1/52. carbon dioxide insufflation aids video-assisted thoracic surgery in a young child.A 3-year-old girl with pectus excavatum successfully underwent exploration using video-assisted thoracic surgery. A complete pericardial defect was identified. The lung was kept totally collapsed during the procedure using low-flow (1 L/min), low-pressure (7 mmHg) carbon dioxide insufflation. This technique is expected to be a safe adjunct to thoracoscopic procedures in infants and small children.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/52. Oesophageal perforation following perioperative transoesophageal echocardiography.Transoesophageal echocardiography (TOE) is being used more often by cardiothoracic anaesthetists for the perioperative management of cardiac problems. Reports of iatrogenic oesophageal perforation by instrumentation of the oesophagus are increasing. Although TOE is considered safe, it may be more risky during surgery, because the probe is passed and manipulated in an anaesthetized patient. It may be in place for several hours so the risk of mucosal pressure and thermal damage is increased. patients on cardiopulmonary bypass are also fully anticoagulated. We describe a case of oesophageal perforation following insertion of the TOE probe in a patient with gross cardiomegaly. Oesophageal distortion by cardiac enlargement may increase the risk of oesophageal perforation. Difficulty in passage of the TOE probe should be regarded with suspicion and withdrawal should be contemplated because the symptoms of oesophageal perforation are often delayed and non-specific. Delay in investigation, diagnosis and treatment will increase morbidity and mortality.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/52. Huge calcified aneurysm of the sinus of valsalva.Aneurysms of the sinus of valsalva often remain undiagnosed until they rupture. A 61-year-old man had a huge, heavily calcified unruptured aneurysm, originating from the right sinus of valsalva, detected incidentally on a chest radiograph taken for the diagnosis of cardiomegaly. Two-dimensional echocardiography revealed pericardial effusion with a huge calcified mass compressing the right ventricular outflow tract. The Doppler color-flow echocardiogram showed blood flow from the aortic root into the aneurysm. A chest computed tomographic scan revealed a large thrombosed aneurysm originating from the aortic root and measuring 10x10 cm. After pericardiocentesis, cardiac catheterization was performed, which showed that the right ventricular systolic pressure had elevated to 80 mmHg. Aortic root aortography demonstrated a huge unruptured calcified aneurysm in the sinus of valsalva arising from the right coronary sinus. The patient underwent surgical correction to prevent aneurysmal rupture and to relieve the right ventricular outflow obstruction.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/52. Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis.A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
5/52. Persistent atrial standstill, report of three cases.Three cases, of which two are brothers, of persistent atrial standstill are reported. The diagnosis was made by the lack of P wave in routine 12 leads and right atrial cavity lead, no response of atrium to electrical stimulation and absence of "a" wave in right atrial pressure curve.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/52. Vasospastic angina in a 16-year-old female.A 16-year-old female with a family history of coronary artery disease was referred to hospital because of recurrent chest oppression unrelated to exertion. Although a selective coronary angiogram showed no atherosclerotic lesions, coronary spasm was provoked by acetylcholine in the left coronary artery, accompanied by chest pain and depression of blood pressure. This is the youngest healthy young female to be diagnosed with coronary vasospasm by provocation test. Because there are no risk factors, the vasospasm must be related to unknown hereditary factors.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/52. Premature opening of aortic valve in severe aortic regurgitation.Premature opening of the aortic valve in late diastole has been demonstrated by echocardiography in a patient with severe aortic regurgitation. Valve opening coincided with the end of the diastolic murmur and equalization of aortic and left ventricular diastolic pressures. echocardiography of the aortic valve in severe aortic reflux may, therefore, provide valuable information about the underlying haemodynamic disturbance.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/52. pulmonary edema and respiratory insufficiency in acute pancreatitis.pulmonary edema, cardiac enlargement, and respiratory insufficiency may occur in patients with acute pancreatitis. The mechanisms are complex and incompletely understood, but probable etiologic factors include fluid overload, left ventricular failure, impaired respiratory excursion and microatelectasis, and a nonspecific response of the lung to various types of pulmonary injury including hypotension, intravenous crystalloids, and the effects of circulating pancreatic enzymes. Recognition of the association of pulmonary edema and respiratory insufficiency with pancreatitis is importance because early treatment with positive pressure breathing, careful fluid management and diuretics, and corticosteroids may prevent the development of irreversible respiratory failure.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/52. Persistent right atrial standstill.An asymptomatic patient with cardiomegaly caused by isolated right atrial standstill is reported. The right atrium showed no evidence of contraction on pressure records or angiographically, while the left atrium functioned normally.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/52. Malignant hypertension and microangiopathic hemolytic anemia.The fourth case found in japan manifesting the features of malignant hypertension and microangiopathic hemolytic anemia (MHA) was reported. In this case, bilateral nephrectomy brought down the blood pressure and relieved MHA. The patient has since been maintained alive and well on hemodialysis up to the time of this report.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
| | Next -> |