Diagnóstico de trombosis de stent de vena cava superior mediante ecobroncoscopia / Diagnosing Superior Vena Cava Stent Thrombosis by Endobronchial Ultrasound

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[Translated article] Diagnosing Superior Vena Cava Stent Thrombosis by Endobronchial Ultrasound / Diagnóstico de trombosis de stent de vena cava superior mediante ecobroncoscopia

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Síndrome de vena cava superior en varón de 93 años / Superior vena cava syndrome in a 93-year-old man

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Principales emergencias oncológicas en el cáncer de pulmón: un análisis de un único centro / Main structural oncologic emergencies in lung cancer: a single center analysis

Introduction: Lung cancer is the leading cause of structural oncologic emergencies (OE). The clinical outcome of patients with OE is often poor and mortality is high. The aim of this study was to evaluate the incidence, clinical presentation and outcomes of patients with structural OE in patients with lung cancer. Method: Retrospective cohort study involving all lung cancer patients admitted with a structural OE (superior vena cava syndrome (SVCS) and metastatic spinal cord compression (MSCC)) between January 1, 2015 and November 30, 2019. Long-term outcome was evaluated at 90 days after de OE and during the follow-up time. A comparative analysis between SVCS group and MSCC was also made. Data analysis was performed using the SPSSv.25.0.0 with a significant level of α=5%. Results: Of the 610 patients with the diagnosis of lung cancer, and 35 (~6%) had an OE:16 a SVCS and 19 had a MSCC. OE was the first manifestation of cancer in more than 50% of patients (8 in SVCS group and in 12 in MSCC group).The mortality rate was 66% 90 days after OE and 97% at the end of follow up. Patients with MSCC had worse outcomes when compared to SVCS, with more mortality in the first 3 months and more morbidity. Conclusion: In this study, structural OE was the first manifestation of lung cancer in more than 50% of patients and its occurrence is associated with a worse prognosis. We need to be aware of this situation, especially in the emergency department, in order to minimize those consequences. Future studies are needed to determine the impact of early diagnosis, treatment patterns on OE outcomes and strategies for reducing structural OE related costs. (AU)

Abordaje toracoscópico de perforación iatrogénica de vena cava superior por catéter de diálisis / Thoracoscopic approach of iatrogenic superior vena cava perforation after dialysis catheter placement

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Unusual Coexistence: Double Superior Vena Cava and Bronchial Atresia / Una coincidencia infrecuente: doble vena cava superior y atresia bronquial

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Tumor fibroso pleural gigante / Giant pleural fibrous tumour

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Bocio endotorácico como causa infrecuente de síndrome de vena cava superior / Endothoracic goitre as an uncommon cause of superior vena cava syndrome

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Vena cava superior izquierda persistente: su importancia clínica / Persistent left superior vena cava: Clinical significance

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Seudometástasis vertebrales secundarias a circulación colateral en el síndrome de vena cava superior / Vertebral pseudometastases secondary to collateral circulation in superior vena cava syndrome

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Ausencia de vena cava superior derecha con cava superior izquierda persistente: diagnóstico fetal / Absence of the right superior vena cava and persistence of the left superior vena cava: antenatal diagnosis

La persistencia de la vena cava superior izquierda se puede considerar la anomalía venosa más común en el tórax. Sin embargo, la persistencia de vena cava superior izquierda con ausencia de la vena cava superior derecha supone una alteración muy infrecuente. Existen casos comunicados en adultos o niños, sin embargo existe muy escasa literatura sobre esta malformación en diagnóstico prenatal. Se presentan hallazgos en caso fetal (AU)

Persistence of the left superior vena cava is the most common vascular anomaly in the thoracic venous system. However, the specifi c combination of a persistent left superior vena cava and absent right superior vena cava is extremely rare. Cases have been reported in children and adults but reports of antenatal diagnosis are extremely scarce. We report the fi ndings in an antenatal case (AU)

Persistencia de la vena cava superior izquierda, un desafío en el implante de marcapasos y cateterización venosa central / Persistent left superior vena cava, challenge in implanting pacemakers and central venous catheterization

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Vena cava superior izquierda persistente con agenesia de la vena cava superior derecha / Persistent left superior vena cava with absent right superior vena cava

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Síndrome de Raghib. Tratamiento quirúrgico / Raghib Syndrome. Surgical treatment

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Síndrome de vena cava superior secundario a una forma focal idiopática de fibrosis mediastínica / Superior vena cava syndrome caused by an idiopathic localized form of mediastinal fibrosis

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Las tendencias en el tiempo de las saturaciones de oxígeno en la vena cava superior y la arteria pulmonar no son equivalentes en cirugía cardiaca / The changes in the oxygen saturations in the superior vena cava and the pulmonary artery are not the same during cardiac surgery

Objetivo Comparar los cambios de signo y magnitud de las tendencias (tSO2) de las saturaciones venosas de arteria pulmonar (tSV O2 ) y de vena cava superior (tSVC O2 ) en pacientes sometidos a cirugía cardíaca.
Pacientes y métodos: Realizamos un estudio prospectivo y observacional en 34 pacientes sometidos a cirugía cardíaca. Las medidas hemodinámicas y las extracciones de sangre se realizaron a intervalos predefinidos. Se extrajeron muestras simultáneamente del puerto distal del catéter pulmonar (SV O2 ) y del introductor del mismo (SVC O2 ). Las tSO2 se calcularon como la diferencia entre 2 medidas consecutivas. Los datos fueron procesados por test ANOVA, correlación de Pearson y análisis de Bland-Altman. Resultados: Las tSO2 de ambas variables mostraron una correlación positiva (R2 = 0,55), siendo la diferencia de las medias de 0,36 ± 7,75% y los límites de discordancia desde −15,1 a 15,9%. La probabilidad de que un cambio direccional en tSVCO2 pueda ser seguido de un cambio similar en tSVO2, mostró que el signo de las mismas coincidió en el 85,1%. Sin embargo, la magnitud del cambio coincidió en un porcentaje menor, dependiendo del considerado. Entre 0 y 5% de cambio en la tSVCO2, se encontró coincidencia con la tSVO2 en el 44,7% de los casos. Conclusiones: Considerando que el signo y magnitud de las tendencias de ambas SO2 no son intercambiables, las decisiones terapéuticas basadas en la consideración de estos parámetros deben hacerse con precaución (AU)

Objective: To evaluate the changes over time (trend) in sign and magnitude for SSVO2 and SVO2 during and after cardiac surgery.
Patients and methods: A prospective and observational study was conducted on 34 cardiac sur- gery patients. Venous blood samples were taken simultaneously from the introductor (SVCO2) and distal (SVO2) port of the pulmonary artery catheter at predefined intervals. Systemic and pulmonary hemodynamic variables were measured at the same time. The trend was calculated as the difference between 2 consecutive measurements (tSO2). Data were processed with ANOVA for multiple comparisons, Pearson correlation coefficient and Bland-Altman analysis. Results: There was a significant correlation between SVCO2 and tSVO2 (R2 =0.55), the mean of the differences was 0.36 ± 7.75%, and the limits of agreement ranged from −15.1 to 15.9%. The sign of the trend was similar in 85.1% of the paired data. However, the magnitude of the changes in tSVCO2 and tSVO2 were not always equivalent. Between 0 and 5% of the change in the tSVCO2 was coincident with only 44.7% of the tSVO2. A wide variation was found between both trends when the signs and magnitudes of the changes were taken into account. Conclusions: When considering the sign and magnitude, the change over time of central venous O2 saturations were not interchangeable in cardiac surgery patients. Clinical decisions based exclusively on tSVCO2 monitoring should be taken with caution (AU)