A & A case reports
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Case Reports
Transcranial Doppler-guided deairing of a pediatric ventricular assist device: experience with twins.
We report the intraoperative courses of 2 consecutive Berlin Heart Excor® Pediatric Ventricular Assist Device implantations, in which transcranial Doppler ultrasonography helped to detect macroscopically undetected residual air bubbles captured in the pump after air removal had been correctly performed according to manufacturer's specifications. Our experience with these cases suggests that a beat-to beat deairing maneuver guided by transcranial Doppler is a useful strategy for reducing cerebral exposure to perioperative gaseous microembolism.
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Case Reports
Previously undiagnosed Reinke edema as a cause of immediate postextubation inspiratory stridor.
Reinke edema (RE) is an uncommon lesion of the vocal folds and a potential cause of complications during airway management. We report the case of a woman with previously unknown RE admitted to the intensive care unit who experienced postextubation inspiratory stridor immediately after separation from mechanical ventilation. RE should be considered among causes of postextubation stridor.
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Case Reports
Successful pregnancy and delivery in a patient with Carney complex: implications for anesthesiologists.
Carney complex is an autosomal dominant condition with widespread manifestations, including cardiac myxomas, nerve sheath tumors, and endocrinopathies. Although often associated with infertility, there are several reports of successful pregnancies in patients with Carney complex. However, none of the previous reports describe anesthetic considerations. Herein, we present a patient with Carney complex who successfully delivered vaginally with labor epidural analgesia.
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Spontaneous intracranial hypotension is a rare syndrome characterized by orthostatic headache not associated with trauma or dural puncture. In most cases, it is caused by a spontaneous spinal cerebrospinal fluid leakage as demonstrated by neuroradiological studies. ⋯ When such conservative therapy fails, an epidural blood patch is recommended. In this report, we describe the treatment of 2 patients with spontaneous intracranial hypotension who failed conservative treatment and went on to have complete and sustained resolution of their symptoms after the administration of oral fludrocortisone.