Multiple systemic paradoxical embolisation of a lower limb deep vein thrombosis due to interatrial septal puncture: a rare complication of left atrial appendage occlusion.

A 75-year-old woman with a history of intracranial haemorrhage, atrial fibrillation and coronary artery bypass graft underwent elective left atrial appendage occlusion (LAAO) for stroke prevention. The procedure was successful, however on the third postoperative day, she presented with a lymph leak at the right femoral venous access site. She was admitted for conservative management of the lymph leak with immobility and intravenous fluids. Her inpatient stay was complicated by a right lower limb deep vein thrombosis (DVT), left middle cerebral artery territory ischaemic stroke, pulmonary emboli (PEs) and a splenic infarction. The mechanism of the systemic emboli was that of paradoxical emboli from the DVT passing through an interatrial septal defect created as part of the LAAO procedure, a previously unreported complication of LAAO. She was managed with 6 months of low-dose oral anticoagulation for treatment of DVT and PE and has made a full neurological recovery.

The first reported case of rabbit hemorrhagic disease in Canada.

In March 2011, rabbit hemorrhagic disease (RHD) was suspected in a 1-year-old male neutered lop-eared rabbit that had acute onset liver failure. Gross pathology, histopathology, immunohistochemistry, partial nucleic acid sequencing and phylogenetic analysis of the major capsid protein (VP60) and animal inoculation studies all supported this diagnosis making it the first confirmed case of RHD in Canada.In March 2011, rabbit hemorrhagic disease (RHD) was suspected in a 1-year-old male neutered lop-eared rabbit that had acute onset liver failure. Gross pathology, histopathology, immunohistochemistry, partial nucleic acid sequencing and phylogenetic analysis of the major capsid protein (VP60) and animal inoculation studies all supported this diagnosis making it the first confirmed case of RHD in Canada.

RésuméLe premier cas signalé de maladie hémorragique du lapin au Canada. En mars 2011, la maladie hémorragique du lapin (MHL) a été suspectée chez un lapin bélier mâle castré âgé de 1 an qui a présenté l'apparition soudaine d'une insuffisance hépatique. La pathologie macroscopique, l'histopathologie, l'immunohistochimie, le séquençage partiel de l'acide nucléique et l'analyse phylogénétique de la principale protéine de la capside (VP60) et des études d'inoculation animale ont confirmé d'emblée ce diagnostic, ce qui en fait le premier cas confirmé de MHL au Canada.(Traduit par Isabelle Vallières).