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Successful Treatment of Persistent Pain After Pectus Excavatum Repair Using Paravertebral Nerve Radiofrequency Thermoablation. 椎旁神经射频热消融成功治疗漏斗胸修复术后持续性疼痛。
A&A Case Reports Pub Date : 2017-01-01 DOI: 10.1213/XAA.0000000000000411
H. N. Ladenhauf, O. Stundner, R. Likar, Jörg Schnöll, R. Metzger
{"title":"Successful Treatment of Persistent Pain After Pectus Excavatum Repair Using Paravertebral Nerve Radiofrequency Thermoablation.","authors":"H. N. Ladenhauf, O. Stundner, R. Likar, Jörg Schnöll, R. Metzger","doi":"10.1213/XAA.0000000000000411","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000411","url":null,"abstract":"We present a case of a 25-year-old male patient suffering from severe prolonged pain after uneventful pectus excavatum repair that could be treated successfully by paravertebral nerve radiofrequency thermoablation. The patient was scheduled for a minimally invasive Nuss pectus excavatum repair. Surgical correction was performed under general anesthesia in combination with a thoracic peridural catheter. The immediate postoperative course was uneventful; however, the patient developed severe prolonged bilateral chest wall pain across segments T8 and T9. After failure of conservative treatment options, a specialized interventional anesthesiologist performed paravertebral nerve radiofrequency thermoablation of segment T9 bilaterally, after which the patient was pain free until scheduled removal of the pectus bar 3 years after placement.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86400021","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}
引用次数: 4
Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm. 羟钴胺素治疗肝移植血管麻痹综合征:血压恢复无血管痉挛。
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000398
H. Woehlck, Brent T. Boettcher, K. Lauer, D. Cronin, Johnny C. Hong, M. Zimmerman, Joohyun Kim, M. Selim
{"title":"Hydroxocobalamin for Vasoplegic Syndrome in Liver Transplantation: Restoration of Blood Pressure Without Vasospasm.","authors":"H. Woehlck, Brent T. Boettcher, K. Lauer, D. Cronin, Johnny C. Hong, M. Zimmerman, Joohyun Kim, M. Selim","doi":"10.1213/XAA.0000000000000398","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000398","url":null,"abstract":"Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue. This case represents the first report of hydroxocobalamin use in liver transplantation and may represent a new option for the treatment of vasoplegia and the potential vasospasm that may result from traditional vasopressors.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90046124","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}
引用次数: 23
Hypertensive Crisis From the Aquamantys Bipolar Sealing System. 来自Aquamantys双极密封系统的高血压危象。
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000401
Brian C Hardy, C. Giordano
{"title":"Hypertensive Crisis From the Aquamantys Bipolar Sealing System.","authors":"Brian C Hardy, C. Giordano","doi":"10.1213/XAA.0000000000000401","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000401","url":null,"abstract":"Hypertension is a common occurrence during general anesthesia. Apart from pathological causes of hypertension, it is rarely extreme enough to be classified as a hypertensive crisis (systolic blood pressure >180 mm Hg or diastolic blood pressure >120 mm Hg). There is literature concerning the unintentional electrocauterization of the adrenal gland leading to hypertensive crisis, but to date, no reports have been made of adrenal stimulation from the use of an Aquamantys for hemostasis. Here, we report such a case when a hypertensive crisis (systolic blood pressure >300 mm Hg) occurred while using an Aquamantys during a liver transplant after unintentional stimulation of the adrenal glands.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88212268","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}
引用次数: 1
Garlic-Induced Surgical Bleeding: How Much Is Too Much? 大蒜引起的手术出血:多少才算多?
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000403
Anna Woodbury, R. Sniecinski
{"title":"Garlic-Induced Surgical Bleeding: How Much Is Too Much?","authors":"Anna Woodbury, R. Sniecinski","doi":"10.1213/XAA.0000000000000403","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000403","url":null,"abstract":"A patient underwent C2-T2 decompression and fusion with excessive intraoperative bleeding and no clear source. The patient denied the use of blood-thinning medications, but had consumed the equivalent of 12 g garlic daily in the days leading up to the surgery. He was treated with desmopressin acetate (DDAVP) and cryoprecipitate with adequate control of bleeding. Garlic is known to have an antiplatelet effect, although the dose range necessary to create a bleeding abnormality has not yet been well described nor has the effect of taking garlic with sertraline or other agents with an established or potential effect on coagulation.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77230777","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}
引用次数: 11
Fully Automated Anesthesia and Fluid Management Using Multiple Physiologic Closed-Loop Systems in a Patient Undergoing High-Risk Surgery. 在高危手术患者中使用多个生理闭环系统的全自动麻醉和液体管理。
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000405
A. Joosten, A. Delaporte, M. Cannesson, J. Rinehart, Jean Philippe Dewilde, L. Van Obbergh, L. Barvais
{"title":"Fully Automated Anesthesia and Fluid Management Using Multiple Physiologic Closed-Loop Systems in a Patient Undergoing High-Risk Surgery.","authors":"A. Joosten, A. Delaporte, M. Cannesson, J. Rinehart, Jean Philippe Dewilde, L. Van Obbergh, L. Barvais","doi":"10.1213/XAA.0000000000000405","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000405","url":null,"abstract":"Automated delivery of anesthesia guided by processed electroencephalogram monitoring using a closed-loop system is no longer a novel concept. However, combining multiple independent physiologic closed-loop systems together has never been documented before. The purpose of this case report was to evaluate the feasibility of automated anesthesia and fluid management based on a combination of physiological variables (bispectral index, stroke volume, and stroke volume variations) using 2 independent closed-loop systems.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83494275","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}
引用次数: 18
Airway Management of a 3-Year-Old Child With a Penetrating Oropharyngeal Foreign Body Risking Vascular Injury. 1例3岁儿童穿入口咽异物致血管损伤的气道处理。
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000400
J. Eskildsen, B. Thorp, H. Baboolal
{"title":"Airway Management of a 3-Year-Old Child With a Penetrating Oropharyngeal Foreign Body Risking Vascular Injury.","authors":"J. Eskildsen, B. Thorp, H. Baboolal","doi":"10.1213/XAA.0000000000000400","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000400","url":null,"abstract":"Management of anesthesia for a child with an upper airway foreign body is fraught with particular challenges. We present the case of a 3-year-old girl who presented to the emergency department with a 12-cm sewing needle protruding from her mouth and unknown vascular involvement. We were faced with establishing a secure airway despite exclusion of mask ventilation or use of a laryngeal mask airway. Moreover, peripheral intravenous access was lost before adequate sedation. Ultimately, we were able to safely induce anesthesia and achieve endotracheal intubation. The penetrating foreign body was removed with no perioperative complications.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81198897","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}
引用次数: 3
Left Ventricular Assist Device Insertion in a Patient With Biventricular Noncompaction Cardiomyopathy, Ebstein Anomaly, and a Left Atrial Mass: A Case Report. 双室非压实性心肌病、Ebstein异常和左心房肿块患者的左心室辅助装置置入:1例报告。
A&A Case Reports Pub Date : 2016-12-15 DOI: 10.1213/XAA.0000000000000399
Nikhil Kumar, C. Troianos, Joshua S. Baisden
{"title":"Left Ventricular Assist Device Insertion in a Patient With Biventricular Noncompaction Cardiomyopathy, Ebstein Anomaly, and a Left Atrial Mass: A Case Report.","authors":"Nikhil Kumar, C. Troianos, Joshua S. Baisden","doi":"10.1213/XAA.0000000000000399","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000399","url":null,"abstract":"In this report, we present the case of a patient with biventricular noncompaction cardiomyopathy, Ebstein anomaly, and a left atrial mass who required emergent placement of a left ventricular assist device. The noncompaction cardiomyopathy complicated the left ventricular assist device implantation procedure because the thickened, trabeculated myocardium made it difficult to place the inflow cannula. We discuss our perioperative management strategy, in which transesophageal echocardiography was used, to help the surgical team identify the proper cannula placement and provide a bridge to transplantation.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"31 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78327000","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}
引用次数: 2
Reversal of Anticoagulation With Dabigatran in an 82-Year-Old Patient With Traumatic Retroperitoneal Arterial Bleeding Using the New Antidote Idarucizumab: A Case Report. 达比加群抗凝逆转82岁外伤性腹膜后动脉出血患者使用新解药Idarucizumab: 1例报告
A&A Case Reports Pub Date : 2016-12-01 DOI: 10.1213/XAA.0000000000000395
S. Hofer, C. Philipsenburg, M. Weigand, T. Brenner
{"title":"Reversal of Anticoagulation With Dabigatran in an 82-Year-Old Patient With Traumatic Retroperitoneal Arterial Bleeding Using the New Antidote Idarucizumab: A Case Report.","authors":"S. Hofer, C. Philipsenburg, M. Weigand, T. Brenner","doi":"10.1213/XAA.0000000000000395","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000395","url":null,"abstract":"Dabigatran etexilate is a direct oral anticoagulant used for the prevention of stroke in atrial fibrillation. Idarucizumab is a recently approved specific antidote that reverses the effect of dabigatran within minutes. We report the case of an 82-year-old patient with traumatic retroperitoneal arterial bleeding under anticoagulation with dabigatran etexilate. By administration of idarucizumab, we successfully normalized coagulation and saved the patient from an operation. In the course of the disease, a slight reincrease in dabigatran etexilate plasma levels was observed 2 days after the reversal, which could lead to a new onset of bleeding.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81223450","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}
引用次数: 8
Unsuccessful Redo MitraClip Procedure Leads to Acute Right Ventricular Failure in a Patient With Homozygous Familial Hypercholesterolemia and a Preexisting Atrial Septal Defect. 一例纯合子家族性高胆固醇血症和先前存在房间隔缺损的患者，不成功的二次MitraClip手术导致急性右心室衰竭。
A&A Case Reports Pub Date : 2016-12-01 DOI: 10.1213/XAA.0000000000000393
P. Saththasivam, E. Herrera, G. Lawrie, Odeaa al Jabbari, Collin M Barker, R. Sheinbaum
{"title":"Unsuccessful Redo MitraClip Procedure Leads to Acute Right Ventricular Failure in a Patient With Homozygous Familial Hypercholesterolemia and a Preexisting Atrial Septal Defect.","authors":"P. Saththasivam, E. Herrera, G. Lawrie, Odeaa al Jabbari, Collin M Barker, R. Sheinbaum","doi":"10.1213/XAA.0000000000000393","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000393","url":null,"abstract":"The MitraClip procedure is an emerging endovascular technique for treating mitral regurgitation and an attractive alternative for patients who are at high risk for open heart mitral valve repair or replacement. We present the case of a failed redo MitraClip procedure that led to acute right ventricular failure in a patient with homozygous familial hypercholesterolemia and a preexisting secundum atrial septal defect. We highlight the sequelae of the failed redo MitraClip procedure and the anesthetic challenges associated with the emergent redo sternotomy and cardiopulmonary bypass procedure required to replace the mitral valve and repair the tricuspid valve and atrial septal defect.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86393957","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}
引用次数: 9
Massive Fulminant Thrombosis During Liver Transplantation in a Patient With a Previously Unknown Antithrombin Pathway Mutation. 肝移植过程中大量暴发性血栓形成患者先前未知的抗凝血酶途径突变。
A&A Case Reports Pub Date : 2016-12-01 DOI: 10.1213/XAA.0000000000000396
D. Bezinover, S. Sugino, Yuka Imamura-Kawasawa, M. S. Bell, Z. Kadry, P. Janicki
{"title":"Massive Fulminant Thrombosis During Liver Transplantation in a Patient With a Previously Unknown Antithrombin Pathway Mutation.","authors":"D. Bezinover, S. Sugino, Yuka Imamura-Kawasawa, M. S. Bell, Z. Kadry, P. Janicki","doi":"10.1213/XAA.0000000000000396","DOIUrl":"https://doi.org/10.1213/XAA.0000000000000396","url":null,"abstract":"We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event.","PeriodicalId":6824,"journal":{"name":"A&A Case Reports ","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85303635","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}
引用次数: 0
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