ABSTRACT
OBJECTIVE: Pediatric heart failure is an important cause of morbidity and mortality in childhood. Left ventricular assist devices (L-VAD) are used for bridging to transplantation in patients with indications for heart transplantation. PATIENTS AND METHODS: The children included in the study were patients who underwent implantation of an L-VAD due to advanced heart failure at Ege University Faculty of Medicine Hospital between January 2009 and January 2023. RESULTS: Of the 33 patients who underwent L-VAD implantation, 16 (48.5%) were female and 17 (51.5%) were male. The median age at surgery was 13 years (IQR, 9.5-15). The median weight was 44 kg (IQR, 25.65-52), the median height was 158 cm (IQR, 134.5-168.5), and the median body surface area was 1.37 m2 (IQR, 0.95-1.51). All patients who underwent L-VAD implantation had an echocardiographic diagnosis of dilated cardiomyopathy. The patients underwent a median of 16 (IQR, 9-21) ECGs, and the median number of 24-hour Holter ECGs obtained was 3 (IQR, 2-5). Arrhythmias that occurred after L-VAD implantation were classified as atrial and ventricular. Ventricular arrhythmia included ventricular tachycardia (VT) lasting for more than 30 seconds (sustained VT), VT lasting for less than 30 seconds (nonsustained VT), and ventricular fibrillation. Atrial arrhythmias included atrial flutter, atrial fibrillation, supraventricular tachycardia, and atrial ectopic tachycardia. During the follow-up, atrial or ventricular arrhythmias were observed in 11 (33%) patients. The most common rhythm disturbances before L-VAD implantation were ventricular arrhythmias, while after the surgery, atrial arrhythmias were found to be the most frequent. A total of 5 patients underwent cardioversion (n=2) or defibrillation (n=3) due to arrhythmia. CONCLUSIONS: In patients undergoing L-VAD implantation, rhythm disorders that could normally lead to hemodynamic instability are frequently encountered. In these rhythm disorders, medical therapy should be attempted before resorting to cardioversion or defibrillation, and subsequently, more aggressive treatment methods should be considered.
Subject(s)
Atrial Fibrillation , Heart Failure , Heart-Assist Devices , Tachycardia, Supraventricular , Tachycardia, Ventricular , Humans , Male , Female , Child , Adolescent , Heart-Assist Devices/adverse effects , Heart Failure/therapy , Heart Failure/complicationsABSTRACT
A young pregnant rottweiler bitch was presented with a large mass of tissue protruding through the vulvar lips. Foetal death was diagnosed on ultrasonography, and ovariohysterectomy was performed, at which time the bladder was observed to be dislocated caudally into the pelvic cavity under the vagina. The bladder was manually repositioned during surgery. One week later, the bitch was healthy with no evidence of dysuria, stranguria or urinary incontinence. Two months later, the owner reported that the bitch was clinically normal with no recurrence of the retroflexion. To the authors' knowledge, this is the first reported case of retroflexion of the urinary bladder during pregnancy.
Subject(s)
Dog Diseases/diagnosis , Hernia/veterinary , Pregnancy Complications/veterinary , Urinary Bladder Diseases/veterinary , Animals , Dog Diseases/etiology , Dog Diseases/surgery , Dogs , Female , Fetal Death/diagnostic imaging , Fetal Death/veterinary , Hernia/diagnosis , Herniorrhaphy , Hysterectomy/veterinary , Ovariectomy/veterinary , Perineum/surgery , Postoperative Care/veterinary , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/etiology , Pregnancy Complications/surgery , Treatment Outcome , Ultrasonography , Urinary Bladder/surgery , Urinary Bladder Diseases/diagnosis , Urinary Bladder Diseases/surgeryABSTRACT
A modified surgical technique has been developed for repairing third-degree perineal lacerations in mares. Complications of the currently used methods include rectovaginal fistula formation, urine pooling, complete dehiscence of the repair, constipation, tenesmus and difficulty of performance in the practice. The modified method is simpler and more practical. This method was performed on eight Thoroughbred mares with third-degree perineal lacerations after delivery. The rectovestibular septum was reconstructed by three lines of sutures in a transverse direction in relation to the longitudinal axis of the rectum. In one of the eight cases pneumorectum was observed after using the new method. The conception rate obtained after using the new surgical technique was 62.5%. Pregnant mares delivered normally without any new lacerations at the subsequent parturition. It can be concluded that this new surgical technique can be used successfully for repairing third-degree perineal lacerations in mares.
