Total Aortic Arch Replacement With E-Vita OPEN PLUS Hybrid Prosthesis - Initial Experience From A Single Surgical Center.

We report a rare case of an advanced stage thymoma with right superior pulmonary lobe, superior vena cava, innominate vein and pericardium invasion in a patient with Good's syndrome. In a multidisciplinary discussion, surgical resection was deemed the best initial approach, since invaded structures could be safely managed. The tumor was fully resected and included partial resection of the superior pulmonary lobe, superior vena cava and innominate vein. The encircled right phrenic nerve was dissected from the tumor and preserved. The superior vena cava and innominate vein were reconstructed using autologous pericardium patch. Immunoglobulin replacement and radiotherapy were initiated afterwards. No signs of relapse at 6 months follow-up. In such advanced cases, aggressive surgical intervention should be considered as first line of treatment, as long as full resection can be anticipated, since complete resection is the leading factor for long-term prognosis.

[Takotsubo cardiomiopathy in the context of a general anaesthesia - Case report]. / Miocardiopatia de Takotsubo no Contexto de uma Anestesia Geral - Caso Clínico.

Takotsubo cardiomiopathy was first described in 1900 by Sato et al and reported in the anaesthetic literature by Mizutani et al and Takigawa et al in 20061,4. Doron Gavish et al. were the first to publish a case report concerning a general anaesthesia. This rare syndrome results in an acute, reversible left ventricule dysfunction in the absence of an obstructive coronary disease1-3 and mimics an acute coronary syndrome. We report the clinical case of a 66 years old man, without relevant medical history, who underwent an elective inguinal hernia repair. During anesthetic emergence, the patient started with hemodynamic instability, followed by a cardiorespiratory arrest. Electrocardiographic changes were compatible with an acute myocardial infarction. The patient also revealed cardiac enzymes elevation, normal coronary angiography and severe left ventricule dysfunction and motility wall changes on ventriculogram, both typical of Takotsubo cardiomiopathy. With this case report we intend to divulge an event of this rare miocardiopathy in an anaesthetic-surgical context, probably related to physical and emotional distress.