RESUMO
Coronary–cameral fistulas (CCFs) are mostly congenital in origin and rarely acquired. Clinical symptoms are decided by the hemodynamic significance of the coronary fistula. Even in asymptomatic patients, it is essential to know about coronary CCF particularly if the patient is to undergo cardiac surgery with cardioplegic cardiac arrest. Incidental finding of coronary CCF should never be ignored. Intraoperative myocardial protection and methods used are significantly influenced by such fistula.
RESUMO
Peripheral nerves can be injured by a direct result of the anesthetic technique of regional anesthesia or it can be contributed/compounded by poor perioperative positioning and padding, tourniquets, and the nature of surgery and diseases affecting the microvasculature of nerves. We present a case of perioperative peripheral nerve injuries which could not be explained by anesthesia technique nor surgery per se.
RESUMO
A patient having mitral stenosis with chronic atrial fibrillation, large left atrium, and spontaneous echo contrast is expected to have clot in LA or LAA. TEE is more sensitive to detect thrombus in LA and LAA than transthoracic echocardiography. However, false-negative results can still occur due to multilobed LAA, and a thrombus can be potentially missed.
RESUMO
Catheter insertion in central vein can potentially cause accidental arterial injury. However it is very unusual to see such catheter in aorta causing aortic regurgitation. Pressure monitoring and Ultrasound guidance can reliably prevent accidental arterial puncture.
RESUMO
High Doppler valve gradient is generally suggestive of valve thrombosis. However, it should be corroborated with the finding of restricted leaflet movement to confirm the diagnosis. In the present case, abnormally high gradient was not associated with limited leaflet movements or any valve thrombus.