Subject(s)
Coronary Artery Bypass , Coronary Disease/surgery , Coronary Vessels/pathology , Arrhythmias, Cardiac/etiology , Arteriosclerosis/pathology , Arteriosclerosis/surgery , Coronary Disease/pathology , Coronary Vessels/surgery , Humans , Internal Mammary-Coronary Artery Anastomosis , Intra-Aortic Balloon Pumping , Myocardial Infarction/etiology , Postoperative ComplicationsSubject(s)
Bioprosthesis , Heart Valve Prosthesis , Mitral Valve , Postoperative Complications , Humans , Prosthesis Design , ReoperationABSTRACT
Non-chromaffin paragangliomas are very rare tumours. They arise from chemoreceptor cells at multiple sites throughout the body. They are usually very vascular and most arise in intimate contact with vital structures making their excision a surgical challenge. We describe in this paper four cases of paragangliomas in the carotid body and the jugular bulb. Their presentation was unusual. Two cases underwent excisional surgery and two had radiation treatment because they were not fit for surgery. We had to use a temporary pacemaker for preoperative preparation of the carotid body because of an associated hypersensitive carotid sinus syndrome. The clinical presentation and the surgical management will be described in this paper.
Subject(s)
Cardiac Pacing, Artificial , Carotid Body Tumor/surgery , Glomus Jugulare Tumor/surgery , Preoperative Care/methods , Adult , Aged , Carotid Body Tumor/complications , Carotid Body Tumor/diagnostic imaging , Female , Glomus Jugulare Tumor/diagnostic imaging , Humans , Male , Middle Aged , Paraneoplastic Syndromes/etiology , Paraneoplastic Syndromes/therapy , Patient Care Team , Radiography , Syncope, Vasovagal/etiology , Syncope, Vasovagal/therapyABSTRACT
OBJECTIVE: To evaluate the complication of vocal cord dysfunction following open heart surgery and its short- and long-term effects. MATERIALS AND METHODS: Five cases (1.9%) of vocal cord dysfunction which were diagnosed among 270 cases of adult open heart surgery performed at this centre between February 1993 and May 1995. RESULTS: All five patients developed respiratory insufficiency following tracheal extubation. They required reintubation and ventilation. Diagnosis was delayed in three cases because of unawareness of the problem. Tracheostomy was performed in three cases and minitracheostomy in two. In one case, shortness of breath on exertion persisted due to partial laryngeal obstruction from bilateral cord paresis and required arytenoidectomy 11 months postoperatively. CONCLUSIONS: Vocal cord dysfunction can be an easily overlooked complication after open heart surgery. It can be the cause of respiratory insufficiency following tracheal extubation and may lead to reintubation and reventilation. The cause of the problem cannot always be traced but it may be due to direct trauma of the vocal cords during tracheal intubation, or trauma of the recurrent laryngeal nerve from the cuff of the endotracheal tube. A less likely possibility is that it may result from nerve injury due to central venous cannulation, or from cold. The condition may resolve within months, but, in rare cases, may lead to permanent morbidity.
Subject(s)
Coronary Artery Bypass , Heart Valve Diseases/surgery , Heart Valve Prosthesis , Mitral Valve/surgery , Postoperative Complications/physiopathology , Vocal Cords/physiopathology , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrent Laryngeal Nerve/physiopathology , Recurrent Laryngeal Nerve Injuries , Risk Factors , Vocal Cord Paralysis/physiopathologyABSTRACT
A 23-year-old female underwent uneventful caesarian section, which was followed by massive pulmonary embolism. Pulmonary embolectomy on cardiopulmonary bypass was performed, and was complicated by massive intraabdominal haemorrhage due to a hepatic subcapsular rupture. To our knowledge, this is the first surgically orientated case of postpartum pulmonary embolectomy to be reported in the literature.
Subject(s)
Cesarean Section/adverse effects , Puerperal Disorders/etiology , Puerperal Disorders/surgery , Pulmonary Embolism/etiology , Pulmonary Embolism/surgery , Adult , Cardiopulmonary Bypass , Embolectomy , Female , Humans , Liver Diseases/etiology , Pregnancy , Rupture, Spontaneous , Treatment OutcomeABSTRACT
The authors describe a sixty-four-year-old man who underwent coronary angiography for angina pectoris and was found to have a left coronary sinus aneurysm--an extremely rare malformation.
Subject(s)
Aortic Aneurysm/congenital , Sinus of Valsalva/abnormalities , Aortic Aneurysm/diagnosis , Coronary Angiography , Echocardiography , Electrocardiography , Humans , Male , Middle AgedABSTRACT
The authors describe a case of jellyfish sting that resulted in deep venous thrombosis of the leg and thigh of a thirty-five-year-old healthy man. The authors found no mention of this complication from jellyfish sting in the literature. Successful treatment measures are described.
Subject(s)
Bites and Stings/complications , Femoral Vein , Scyphozoa , Thrombosis/etiology , Adult , Animals , Humans , Male , Thrombosis/diagnosis , Thrombosis/therapyABSTRACT
We report a case of descending necrotising mediastinitis complicating an oropharyngeal infection in a 25-year-old male. The clinical presentation, the diagnosis and the management of this rare disease and its complications are discussed in this case report with a brief review of the literature.
