ABSTRACT
Devices originally designed for closure of cardiac septal defects have also been proposed for the treatment of acquired tracheo-oesophageal fistula (TOF). Choosing the right occluder device to match TOF size and shape is essential for a tailored treatment. We report the successful endoscopic closure of a post-radiotherapy TOF using preprocedural CT scan with holographic three-dimensional reconstruction and an Amplatzer atrial septal device. Complete TOF sealing was achieved with resolution of respiratory symptoms, and the patient was maintaining his ability to eat at 4-month follow-up.
Subject(s)
Heart Septal Defects, Atrial , Heart Septal Defects , Septal Occluder Device , Tracheoesophageal Fistula , Heart Septal Defects, Atrial/surgery , Humans , Surgical Mesh , Tracheoesophageal Fistula/diagnostic imaging , Tracheoesophageal Fistula/surgeryABSTRACT
BACKGROUND: Acute strangulated ventral hernia is associated with operative morbidity and mortality. General anesthesia may increase the operative risk, especially in morbidly obese and COVID-19-positive individuals. METHODS: A 67-year-old woman with body mass index (BMI) 51 kg/m2, hospitalized for SARS-CoV-2-related interstitial pneumonia and renal failure, presented with acute abdominal pain, nausea, vomiting, and abdominal tenderness secondary to giant ventral hernia strangulation. RESULTS: Due to the suspicion of vascular bowel compromise at contrast-enhanced CT scan, urgent open surgical repair surgery was performed under spinal anesthesia and Venturi mask support. There was no need for an intensive care unit (ICU) stay. Postoperative course was uneventful, and the patient was transferred to a rehabilitation center on postoperative day 10. CONCLUSION: Although some anesthetists and surgeons may be reluctant to use regional anesthesia for both emergent and elective ventral hernia repair, this may represent an excellent option in obese patients with a high respiratory risk.