Subclavian artery aneurysms are rare peripheral aneurysms. A giant subclavian artery aneurysm can lead to compression of the trachea or brachial plexus, erosion of the lung causing hemoptysis, hoarseness of voice, dysphagia, Horner’s syndrome, and upper extremity deep vein thrombosis. Compression of the trachea and inability to ventilate the patient can be a real challenge for the anesthesiologist and must be anticipated. Computed tomographic angiography is a useful imaging modality for its diagnosis and to rule out additional aneurysms in the body.
{"title":"Giant Subclavian Artery Aneurysm","authors":"Chinmaya Nanda, Ajmer Singh, Yatin Mehta","doi":"10.25259/jccc_60_2023","DOIUrl":"https://doi.org/10.25259/jccc_60_2023","url":null,"abstract":"Subclavian artery aneurysms are rare peripheral aneurysms. A giant subclavian artery aneurysm can lead to compression of the trachea or brachial plexus, erosion of the lung causing hemoptysis, hoarseness of voice, dysphagia, Horner’s syndrome, and upper extremity deep vein thrombosis. Compression of the trachea and inability to ventilate the patient can be a real challenge for the anesthesiologist and must be anticipated. Computed tomographic angiography is a useful imaging modality for its diagnosis and to rule out additional aneurysms in the body.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":" 99","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Symmetrical peripheral gangrene is an unusual complication of extracorporeal membrane oxygenation (ECMO) which can arise due to low cardiac output state, high inotropic support, inadequate anticoagulation, disseminated intravascular coagulation, and sepsis. In symmetrical peripheral gangrene, there is no evidence of large vessel occlusion or vasculitis. It can be due to the absence of pulsatile flow in the peripheral arteries that result in stasis and microthrombi formation which causes occlusion of small arterioles. A 10-month-old male child who underwent anomalous left coronary artery from pulmonary artery repair and required central venoarterial ECMO support post-surgery due to severe myocardial dysfunction developed symmetrical peripheral ischemia with gangrenous changes in the right-hand fingers while on extracorporeal membrane oxygenation (ECMO). The limb ischemic changes improved to normal after the child convalesced from heart failure. We describe these changes and the management here.
{"title":"A Rare Case of Symmetrical Peripheral Gangrene in Central Venoarterial Extracorporeal Membrane Oxygenator in a Pediatric Patient, an Unusual Complication of Extracorporeal Membrane Oxygenation","authors":"Meera Rajeev, M. Sahu","doi":"10.25259/jccc_58_2023","DOIUrl":"https://doi.org/10.25259/jccc_58_2023","url":null,"abstract":"Symmetrical peripheral gangrene is an unusual complication of extracorporeal membrane oxygenation (ECMO) which can arise due to low cardiac output state, high inotropic support, inadequate anticoagulation, disseminated intravascular coagulation, and sepsis. In symmetrical peripheral gangrene, there is no evidence of large vessel occlusion or vasculitis. It can be due to the absence of pulsatile flow in the peripheral arteries that result in stasis and microthrombi formation which causes occlusion of small arterioles. A 10-month-old male child who underwent anomalous left coronary artery from pulmonary artery repair and required central venoarterial ECMO support post-surgery due to severe myocardial dysfunction developed symmetrical peripheral ischemia with gangrenous changes in the right-hand fingers while on extracorporeal membrane oxygenation (ECMO). The limb ischemic changes improved to normal after the child convalesced from heart failure. We describe these changes and the management here.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transesophageal echocardiography (TEE) is essential in delineating the anatomy, physiology, and perioperative management of single ventricle (SV) lesions. SV lesion is commonly associated with heterotaxy syndrome causing abnormal lateralization of organs across the body’s left-right axis. It is manifested as right atrial or left atrial isomerism. Patients with SV physiology require the Glenn procedure for surgical palliation whereas Fontan operation as definitive intervention. However, in a patient with interrupted inferior vena cava (IVC), the Kawashima procedure is used for definitive palliation. We report a 15-year-old female child diagnosed with SV physiology and interrupted IVC in association with heterotaxy syndrome posted for the Kawashima procedure and hepatic vein rerouting and illustrate the importance of perioperative TEE in delineating the anatomy, decision-making, and confirming the success of repair.
经食道超声心动图（TEE）对于确定单心室（SV）病变的解剖、生理和围手术期管理至关重要。单心室病变通常与异位综合征有关，该综合征会导致身体左右轴上的器官异常侧位。表现为右心房或左心房异位。SV 生理学患者需要格伦手术来缓解病情，而方坦手术则是最终的干预措施。然而，对于下腔静脉（IVC）中断的患者，则采用川岛手术进行最终缓解。我们报告了一名 15 岁女性患儿的情况，她被诊断为 SV 生理学和下腔静脉断流，并伴有异向综合征，因此需要进行川岛手术和肝静脉改道，并说明了围手术期 TEE 在描述解剖结构、决策和确认修复成功方面的重要性。
{"title":"Transesophageal Echocardiographic Assessment of Single Ventricle Physiology with Interrupted Inferior Vena Cava in a Case of Heterotaxy Syndrome Posted for Kawashima Procedure and Hepatic Vein Rerouting","authors":"Devishree Das, N. Makhija, M. Prakash","doi":"10.25259/jccc_53_2023","DOIUrl":"https://doi.org/10.25259/jccc_53_2023","url":null,"abstract":"Transesophageal echocardiography (TEE) is essential in delineating the anatomy, physiology, and perioperative management of single ventricle (SV) lesions. SV lesion is commonly associated with heterotaxy syndrome causing abnormal lateralization of organs across the body’s left-right axis. It is manifested as right atrial or left atrial isomerism. Patients with SV physiology require the Glenn procedure for surgical palliation whereas Fontan operation as definitive intervention. However, in a patient with interrupted inferior vena cava (IVC), the Kawashima procedure is used for definitive palliation. We report a 15-year-old female child diagnosed with SV physiology and interrupted IVC in association with heterotaxy syndrome posted for the Kawashima procedure and hepatic vein rerouting and illustrate the importance of perioperative TEE in delineating the anatomy, decision-making, and confirming the success of repair.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transesophageal echocardiography (TEE) probe-induced esophageal perforation is rare. A 67-year-old man underwent a Bentall procedure with mitral valve replacement under TEE monitoring. Two hours later, the patient had a blood-stained aspirate from the nasogastric tube. Contrast-enhanced computed tomography of the chest showed esophageal perforation, which was treated with the fluoroscopic deployment of covered metal stents. The patient had an uneventful recovery.
经食道超声心动图（TEE）探头诱发食道穿孔的情况非常罕见。一名 67 岁的男子在 TEE 监测下接受了二尖瓣置换的 Bentall 手术。两小时后，患者从鼻胃管吸出带血迹的吸液。胸部对比增强计算机断层扫描显示食管穿孔，通过透视部署有盖金属支架进行了治疗。患者恢复顺利。
{"title":"Transesophageal Echocardiography Probe-induced Esophageal Perforation","authors":"Ajmer Singh, Chinmaya Nanda, Yatin Mehta","doi":"10.25259/jccc_57_2023","DOIUrl":"https://doi.org/10.25259/jccc_57_2023","url":null,"abstract":"Transesophageal echocardiography (TEE) probe-induced esophageal perforation is rare. A 67-year-old man underwent a Bentall procedure with mitral valve replacement under TEE monitoring. Two hours later, the patient had a blood-stained aspirate from the nasogastric tube. Contrast-enhanced computed tomography of the chest showed esophageal perforation, which was treated with the fluoroscopic deployment of covered metal stents. The patient had an uneventful recovery.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subglottic stenosis is a condition causing narrowing of the trachea, which can occur rarely secondary to trauma, infection, tumors, inflammatory, and iatrogenic causes. In our case, the child developed subglottic stenosis post-cardiac surgery after being mechanically ventilated in the postoperative period. The causes for subglottic stenosis may be some trauma in the presence of coagulation abnormalities in cyanotic heart diseases such as TOF, the ischemia to the subglottic tissue by reduced perfusion during cardiopulmonary bypass, and/or the trauma caused by crying and fighting of the child while being with the endotracheal tube. Anesthetic management of the surgery is challenging for the anesthesiologist due to the shared airway by the surgeon and the anesthesiologist. The inability to effectively ventilate the patient after induction of general anesthesia will result in catastrophic complications. Subglottic stenosis requires careful planning and execution along with proper communication between the team.
{"title":"Shared Airway for Tracheal Resection and Anastomosis in a Patient with Severe Subglottic Stenosis after Intra-cardiac Repair for Tetralogy of Fallot","authors":"Vishnu Anandan, Sambhunath Das","doi":"10.25259/jccc_54_2023","DOIUrl":"https://doi.org/10.25259/jccc_54_2023","url":null,"abstract":"Subglottic stenosis is a condition causing narrowing of the trachea, which can occur rarely secondary to trauma, infection, tumors, inflammatory, and iatrogenic causes. In our case, the child developed subglottic stenosis post-cardiac surgery after being mechanically ventilated in the postoperative period. The causes for subglottic stenosis may be some trauma in the presence of coagulation abnormalities in cyanotic heart diseases such as TOF, the ischemia to the subglottic tissue by reduced perfusion during cardiopulmonary bypass, and/or the trauma caused by crying and fighting of the child while being with the endotracheal tube. Anesthetic management of the surgery is challenging for the anesthesiologist due to the shared airway by the surgeon and the anesthesiologist. The inability to effectively ventilate the patient after induction of general anesthesia will result in catastrophic complications. Subglottic stenosis requires careful planning and execution along with proper communication between the team.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain following thoracotomy is severe and requires adequate analgesia for better postoperative recovery. Epidural analgesia is considered the gold standard for thoracotomy pain. A newer ultrasound-guided analgesic technique, erector spinae plane block, has multidermatomal sensory block. We report two cases, for which an ultrasound-guided continuous erector spinae plane block was given using an 18G catheter. Both the patients received a continuous local anesthetic infusion for 48 hours and were pain-free. Erector spinae plane block can be a suitable alternative for analgesia in patients with failed epidural or contraindication to epidural analgesia.
{"title":"Continuous Erector Spinae Plane Block in Patients with Failed Epidural","authors":"Krishna Prasanth Yadavilli, Prasanta Kumar Das, Parnandi Bhaskar Rao, Satyapriya Mohanty","doi":"10.25259/jccc_30_2023","DOIUrl":"https://doi.org/10.25259/jccc_30_2023","url":null,"abstract":"Pain following thoracotomy is severe and requires adequate analgesia for better postoperative recovery. Epidural analgesia is considered the gold standard for thoracotomy pain. A newer ultrasound-guided analgesic technique, erector spinae plane block, has multidermatomal sensory block. We report two cases, for which an ultrasound-guided continuous erector spinae plane block was given using an 18G catheter. Both the patients received a continuous local anesthetic infusion for 48 hours and were pain-free. Erector spinae plane block can be a suitable alternative for analgesia in patients with failed epidural or contraindication to epidural analgesia.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mitral valve replacement is a surgical procedure to replace a damaged or diseased mitral valve in the heart. There are different techniques for mitral valve replacement, including open-heart surgery and minimally invasive heart surgery. Here, we describe detailed steps of mitral valve replacement with a mechanical bileaflet valve which can be used by early career surgeons as a reference to perform safe cardiac surgery.
{"title":"Technical Aspects of Mitral Valve Replacement: A Guide for Beginners","authors":"A. Satsangi, S. Murtaza","doi":"10.25259/jccc_49_2023","DOIUrl":"https://doi.org/10.25259/jccc_49_2023","url":null,"abstract":"Mitral valve replacement is a surgical procedure to replace a damaged or diseased mitral valve in the heart. There are different techniques for mitral valve replacement, including open-heart surgery and minimally invasive heart surgery. Here, we describe detailed steps of mitral valve replacement with a mechanical bileaflet valve which can be used by early career surgeons as a reference to perform safe cardiac surgery.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"176 11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139233349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Extracorporeal Membrane Oxygenation in Respiratory Failure: The Challenges Ahead for a Nation","authors":"Sarvesh Pal Singh","doi":"10.25259/jccc_36_2023","DOIUrl":"https://doi.org/10.25259/jccc_36_2023","url":null,"abstract":"","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136236489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Veno-arterial ECMO and Prone Ventilation","authors":"Yatin Mehta, Prajeesh M. Nambiar","doi":"10.25259/jccc_45_2023","DOIUrl":"https://doi.org/10.25259/jccc_45_2023","url":null,"abstract":"","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136236490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tubercular tenosynovitis has also been known as compound palmar ganglion which is a misnomer. Cardiovascular complications of tuberculosis (TB) are one of the most common extrapulmonary involvements of the disease. These cardiac complications arising due to tubercular inflammation are many and varies. These range from pericarditis (high prevalence) to acute myocardial infarction, aortitis, myocarditis, and mycotic aneurysms and many others. Cardiovascular complications of TB have a high rate of morbidity and mortality rate. There should be a high index of suspicion and interdisciplinary involvement of the various required specialties in the management of such a swelling with cardiac pathophysiology as well. This case report highlights one such example of tuberculosis with acute myocardial infarction (AMI) which got unmasked post TTS surgery.
{"title":"Tubercular Tenosynovitis of the Wrist and Cardiac Correlation","authors":"Pranav Kapoor, Amrik Singh, Ayush Sood","doi":"10.25259/jccc_41_2023","DOIUrl":"https://doi.org/10.25259/jccc_41_2023","url":null,"abstract":"Tubercular tenosynovitis has also been known as compound palmar ganglion which is a misnomer. Cardiovascular complications of tuberculosis (TB) are one of the most common extrapulmonary involvements of the disease. These cardiac complications arising due to tubercular inflammation are many and varies. These range from pericarditis (high prevalence) to acute myocardial infarction, aortitis, myocarditis, and mycotic aneurysms and many others. Cardiovascular complications of TB have a high rate of morbidity and mortality rate. There should be a high index of suspicion and interdisciplinary involvement of the various required specialties in the management of such a swelling with cardiac pathophysiology as well. This case report highlights one such example of tuberculosis with acute myocardial infarction (AMI) which got unmasked post TTS surgery.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136236488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：