Implante valvular aórtico transfemoral en paciente con regurgitación aórtica severa rechazado para cirugía / Transfemoral aortic valve implantation in a patient with severe aortic regurgitation rejected for surgery

No disponible

[Arrhythmias in the pulmonary exeresis postoperative period]. / Arritmias en el postoperatorio de cirugía para exéresis pulmonar.

OBJECTIVES: To determine the frequency of episodes of cardiac arrhythmia during the period following elective exeresis of the pulmonary parenchyma (pneumonectomies, double and single lobectomies), and to study the temporal patterns of occurrence and the association of arrhythmia and certain risk factors. PATIENTS AND METHODS: Retrospective analysis of data recorded in the case histories of 100 patients admitted to the postoperative intensive care unit (PICU) between November 1991 and March 1995. RESULTS: We monitored changes in heart rate after surgery by continuous electrocardiography in 38 of the 100 patients (38%). Changes were more common in certain subgroups: older patients, those with preoperative cardiovascular and electrocardiographic abnormalities, and those who needed prolonged postoperative mechanical ventilation. Most arrhythmias were supraventricular (97.3%), the most common being atrial fibrillation (55.3%). Most diagnoses of arrhythmia (87%) were made within the first three days after surgery. Several drugs were used for treatment, based on the diagnosing anesthesiologist's criteria. Digitalis was the drug most often prescribed. Seven patients (7%) died in the PICU. Three were discharged with atrial fibrillation with ventricular response of less than 100 beats per minute. Postoperative cardiac arrhythmia was a direct cause of death of only one patient, who had ventricular fibrillation upon admission to the PICU.

[Unilateral post-bilobectomy pulmonary edema originating from thrombosis of the pulmonary vein]. / Edema pulmonar unilateral posbilobectomía originado por trombosis de la vena pulmonar.

Foucart (1875) and Ortner (1899) were the first to describe unilateral pulmonary edema as a complication of drainage of hydrothorax. Although various causes have been reported for this entity, it continues to be rare. We report a case of right unilateral pulmonary edema due to thrombosis of the superior pulmonary vein that was detected while a patient was in the recovery room after bilateral lobectomy for pulmonary tumors. The possible pathophysiological mechanisms contributing to pulmonary edema are discussed.