Texas Heart Institute journal
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Chronic tricuspid valve insufficiency secondary to blunt chest trauma is rare in the pediatric population, with fewer than 10 cases reported. Surgical repair has focused on the tricuspid valve. We present 2 cases of traumatic tricuspid valve insufficiency in pediatric patients after blunt chest trauma in whom tricuspid valve repair was performed along with superior cavopulmonary anastomosis. To our knowledge, this is the 1st report of the use of this combination of surgical procedures for repair of traumatic tricuspid regurgitation in either adults or children.
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A 41-year-old woman had acute respiratory failure related to a myocardial infarction. Attempts at orotracheal intubation were unsuccessful; therefore, an emergency percutaneous tracheostomy was performed. ⋯ After the tracheostomy cannula was removed, the patient recovered successfully and was discharged from the hospital. The percutaneous tracheostomy technique may be useful in similar patients who need emergency airway access.
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We designed this study to define determinants of gastrointestinal complications after cardiac surgery. From January 1992 through December 2000, 11,058 patients underwent cardiac surgery on cardiopulmonary bypass at our institution. Data were prospectively collected and univariate and multivariate analyses conducted. ⋯ Furthermore, excessive anticoagulation after valve replacement may lead to GI hemorrhage. Valve surgery, often requiring anticoagulation, increases bleeding. Monitoring mechanical ventilation and hemodynamic parameters, adopting early extubation and mobilization measures, preventing infections, and strictly monitoring renal function and anticoagulation may prevent catastrophic abdominal complications.
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Case Reports
Benzocaine-induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
We describe the cases of 2 patients who developed benzocaine-induced methemoglobinemia after the administration of benzocaine as premedication for transesophageal echocardiography. The use of intravenous methylene blue resolved the cyanosis in both patients. Physicians who perform procedures involving the application of topical anesthesia need to be aware of this side effect to prevent morbidity and mortality.
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Rupture of the pericardium with luxation of the heart after blunt trauma is a fairly rare condition but carries a high mortality rate. In this report, we describe our experience with a case of right luxation of the heart in a young patient with multiple injuries due to an automobile accident. The patient, who was in hemodynamic failure, underwent successful emergency surgical treatment to replace the heart in its anatomic site. We discuss the diagnosis and management of this dangerous event.