ABSTRACT
Few patients with cyanotic congenital heart disease reach adulthood without a cardiac operation. The prognosis for ''unrepaired'' pulmonary atresia with ventricular septal defect is approximately 8% in the 1st decade of age. Consequently, the number of adults with this particular heart disease (unrepaired) who are expected to need a non-cardiac surgery is extremely low. General anesthesia may aggravate the preexisting right to left shunt and lead to persistent severe hypoxemia. The goal of anesthetic management should be to maintain intravascular volume. Systemic and pulmonary vascular resistance changes, such as might occur due to acidosis, hypothermia, hypercarbia or excessive airway pressures, should be avoided. Maintenance of preload, contractility and sinus rhythm is of major importance. The complex pathophysiology of such heart disease, in addition to the circumstances of emergency operation, exacerbate the total anesthetic risk. We present here a rare case of an acute appendectomy with successful outcome in an adult with pulmonary atresia and ventricular septal defect.
Subject(s)
Anesthesia, Intravenous/methods , Appendectomy , Appendicitis/surgery , Heart Defects, Congenital/complications , Androstanols , Appendicitis/complications , Arrhythmias, Cardiac/prevention & control , Contraindications , Cyanosis , Embolism, Paradoxical/prevention & control , Emergencies , Endocarditis, Subacute Bacterial/prevention & control , Female , Fentanyl , Heart Defects, Congenital/diagnostic imaging , Heart Defects, Congenital/physiopathology , Humans , Intraoperative Complications/prevention & control , Ketamine , Narcotics , Oxygen/administration & dosage , Propofol , Risk , Rocuronium , Ultrasonography , Vascular Resistance/drug effects , Young AdultSubject(s)
Endocarditis, Subacute Bacterial/diagnosis , Anti-Bacterial Agents/therapeutic use , Bacteria/isolation & purification , Echocardiography , Endocarditis, Subacute Bacterial/complications , Endocarditis, Subacute Bacterial/diagnostic imaging , Endocarditis, Subacute Bacterial/drug therapy , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/microbiology , Endocarditis, Subacute Bacterial/prevention & control , Endocarditis, Subacute Bacterial/surgery , Fatigue/etiology , Fever/etiology , Heart Valve Prosthesis Implantation , Humans , Risk Factors , Staphylococcus aureus/isolation & purification , StreptococcusSubject(s)
Antistreptolysin/drug effects , Penicillins/administration & dosage , Scarlet Fever/drug therapy , Antistreptolysin/blood , Antistreptolysin/metabolism , Child , Delayed-Action Preparations/administration & dosage , Delayed-Action Preparations/adverse effects , Endocarditis, Subacute Bacterial/prevention & control , Glomerulonephritis/prevention & control , Humans , Male , Penicillins/adverse effects , Scarlet Fever/complicationsSubject(s)
Dental Care for Children/methods , Endocarditis, Subacute Bacterial/prevention & control , Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Antibiotic Prophylaxis/methods , Child , Clindamycin/administration & dosage , Humans , Penicillins/administration & dosageSubject(s)
Endocarditis, Bacterial/prevention & control , Endocarditis, Subacute Bacterial/prevention & control , Endocarditis, Bacterial/classification , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/pathology , Endocarditis, Subacute Bacterial/classification , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/pathologySubject(s)
Endocarditis, Bacterial/prevention & control , Endocarditis, Subacute Bacterial/prevention & control , Endocarditis, Bacterial/classification , Endocarditis, Bacterial/pathology , Endocarditis, Bacterial/etiology , Endocarditis, Subacute Bacterial/classification , Endocarditis, Subacute Bacterial/pathology , Endocarditis, Subacute Bacterial/etiologySubject(s)
Endocarditis, Bacterial , Child , Child, Preschool , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/prevention & control , Endocarditis, Subacute Bacterial/diagnosis , Endocarditis, Subacute Bacterial/drug therapy , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/prevention & control , Heart Defects, Congenital/complications , Humans , Risk FactorsSubject(s)
Endocarditis, Bacterial/epidemiology , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/epidemiology , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/prevention & control , Endocarditis, Subacute Bacterial/epidemiology , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/prevention & control , Humans , Incidence , Postoperative Care/nursing , Preoperative Care/nursing , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/prevention & controlABSTRACT
En este trabajo se trata de demostrar, mediante una investigación a nivel hospitalario, la entrada de microorganismos que normalmente habitan en la flora bucal, al torrente circulatorio (bacteremias transitorias), a consecuencia de una manipulación dental, pero que pueden llegar a causar inflamación del endocardio
Subject(s)
Humans , Male , Female , Bacteremia/complications , Bacterial Infections/blood , Dental Prophylaxis/adverse effects , Anti-Bacterial Agents/administration & dosage , Bacteria, Anaerobic/isolation & purification , Endocarditis, Subacute Bacterial/prevention & controlSubject(s)
Humans , Endocarditis, Bacterial/prevention & control , Anti-Bacterial Agents/standards , Endocarditis, Bacterial/etiology , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/prevention & control , Endoscopy, Gastrointestinal/adverse effects , Endoscopy, Gastrointestinal/standards , Tooth Extraction/adverse effects , Medical Assistance/standards , Heart Valve Prosthesis/standardsSubject(s)
Humans , Endocarditis, Bacterial/prevention & control , Endocarditis, Bacterial/etiology , Endocarditis, Subacute Bacterial/etiology , Endocarditis, Subacute Bacterial/prevention & control , Endoscopy, Gastrointestinal/adverse effects , Endoscopy, Gastrointestinal/standards , Heart Valve Prosthesis/standards , Anti-Bacterial Agents/standards , Medical Assistance/standards , Tooth Extraction/adverse effectsABSTRACT
Dentists routinely treat patients who require antibiotic prophylaxis for infective endocarditis. In this article, the signs and symptoms of infective endocarditis as well as the hemodynamic events involved are discussed. Furthermore the rationale for the choice of antibiotic, the type of patient requiring prophylaxis, and the different regimes as recommended by the American Heart Association are presented.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Endocarditis, Bacterial/prevention & control , Premedication , Dental Care for Disabled , Endocarditis, Subacute Bacterial/prevention & control , HumansABSTRACT
The use of antibiotic prophylaxis during procedures in the oral cavity is described in the article. A bacteremia from oral procedures may lead to subacute bacterial endocarditis, particularly where damaged heart valves and congenital heart diseases are present. Streptococci still account for the majority of cases of bacterial endocarditis. It is also clear that certain patient groups, i.e. those with prosthetic valves, are at the greatest risk and therefore need more intensive, primarily parenteral antibiotic protection. The latest American Heart Association recommendations and the recommendations of the British Society for Antimicrobial Chemotherapy are presented in detail.
