A&A practice
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Transesophageal echocardiography can be useful not only in diagnosing venous air embolism but also in guiding aspiration of air from the pulmonary artery. A 59-year-old man with a history of cirrhosis underwent combined kidney and liver transplantations. ⋯ Transesophageal echocardiography revealed air in the pulmonary artery resulting in outflow obstruction. Under echocardiographic guidance, the pulmonary arterial catheter was withdrawn to the air pocket and aspirated, resulting in improved hemodynamics and successful completion of transplantations.
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Case Reports
Challenges in Obstetric Anesthesia in a Parturient With Native American Myopathy: A Case Report.
Native American Myopathy (NAM) is an inherited, malignant hyperthermia-susceptible myopathy associated with abnormal craniofacial development and neuromuscular scoliosis. There is scant NAM anesthetic literature and, to our knowledge, no existing publications describing the anesthetic management of a NAM parturient. The constellation of symptoms of NAM in the parturient presents a number of challenges to the obstetric anesthesiologist, including difficult airway associated with craniofacial abnormalities and pregnancy, malignant hyperthermia susceptibility, and possible difficult neuraxial block. In this report, we present the anesthetic management of a parturient with NAM and previous extensive posterior spinal fusion undergoing cesarean delivery under general anesthesia.