RESUMO
OBJECTIVE: To observe the safety of trans-jugular pressure-monitoring catheter insertion at a tertiary care teaching hospital in Rawalpindi, Pakistan. METHODS: The observational study was carried out at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from January 1, 2004 to March 31, 2010. All patients electively scheduled to undergo cardiac surgery for congenital heart disease who had percutaneous trans-jugular pressure monitoring catheters inserted peri-operatively were included in the study. Dedicated Medtronic 3 Fr pressure monitoring catheters were passed through internal jugular vein using the modified Seldinger. The patients were followed up during the hospital stay for complications related to catheter insertion/removal. Data was analysed using SPSS version 15. RESULTS: Of the 572 patients in the study, the catheters were ultimately positioned with the tips in the pulmonary artery in 447 (78.14%)patients, right ventricle 54 (9.44%) patients, left atrium in 52 (9.09%), and in both pulmonary artery and left atrium in 19 (3.32%) patients. Duration of pressure monitoring from all the chambers was 53 +/- 19 hours post-operatively. Transient and self-limiting atrial or ventricular ectopic beats were noticed in 163 (27.58%) patients during insertion. Catheter was found to be non-functional in 12 (2.03%) patients. Only one (0.16%) patient experienced recurrent tachyarrhythmia which required the withdrawal of catheter. CONCLUSION: Insertion of trans-jugular pressure monitoring catheters during cardiac surgery for congenital heart disease is a safe and reliable technique.
Assuntos
Arritmias Cardíacas/etiologia , Cateterismo Venoso Central , Cardiopatias Congênitas/cirurgia , Veias Jugulares/cirurgia , Monitorização Intraoperatória , Complicações Pós-Operatórias/diagnóstico , Pressão Atrial , Procedimentos Cirúrgicos Cardíacos/métodos , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/métodos , Cateteres Venosos Centrais/efeitos adversos , Pré-Escolar , Análise de Falha de Equipamento , Feminino , Humanos , Lactente , Masculino , Monitorização Intraoperatória/efeitos adversos , Monitorização Intraoperatória/instrumentação , Monitorização Intraoperatória/métodos , Paquistão , Artéria Pulmonar/cirurgia , Pressão Propulsora Pulmonar , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
Coarctation of abdominal aorta, Middle aortic syndrome (MAS) is a rare disease with only 200 reported cases. MAS may present clinically as uncontrolled hypertension, abdominal claudication or lower limb claudication. Surgical treatment is effective in controlling symptoms and improves life expectancy. We present another case of this rare entity, diagnosed and treated at Armed Forced Institute of Cardiology and Combined Military Hospital, Rawalpindi. This is the second reported case of MAS diagnosed and treated in Pakistan.
