[Cerebrospinal fluid drainage in endovascular repair of thoracic aortic lesions: preliminary report of experience with 5 patients].

Endovascular repair of thoracic or thoracoabdominal aortic lesions as an alternative to open surgery, to avoid the high complication and mortality rates associated with the conventional approach, does not eliminate the risk of postoperative paraplegia. We report on a series of 5 patients with different thoracic aortic lesions who underwent endovascular stent-graft repair procedures. We describe measures to drain cerebrospinal fluid to prevent ischemic spinal cord injury.

[Severe hemodynamic deterioration during epidural anesthesia for endovascular treatment of thoracic aortic stenosis].

A 72-year-old woman diagnosed with critical descending aortic stenosis was scheduled for endovascular treatment by angioplasty and implantation of an aortic stent. Her medical history included arterial hypertension, lipid metabolic disorder, obesity, Takayasu disease, dermatopolymyositis, and alleged allergy to iodine contrast and local anesthetics. After the allergies were ruled out, it was decided to use a regional anesthetic technique to avoid the postoperative complications of general anesthesia and achieve better hemodynamic control during surgery.

[Lung transplantation and hemophilia. Preoperative considerations].

Lung transplantation is indicated in certain patients with terminal pulmonary disease. We report a case in which a single lung (left) was transplanted to a 16-year-old girl with hemophilia B; she also suffered idiopathic pulmonary fibrosis and had a history of malnutrition, osteoporosis, severe scoliosis, hepatitis C positivity and recurrent bilateral pneumothorax. Treatment with pure factor IX was started the moment the donor lung was available and was continued for 37 days after surgery.

[Refractory hypotension sustained during general anesthesia due to chronic treatment with angiotensin-converting enzyme inhibitors].

Perioperative management of angiotensin-converting enzyme inhibitors (ACEI) is controversial because of associated hypertensive episodes during induction and maintenance of anesthesia. A 71-year-old woman with a non-functioning thyroid node was scheduled for thyroid lobectomy. Her medical history included high blood pressure and she was being chronically treated with ACEI, which were taken until the morning of surgery.

[A case of malignant hyperthermia: anesthesia and recovery].

We report the case of a 29-years-old woman with Menière's syndrome undergoing surgery to drain the endolymphatic sack. After anesthetic induction trismus developed but tubes were inserted without difficulty. Tachycardia began 15 min after start of balanced anesthesia with isoflurane, as arterial oxygen saturation and CO2 pressure decreased and temperature increased.

[Selection and maintenance of lung donors].

Lung transplantation is a relatively modern procedure that can afford improvement in quality of life to certain terminal patients with irreversible respiratory failure. Selection of the donor and the recipient must be both strict and flexible, as we apply criteria that are constantly being revised and extended. The care afforded the donor must include certain elements: exhaustive monitorization that serves to guide the intravenous replacement of fluids and maintenance of hemodynamic stability; assisted ventilation with PEEP, FiO2 under 0.

Biomechanical consequences of callus development in Hoffmann, Wagner, Orthofix and Ilizarov external fixators.

A theoretical analysis by a finite elements model (FEM) of some external fixators (Hoffmann, Wagner, Orthofix and Ilizarov) was carried out. This study considered a logarithmic progress of callus elastic characteristics. A standard configuration of each fixator was defined where design and application characteristics were modified.

[Application of continuous positive pressure to the uppermost lung in patients ventilated through a single lung].

We have studied the oxygenation process in a series of 20 patients who underwent thoracic surgery and were ventilated through a single lung. There were 19 men and one woman with a mean age (+/- SD) of 63 +/- 10.5 years, a mean height of 166 +/- 37.