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Yamaguchi S, Ishida Y, Sasaki T, Higuchi S, Bito K, Oe K. Remimazolam for simultaneous percutaneous mitral valve clip and percutaneous left atrial appendage closure in an elderly patient with impaired cardiac function: A case report. Clin Case Rep 2024; 12:e9215. [PMID: 39040608 PMCID: PMC11260761 DOI: 10.1002/ccr3.9215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024] Open
Abstract
Remimazolam is a short-acting benzodiazepine sedative with a short half-life and little circulatory depression. The safe use of remimazolam in the anesthetic management of an elderly patient with impaired cardiac function is reported. The patient's hemodynamics remained stable, and the patient was managed without serious complications. Remimazolam may be an option for sedation in elderly patients with reduced cardiac function.
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Affiliation(s)
- Sumika Yamaguchi
- Department of AnesthesiologyShowa University School of MedicineTokyoJapan
| | - Yusuke Ishida
- Department of AnesthesiologyShowa University School of MedicineTokyoJapan
| | - Tomomi Sasaki
- Department of AnesthesiologyShowa University School of MedicineTokyoJapan
| | - Satoshi Higuchi
- Department of AnesthesiologyTokyo Saiseikai Central HospitalTokyoJapan
| | - Kiyoko Bito
- Department of AnesthesiologyShowa University School of MedicineTokyoJapan
| | - Katsunori Oe
- Department of AnesthesiologyShowa University School of MedicineTokyoJapan
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Zhao Y, Li T, Wu M, Zeng Z, Gao M, Bao X, Xu Z, Zhou J, Feng J, Feng R, Jing Z. Simultaneous transcatheter treatment of ascending aortic aneurysm with aortic and mitral regurgitation: an in vitro study. Interact Cardiovasc Thorac Surg 2021; 33:474-482. [PMID: 34115874 DOI: 10.1093/icvts/ivab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/22/2020] [Accepted: 02/18/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We sought to explore the efficacy of the endovascular repair of an ascending aortic aneurysm with aortic and mitral regurgitation by 2 novel valved stents. METHODS We established models of ascending aortic aneurysms combined with aortic and mitral regurgitation in 10 pig hearts, then implanted self-expanding aortic fenestrated and mitral valved stents via the transapical approach. We applied a fluoroscopy-guided in vitro setting to test the approach, then analysed continuous circulating flushing at 37°C. Finally, we determined operating times, echocardiography and changes of coronary flow as well as fenestration alignment with the coronary ostia. RESULTS This approach resulted in a 100% overall technical success rate, excellent handling properties and precise positioning. The time taken to implant the 2 valved stents was 59 ± 12 min. Flow of the left and right coronary arteries did not significantly decrease after the stents were implanted (330.4 ± 12.06 ml/min vs 289.4 ± 5.29 ml/min, P < 0.001; 376.8 ± 10.5 ml/min vs 350.0 ± 14.5 ml/min; P < 0.001). We found no obvious regurgitation and perivalvular leakage; nor did the gradients of the aortic and mitral valves as well as of the left ventricular outflow tract increase significantly. The final angiographic examination and profile of the coronary opening confirmed the good position of the valved stents, the exclusion of the aneurysm and the patency of both coronary arteries. CONCLUSIONS These findings indicate the potential for combined transcatheter aortic root and mitral valve replacement in treating aortic root pathologies. In future, in vivo studies are expected to validate this approach and ascertain its durability.
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Affiliation(s)
- Yuxi Zhao
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Tao Li
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China.,Department of Cardiovascular Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Mingwei Wu
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Zhaoxiang Zeng
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Minxin Gao
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Xianhao Bao
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Ziyi Xu
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Jian Zhou
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Jiaxuan Feng
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Rui Feng
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
| | - Zaiping Jing
- Department of Vascular Surgery, Changhai Hospital, Endovascular Diagnosis and Treatment Center for Heart Valvular Diseases, and Endovascular Diagnosis and Treatment Center for Aortic Dissection, Navy Medical University, Shanghai, China
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