Mitraclip and TEE for MR

  European Heart Journal – Cardiovascular Imaging (2013) 14, 935–949.  Peri-interventional echo assessment for the MitraClip procedure.  Everest Clinical Trial results PPT Open Heart 2014;1:e000056. Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome. ASE Echo 2016: Percutaneous approaches to MR. UofMichigan PPT. 2015: The role

Continue reading

Lidocaine infusions for pain

BJA Educ, April 2016. Intravenous lidocaine for acute pain: an evidence-based clinical update Lidocaine Infusion for Perioperative Pain Management – Vanderbilt Cocharane Library, July 2015. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Perioperative Use of Intravenous Lidocaine. Anesthesiology 4 2017, Vol.126, 729-737. Open Access Journals, Jan 2017. Lidocaine Infusion: A Promising Therapeutic Approach for

Continue reading

Methadone and acute and chronic pain management

We had a journal club where we discussed this article: Anesthesiology, May 2017; Clinical effectiveness and safety of intraoperative methadone in patients undergoing posterior spinal fusion surgery: a randomized, double-blinded, controlled trial. IV Methadone 0.2 mg/kg vs IV hydromorphone 2mg at surgical closure in 2+ level spinal fusion Decreased postop IV and opioid requirements and

Continue reading

Deep Hypothermic Circulatory Arrest

Case     OpenAnesthesia.org: Cerebral ischemia: deep hypothermia SCA 2013 PBLD: Anesthetic Management for Deep Hypothermic Circulatory Arrest BJA: Deep hypothermic circulatory arrest. July 2010 JCVA: Perioperative management of deep hypothermic circulatory arrest. Aug 2010. Anaesthesia, Pain, and Intensive Care: Deep hypothermic circulatory arrest – anesthetic considerations. Aug 2016. Annals of Thoracic and Cardiovascular Surgery:

Continue reading

Cardiac Surgery in a Jehovah’s Witness Patient

AVR Brief case summary Literature Search Blood Transfusion: 2011; April 9(2); 189-217.  Recommendations for the transfusion management of patients in the peri-operative period. II. The intra-operative period. BMJ Case Rep. 2012; 2012: bcr1220115403.  Aortic valve replacement in a Jehovah’s Witness: a case of multi-disciplinary clinical management for bloodless surgery. Journal of Cardiothoracic and Vascular Anesthesia,

Continue reading

The healthcare debate

KAREN BLEIER/AFP/Getty Images/MarketWatch

Here it is.  I didn’t want to opine, but it’s here and I can’t get away from the topic.  I see it at work.  I watch it at home.  It comes up in discussions…  so in order to make it stop, I’m going to give you an idea of what I see and what I

Continue reading

Ventricular Assist Devices: Impella

“There’s an emergent case coming for impella placement.” Impella?  I’ve read about these devices and I’m familiar with managing patients on LVADs as well as providing anesthesia for LVAD placement.  But, I’ve never done an Impella on a critically unstable patient. YouTube video describing the purpose and placement of the Impella Cath Lab Digest: Overview

Continue reading