Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Dynamic left intraventricular obstruction after reconstructive mitral valve surgery].
A 71-years-old patient, undergoing mitral valve repair for degenerative valvulopathy and correction of pectus excavatus experienced a cardiogenic shock after weaning from cardiopulmonary bypass. The shock occurred after calcium chloride administration and was unresponsive to inotropic drugs. ⋯ Discontinuation of inotropic drugs and volume expansion restored the haemodynamic status. By its haemodynamic effects calcium chloride can cause left ventricular outflow tract obstruction, recognized by transoesophageal echocardiography.
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We report the case of a patient with a history of facio-thoracic burns, the treatment of which included prolonged intubation, whose trachea could not be intubated because of a subglottic obstacle. The ventilation was easily controlled with a laryngeal mask. ⋯ The band was resected one week later. The conventional indicators for difficult intubation cannot detect the laryngotracheal obstacles to tracheal tube insertion.