A biventricular repair for Jayce ’s one-of-a-kind heart
Amanda Mattioli was working in Afghanistan as a government contractor and had just completed a whirlwind round of travel to three separate continents when she learned she was pregnant. The helicopter unit that took her back to the main base so she could return home for her pregnancy gave her a unit sticker to commemorate her baby’s first helicopter ride. Little did she know it would also mark the beginning of a much longer journey for her and her son, William “Jayce” James. Amanda got her first hint the ride would be bumpy at her 20-week ultrasound, when she learned Jayce’s heart was on the right side of his chest, rather than the left side. She was sent to a hospital in nearby Pittsburgh for a level 2 ultrasound, where doctors discovered Jayce had three other major heart defects: complete atrioventricular canal defect (AV canal), transposition of the great arteries (TGA) and pulmonary atresia. Amanda was also referred to a geneticist. The geneticist told her it was very likely he had trisomy 18, a genetic disorder that causes severe birth defects. “She said he probably wouldn’t make it to birth, and if he did, he wouldn’t make it more than a few hours.” Amanda, overwhelmed and upset by the way this news had been delivered, returned to her local doctor and was referred to a private cardiologist in Pittsburgh for a second opinion, Dr. Prapti Kanani, a former cardiology fellow at Boston Children’s Hospital. Finding a b...
Authors: Kolb A, Gibson P, O'Sullivan ED PMID: 28931703 [PubMed - in process]
ConclusionEven though there is no strong evidence to support its use, utilization rates of mesh for laparoscopic PEHR remained high and stable between 2011 and 2014 in the USA. The use of mesh was not associated with a higher incidence of postoperative complications.
We report a patient in whom mechanical compression of the internal carotid artery by a giant external carotid artery pseudoaneurysm caused a stroke. This was a case of vascular Eagle syndrome due to the impingement of an elongated styloid process on the external carotid artery with subsequent dissection and formation of a pseudoaneurysm. Carotid ultrasonographic examination allowed distinguishing the pseudoaneurysm from other vascular and solid masses of the neck.
As a baby intern, I would leap at any excuse to (voluntarily) admit someone to the inpatient psychiatry unit. For good or ill, we are given huge autonomy, so 100% of the times I advocated for admitting someone, they were admitted, even though in retrospect some of those patients could have been treated as outpatients. Now, as a still baby PGY-2, I have taken the "least restrictive environment" mantra to heart. I'm not sure if that's a good thing, but there have been times where I had some... It's almost frightening how I've shifted from "admit all" mentality to "how can we safely discharge"
CONCLUSION: Our findings suggest that the implantation of ECMO might be considered in highly selected LT recipients with refractory septic shock. PMID: 28932731 [PubMed]
CONCLUSION: I suggested that TILT procedure could be a noninvasive operative option, predicting of size mismatched anastomosis causing prolonged ileus. Passive drainage of proximal intestinal contents might be helpful for decompress endoluminal pressure during the time of anastomosis healing with bowel movement recovery. PMID: 28932729 [PubMed]
The pregnancy association votes to regulate terminations in line with other medical procedures.
We describe a case involving a 61-year-old woman who was suffering from COA with a concomitant arch aneurysm and coronary artery disease. We managed her case via single-stage surgery that included a median sternotomy. PMID: 28932592 [PubMed]
Authors: Matsumoto K, Yamasaki N, Tsuchiya T, Miyazaki T, Kamohara R, Hatachi G, Tanigawa K, Eishi K, Nagayasu T Abstract The number of patients who need cardiac support with a left ventricular assist device (LVAD) has increased over the last decade. However, the number of reports of organ retrieval from donors with an LVAD is still small. Successful lung retrieval for single lung transplantation was performed from a donor on LVAD support. This required special care not to injure the heart, great vessels, and the device, particularly the outflow conduit, because of significant conglutination around the device. A ri...
Authors: Thabut G, Mal H Abstract With more than 50,000 procedures having been performed worldwide, lung transplantation (LT) has become the standard of care for patients with end-stage chronic respiratory failure. LT leads to dramatic improvements in both pulmonary function and health related quality of life. Survival after LTs has steadily improved, but still lags far behind that observed after other solid organ transplantations, as evidenced by a median survival rate that currently stands at 5.8 years. Because of these disappointing results, the ability of LT to expand survival has been questioned. However, the ...
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