1/74. The fracture, dislodgement and retrieval of a probe III balloon-on-a-wire catheter.The fracture and dislodgement of an angioplasty device within the coronary arteries is a rare but increasingly noted complication. If the fragment of angioplasty balloon or guidewire is dislodged in a proximal and patent coronary artery, the likelihood of acute embolization which could lead to an acute coronary thrombus and/or myocardial infarction exists. Therefore, the immediate removal of the broken piece of the angioplasty catheter is imperative. A case of unusual fracture and dislodgement of a Probe III Balloon-on-A-Wire catheter and retrieval of the broken piece is reported.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/74. A surgical gauze appearing as a retrocardiac mass in a patient after coronary artery bypass surgery.Five years after open chest surgery because of three vessel coronary artery disease a patient was referred for progressing dyspnea and recent onset of atrial fibrillation. A retrocardiac mass was detected on chest X-ray and echocardiography. On CT-scan, the inhomogenous tumor made the diagnosis of a retained surgical gauze likely. Through a left incision the sponge was removed uneventfully and the dyspnea resolved.- - - - - - - - - - ranking = 1.6666666666667keywords = coronary (Clic here for more details about this article) |
3/74. Catheter entrapment by atrial suture during minimally invasive port-access cardiac surgery.PURPOSE: The port-access approach allows surgeons to perform heart operations through small intercostal openings, or "ports". This technique requires new skills for anesthesiologists. A pulmonary artery venting (PAV) catheter and, in some cases, a coronary sinus catheter (for administration of retrograde cardioplegia) are positioned with the aid of fluoroscopy and transesophageal echography (TEE). Both catheters have a wider diameter than the more commonly used conventional PA catheter and present distinctive features. We report a case in which a pulmonary artery venting catheter was entrapped by a suture during a port-access procedure. CLINICAL FEATURES: A 35-yr-old man with severe mitral valve insufficiency was scheduled for valve repair. After a successful bypass procedure, resistance was felt while attempting to withdraw the PAV catheter. On fluoroscopy, fixation of the catheter at the heart level was established and perforation by suture was confirmed after injection of a contrast agent. Because of the risk of cardiac wall rupture and tamponade, the thorax was reopened. After release of some atrial sutures, the catheter could be withdrawn easily. Transfixion by a suture was confirmed by visual examination. CONCLUSION: The more frequent use of a PAV catheter in minimally invasive cardiac surgery with the port-access technique should remind the anesthesiologist of the higher risk of entrapment by surgical sutures. Surgeons should be aware of the risk of accidentally transfixing this catheter during closure of the atriotomy via the port.- - - - - - - - - - ranking = 0.33333333333333keywords = coronary (Clic here for more details about this article) |
4/74. A technique to retrieve stents dislodged in the coronary artery followed by fixation in the iliac artery by means of balloon angioplasty and peripheral stent deployment.An unwelcome complication of the increasingly applied technique of coronary stenting is stent dislodgment, which may cause arterial occlusion or distal embolization, both with potentially adverse sequel. Stent dislodgment tends to occur when negotiating a tortuous artery with a balloon-mounted stent, especially if the artery is irregularly calcified or when applying a rigid stent. We have successfully applied in several patients at our laboratory a technique to retrieve a dislodged stent from the coronary artery, tow it to the iliac artery, and then deploy it locally by a peripheral balloon when retrieval through the vascular sheath seems impossible. Finally, the retrieved stent is secured by local anchoring with a peripheral stent. This technique was found to be useful and may prevent further complications and more costly interventions and hence result in a more benign clinical course. Cathet. Cardiovasc. Intervent. 49:77-81, 2000.- - - - - - - - - - ranking = 2keywords = coronary (Clic here for more details about this article) |
5/74. An unusual cause of femoral embolus.Acute lower limb ischaemia is associated with high morbidity and mortality. The authors describe an unusual cause of arterial occlusion two weeks following aorto-coronary bypass surgery. This case should make vascular surgeons aware of the possibility of prosthetic materials acting as emboli. Furthermore, they should also be mindful that the presenting symptom may be at a site and time remote from the original intervention.- - - - - - - - - - ranking = 0.33333333333333keywords = coronary (Clic here for more details about this article) |
6/74. Missiles in the heart causing coronary artery disease 44 years after injury.We present a case of two missiles in the heart causing coronary artery disease with first onset 44 years after the injury. The missiles were close to the right coronary artery and the left anterior descending coronary artery. The missiles initiated local arteriosclerosis in these vessels, with an extremely stretched time frame from injury to the onset of symptoms for coronary artery disease.- - - - - - - - - - ranking = 2.6666666666667keywords = coronary (Clic here for more details about this article) |
7/74. Uneventful 25-year course of an intracardiac intravenous catheter fragment in the right heart.We describe a patient with an intracardiac intravenous catheter fragment in the right heart that was found during fluoroscopy. The catheter fragment had broken off from an intravenous catheter inserted 25 years previously when the patient was admitted after a road accident. There were no complications during these years. The fragment was removed during coronary bypass surgery. Other cases of intracardiac foreign bodies have been described, some causing complications even after many years. Uninfected, these can be removed easily with local interventional techniques. Removal of an infected foreign body per cardiotomy has a much higher mortality risk.- - - - - - - - - - ranking = 0.33333333333333keywords = coronary (Clic here for more details about this article) |
8/74. Surgical management of entrapped percutaneous transluminal coronary angioplasty hardware.Entrapment and fracture of coronary angioplasty hardware are rare complications of percutaneous coronary artery interventions; however, when such incidents occur, they frequently require surgical management. Percutaneous retrieval should be attempted before surgical retrieval unless hemodynamic stability is a problem. Surgical intervention should focus on grafting the affected coronary vessel(s) and ensuring that there is no hardware in the aortic root that could serve as a nidus for thrombus formation. We present 3 cases from our recent experiences of entrapped, fractured hardware.- - - - - - - - - - ranking = 2.3333333333333keywords = coronary (Clic here for more details about this article) |
9/74. death due to intravenous application of enteral feed.A 6-month-old male infant was treated with intravenous infusions and enteral feed via a naso-gastric tube. Accidentally, enteral feed containing pureed carrots diluted with water was injected intravenously and the child died immediately. Carrot material could be found in the pulmonary blood vessels and in various organs of the systemic circulation.- - - - - - - - - - ranking = 0.027385096918906keywords = circulation (Clic here for more details about this article) |
10/74. Gunshot injury of the heart: an unusual cause of acute myocardial infarction.A 30-year-old man had multiple pellet injuries after being shot. An asymptomatic, acute, inferior-wall myocardial infarction was detected on an electrocardiogram at the time of a pre-anesthetic evaluation for eye surgery. A computed tomographic scan of the chest confirmed the presence of an intracardiac foreign body. coronary angiography showed occlusion of the distal right coronary artery by a pellet. The patient was managed conservatively with aspirin and metoprolol. In conclusion, a single coronary lesion, the absence of other cardiac complications, and a favorable outcome with conservative medical treatment after a gunshot injury contribute to the rarity of this case of myocardial infarction.- - - - - - - - - - ranking = 0.66666666666667keywords = coronary (Clic here for more details about this article) |
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