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At least 1,405 records · Page 78Linked to original sources
PubMed1991

Intraoperative management of severe endobronchial hemorrhage.

Endobronchial hemorrhage due to pulmonary artery perforation by a Swan-Ganz catheter developed during coronary artery bypass grafting while weaning from cardiopulmonary bypass. After reinstitution of cardio-pulmonary bypass with pulmonary artery venting, bleeding was localized to the right lower lobe bronchus using fiberoptic bronchoscopy. A Fogarty embolectomy catheter was inflated in the bronchus to tamponade successfully only the right lower lobe. This case illustrates a method of distal bronchial blockade for maximal retention of pulmonary function and avoidance of pulmonary resection.

Blood Loss, Surgical↗
PubMed1992

Prognostic significance of massive bronchogenic tumor embolus.

Massive arterial bronchogenic tumor embolus is rare, and most commonly occurs intraoperatively during pulmonary resection. Arterial obstruction from the tumor embolus carries substantial morbidity and mortality. For those patients who survive embolectomy, prognosis is most closely correlated with the TNM staging of the primary lung tumor ignoring the tumor embolus.

Bronchoscopy↗
PubMed1995

Paradoxical embolism in the presence of right-to-left shunt due to tricuspid occlusion.

The case of a 33-year-old woman suffering from a paradoxical peripheral embolism in the presence of a right-to-left shunt at the level of an ostium secundum defect is presented. A functional stenosis of the tricuspid valve due to obstruction through a thrombotic atrial mass was found to be responsible for the right-to-left shunt. Treatment consisted of peripheral embolectomy, removal of the atrial mass, and closure of the atrial septum defect.

Adult↗
PubMed1995

Extracorporeal membrane oxygenation for the treatment of massive pulmonary embolism.

After witnessing the death of a patient following pulmonary embolectomy, John H. Gibbon, Jr, developed the idea of a device for extracorporeal oxygenation and circulation. What followed has led to the present-day method of extracorporeal membrane oxygenation as an effective method of cardiorespiratory support. In this case of massive acute pulmonary embolism, its use in a conscious patient completes the circle from the first ideas of Gibbon.

Acute Disease↗
PubMed1996

Successful management of massive pulmonary tumor embolism from renal cell carcinoma.

Renal cell carcinoma occasionally invades the inferior vena cava and rarely extends to the right atrium. However, despite the frequency of venous extension, it is unusual to recognize patients with massive pulmonary tumor embolus clinically. We describe a 60-year-old man who underwent pulmonary tumor embolectomy using cardiopulmonary bypass combined with profound hypothermia and intermittent low-flow perfusion. The patient is currently alive and well without implantation metastasis 6 months after the operation.

Carcinoma, Renal Cell↗
PubMed1983

The importance of the subendothelial connective tissue to the permeability of the neointimal barrier.

The thoracic aortas from two rabbits that had survived a single embolectomy catheter lesion for 2 years were studied by transmission electron microscopy after vital staining with Evans blue. An intimal thickening was formed inside the original internal elastic lamella in the re-endothelialized areas. Small blue areas in the ventral aortic wall showed intact endothelial cells covering an amorphous structureless subendothelial matrix. These observations indicate that endothelial cells do not form an effective barrier in the absence of differentiated subendothelial connective tissue.

Animals↗
PubMed1990

Percutaneous transperineal pouch localization in low imperforate anus: a new approach.

Patients who have an imperforate anus with associated infralevator, or low rectal pouch, are candidates for a perineal anoplasty. However, in the absence of a perineal fistula, intraoperative localization and isolation of the rectal pouch can be difficult. We have developed a technique to facilitate isolation and dissection of the rectal pouch for perineal anoplasty in patients with a low imperforate anus who do not have a perineal fistula present. Pouch localization is carried out preoperatively by fluoroscopic percutaneous transperineal placement of a Fogarty embolectomy catheter through the center of the anal wink. We have used this technique successfully in four consecutive patients who had a low imperforate anus, in the absence of a perineal fistula, with the pouches 1.0 to 1.5 cm from the perineum. Results have been excellent, and the dissection of the rectal pouch was facilitated greatly by the presence of the inflated Fogarty balloon.

Anal Canal↗
PubMed1975

Retrieval of indwelling ureteral stent utilizing Fogarty catheter.

The efficacy of silicone rubber ureteral stents for long-term urinary diversion has been demonstrated to be of value in certain cases. However, complications, including migration of the stent, do occur. A method for retrieval of the ureteral stent utilizing a Fogarty arterial embolectomy catheter is described.

Female↗
PubMed1990

Catheterization of branchial sinus tracts. A new method.

The complete surgical extirpation of branchial cleft abnormalities is essential in avoiding recurrent disease. The most technically difficult maneuver is often the localization and excision of associated sinus tracts and fistulae. The authors communicate a simple yet effective technique for dealing with this difficulty utilizing the Fogarty embolectomy catheter.

Branchioma↗
PubMed1990

Cardiac myxoma--clinical experience in 24 patients.

We reviewed our clinical experience in 24 patients with cardiac myxoma. There were 8 males and 16 females, their ages ranged from 14 to 73 (mean, 48) years. Prior to echocardiographic examination, cardiac myxoma was suspected clinically in only 2 cases. The remaining patients were initially diagnosed as having mitral valvar disease (9 cases), infective endocarditis (3 cases), congestive cardiomyopathy (4 cases), pericardial effusion (1 case), systemic embolism of unknown cause (1 case), cerebrovascular accident (2 cases), ventricular septal defect (1 case) and Ebstein's malformation (1 case). The tumor was in the left atrium in 16, in the right atrium in 2, in the biatrium in 1, while one was in the right ventricle and peripheral arterial occlusion had been produced by myxoma without demonstrable cardiac tumors in the other two. Twenty-two patients underwent open heart surgery for excision of myxoma and there was no surgical mortality. Abdominal embolectomy was carried out in 2 patients; one of these 2 patients survived and 1 died. Follow-up for a mean period of 32 months (range 2 to 99 months) was possible in in 18 patients with no evidence of recurrence. We conclude that cardiac myxoma may mimic many cardiovascular diseases, so a high index of suspicion is important for its diagnosis. Echocardiography is the most useful diagnostic screening tool.

Adolescent↗
PubMed1990

Subclavian artery false aneurysm associated with brachial plexus palsy: a complication of parenteral drug addiction.

A 35-year-old female drug addict developed a painful left supraclavicular swelling and profound left arm weakness associated with left hand paresthesia and swelling after cocaine injection into the left base of her neck. Arteriogram confirmed a 3.7-cm false aneurysm of the left subclavian artery and a filling defect of the proximal left axillary artery. Emergent intraoperative treatment consisted of false aneurysm resection, embolectomy, and placement of a prosthetic graft. Distal circulation was restored, but the neurological deficit persisted in the left arm and a fever developed in the patient, necessitating rehospitalization 3 weeks after discharge. False aneurysm, a vascular complication of parenteral drug abuse, may lead precipitously to death by exsanguination if not efficiently and effectively diagnosed and treated.

Adult↗
PubMed1993

Arterial emboli of the upper extremity presenting as ischemic heart disease: case report and review.

A case of brachial artery embolism presenting as ischemic coronary artery disease is presented. The patient presented with sudden onset of left arm pain, shortness of breath, nausea, vomiting, and diaphoresis. Initial relief with sublingual nitroglycerin was seen. With further evaluation, a brachial artery embolus was diagnosed, and an embolectomy was successfully performed. Delay in diagnosis and treatment can lead to substantial morbidity, including gangrene and amputation. Misdiagnosis is common, as it is seen in the same patients at risk for ischemic heart disease, stroke, and other vascular abnormalities. An awareness of this problem is important among those who initially evaluate patients in emergency departments.

Aged↗
PubMed1991

Tumor-related obstruction of the inferior vena cava extending into the right heart--a plea for surgery in deep hypothermic circulatory arrest.

This study reviews eight patients, 39-63 years old, with tumor-related obstruction of the inferior vena cava (IVC) extending into the right atrium (n = 5) and ventricle (n = 3). Five patients suffered from renal cell carcinoma, 3 from sarcomatous disease. The general approach was a median sternotomy and laparotomy with hypothermic circulatory arrest (17.0-20.5 degrees C; 23-46 min) in six patients, while in two patients, the IVC was clamped sequentially under moderate hypothermia and extracorporeal circulation. Four patients had tumor infiltration of the IVC necessitating partial caval resection. In three, the IVC was reconstructed by fabric patches or tubular prothesis. In one patient, the continuity of the IVC was interrupted permanently. Three patients underwent nephrectomy during the same procedure, two before and one after IVC disobliteration. In one patient each, pulmonary embolectomy and intrahepatic IVC stenting were performed. Two patients died early, one due to uncontrollable hemorrhage the other due to non-cardiogenic pulmonary edema. Six patients were discharged in good physical condition and are still alive at a mean follow-up of 24 months. Five patients have since remained free of recurrence, one patient underwent three further surgical interventions for bone metastases. We feel that IVC desobliteration is feasible in selected cases with extended tumor-related obstruction with an acceptable early risk and late outcome.

Adult↗
PubMed2006

Evaluation of B-type natriuretic peptide to predict complicated pulmonary embolism in patients aged 65 years and older: brief report.

PURPOSES: We evaluated the use of plasma B-type natriuretic peptide (BNP) levels for risk stratification in elderly patients with acute pulmonary embolism (PE). BASIC PROCEDURES: Bedside BNP assay was performed blindly at admission in consecutive patients older than 65 years with acute PE. A complicated PE was defined as any of the following: death, cardiopulmonary resuscitation, mechanical ventilation, use of vasopressors, thrombolysis, surgical embolectomy, or admission in intensive care unit. MAIN FINDINGS: Fifty-one patients (age, 79 +/- 9 years) were included. Thirteen patients had adverse events: 11 were admitted in the intensive care unit and 3 died. The median BNP level (95% confidence interval [CI]) was higher in the group of patients with complicated PE, 274 pg/mL (95% CI, 142-581 pg/mL) vs 78 pg/mL (95% CI, 33-230 pg/mL) (P < .05), respectively. The receiver operating characteristic curve showed that BNP significantly predicted a complicated PE with an area under the receiver operating characteristic curve of 0.72 (95% CI, 0.58-0.83) (P < .05). The best threshold value was 200 pg/mL with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 0.69 (0.43-0.87), 0.63 (0.47-0.77), 0.39 (0.22-0.59), 0.86 (0.69-0.94), and 0.65 (0.51-0.77), respectively. CONCLUSION: Our study suggests that BNP is not a reliable marker of complicated PE in elderly patients.

Aged↗
PubMed2006

[Massive pulmonary embolism and stroke due to thrombus across the foramen ovale].

We report the case of a man admitted for massive pulmonary embolism. Transthoracic echocardiography showed a serpentine thrombus in the right atrium across the foramen oval. Because of an acute worsening of the circulatory insufficiency, an intravenous thrombolysis was prescribed and the patient recovered progressively. An early control echocardiography showed the disappearing of the intracardiac thrombus and no evidence of abnormality of interatrial septum. While there was no evidence of venous thrombosis in legs, a renal cancer was diagnosed by echography. Silent stroke were highlighted at the scanner. This clinical case leads to discuss the origin of thrombus (in situ formation or thrombus migration) as well as the treatment (heparinotherapy, thrombolysis, surgical embolectomy, definitive closure of the foramen oval).

Aged, 80 and over↗
PubMed2005

Pulmonary and paradoxical embolism in protein C and S deficient patient.

We document the case of a 67-year-old woman who presented with a history of right upper quadrant anopia, dyspnea, hypoxemia, and a systolic murmur. An intracardiac embolus wedged at a patent foramen ovale was successfully removed by resecting the atrial septum along with a pulmonary embolectomy on cardiopulmonary bypass. We review the literature with specific focus on the pathogenesis and acute treatment options of this life-threatening occurrence.

Aged↗