ABSTRACT
ABSTRACT Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. Methods: Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). Results: Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. Conclusion: These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.
ABSTRACT
RESUMEN La comunicación inter auricular es la segunda cardiopatía congénita después de la aorta bicuspide. Las mejoras en la técnica diagnosticas de imagen, así como el perfeccionamiento en los catéteres y dispositivos han convertido a esta técnica en el gold estándar. El uso del eco cardiograma por parte de anestesiólogos es de uso frecuente en el mundo y viene incrementándose en nuestro medio, en este caso se muestra la utilidad de la ecografía trans torácica y trans esofágica para el cierre de CIA en el laboratorio de hemodinamia, apoyados en la reconstrucción tridimensional.
ABSTRACT Inter-auricular communication is the second congenital heart disease after the bicuspid aorta. Improvements in imaging techniques as well as improvements in catheters and devices have made this technique the gold standard. The use of cardiogram echo by anesthesiologists is of frequent use in the world and is increasing in our environment, in this case the usefulness of trans thoracic and trans esophageal ultrasound for the closure of CIA in the laboratory of hemodynamics, supported in three-dimensional reconstruction.
RESUMO A comunicação interauricular é a segunda cardiopatia congênita após a aorta bicúspide. Melhorias nas técnicas de imagem, bem como melhorias nos cateteres e dispositivos fizeram desta técnica o padrão ouro. O uso de ecocardiograma por anestesiologistas é de uso frequente no mundo e está aumentando em nosso meio, neste caso a utilidade da ultrassonografia trans torácica e transesofágica para o fechamento da CIA no laboratório de hemodinâmica, apoiada na reconstrução tridimensional.
ABSTRACT
RESUMEN: El uso de la anestesia regional se ha expandido en las últimas tres décadas, cada vez son más los profesionales que optan por esta técnica frente a la administración de anestesia general. La incidencia del síndrome de cauda equina SCE se reporta aproximadamente de 1 paciente en 32000. Se describe el caso de una paciente que presenta esta complicación, su tratamiento y evolución.
ABSTRACT: The use of regional anesthesia has expanded over the last three decades, more and more professionals opting for this technique versus the administration of general anesthesia. The incidence of SCE equine tail syndrome is reported in approximately 1 patient in 32000. The case of a patient presenting this complication, its treatment and evolution is described.
RESUMO: O uso da anestesia regional se expandiu nos últimos tres débitos, cada vez mais filho e os profesionales que optan por esta técnica frente a administração de anestesia geral. A incidencia da síndrome da cauda equina SCE se reporta a aproximadamente 1 paciente em 32000. Se descreve o caso de uma paciente que esta complicada, su tratamiento y evolución.
ABSTRACT
Resumen: Las masas mediastinales son poco frecuentes, las mismas están constituidas por un grupo heterogéneo de tumores representan el 3 % de la cirugía torácica en niños (Benignos 75% y malignos 25%), a su vez pueden encontrarse en el mediastino anterior medio o posterior.1 Los síntomas, dependen de su ubicación más que del tamaño o la estirpe tumoral. Los tumores de mediastino anterior, son un desafío para el anestesiólogo por su relación con las estructuras anatómicas con riesgo de colapso del sistema cardiorespiratorio. El objetivo de esta publicación, es presentar un caso clínico de una niña con una masa mediastinal anterior y exponer el manejo anestesiológico del perioperatorio. Se enfatizarán, los conceptos más relevantes en lo referente a: presentación de cuadro clínico, exámenes de diagnósticos e implicancias anestésicas, así como el tratamiento preoperatorio, manejo anestésico del intraoperatorio y sus posibles complicaciones.
Abstract: Mediastinal masses are infrequent; they consist of a heterogeneous group of tumors that represent 3% of all thoracic surgeries performed in children (benign 75%, malignant 25%). They can be found in the mediastinum anterior middle or posterior, and the symptoms seem to depend on their location, rather than the size or tumor strain. Anterior mediastinal tumors are a challenge for anesthesiologists, because of their relationship with anatomical structures and the risk of collapse of the cardiorespiratory system. The objective of this article is to present a clinical case of a girl with an anterior mediastinal mass and to expose the anesthesiological management of the perioperative process. An emphasis is placed on the most relevant concepts regarding: clinical presentation, diagnostic tests, and anesthetic implications, and on preoperative treatment, intraoperative anesthetic management, and possible complications.
Resumo: As massas mediastinais são pouco frequentes, as mesmas consistem em um grupo heterogêneo de tumores que representam 3% da cirurgia torácica em crianças (75% benignos e 25% malignos), podem ser encontrados no mediastino anterior, médio ou posterior. 1 Os sintomas dependem mais da sua localização; que do tamanho ou estirpe tumoral. Os tumores mediastinais anteriores são um desafio para o anestesiologista, devido à sua relação com estruturas anatômicas com risco de colapso do sistema cardiorrespiratório. O objetivo desta publicação é apresentar um caso clínico de uma menina com massa mediastinal anterior e expor a manipulação anestésica do período pré-operatório. Será dada ênfase aos conceitos mais relevantes sobre: a apresentação do quadro clínico, testes diagnósticos e implicações anestésicas, assim como tratamento pré-operatório, manipulação anestésica intra-operatório e suas possíveis complicações.