Appropriate Delivery of Antitachyarrhythmia Therapy Despite Magnet Placement Over Implanted Cardioverter-Defibrillator: A Case Report.

The fundamental perioperative concern for patients with implantable cardioverter-defibrillators (ICDs) is the potential for electromagnetic interference (EMI) from monopolar electrosurgery. The ICD may interpret electromagnetic signals as a tachyarrhythmia and deliver an inappropriate shock to the patient. Magnet placement is often used to avoid this problem since a magnet will often deactivate an ICD's tachyarrhythmia therapy. We report a case in which magnet placement over an ICD failed to suspend tachyarrhythmia therapy because of imprecise magnet positioning. This case demonstrates the possibility for error when relying on a magnet to suspend tachyarrhythmia therapies.

Airway Fire During Left Internal Mammary Dissection in Cardiac Surgery: A Case Report.

Previous case reports describing fire during left internal mammary artery dissection involved patients with pulmonary blebs and did not involve the airway. We present a case of an airway fire, diagnosed by the sound of a pop, the appearance of a spark, and the development of an airway circuit leak in a patient with a 4-year-old tracheostomy scar who presented for coronary artery bypass with a left internal mammary artery. The case description is followed by a brief discussion of operating room fires and their management.

Collaborative Management of Missile Injury to Right Ventricle and Subsequent Pulmonary Embolization.

Pulmonary embolization of a missile is a rare phenomenon. Localization after embolization can be confounding, and there is no consensus on management. This report describes a case of a gunshot wound to the chest with preoperative and initial intraoperative imaging localizing the bullet to the right ventricle but a negative intraoperative exploration of the right-sided cardiac chambers. Intraoperative fluoroscopy allowed for immediate localization of the bullet to the hilum of the left lung, with subsequent endovascular retrieval.