cardiothoracic

Bovine Aortic Arch

Over a dozen different aortic arch great vessel configurations have been described in humans. I’ve illustrated the two most common types in this diagram. The “normal” aortic arch gives rise to three “great vessels.”...

Surgical Steps In Heart Transplantation

Orthotopic heart transplantations (OHTs) are some of my favorite procedures as a cardiothoracic anesthesiologist! After establishing general endotracheal anesthesia (GETA) with standard monitors, an arterial line, a central line (often with pulmonary artery catheter),...

United Network for Organ Sharing (UNOS) 2018 Heart Transplant Listing Guidelines Revision

The United Network for Organ Sharing (UNOS) is a non-profit organization that oversees national transplant waiting lists, collects data about every organ transplant that occurs in the United States, promotes awareness about the importance...

Ozaki Procedure – Autologous Pericardial Aortic Valve

In my first year of anesthesiology residency, I had the opportunity to do a very unique aortic valve replacement (AVR) case for aortic stenosis - the Ozaki repair performed by Dr. Ozaki himself! This...

Epiaortic Ultrasound (EAS)

Today's didactic lecture on epiaortic ultrasonography was given by one of my wonderful cardiothoracic anesthesiology attendings - Dr. Jeff Swanson. As part of traditional cardiac surgeries, the aorta can be extensively manipulated - especially...

The Heart’s Fibrous Skeleton

There’s a complex yet beautiful architecture within the heart's fibrous skeleton and valvular geometry. To become a proficient perioperative echocardiographer, one must understand these spatial relationships in three dimensions and the implications that specific...

Left Ventricular Pressure-Volume Work Loop With Mechanical Circulatory Support

Mechanical circulatory support (MCS) devices allow us to offload myocardial work from the heart, and for the purposes of this post, the left ventricle (LV). Referring to my previous post on the work of...

Starling Equation – Hydrostatic and Oncotic Pressures

"Starling forces" describe the movement across capillaries as a balance between hydrostatic and oncotic pressure gradients within the capillary and in the surrounding interstitium. Filtration across the capillary membrane occurs along its entire length...

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