients. Patients with mitral valve (MV) disease are at increased risk of RV dysfunction before and after MV operations. Yet RV funct ... Full text Link to item Cite

Functional Tricuspid Regurgitation in Mitral Valve Disease.

Journal Article Semin Cardiothorac Vasc Anesth · March 2019 Functional tricuspid regurgitation is a common finding in patients with left-sided heart disease. If left untreated, it may reduce survival, limit functional capacity and cause end-organ dysfunction. Annulus dilation and leaflet tethering due to right vent ... Full text Link to item Cite

Predictors and Changes in Cardiac Hemodynamics and Geometry With Transcatheter Aortic Valve Implantation.

Journal Article Am J Cardiol · March 1, 2019 The introduction of transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with severe aortic stenosis (AS). However, despite the great clinical success of TAVI, less is known about the cardiac hemodynamics and structur ... Full text Link to item Cite

Intraoperative Renal Resistive Index as an Acute Kidney Injury Biomarker: Development and Validation of an Automated Analysis Algorithm.

Journal Article J Cardiothorac Vasc Anesth · October 2018 OBJECTIVE: Intraoperative Doppler-determined renal resistive index (RRI) is a promising early acute kidney injury (AKI) biomarker. As RRI continues to be studied, its clinical usefulness and robustness in research settings will be linked to the ease, effic ... Full text Link to item Cite

A Case of Gerbode Ventricular Septal Defect Endocarditis.

Journal Article CASE (Phila) · October 2018 •A Gerbode VSD is a communication between the left ventricle and right atrium.•Etiologies include trauma, infective endocarditis, and iatrogenic causes.•Echocardiographic evaluation for this defect requires a careful interrogation. ... Full text Link to item Cite

Utility of Angle Correction for Hemodynamic Measurements with Doppler Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · August 2018 OBJECTIVES: The routine application angle correction (AnC) in hemodynamic measurements with transesophageal echocardiography currently is not recommended but potentially could be beneficial. The authors hypothesized that AnC can be applied reliably and may ... Full text Link to item Cite

The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.

Journal Article Ann Thorac Surg · July 2018 BACKGROUND: Acute kidney injury (AKI) is a common serious complication after cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (in ... Full text Link to item Cite

Primary graft dysfunction after heart transplantation: Incidence, trends, and associated risk factors.

Journal Article Am J Transplant · June 2018 Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutiv ... Full text Link to item Cite

Echocardiographic Imaging for Transcatheter Aortic Valve Replacement.

Journal Article J Am Soc Echocardiogr · April 2018 Transcatheter aortic valve replacement has become an accepted alternative to surgery for patients with severe, symptomatic aortic stenosis who are inoperable or are at high surgical risk. Recent trials support the use of transcatheter aortic valve replacem ... Full text Link to item Cite

The Sound and Science of Perioperative Echocardiography.

Journal Article J Am Soc Echocardiogr · April 2018 Full text Link to item Cite

Noteworthy Literature Published in 2017 for Thoracic Transplantation Anesthesiologists.

Journal Article Semin Cardiothorac Vasc Anesth · March 2018 Thoracic organ transplantation constitutes a significant proportion of all transplant procedures. Thoracic solid organ transplantation continues to be a burgeoning field of research. This article presents a review of remarkable literature published in 2017 ... Full text Link to item Cite

ECHOCARDIOGRAPHIC MEASUREMENT OF CARDIAC TWIST: A SYSTEMATIC REVIEW AND META-ANALYSIS

Conference Journal of the American College of Cardiology · March 2018 Full text Cite

The Role of Echocardiography in Mitral Valve Repair

Chapter · January 1, 2018 Echocardiography is a versatile diagnostic technology integral to the assessment and treatment of mitral regurgitation (MR). MR is broadly classified as primary—resulting from abnormalities of the MV leaflets or apparatus, or secondary—arising from left ve ... Full text Cite

Changes in Tricuspid Annular Geometry in Patients with Functional Tricuspid Regurgitation.

Journal Article J Cardiothorac Vasc Anesth · December 2017 OBJECTIVE: To determine whether the indices of tricuspid annular dynamics that signify irreversible tricuspid valvular remodeling can improve surgical decision making by helping to better identify patients with functional tricuspid regurgitation who could ... Full text Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Left Atrial Appendage Membrane in a Patient Presenting with Stroke.

Journal Article CASE (Phila) · October 2017 • LAA membranes are a rare abnormality of the LAA. • Left-sided cardiac myxomas may be associated with LAA membranes. • Comprehensive perioperative TEE should be performed in cardiac surgery. ... Full text Link to item Cite

Anesthesia for Lung Transplantation.

Journal Article Anesthesiol Clin · September 2017 Perioperative management of patients undergoing lung transplantation is challenging and requires constant communication among the surgical, anesthesia, perfusion, and nursing teams. Although all aspects of anesthetic management are important, certain intra ... Full text Link to item Cite

Elective Venovenous Extracorporeal Membrane Oxygenation for Resection of Endotracheal Tumor: A Case Report.

Journal Article A A Case Rep · August 15, 2017 We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room an ... Full text Link to item Cite

Postoperative management of heart transplantation patients.

Journal Article Best Pract Res Clin Anaesthesiol · June 2017 Heart transplant recipients are at risk for a number of post-transplantation complications such as graft dysfunction, rejection, and infection. The rates of many complications are decreasing over time, and prognosis is improving. However, these patients co ... Full text Link to item Cite

Neuroendocrine stress response: implications for cardiac surgery-associated acute kidney injury.

Journal Article Rom J Anaesth Intensive Care · April 2017 Surgical stress causes biochemical and physiologic perturbations of every homeostatic axis. These alterations include volume/baroreceptor regulation, sympathetic activation, parasympathetic suppression, neuroendocrine activation, acute phase response prote ... Full text Link to item Cite

Use of Adjuncts Reduces Cardiopulmonary Bypass Time During Minimally Invasive Aortic Valve Replacement.

Journal Article J Heart Valve Dis · March 2017 BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous co ... Link to item Cite

Tricuspid Valve Regurgitation and Right Ventricular Dysfunction During Left Ventricular Assist Device Implantation

Chapter · January 1, 2017 Significant right ventricular dysfunction occurs in approximately 22% of patients undergoing left ventricular assist device (LVAD) implantation and is a predictor of early and late mortality [1, 2]. Despite previously described predictors of RV failure suc ... Full text Cite

Neurophysiological Intraoperative Monitoring During Aortic Arch Surgery.

Journal Article Semin Cardiothorac Vasc Anesth · December 2016 Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by s ... Full text Link to item Cite

Echocardiographic Confirmation of Coronary Blood Flow.

Journal Article J Cardiothorac Vasc Anesth · June 2016 Full text Link to item Cite

Discordance in Grading Methods of Aortic Stenosis by Pre-Cardiopulmonary Bypass Transesophageal Echocardiography.

Journal Article Anesth Analg · April 2016 BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) ≤1.0 cm by the continuity equation and mean gradient (ΔPm) ≥ 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approxi ... Full text Open Access Link to item Cite

Diastolic heart failure: diagnosis and therapy.

Journal Article Curr Opin Anaesthesiol · February 2016 PURPOSE OF REVIEW: This article focuses on the recent findings in the diagnosis and treatment of diastolic heart failure (DHF) or heart failure with preserved ejection fraction. RECENT FINDINGS: DHF has become the most common form of heart failure in the p ... Full text Link to item Cite

Diastolic dysfunction, diagnostic and perioperative management in cardiac surgery.

Journal Article Curr Opin Anaesthesiol · February 2015 PURPOSE OF REVIEW: The review focuses on recent findings on the role of diastolic dysfunction in the perioperative period and on recent advances in the diagnosis and perioperative management of diastolic function. RECENT FINDINGS: Left ventricular diastoli ... Full text Link to item Cite

Use of mobile tablet devices and reduction in time to perioperative transesophageal echocardiography reporting: a historical cohort study.

Journal Article Can J Anaesth · January 2015 PURPOSE: Timely communication of intraoperative transesophageal echocardiography (TEE) findings to the postoperative care team is critical to optimizing patient care. We compared the use of a personal computer (PC) system with the use of a mobile tablet de ... Full text Open Access Link to item Cite

Anesthesia for catheter ablation procedures.

Journal Article J Cardiothorac Vasc Anesth · December 2014 Over the past decade, the role of the anesthesiologist has evolved continuously into a sine qua non component of the EP team, having intimate knowledge of the complex interventional procedures and the specific demands of the EP environment. With emphasis o ... Full text Link to item Cite

Diastolic dysfunction in patients undergoing cardiac surgery: the role of gender and age-gender interaction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVES: To test the hypothesis that females presenting for coronary artery bypass graft (CABG) surgery are at a higher risk of left ventricular diastolic dysfunction (LVDD) and that age and gender interact to influence this risk. DESIGN: Retrospective ... Full text Link to item Cite

Perioperative Diastolic Dysfunction: A Comprehensive Approach to Assessment by Transesophageal Echocardiography.

Journal Article Semin Cardiothorac Vasc Anesth · June 2014 Left ventricular diastolic dysfunction (LVDD) has only recently been recognized as an important determinant of perioperative morbidity. Intraoperative echocardiographers have been slow to adopt assessment of LVDD into clinical practice. This has been partl ... Full text Link to item Cite

New developments in the treatment of acute pain after thoracic surgery.

Journal Article Curr Opin Anaesthesiol · February 2014 PURPOSE OF REVIEW: This review examines recent advances and findings in the field of pain management in patients undergoing thoracic surgery. RECENT FINDINGS: Acute and chronic postoperative pain continues to remain a major problem and a primary concern fo ... Full text Link to item Cite

Multinational institutional survey on patterns of intraoperative transesophageal echocardiography use in adult cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · February 2014 OBJECTIVES: To assess institutional patterns of perioperative transesophageal echocardiography (TEE) usage. DESIGN: The authors hypothesized that TEE is performed more frequently and comprehensively in academic centers, mainly by anesthesiologists, and bar ... Full text Link to item Cite

Delayed postmyectomy ventricular septal defect.

Journal Article J Cardiothorac Vasc Anesth · April 2013 Full text Link to item Cite

Ventricular Function

Chapter · December 7, 2011 Full text Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.

Journal Article Blood Purif · 2009 BACKGROUND/AIMS: Acute renal failure is associated with a high risk of mortality when it complicates coronary artery bypass graft (CABG) surgery. We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated a ... Full text Link to item Cite

Dexmedetomidine related cardiac arrest in a patient with permanent pacemaker; a cautionary tale.

Journal Article Pacing Clin Electrophysiol · September 2007 Dexmedetomidine (Precedex), an alpha-2 adrenergic receptor agonist is frequently and safely used as sedative agent during surgical procedures. We report a case of a 76-year-old woman who developed cardiac arrest from the use of dexmedetomidine during pacem ... Full text Link to item Cite