1/9. Excessive bleeding on extracorporeal membrane oxygenation after surgical repair of type I truncus arteriosus: A case report.Severe bleeding remains the most common complication of extracorporeal membrane oxygenation (ECMO) following surgical repair of congenital heart defects. We present a case of excessive hemorrhage within the first hours on ECMO support after repair of a type I truncus arteriosus. Bleeding control was achieved by surgical repair following failure of conventional interventions to control hemorrhage despite normalization of laboratory coagulation parameters. Aspects associated with bleeding and bleeding control during extracorporeal circulation after cardiac surgery are discussed.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/9. Aortopulmonary collateral artery embolization during postoperative extracorporeal membrane oxygenation after arterial switch procedure.Aortopulmonary collateral arteries sometimes complicate cyanotic congenital heart defects. Combined with a relevant left-right shunt, this could result in massive airway bleeding during and after corrective surgery. A preoperatively diagnosed 1.2 mm small aortopulmonary collateral artery in a newborn suffering from transposition of the great arteries caused life-threatening airway bleeding during surgery. Postoperative extracorporeal membrane oxygenation (ECMO) was necessary, and coil embolization was performed on ECMO to terminate pulmonary bleeding.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/9. extracorporeal membrane oxygenation discontinuation despite technically successful reoperation: A case report.death remains a probable outcome of pediatric cardiac extracorporeal membrane oxygenation (ECMO) despite increasing efforts to improve the results. On venoarterial ECMO, in an obviously hopeless situation, the decision to withdraw a life supporting measure resulting in the sudden death of a child places a heavy burden on the team. After valvulotomy of critical aortic stenosis in a prenatally diagnosed term neonate, ECMO had to be installed during postoperative resuscitation. Despite technically successful homograft implantation while on ECMO complicated by postoperative bleeding, advancing multiorgan failure resulted in ECMO withdrawal. As shown in this case report, exact termination criteria are lacking but are necessary to prevent increasing team and resource related conflicts in pediatric cardiac ECMO.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/9. Use of intraligamentary anesthesia in a patient with severe hemophilia and factor viii inhibitor.This article reviews the therapeutic problems that arise in the dental management of hemophilia patients with inhibitor and suggests an anesthesia technique that may eliminate the need for factor replacement during restorative procedures. Intraligamentary anesthesia was used during restorative procedures that were performed throughout an 8-year period on a patient with factor viii inhibitor. Multiple restorative procedures were accomplished without the use of replacement factor and with no postoperative bleeding. This technique, in consultation with the patient's physician, may be performed by most general practitioners in their private offices.- - - - - - - - - - ranking = 5.6089086365866keywords = ligament (Clic here for more details about this article) |
5/9. popliteal artery laceration during arthroscopic posterior cruciate ligament reconstruction.We report a case of acute laceration of the popliteal artery during an arthroscopic posterior cruciate ligament reconstruction. This injury can occur during the creation of the posteromedial portal, the manipulation of the tissues in the posterior part of the capsule of the knee joint, or when drilling the tibial hole. We recommend that a qualified vascular surgeon should be immediately available at the time of the surgery. In case of suspecting the occurrence of a popliteal artery injury, the vascular surgeon should be immediately consulted and arteriography and vascular repair should be performed.- - - - - - - - - - ranking = 5.6089086365866keywords = ligament (Clic here for more details about this article) |
6/9. Mechanical circulatory support for profound cardiac circulatory shock status due to postoperative pulmonary artery bleeding.A 77-year-old patient suffering from life-threatening pulmonary artery bleeding after pulmonary lobectomy was resuscitated but had refractory cardiogenic shock after the bleeding was controlled. We used mechanical circulatory support with extracorporeal membrane oxygenation and intra-aortic balloon pump to overcome the hemorrhagic shock-related cardiac suppression and multi-organ injury in the post-resuscitation critical period.- - - - - - - - - - ranking = 0.2keywords = membrane (Clic here for more details about this article) |
7/9. Perioperative management of a heterozygous carrier of Glanzmann's thrombasthenia submitted to coronary artery bypass grafting with cardiopulmonary bypass.Glanzmann's thrombasthenia is a congenital hemorrhagic disorder transmitted as an autosomal recessive trait and characterized by altered production and/or assembly of the platelet membrane glycoprotein iib/IIIa receptor. We describe the perioperative management of a heterozygous carrier of Glanzmann's thrombasthenia submitted to cardiac surgery with cardiopulmonary bypass and the case was complicated by early excessive postoperative bleeding.- - - - - - - - - - ranking = 0.2keywords = membrane (Clic here for more details about this article) |
8/9. Use of thromboelastograph and factor VII for the treatment of postoperative bleeding in a pediatric patient on ECMO after cardiac surgery.This report describes a case of possibly fatal bleeding treated successfully with an "overdose" of recombinant factor VII (rFVII; Novo7). A 3.5-year-old boy had surgery for aortic stenosis and aortic arch repair and was placed on extracorporeal membrane oxygenation (ECMO) after a prolonged cardiopulmonary bypass time (CPB); there was subsequent failure to wean from CPB because of right ventricular failure. Subsequently, a severe coagulopathy developed, and despite large volume transfusions with blood and blood products, this was unresolved. Thromboelastograph (TEG) measurements were obtained, and on the advice of the hematology Department, Novo7 (recommended dose: 15-30 microg/kg) was administered at a dose of 200 microg/kg because of the severity of the bleeding. TEG was repeated, and a further dose of Novo7 was administered at 500 microg/kg; a further TEG after 15 minutes showed normalization, and the remaining bleeding was treated surgically. The patient was weaned from ECMO 48 hours later and was subsequently discharged home with no further problems. Novo7 in an "overdose" can apparently correct major coagulopathy even in patients on ECMO support with no dire effects on the ECMO circuit or the patient in a life-threatening scenario.- - - - - - - - - - ranking = 0.2keywords = membrane (Clic here for more details about this article) |
9/9. Portal hypertensive enteropathy in biliary atresia.This paper describes a rare case of biliary atresia (BA) in which massive postoperative bleeding developed due to portal hypertensive enteropathy. A 15-year-old boy had been doing well after Kasai's operation for BA. At around the age of 6 years he developed recurrent episodes of esophageal variceal bleeding and underwent esophageal transection, splenectomy, sclerotherapy, and embolization of the left gastric vein. At the age of 15 years he suddenly developed abdominal pain, hematemesis, and massive tarry stools. His hemoglobin level was 6.3 g/dl. endoscopy showed several small, polypoid lesions in the jejunum beyond Treitz' ligament. The source of the bleeding was one of these lesions located in the proximal jejunojejunostomy of the Roux-en-Y loop. Because he had repeated episodes of melena, he underwent partial resection of the jejunum under endoscopic guidance. He has since been free of gastrointestinal (GI) bleeding. From this experience, we conclude that the polypoid lesions of an enteropathy may be a cause of massive GI bleeding in the postoperative portal hypertension of BA.- - - - - - - - - - ranking = 1.1217817273173keywords = ligament (Clic here for more details about this article) |