A&A practice
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Case Reports
Tricuspid Valve Avulsion After Blunt Chest Wall Trauma: A Case Report for Urgent Valve Replacement.
Tricuspid valve (TV) avulsion is rare and ordinarily does not require emergent intervention. We present the case of a polytrauma patient with traumatic TV avulsion who ultimately required urgent TV replacement in the setting of hemodynamic instability. Urgent TV replacement may be warranted after careful consideration of patient risk factors and clinical context.
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We present a case of left ventricular outflow tract (LVOT) obstruction detected by limited bedside transthoracic echocardiography (TTE). This involved a young and otherwise healthy patient presenting for elective hand surgery with a previously undetected cardiac murmur. It highlights the utility of bedside TTE as an assessment tool and shows the importance of anesthesiologists as perioperative physicians.
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We present a case of a pediatric patient who developed recurarization after a cardiac catheterization procedure. Intraoperative neuromuscular blockade was achieved with 2 doses of rocuronium, and the blockade was reversed with a bolus dose of sugammadex at the end of the procedure. While recovering in the pediatric cardiac intensive care unit, the patient developed respiratory failure and a decline in the train-of-four response. The patient fully recovered after receiving a second dose of sugammadex.
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We present a case of a 69-year-old man who underwent tracheobronchoplasty for tracheobronchomalacia using a single-lumen endotracheal tube and a Y-shaped bronchial blocker for airway management. Tracheobronchoplasty is performed by sewing mesh to plicate the posterior, membranous wall of the distal trachea and main bronchi through a right posterolateral thoracotomy. ⋯ Ideally, only conventional airway management tools are used. This case demonstrates that a single-lumen endotracheal tube with a bronchial blocker can be a straightforward strategy for airway management during tracheobronchoplasty.
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Case Reports
Fetus-in-Fetu Airway Teratoma Management of a Newborn in a Low-Resource Country: A Case Report.
A term baby was delivered by cesarean and found to have an unexpected large teratoma attached to its mouth. Surgical excision was planned within 24 hours. Anesthesia concern of airway control required multidisciplinary team consultation, airway and patient preparation, and anticipation for failure. Challenging airway cases in low-resource countries can be successfully managed with deliberate attention to detail, preparation, and experience.