1/76. Perioperative management of a patient with Werlhof disease undergoing myocardial revascularization.We herein report the case of a patient with idiopathic thrombocytopenic purpura (Werlhof disease) and coronary artery disease undergoing myocardial revascularization. The use of monomeric immunoglobulins, corticosteroids, platelets transfusion, use of a cell saver, normothermic cardiopulmonary bypass, aprotinine and homologous blood transfusion were combined in order to minimize the risk of bleeding complications in the postoperative period.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/76. 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 = 5keywords = artery (Clic here for more details about this article) |
3/76. Fatal fungal infection complicating aortic dissection following coronary artery bypass grafting.The case of a 52-year-old man with severe coronary atheroma/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went on to suffer a massive fatal haemoptysis. autopsy revealed candida infection of the graft with a secondary aortobronchial fistula.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
4/76. life-threatening haemorrhage after elevation of a fractured zygoma.A 21-year-old man presented with a fractured left zygoma after an alleged assault. The fracture was elevated four days later, at which time he had a brisk left-sided epistaxis. Recovery was uneventful except for a haematoma that was drained a month later. Two weeks after this, he was admitted after having collapsed. He was shocked and bleeding profusely from his nose. He had a further major bleed in hospital and this was treated by tying off the left external carotid artery. He has made an uneventful recovery and investigations have shown no bleeding diathesis.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
5/76. Massive postoperative swelling of the tongue: manual decompression and tactile intubation as a life-saving measure.Massive swelling of the tongue due to haemorrhage is a rare but potentially fatal complication secondary to trauma, surgery, tumour invasion or uncontrolled anticoagulant therapy. This article presents a report of bleeding from the left lingual artery secondary to elective excision of a lipoma of the floor of the mouth and subsequent life-threatening upper airway obstruction. In this case, the upper airway obstruction was managed by manual decompression of the tongue and tactile nasal intubation. To our knowledge this case provides the first description of using this method in life-threatening upper airway obstruction caused by massive haemorrhagic swelling of the tongue.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
6/76. Conservative management (packing) of hemorrhage complicating mediastinoscopy.Major hemorrhage is an uncommon complication of mediastinoscopy. Although there is a paucity of published data on the management of this problem, sternotomy and arterial repair is usually considered the treatment of choice. Two major hemorrhagic complications (1 definite and 1 possible pulmonary artery tear) occurred in a series of 324 mediastinoscopies. Mediastinoscopic gauze packing successfully controlled the hemorrhage.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
7/76. life-threatening hemorrhage of an unanticipated superficial circumflex iliac artery origin imaged with Tc-99m-labeled erythrocytes.The authors report, for the first time, the nuclear medicine diagnosis of extraperitoneal bleeding that originated from the superficial circumflex iliac artery and review the critical role of dynamic nuclear imaging techniques in the localization of sites of nonenteric hemorrhage. Dynamic imaging techniques using Tc-99m-labeled erythrocytes played a critical role in the localization of an extraperitoneal bleeding site near the entrance site of a Jackson-Pratt drain. Localization of the site remained undiagnosed before nuclear imaging despite two exploratory laparotomies and diagnostic angiography.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
8/76. Percutaneous vascular surgical closure of the brachial artery.For the first time, a suture mediated closure device was used to obtain hemostasis after a catheterization procedure was performed via the brachial artery approach. Two successive catheterization procedures, using the right and left brachial arteries, were performed in a patient, contraindicated for a procedure through the femoral approach. In both cases the closures were successful and without complications. An aggressive anticoagulation regimen could safely be prescribed to this patient because of the percutaneous surgical achievement of hemostasis. This technique should provide interesting clinical benefits in selected patients undergoing catheterization via the brachial approach.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
9/76. Recurrent hemoptysis following a systemic-to-pulmonary anastomosis in a child with a complex congenital cardiomyopathy.A 14-year-old boy with a history of congenital cardiopathy is presented. At age 4, a left systemic-to-pulmonary fistula was performed, using a tubular prosthesis to anastomose the left subclavian artery to the left pulmonary artery. Following this procedure, he developed recurrent episodes of hemoptysis, cough, and left upper lobe consolidation. Treatment resulted in clinical but no radiologic resolution. At age 6, a new right systemic-to-pulmonary anastomosis was needed, as the left one was no longer functioning. After placement of the second shunt, the hemoptysis disappeared. At age 14, flexible bronchoscopy revealed a foreign body granuloma at the left secondary carina. Rigid bronchoscopy and laser photoresection showed it to be the left vascular prosthesis, placed 10 years before. Surgery failed to remove it.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
10/76. Tracheo-innominate fistula after initial percutaneous tracheostomy.We report a tracheo-innominate fistula formation after tracheostomy in a 68-year-old man with guillain-barre syndrome. The initial percutaneous tracheostomy had to be revised surgically after the tube dislodged from its insertion site in the trachea. Three days later, massive bleeding occurred and emergency surgery revealed a fistula. This was surgically repaired but subsequently re-bled with a fatal outcome. The post mortem report found an aneurysmal ectatic innominate artery with a fistula involving the anterior tracheal wall. The aetiology, diagnosis and management of tracheo-innominate fistula are discussed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
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