Real-Time 3-Dimensional Transesophageal Echocardiography Imaging–Guided Percutaneous Closure of Left Ventricular to Left Atrial Fistula No abstract available

A High Doppler Gradient: Obstruction or No Obstruction?: A Case Report The angle correction feature in ultrasound systems is used when there is difficulty accurately aligning the Doppler beam with the flow to be interrogated. The operator can manually “correct” the angle to the actual direction of flow. Subsequently, the machine corrects the peak velocity for the angle. We present a case of aortic valve replacement (AVR) in which falsely high transaortic gradients were obtained immediately after separation from cardiopulmonary bypass (CPB). We recommend that there be a more prominent notification when the angle correction feature is used with machine prompts confirming when a peak velocity is obtained using angle correction. Accepted for publication September 13, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Feroze Mahmood, MD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Address e-mail to fmahmood@bidmc.harvard.edu. © 2019 International Anesthesia Research Society

Anesthetic Management During Pediatric Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy With Cisplatin in a Small Child: A Case Report and Systematic Literature Review Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) present a challenging task for anesthesia providers. Anesthesia management may be complicated by hyperthermia, fluid shifts, and distinct inflammatory response. Only a few reports dealing with the anesthesia management of pediatric CS and HIPEC have been published. We report a case of a 2-year-old child with a relapse of an alveolar rhabdomyosarcoma of the uterus and peritoneal carcinomatosis treated with CS and HIPEC. For children, careful temperature measurement, intraoperative prevention of hyperthermia, and sufficient volume management are important, as well as postoperative pediatric intensive care with experience CS and HIPEC patients. Accepted for publication September 18, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Thomas S. Zajonz, MD, Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg GmbH, Campus Giessen Rudolf-Buchheim-Str. 7, 35392 Giessen, Germany. Address e-mail to thomaszajonz@chiru.med.uni-giessen.de. © 2019 International Anesthesia Research Society

Point-of-Care Thromboelastography for Intrathecal Drain Management in Patients With Coagulopathy and Thoracic Aorta Surgery: A Case Report Spinal drain placement to prevent spinal cord ischemia during thoracic aorta surgery is a necessary yet complex undertaking in patients with coagulopathies. Thromboelastography (TEG) can be used as a point-of-care management tool to monitor coagulation status before drain placement and removal. We present 2 cases: a case of a patient with factor VII deficiency and a case of a patient with thrombocytopenia for whom TEG was an important procedural adjunct during coagulopathy reversal. TEG parameters are also discussed to encourage more frequent TEG use as an adjunct during these complex cases. Accepted for publication September 23, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Robina Matyal, MD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Address e-mail to rmatyal1@bidmc.harvard.edu. © 2019 International Anesthesia Research Society

In Response No abstract available

The OxyTain Algorithm: An Adaptation of Existing Emergency Front of Neck Access Approaches Within a North American Tertiary Referral Health Care System No abstract available

Low ACT After High-Dose Heparin: Is Hemodilution Best Option to Pass by Syclla and Charybdis? No abstract available

A Commendable and Sensible but Not Novel Approach No abstract available

OxyTain: Not Unique, But a Successful Adaptation of the Royal Perth Hospital "Cannot Intubate, Cannot Oxygenate" Rescue Approach in a North American Setting No abstract available

Sphenopalatine Ganglion Blocks in the Management of Head and Neck Cancer–Related Pain: A Case Series Head and neck cancer can be painful, debilitating, and refractory to oral medications. Due to the association of the sphenopalatine ganglion (SPG) with maxillary nerve sensory fibers, SPG blocks may be used to treat the pain of the hard and soft palate, tonsils, nasal cavity, paranasal sinuses, oral gingiva, premaxillary soft tissue, maxilla, and orbital floor. We present the first case series of performing SPG blocks utilizing TX360 nasal atomizers or angiocatheters to treat head and neck cancer–related pain. Pain scores were reduced by 38% to 80% with an average pain relief duration of 23 days. Accepted for publication September 3, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Lynn R. Kohan, MD, Pain Management Center, Fontaine Research Park, Third Floor, 545 Ray C. Hunt Dr, Charlottesville, VA 22908. Address e-mail to lrk9g@hscmail.mcc.virginia.edu. © 2019 International Anesthesia Research Society