Critical Cyanosis in a Neonate With Unusual Congenital Tricuspid Valve Lesion

2020 ◽  
Vol 11 (4) ◽  
pp. 504-506
Author(s):  
Ventsislav Boshnakov ◽  
Stojan D. Lazarov ◽  
Plamen Mitev ◽  
Ivaylo Mitev ◽  
George Konstantinov ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Normal Function ◽  
Foramen Ovale ◽  
Large Tumor ◽  
Birth Weight Neonate ◽  
The Right ◽  
Valve Lesion

We describe a case of a low birth weight neonate who presented on second day of life with progressive cyanosis and oxygen saturation of 60% by pulse oximetry. The echocardiography examination revealed a large tumor-like mass connected to the tricuspid valve, with severe obstruction of the right ventricular inflow and massive right-to-left shunt through the distended foramen ovale. A large vegetation-like lesion with calcifications was discovered intraoperatively and was debrided by shave excision technique under deep hypothermic circulatory arrest. Follow-up showed normal function of the tricuspid valve and preserved biventricular function.

Successful One-Stage Operative Resection of an Intravenous Leiomyomatosis Involving the Right-Sided Heart Chambers and Pulmonary Artery

2016 ◽  
Vol 19 (2) ◽  
pp. 064
Author(s):  
Rongjian Xu ◽  
Qi Miao ◽  
Xingrong Liu ◽  
Chaoji Zhang ◽  
Guotao Ma
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Unique Feature ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
One Stage ◽  
The Right

Intravenous leiomyomatosis (IVL) is a rare neoplastic disorder. It may extend into the right cardiac chambers, which are named after intracardiac leiomyomatosis (ICL). We describe a case of IVL extending into the right heart and pulmonary artery in a 46-year-old woman. The patient successfully underwent a one-stage operation under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest. The patient fully recovered without major complications and did not exhibit any recurrence at the 9-month follow-up. The unique feature of this case is its involvement with the pulmonary artery, which is uncommon but potentially lethal.

Treatment of Hepatic Embryonal Undifferentiated Sarcoma With Cardiothoracic Involvement

2018 ◽  
Vol 11 (4) ◽  
pp. NP199-NP202 ◽  
Author(s):  
Carlos Domínguez-Massa ◽  
Félix Serrano-Martínez ◽  
Óscar R. Blanco-Herrera ◽  
Alberto Berbel-Bonillo ◽  
Fernando Hornero-Sos ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Circulatory Arrest ◽  
Tumor Resection ◽  
Vena Cava ◽  
Hepatic Tumors ◽  
Undifferentiated Sarcoma ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Disease Free

Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided. The hepatic tumor resection was the first procedure to be performed. One week later, under cardiopulmonary bypass, deep hypothermia, and circulatory arrest, thrombectomy of the inferior vena cava and right atrium was accomplished, plus thromboendarterectomy of the right pulmonary artery. During a four-year follow-up, the patient continues to be disease-free.

scholarly journals Tricuspid valve infective endocarditis in a non-IVDU patient with atopic dermatitis

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Heerani Woodun ◽  
Sarah Bouayyad ◽  
Sura Sahib ◽  
Nadir Elamin ◽  
Steven Hunter ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Intravenous Drug User ◽  
Blood Cultures ◽  
Topical Steroids ◽  
Foramen Ovale ◽  
History Of ◽  
The Right ◽  
Systemic Infections

Abstract A 29-year-old male, with chronic atopic dermatitis (AD), presented with a 2-week history of fatigue, pyrexia and weight loss. Examination showed eczematous patches with lichenified papules, erosions on the right shin and a new murmur. Blood cultures isolated methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography showed vegetation on the tricuspid valve (TV) that was adherent to the septal leaflet. He was treated for infective endocarditis, attributed to poorly controlled AD, with intravenous Flucloxacillin. Due to ongoing sepsis and pulmonary septic emboli, Clindamycin was added. He underwent TV repair; the septal leaflet was excised, and the remnant two leaflets were brought together with a ring. His patent foramen ovale was closed. His skin was treated with topical steroids and emollients. Right-sided endocarditis of an intact TV is uncommon in a non-intravenous drug user. Therefore, this novel case portrays the importance of aggressively managing AD as it is a risk factor for significant systemic infections.

scholarly journals Complete Resolution of Wegener’s Granulomatosis Lung Granuloma After Aortic Root Replacement

Aorta ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 25-28
Author(s):  
Sarah-Jayne Edmondson ◽  
Saina Attaran ◽  
Ulrich Rosendahl
Keyword(s):  
Aortic Root ◽  
Complete Resolution ◽  
Systemic Vasculitis ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Aortic Root Replacement ◽  
Immune Stimulation ◽  
Aortic Root Dilatation ◽  
Necrotizing Granulomas

AbstractWegner’s granulomatosis (WG) is an autoimmune systemic vasculitis that results in necrotizing granulomas. We report a WG patient with a lung granuloma and aortic root dilatation, who underwent aortic root replacement on cardiopulmonary bypass (CPB). Intraoperatively, the patient suffered an aortic dissection, which was repaired immediately under deep hypothermic circulatory arrest (DHCA). Follow-up imaging showed complete granuloma resolution, despite absence of immunosuppressive therapy. Immune stimulation following CPB is well described; here, the opposite was observed and DHCA effects are discussed.

Tumors of the right atrium and the inferior vena cava operated in deep hypothermic circulatory arrest

2020 ◽  
Vol 92 (4) ◽  
pp. 17-22
Author(s):  
Edward Pietrzyk ◽  
Olga Jelonek ◽  
Iwona Gorczyca ◽  
Piotr Bryk ◽  
Beata Wożakowska-Kapłon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Inferior Vena Cava ◽  
Hospital Mortality ◽  
Kidney Cancer ◽  
Right Atrium ◽  
Inferior Vena ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Deep Hypothermic Circulatory Arrest ◽  
The Right

Introduction: Tumors which most frequently metastasize to the heart include: malignant melanoma, lung cancer, breast cancer, ovarian cancer, kidney cancer, leukemia, lymphomas and esophageal cancer. Purpose: The purpose of this paper was clinical analysis of a group of patients operated in deep hypothermic circulatory arrest due to tumors of the right atrium and the inferior vena cava. Material and method: The study covered 7 patients operated at the Cardiac Surgery Clinic with a cardiac tumor diagnosed on the basis of an echocardiographic assessment in the years 2012–2019. Before qualifying for surgical treatment, each patient underwent: thorough interview and physical examination, 12-lead ECG, laboratory tests and echocardiography. Patients additionally underwent: computed tomography of the chest or abdomen, magnetic resonance imaging and coronary angiography on the basis of which patients with significant coronary artery changes underwent simultaneous coronary artery bypass graft. After preparation, the tumor was excised from the vena cava and right atrium with simultaneous removal of the primary tumor, most often kidney cancer. Early and distant results of treatment were analyzed in the examined group of patients to determine the following endpoints: hospital mortality and survival after surgery: after 3 months and 12 months. Results: Of all operated patients: 2 individuals died in the early postoperative period due to hemorrhagic complications (hospital mortality - 28.6%), and 5 patients (71.4%) were discharged from the Clinic in a good general condition. In total, 3-month survival was 71.4%, and 12-month survival amounted to 28.6%. Conclusions: Surgeries are very complex and challenging, and usually take on average 8-10 hours. It can improve the outcomes of palliative oncological treatment, better physical function (cardiovascular fitness) and extend life from several months to several years in more than 2/3 patients.

Extradural Devascularization for Resection of a Lesser Sphenoid Wing Meningioma: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (1) ◽  
pp. E49-E49
Author(s):  
David Gallardo-Ceja ◽  
Thalia E Sanchez-Correa ◽  
Diego Mendez-Rosito
Keyword(s):  
Magnetic Resonance ◽  
Complete Removal ◽  
Resonance Imaging ◽  
Large Tumor ◽  
Anterior Clinoid Process ◽  
Operative Case ◽  
History Of ◽  
Head Clamp ◽  
The Right

Abstract We describe the case of a 42-yr-old female patient with a 2-yr history of headache that has progressively worsened. Physical examination revealed no neurological deficit. Magnetic resonance imaging showed a large tumor of the left lesser sphenoid wing that enhanced with gadolinium and produced displacement of the midline and the Sylvian fissure. A thorough analysis of the origin of the tumor was done to establish the surgical strategy. With the patient positioned supine with the head slightly turned to the right side, fixed in a 3-pin head clamp, a pterional craniotomy was performed. Since the origin of the tumor is in the lesser wing an early extradural devascularization of the tumor was done with drilling out all the hyperostotic bone of the lesser sphenoid wing, including the lateral base of the anterior clinoid process. Intradural debulking and resection showed the effect of extradural devascularization with an important decrease in bleeding, allowing the total resection of the tumor. An immediate postop magnetic resonance showed a complete removal of the tumor. The patient presented a paresis of the oculomotor nerve that completely resolved in the 3-mo follow-up. In the following video illustration, we narrate this operative case and highlight the nuances of this approach.1 The patient has given assent and written consent for videos, images, or clinical or genetic information to be published.

scholarly journals Foley catheter and deep hypothermic circulatory arrest to control bleeding in redo cardiac surgery

2004 ◽  
Vol 51 (3) ◽  
pp. 117-119
Author(s):  
Dusko Nezic ◽  
S. Borovic ◽  
Milan Cirkovic ◽  
Ljiljana Lausevic-Vuk ◽  
A. Kenkovski ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Circulatory Arrest ◽  
Foley Catheter ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
The Right ◽  
Right Atria ◽  
Combined Technique ◽  
Uncontrolled Bleeding

Two cases with catastrophic hemorrhage in redo cardiac surgery are described. In the first one tearing of right ventricle with uncontrolled bleeding occurred during sternal reentry. In the second one, tearing of the right atria occurred while the patient was on cardiopulmonary bypass. In both cases we were able to control bleeding using Foley catheter, which enabled us to proceed to deep hypothermic circulatory arrest to repair heart chambers (due to dense adhesions it was impossible to m?nage it in any other way). We have found this combined technique to be extremely useful tool to control catastrophic hemorrhage during redo cardiac surgery.

A novel augmented venous-drainage model of cardiopulmonary bypass for deep hypothermic circulatory arrest without blood priming

Perfusion ◽  
2017 ◽  
Vol 33 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Xuan Jiang ◽  
Tianxiang Gu ◽  
Yu Liu ◽  
Chun Wang ◽  
Enyi Shi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Femoral Artery ◽  
Jugular Vein ◽  
Circulatory Arrest ◽  
Venous Drainage ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Blood Gas ◽  
Left Femoral Artery ◽  
The Right

Objective: Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are commonly used in cardiac surgery. However, the mortality and morbidity are still high in practice. Developing novel protective stategies and elucidating the underlying mechanisms for the pathophysiological consequences of DHCA have been hampered because of the absence of a satisfactory recovery animal model. The aim of this study was to establish a novel and safe DHCA model without blood priming in rats to study the pathophysiology of potential complications. Methods: Ten adult male Sprague-Dawley rats (age, 14-16 weeks; weight, 200-300g) were used. The entire CPB circuit consisted of a modified reservoir, a custom-designed small-volume membrane oxygenator, a roller pump and a home-made heat exchanger, all of which were connected via silicon tubing. The volume of the priming solution was less than 10 ml. The right jugular vein, right carotid artery and left femoral artery were cannulated. The blood was drained from the right atrium through the right jugular vein and fed back to the rat via the left femoral artery. CPB was commenced at a full flow rate. The animals were cooled to a pericranial temperature of 18°C and then subjected to 45 minutes of DHCA with global ischemia. Circulatory arrest was followed by rewarming and over 60 minutes of reperfusion. CPB was terminated carefully. Blood in the circuit was centrifuged and slowly transfused to achieve optimal hematocrit. Blood gas and hemodynamic parameters were recorded at each time point before CPB, during CPB and after CPB. Results: All CPB and DHCA processes were achieved successfully. No rat died in our research. Blood gas analyses at different times were normal. Cardiac function and blood pressure were stable after the operation. The vital signs of all the rats were stable. Conclusion: The novel augmented venous-drainage CPB and DHCA model in rats could be established successfully without blood priming.

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