The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE. Cannulation was done via femoral vein and artery. During cardiopulmonary bypass (CPB), the MAE was quickly eliminated, oxygen saturation was normalized, and the patient was hemodynamically stabilized. The surgical repair was successfully completed and the patient was decannulated and recovered without any incident.
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Epilepsia
January 2025
Division of Child Neurology, Stanford Medicine Children's Health, California, USA.
Objective: Seizures are a recognized complication of critical cardiovascular illness in infants and children. We assessed the diagnostic yield of continuous video-electroencephalography (cEEG) in a pediatric and neonatal cardiovascular intensive care unit (CVICU) by the symptoms and risk factors prompting cEEG evaluation.
Methods: This retrospective case series included all consecutive cEEGs in patients ≤21 years old performed in one CVICU over 38 months.
Cureus
December 2024
Anesthesiology, University of Maryland Medical Center, Baltimore, USA.
Left ventricular (LV) free wall rupture is a rare and often fatal complication of an acute myocardial infarction. We report the case of an LV free wall rupture after the induction of general anesthesia in an elderly woman who presented for a coronary artery bypass graft (CABG) procedure in the setting of an inferior wall ST elevation myocardial infarction (STEMI) four days prior. This case emphasizes both the differential diagnosis for and the management of refractory hypotension.
View Article and Find Full Text PDFPerfusion
January 2025
Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece.
Objectives: Compare outcomes of Del Nido (DN) versus conventional blood cardioplegia (BC) in the surgical repair of Tetralogy of Fallot (ToF).
Methods: Medical databases were searched to identify relevant clinical trials. Meta-analysis was conducted for primary (cardiopulmonary bypass [CPB] and aortic cross-clamp [ACC] times, hospital and intensive care unit [ICU] length of stay [LOS], mechanical ventilation time) and secondary (adverse events, lactate levels, volume of additional cardioplegia) endpoints.
J Cardiothorac Surg
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Objective: This study aims to investigate the clinical application value of the central venous-arterial carbon dioxide partial pressure difference (Pv-aCO2) in postoperative cognitive dysfunction(POCD) in patients with acute aortic dissection.
Methods: A retrospective analysis was conducted on the general data of 236 patients. Blood gas samples were collected from the arterial and venous lines at various time points during the surgery, including before and after the initiation of cardiopulmonary bypass (CPB), immediately after CPB initiation, before and after deep hypothermic circulatory arrest, 30 min after rewarming, and 5 min before weaning from CPB.
J Cardiothorac Surg
January 2025
University of Medicine and Pharmacy - Vietnam National University, Hanoi, Vietnam.
Background: .Endoscopic mitral valve repair has progressively been adopted as the standard approach for treating isolated mitral regurgitation across numerous renowned cardiac surgery centers worldwide. Our innovative method for mitral valve exposure has been previously described.
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