ABSTRACT
Traumatic aortic regurgitation (AR) is a rare complication of blunt chest trauma. We described the case of a 35-year-old male who presented to our hospital with shortness of breath 7 years after sustaining blunt chest trauma associated with a motorcycle accident. Transthoracic and transesophageal echocardiogram detected severe AR with two separate jets. The patient was diagnosed with congestive heart failure due to severe AR, and surgical aortic valve replacement was performed. A large perforation of the right coronary cusp likely sustained during the initial blunt chest trauma injury was confirmed surgically. As AR caused by blunt chest trauma can gradually worsen, it is necessary to confirm if there is a history of trauma in patients with severe AR of unknown origin.
Subject(s)
Aortic Valve Stenosis/surgery , Balloon Valvuloplasty/instrumentation , Cardiac Catheters , Device Removal/methods , Transcatheter Aortic Valve Replacement/instrumentation , Aged, 80 and over , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/physiopathology , Balloon Valvuloplasty/adverse effects , Equipment Failure , Female , Humans , Severity of Illness Index , Transcatheter Aortic Valve Replacement/adverse effects , Treatment OutcomeABSTRACT
Cardiovascular complications following cocaine use are well described. We present a case of myocardial infarction and ventricular rupture in a young individual with limited underlying coronary disease and habitual cocaine use. The role of each is discussed.
Subject(s)
Cocaine-Related Disorders/complications , Heart Aneurysm/surgery , Heart Rupture, Post-Infarction/surgery , Myocardial Infarction/chemically induced , Myocardial Revascularization/methods , Adult , Cardiac Catheterization/methods , Cardiopulmonary Bypass/methods , Chest Pain/diagnosis , Chest Pain/etiology , Cocaine-Related Disorders/physiopathology , Coronary Angiography/methods , Dyspnea/diagnosis , Dyspnea/etiology , Emergency Service, Hospital , Follow-Up Studies , Heart Aneurysm/diagnostic imaging , Heart Rupture, Post-Infarction/diagnostic imaging , Humans , Male , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/surgery , Recovery of Function , Risk Assessment , Sternotomy/methods , Treatment Outcome , Wound Closure TechniquesABSTRACT
Benign metastasizing leiomyomatosis is a very rare and significantly interesting pathology of the lungs. It is a challenge to clinicians when presenting a miliary pattern in preoperative radiologic imaging because it could be any other interstitial disease or infectious in etiology such as miliary tuberculosis. We report a case of innumerable tiny nodular densities spread evenly throughout both lungs in a patient with history of hysterectomy for a fibroid uterus.
Subject(s)
Leiomyomatosis/diagnosis , Lung Neoplasms/secondary , Pneumonectomy/methods , Thoracic Surgery, Video-Assisted/methods , Uterine Neoplasms/pathology , Adult , Biopsy , Diagnosis, Differential , Female , Humans , Hysterectomy , Leiomyomatosis/surgery , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Uterine Neoplasms/surgeryABSTRACT
Respiratory failure after Ivor-Lewis esophagectomy results in poor outcomes. Limited treatment strategies are available to manage this severe complication. One possibility is extracorporeal support. We report the successful use of extracorporeal support as a successful strategy for refractory respiratory failure.
Subject(s)
Adenocarcinoma/surgery , Esophageal Neoplasms/surgery , Esophagectomy/methods , Extracorporeal Membrane Oxygenation , Humans , Male , Middle AgedABSTRACT
A 31-year-old woman was admitted to the emergency department with a stab wound to the heart. She was initially stable but rapidly developed hypotension. While the operating room and staff were in preparation, she underwent pericardiocentesis. She was then rushed to the operating room by the general surgical trauma team, who performed a bilateral anterior thoracotomy to control the bleeding. In the recovery room, the patient was still hypotensive, so cardiothoracic surgery was consulted. An echocardiogram revealed severe hypokinesis of both ventricles. The cardiothoracic surgeons returned her to the operating room and discovered that the anterior pericardium had been completely removed by the trauma team. This had caused the posterior pericardium to form a "bowstring" that almost totally obstructed pulmonary venous return and restricted right ventricular outflow of blood, inducing right-sided heart failure. This pericardial string also strangulated the left atrium posteriorly, forming 2 compartments. We repositioned the patient's heart and implanted ventricular assist devices bilaterally to provide temporary circulatory support. The patient made a good recovery. We suggest that bilateral assist device placement can be beneficial in the recovery of a stunned but otherwise normal heart.
