Journal of anesthesia and translational medicine最新文献

{"title":"Anesthetic procedure for transapical beating-heart septal myectomy in patients with hypertrophic obstructive cardiomyopathy: Report of three cases.","authors":"Qiaoqiao Xu, Rui Li, Yani Liu, Yue Chen, Ailin Luo, Xiang Wei, Wenlong Yao","doi":"10.1016/j.jatmed.2024.10.002","DOIUrl":"10.1016/j.jatmed.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>Septal myectomy is the gold standard for treating severe hypertrophic obstructive cardiomyopathy (HOCM). Recently, the cardiothoracic surgery team from our hospital has developed a novel surgical approach known as transapical beating-heart septal myectomy (TA-BSM) for HOCM patients.</p><p><strong>Case presentation: </strong>Anesthesia management is crucial in this groundbreaking procedure. We present three representative cases of patients with HOCM: a typical case, a geriatric case, and a case with extreme hypertrophy of the interventricular septum. Additionally, we summarize the perioperative anesthesia management specific to TA-BSM.</p><p><strong>Conclusions: </strong>Guided by transesophageal echocardiography, TA-BSM significantly reduces left ventricular outflow tract obstruction without cardiopulmonary bypass. Precise perioperative anesthesia management, coupled with seamless collaboration among anesthesiologists, surgeons, and sonographers, has been pivotal to the successful implementation of this procedure in HOCM patients.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 4","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of ACE2/Ang-(1-7)/Mas axis improves cognitive dysfunction induced by isoflurane in mice via inhibiting oxidative stress.","authors":"Qingyun Zhou, Zhiying Zheng, Chaochao Chen, Binwen Liu, Zhengliang Ma, Tianjiao Xia, Xiaoping Gu","doi":"10.1016/j.jatmed.2024.09.003","DOIUrl":"10.1016/j.jatmed.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>Long-term inhalation anesthesia is known to be associated with postoperative cognitive dysfunction. Our previous studies have confirmed that oxidative stress damage contributes to its mechanistic connection. Angiotensin-converting enzyme 2 (ACE2)/Angiotensin-(1-7)/Mas axis plays a crucial role in balancing the classic Renin-Angiotensin System (RAS) and regulating oxidative stress. This research aims to investigate the involvement of the ACE2/Angiotensin-(1-7)/Mas axis in the development of cognitive impairment induced by long-term isoflurane anesthesia.</p><p><strong>Methods: </strong>3-month-old male C57BL/6 mice were randomly assigned to four groups: Control + Vehicle (C + Veh), Anesthesia + Vehicle (A + Veh), Control + Diminazene aceturate (C + DIZE), and Anesthesia + Diminazene aceturate (A + DIZE). Long-term isoflurane exposure was utilized to induce cognitive impairment. DIZE was administered intraperitoneally to mice 10 days prior to anesthesia to intervene ACE2. Cognitive function was administered using Y-maze and fear conditioning test. Flow Cytometry was used to measure the levels of ROS. Western blot was used to determine the expression levels of ACE2 and Mas, as well as the cognitive proteins such as phosphorylated N-methyl-D-aspartate receptor subtype 2B (p-NR2B) and Brain-Derived Neurotrophic Factor (BDNF).</p><p><strong>Results: </strong>We successfully constructed a long-term isoflurane anesthesia-mediated cognitive dysfunction model. Following long-term isoflurane anesthesia, there was a decrease in the levels of ACE2 and Mas in the hippocampus, accompanied by increased oxidative stress and significant cognitive impairment. Treatment with the ACE2 activator DIZE effectively restored the levels of ACE2 and Mas and decreased the content of ROS. Notably, DIZE treatment ameliorated cognitive dysfunction induced by long-term isoflurane exposure.</p><p><strong>Conclusions: </strong>The findings suggest that the activation of the ACE2/Ang-(1-7)/Mas axis could reduce oxidative stress and improve cognitive impairment. ACE2/Ang-(1-7)/Mas axis may play a prophylactic role in mitigating isoflurane-induced cognitive decline and other cognitive impairments related to oxidative stress.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"123-131"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication trends and research hotspots of IL-1: A bibliometric analysis of IL-1 with relevance to anesthesia in highly cited papers from WoSCC.","authors":"Zheng Li, Jie Ju, Xiaoqian Jia, Xiaoling Peng, Anqi Zhang, Jihong Wang, Feng Gao","doi":"10.1016/j.jatmed.2024.09.001","DOIUrl":"10.1016/j.jatmed.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>The IL-1 family has been discovered for more than 40 years, and its roles have been extensively explored in numerous studies, involving innate immunity, acquired immunity, and many inflammatory-associated diseases. In this study, we aimed to identify the research hotspots and forecast future trends through bibliometric analysis.</p><p><strong>Methods: </strong>The articles and reviews were downloaded from the Web of Science Core Collection (WoSCC) database from the inception of the database to October 28th, 2022. CiteSpace and Online Analysis Platform of Literature Metrology were used for bibliometric and knowledge-map analyses.</p><p><strong>Results: </strong>A total of 128,915 papers were included in 5703 academic journals by more than 100,000 authors in 35,411 institutions from 173 countries/regions. USA and China were the most productive countries. University of California System contributed the highest number of papers followed by Harvard University and Udice French Research Universities. The journal PLoS One published the most papers on IL-1. Eicke Latz contributed the most publications. Notably, the number of highly cited papers was 826, included in 358 academic journals by 7443 authors in 1803 institutions from 77 countries/regions. USA was absolutely in the leading position in highly cited papers, with Harvard Medical School producing the most highly cited publications. Nature was the maximum co-cited journal, meanwhile, and published the largest number of highly cited papers. Charles A. Dinarello authored the most papers and had the highest number of co-citations. The most of top 10 co-cited references in highly cited papers on mechanisms and diseases reflected the emphasis on the knowledge basis. The most influential research hotspots included mechanisms, the roles in different diseases, and pharmacological inhibitors. In addition, the cytokine storm emerged as the latest hotspot, driven by the breakout of COVID-19.</p><p><strong>Conclusions: </strong>As a participant in the inflammatory reaction, the IL-1 family plays important roles in a variety of physiological and pathological processes by bibliometric analysis. This analysis of IL-1 will help the researchers identify the current hotspots of this field and forecast potential future research directions.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"96-116"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of perioperative intravenous lidocaine infusion on postoperative sleep of elderly patients with colorectal cancer: A randomized controlled study.","authors":"Xiaomei Wang, Liqin Deng, Yanan Wu, Lu Wang, Yuxue Qiu, Haitao Hou","doi":"10.1016/j.jatmed.2024.09.002","DOIUrl":"10.1016/j.jatmed.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sleep disturbance (POSD) caused by postoperative pain can impede the enhanced rapid recovery of elderly patients with colorectal cancer. We propose that perioperative intravenous lidocaine infusion may enhance postoperative sleep quality by alleviating postoperative pain in elderly patients undergoing laparoscopic radical resection for colorectal cancer.</p><p><strong>Methods: </strong>Sixty-three elderly patients were divided into two groups: the lidocaine group (group L) and the placebo group (group C). Patients in group L received intravenous injection of lidocaine 1.5 mg/kg during the induction of anesthesia, followed by lidocaine 1.0 mg kg^-1 h^-1 during surgery and for 24 h after surgery. Patients in group C received the same volume of normal saline. The primary outcome was postoperative sleep function, which was evaluated using the Athens Insomnia Scale (AIS). The secondary outcomes included the pain-at-rest and pain-on-movement of patients at 2, 4, 6, 12, 24, 48, and 72 h after surgery, opioid and propofol consumption, bowel function recovery time, postoperative complications, and lidocaine side effects.</p><p><strong>Results: </strong>Compared to group C, AIS scores in group L were significantly lower on day 1 (12.9 ± 4.0 vs 10.6 ± 3.9, <i>P</i> < 0.05), day 3 (8.6 ± 4.2 vs 6.2 ± 3.9, <i>P</i> < 0.05), and 1 week (4.3 ± 3.1 vs 2.2 ± 2.5, <i>P</i> < 0.05) after surgery. There were no significant differences in VAS scores between the two groups. The intraoperative consumption of propofol and remifentanil was significantly reduced in group L. Lidocaine infusion significantly shortened the recovery time of bowel function. There were no statistical differences between the two groups regarding the incidences of PONV and postoperative pulmonary complications. No cases of local anesthetic toxicity occurred in either group.</p><p><strong>Conclusions: </strong>Perioperative intravenous administration of lidocaine can facilitate the restoration of postoperative sleep function in elderly patients undergoing laparoscopic radical resection of colorectal cancer.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"117-122"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Directions for analgesic development.","authors":"Ting Ge, Zhou Wu, Sha Sha, Xin Yang, He Liu, Lingzhen Song, Hongxing Zhang","doi":"10.1016/j.jatmed.2024.08.003","DOIUrl":"10.1016/j.jatmed.2024.08.003","url":null,"abstract":"<p><p>Physiological pain represents a protective response to avoid further injury and is helpful for survival. However, pathological pain is a common disease/symptom significantly affecting the quality of daily life in affected patients. Great progress has been made recently in understanding of pain mechanisms and the development of analgesic drugs, yet analgesic development requires continuous innovation. This review aims to summarize potential directions for future analgesic development and to provide guidance for related mechanism studies.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Successful reversal of chronic kidney disease by epidural block with lidocaine.","authors":"Xiaomei Qiu, Baiqin Su, Qifang Li","doi":"10.1016/j.jatmed.2024.08.002","DOIUrl":"10.1016/j.jatmed.2024.08.002","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgA N) is a leading cause of chronic kidney disease (CKD) and renal failure. However, none of the information regarding the pathogenesis of this disease suggests a curable time-limited event. This case demonstrates the feasibility of anesthesia technique for the reversal of IgA N.</p><p><strong>Case presentation: </strong>A 57-year-old male presented with hematuria and proteinuria. Considering the patient's clinical and kidney biopsy characteristics, the final diagnosis was IgA N. Epidural block was located at T6 and sustained via patient-controlled analgesia pump, delivering 0.8 % lidocaine in rapid bolus injections of 6 mL (with a lockout interval of 180 min) for 16 h daily. Following seven months of treatment, Blood pressure was stable and antihypertension drugs halted during the study period. Kidney function also got improved throughout the study in the patient, whether assessed by eGFR (from 56.18 mL/min (1.73 ㎡) to 72.9 mL/min (1.73 ㎡)) or serum creatinine concentration (decreased from 128.9 μmol/L to 103.2 μmol/L). The patient experienced a > 80 % reduction in proteinuria from baseline, and exhibited a complete remission of hematuria.</p><p><strong>Conclusions: </strong>In this case, epidural block with lidocaine successfully reverses the patient from stage 3 to stage 2 of CKD. These data suggest the feasibility of anesthesia technique for the treatment of IgA N.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"83-86"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram-based prediction of emergence delirium in elderly patients undergoing laparoscopic surgery.","authors":"Xiaocheng Zhu, Lu Wang, Wuping Zhuang, E Wang","doi":"10.1016/j.jatmed.2024.08.001","DOIUrl":"10.1016/j.jatmed.2024.08.001","url":null,"abstract":"<p><strong>Background: </strong>A nomogram model has been developed to forecast the incidence of emergence delirium (ED) in elderly patients undergoing laparoscopic surgery.</p><p><strong>Methods: </strong>A secondary analysis was performed on the eMODIPOD trial, which involved elective laparoscopic surgery patients at Xiangya Hospital between October 2017 and October 2019. To assess ED, the Richmond Agitation Sedation Scale (RASS) was combined with the Intensive Care Unit (CAM-ICU) scale, and patients were categorized as ED or non-ED based on the results. The two groups were compared in terms of perioperative information and test results. Logistic regression was utilized to investigate factors contributing to ED occurrence in elderly patients following laparoscopic surgery, and a nomogram was constructed to depict this. The diagnostic performance was evaluated through the utilization of the area under the receiver operating characteristic curve (AUROC) and a calibration plot. Simultaneously, to appraise the clinical value, decision curve analysis (DCA) was employed to assess the clinical value.</p><p><strong>Results: </strong>Of the 565 patients subject to laparoscopic surgery, 94 were subsequently diagnosed with emergence delirium (ED), yielding a positive rate of 16.6 %. The developed Nomogram model was an amalgamation of several variables, which included preoperative cognitive function, educational level, dezocine, penehyclidine, ASA grading, blood loss, fluid infusion, and Post Anesthesia Care Unit-numerical rating scale (PACU-NRS). The model's performance was commendable in terms of its discrimination power, as signified by an area under the curve of 0.713(95 % CI = 0.655-0.772). Furthermore, it exhibited adequate calibration, as affirmed by the Hosmer-Lemeshow test (χ² = 2.243, p = 0.326). Internal validation of the model further emphasized its superior discrimination and calibration capabilities. The decision curve analysis pointed out that when the threshold probability exceeded 0.1, the Nomogram model delivered more substantial benefits compared to the treat-all and treat-none approaches.</p><p><strong>Conclusions: </strong>This scoring system represents the pioneering Nomogram model utilized for predicting emergence delirium (ED) in geriatric patients undergoing laparoscopic surgery. It exhibits robust efficacy in forecasting the risk of ED, thereby furnishing valuable insights for the prevention, management, and treatment of ED.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 3","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hoarseness after general endotracheal anesthesia: A single-center retrospective analysis.","authors":"Kai Wang, Rong Chen, Zi Zeng, Hui-Min Liu, Qing-Tao Meng","doi":"10.1016/j.jatmed.2024.05.002","DOIUrl":"10.1016/j.jatmed.2024.05.002","url":null,"abstract":"<p><strong>Background: </strong>After the extubation of endotracheal tubes or removal of laryngeal masks in patients who underwent general anesthesia, complications such as hoarseness often occur, potentially leading to serious adverse effects on patients. Therefore, this study aimed to analyze the causes of hoarseness to provide improved prevention and treatment options.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent general anesthesia at the Renmin Hospital of Wuhan University from January 2017 to December 2021, excluding patients under 18 years of age, over 80 years old, with preoperative hoarseness and undergoing multiple surgeries. The incidence, duration, influencing factors and causes of hoarseness after tracheal intubation were analyzed.</p><p><strong>Results: </strong>The study found that the incidence of hoarseness after tracheal intubation was 11.77%. Of those patients experiencing hoarseness immediately after the operation, 79.56% could recover on the same day, 15.37% of patients could recover on the day after operation, 4.23% could recover within 3 days of the operation, and 0.83% of patients might need 5 or more days to recover. Patients aged 50 years and older, with an intubation time of more than 3 h, who underwent neck and cardiothoracic surgery, with a low BMI and with difficult airways exhibited a higher incidence of hoarseness after tracheal intubation. The main causes of hoarseness were vocal cord paralysis and arytenoid joint dislocation, with the number of patients at 8.97% (1106) and 7.32% (902) respectively. The incidences of hoarseness caused by psychological stress accounted for 4.15% of the cases. with a total of 512 patients affected.</p><p><strong>Conclusions: </strong>Age, intubation time, surgical site, low BMI and difficult airway were important factors affecting hoarseness after intubation. The vocal cord paralysis and arytenoid joint dislocation were major causes of hoarseness.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 2","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective effects of dantrolene in neurodegenerative disease: Role of inhibition of pathological inflammation.","authors":"Wenjia Zhang, Xu Zhao, Piplu Bhuiyan, Henry Liu, Huafeng Wei","doi":"10.1016/j.jatmed.2024.04.002","DOIUrl":"10.1016/j.jatmed.2024.04.002","url":null,"abstract":"<p><p>Neurodegenerative diseases (NDs) refer to a group of diseases in which slow, continuous cell death is the main pathogenic event in the nervous system. Most NDs are characterized by cognitive dysfunction or progressive motor dysfunction. Treatments of NDs mainly target alleviating symptoms, and most NDs do not have disease-modifying drugs. The pathogenesis of NDs involves inflammation and apoptosis mediated by mitochondrial dysfunction. Dantrolene, approved by the US Food and Drug Administration, acts as a RyRs antagonist for the treatment of malignant hyperthermia, spasticity, neuroleptic syndrome, ecstasy intoxication and exertional heat stroke with tolerable side effects. Recently, dantrolene has also shown therapeutic effects in some NDs. Its neuroprotective mechanisms include the reduction of excitotoxicity, apoptosis and neuroinflammation. In summary, dantrolene can be considered as a potential therapeutic candidate for NDs.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 2","pages":"27-35"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substantial challenge for a patient with severe mitral regurgitation and pulmonary hypertension undergoing transcatheter mitral valve edge-to-edge repair procedure.","authors":"Ge Qu, Yong G Peng","doi":"10.1016/j.jatmed.2024.04.001","DOIUrl":"10.1016/j.jatmed.2024.04.001","url":null,"abstract":"<p><p>The transcatheter mitral valve edge-to-edge repair (TEER) procedure is a percutaneous transcatheter intervention for severe mitral regurgitation in patients deemed to have significant comorbidities. It is considered a minimally invasive procedure. However, pulmonary hypertension as a common concomitant pathology with mitral regurgitation makes anesthetic management of the procedure challenging and may lead to unexpected perioperative adverse events. We present a case highlighting 2 distinctive intraoperative events of a patient with severe mitral regurgitation and pulmonary hypertension undergoing the TEER procedure: (1) rapid and profound cardiogenic shock after apnea episode and (2) significant right-to-left shunt of iatrogenic residual atrial septal defect after clip deployment, where pulmonary hypertension played a pivotal role in both events. An in-depth understanding of the pathophysiology of mitral regurgitation and the TEER procedure sets the foundation for risk assessment and anesthesia planning. Moreover, application of transesophageal echocardiography is essential in resuscitation optimization and surgical decision making.</p>","PeriodicalId":519929,"journal":{"name":"Journal of anesthesia and translational medicine","volume":"3 2","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}