Chest
-
Cancer Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Mediastinal Teratoma is a benign tumor with rare complications. On very few occasions its rupture can produce mediastinitis, fistula to the pericardium, pleura or bronchus. Our aim was to report the evolution of a patient with a cystic teratoma with bronchial fistula. ⋯ The following authors have nothing to disclose: Aurelio Wangüemert Pérez, Rita Gil, Sergio Fumero, Helena Hernandez Rodriguez, Jose Maria Hernandez Perez, Raquel Rodriguez Delgado, Nuria ManesNo Product/Research Disclosure Information.
-
Cardiovascular Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Atrio-esophageal fistula is a fatal complication of radiofrequency ablation, which is associated with 80% mortality rate. Incidence rate for atrio-esophageal fistula formation is reported to be less than 1%. Dissemination of the organisms from the gut into the vasculature is the major cause of mortality. Hence, early diagnosis and immediate surgical intervention is necessary. Here we present a case of atrio-esophageal fistula occurred as a complication of radiofrequency ablation, complicated with sepsis and embolic stroke. ⋯ Given the associated poor prognosis, prompt recognition and emergent intervention are mandatory to decrease the mortality.Reference #1: Dagres N, Hindricks G, Kottkamp H, et al. Complications of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern? J Cardiovasc Electrophysiol 2009; 20:1014-Reference #2: Cappato R, Calkins H, Chen SA, et al. Prevalence and causes of fatal outcome in catheter ablation of atrial fibrillation. J Am Coll Cardiol 2009; 53:1798-803.Reference #3: Damian Sanchez-Quintana, Jose Angel Cabrera, Vicente Climent. Anatomic Relations Between The Esophagus and Left Atrium and Relevance for Ablation of Atrial Fibrillation.Circulation. 8/29/2005DISCLOSURE: The following authors have nothing to disclose: Sravanthi NandavaramNo Product/Research Disclosure Information.
-
Lung Cancer Posters IISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Review the characteristics and outcomes of patients in our series ⋯ The following authors have nothing to disclose: Daniel Valdivia, Lucas Hoyos, Lidia Macias, David Gomez, Andres VarelaNo Product/Research Disclosure Information.
-
Surgery CasesSESSION TYPE: Case ReportsPRESENTED ON: Sunday, March 23, 2014 at 09:00 AM - 10:00 AMINTRODUCTION: Thymoma show a variable and unpredictable evolution, ranging from an indolent non-invasive attitude to a highly infiltrative and metastasising one. For invasive thymoma, the optimal treatment method remains controversial. We present the case of a woman with a thymoma with pleural and pericardial dissemination who received multimodality therapy. ⋯ The following authors have nothing to disclose: Rocio Carrera-Ceron, Juan Jacinto-Tinajero, Luis Marcelo Argote Greene, Patricio Santillán DohertyNo Product/Research Disclosure Information.
-
Cardiovascular Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: We present a case of progressive hypoxemia with platypnea-orthodeoxia developing after lung resection surgery for lung cancer. ⋯ Symptoms of hypoxemia with platypnea-orthodeoxia are concerning for shunt physiology. The differential diagnosis includes sources of intracardiac (ASD, PFO) and intrapulmonary shunting. He had a prior intracardiac shunt on an earlier echo but not on the post-operative study. He had no evidence of other cardiac causes such as pericardial effusion, constrictive pericarditis or aortic aneurysm. He had an interstitial lung disease by CT scan but this was unchanged radiographically. There was no evidence of other pulmonary causes such as COPD, thromboembolic disease or an intrapulmonary shunt (arteriovenous malformation). He had no history of liver disease with shunt from cirrhosis or history of kyphoscoliosis. Platypnea-orthodeoxia was first described in 1949 and major causes are intracardiac shunts and intrapulmonary shunts. The intracardiac shunts are right-to-left and most often include atrial septal defect, patent foramen ovale or fenestrated atrial aneurysm. Other causes include pericardial effusion, lobectomy, pneumonectomy or upper abdominal surgery. This occurs from preferential blood flow towards the atrial septum that is accentuated by altered intracardiac anatomy, compliances of the right and left heart, pulmonary vascular resistance and transient right to left pressure gradients associated with respiratory and positional changes. This is generally not associated with pulmonary hypertension and atrial right-to-left shunting has been reported despite normal right-sided pressures. A right-to-left shunt is more likely to appear after a right-sided lung resection with most patients having symptoms develop a month to several months afterwards. Noncardiac causes can include intrapulmonary shunting, such as thromboembolic disease and AVMs, or cirrhosis and kyphoscolisoss. The key to diagnosis is clinical suspicion of symptoms of dyspnea and hypoxemia, induced or worsened by an upright posture. In conclusion, interatrial shunting through a PFO or ASD is a rare but clinically significant condition after thoracic surgery. There are several underlying etiologies and can occur in the immediate postoperative period or can be more delayed.Reference #1: Interatrial Shunting After Major Thoracic Surgery: A Rare but Clinically Significant Event. Ann Thorac Surg 2012;93:1647-51Reference #2: Dyspnoea and hypoxaemia after lung surgery: the role of interatrial right-to-left shunt. Eur Respir J 2006; 28: 174-181Reference #3: Platypnoea-orthodeoxia syndrome. Heart 2000;83:221-223DISCLOSURE: The following authors have nothing to disclose: Nitin Bhatt, Ulysses MagalangNo Product/Research Disclosure Information.