RESUMO
This case report describes a rare example of double aortic arch with a dominant left aortic arch, patent minor right aortic arch, left descending aorta, and right ligamentum arteriosum causing tracheobronchial compression in a twin baby girl with DiGeorge syndrome. She also had large right subclavian artery arising from right-sided diverticulum of Kommerell, aplastic thymus, T cell lymphopenia with normal immunoglobulin, hypocalcemia, and hypomagnesemia. The diverticulum of Kommerell was resected and minor right aortic arch, right ligamentum arteriosum, and right subclavian artery were divided through right posterolateral thoracotomy. Aortopexy was performed under bronchoscopic guidance to relieve the airway compression. We strongly suggest a right-sided approach in this type of vascular arrangement for easy access and better outcome.
Assuntos
Aorta Torácica/anormalidades , Síndromes do Arco Aórtico/patologia , Síndrome de DiGeorge/patologia , Divertículo/patologia , Ligamentos/anormalidades , Obstrução das Vias Respiratórias/patologia , Aorta Torácica/cirurgia , Síndromes do Arco Aórtico/cirurgia , Síndrome de DiGeorge/cirurgia , Divertículo/cirurgia , Feminino , Humanos , Recém-Nascido , Ligamentos/cirurgia , Artéria Subclávia/anormalidades , Artéria Subclávia/cirurgiaRESUMO
Tinnitus is a challenging condition to manage with no effective treatment. We report a case of lifelong tinnitus present in a patient who was cured with the surgical repair of his coarctation of aorta. The patient was a fit 37-year-old with coarctation of aorta, senserineural deafness and intractable tinnitus. He underwent a thoracotomy and tube by-pass of his coarctation of aorta. A complete relief of his tinnitus and improvement in his hearing was noted postoperatively and confirmed on audiograms. This is the first reported case of tinnitus due to coarctation of aorta relieved by surgical correction of the coarctation.
Assuntos
Cateterismo Cardíaco/efeitos adversos , Desferroxamina/uso terapêutico , Cardiopatias/etiologia , Quelantes de Ferro/uso terapêutico , Trombose/etiologia , Talassemia beta/tratamento farmacológico , Adolescente , Calcinose/etiologia , Calcinose/cirurgia , Cardiomiopatias/etiologia , Cardiomiopatias/cirurgia , Cateteres de Demora/efeitos adversos , Átrios do Coração , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Humanos , Achados Incidentais , Masculino , Trombose/diagnóstico por imagem , Trombose/cirurgia , Prolapso da Valva Tricúspide/etiologia , Prolapso da Valva Tricúspide/cirurgia , Ultrassonografia , Talassemia beta/complicaçõesRESUMO
Mediastinitis has a high mortality and is a major cause for concern in the neonatal cardiac surgical population. Vacuum-Assisted Closure (V.A.C.) is a newly established technique for expediting healing in the management of wounds resistant to established treatments; this includes the treatment of post-cardiotomy mediastinitis in the adult cardiac surgical patient. We describe the previously unreported use of the V.A.C. device for the successful treatment of post-cardiotomy mediastinitis in an infant. The device also improved the mechanics of respiration. We discuss potential risks and benefits of V.A.C. and suggest guidelines for its use.
