RESUMO
The ductus arteriosus is important to fetal circulation. Failure to close at birth is a common event. In this educational pictorial essay, we illustrate the association of the ductus arteriosus with a variety of congenital cardiac, vascular and pulmonary lesions. These lesions can impact the systemic circulation, the pulmonary circulation or the airway and include coarctation of the aorta, ductal origin of the pulmonary artery and vascular rings.
Assuntos
Permeabilidade do Canal Arterial , Canal Arterial , Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/diagnóstico por imagem , Coração , Humanos , Recém-Nascido , Artéria Pulmonar/diagnóstico por imagem , Circulação PulmonarRESUMO
Following extracorporeal membrane oxygenation (ECMO), two patients subsequently developed carotid aneurysms at the site of cannulation. Given the invasive nature of ECMO, vascular ultrasound and/or computerized tomographic imaging should be considered to rule out cannulation-site complications post-ECMO.
Assuntos
Lesões das Artérias Carótidas/etiologia , Oxigenação por Membrana Extracorpórea/efeitos adversos , Aneurisma Intracraniano/etiologia , Adolescente , Lesões das Artérias Carótidas/diagnóstico , Lesões das Artérias Carótidas/cirurgia , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Imageamento Tridimensional , Lactente , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/cirurgia , MasculinoRESUMO
BACKGROUND: Counts are the commonest method used to ensure that all sponges and neuropatties are removed from a surgical site before closure. When the count is not reconciled, plain radiographs of the operative site are taken to determine whether the missing patty has been left in the wound. The purpose of this study was to describe the detectability of commonly used neuropatties in the clinical setting using digital technologies. METHODS: Neuropatties were implanted into the anterior and posterior cranial fossae and the thoracolumbar extradural space of a mature male cadaver. Four neuropatty sizes were used: 3 × 1 in, 2 × ½ in, ½ × ½ in, and » × » in. Neuropatties, with size and location chosen at random, were placed in the surgical sites and anteroposterior/posterior-anterior and lateral radiographs were taken using standard portable digital radiographic equipment. Six clinicians reviewed the digital images for the presence or absence of neuropatties. The readers were not aware of the number and size of the patties that were included in each image. RESULTS: The detectability of neuropatties is dependent on the size of the neuropatty's radiopaque marker and the operative site. Neuropatties measuring 2 × ½ in and 3 × 1 in were detected reliably regardless of the operative site. » × » in neuropatties were poorly detected by neurosurgeons and radiologists in all three operative sites. Readers of various experience and background were similar in their ability to detect neuropatties under these conditions. CONCLUSIONS: Under simulated operating room conditions and using currently available neuropatties and plain radiograph imaging technology, small »-in and ½-in neuropatties are poorly visible/detectable on digital images.
Assuntos
Corpos Estranhos/diagnóstico , Procedimentos Neurocirúrgicos/efeitos adversos , Crânio/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Tampões de Gaze Cirúrgicos , Adulto , Cadáver , Corpos Estranhos/etiologia , Humanos , Masculino , Modelos Anatômicos , Procedimentos Neurocirúrgicos/instrumentação , Variações Dependentes do Observador , Radiografia , Sensibilidade e Especificidade , Crânio/cirurgia , Coluna Vertebral/cirurgiaRESUMO
Coronary artery anomalies are a well recognized feature of many cardiac malformations and have been catalogued in a number of reviews. This overview concentrates on 1) the interplay between congenital heart defects and coronary morphogenesis, examining how some of the embryology fits with the experiments of nature encountered in clinical practice; and 2) the influence of coronary anatomy on patient management. This overview uses, as examples, pulmonary atresia with intact ventricular septum, complete and congenitally corrected transpositions of the great arteries, and tetralogy of Fallot.
Assuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/embriologia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/embriologia , Angiografia Coronária , Anomalias dos Vasos Coronários/terapia , Cardiopatias Congênitas/terapia , HumanosRESUMO
Pneumothorax is a potentially life-threatening condition in the setting of the neonatal special-care nursery (SCN) that may result in rapid deterioration and death. The familiar appearances associated with pneumothorax on AP supine chest radiograph are highly specific, but limited in sensitivity. In this case report, we describe the theory and technique of thoracic ultrasound for detection of pneumothorax in the SCN, providing a viable alternative to the cross-table lateral radiograph without ionising radiation, with highly accurate results, and with minimal patient positioning.
Assuntos
Doenças do Prematuro/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Tubos Torácicos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , UltrassonografiaRESUMO
A right aortic arch, with a retroesophageal transverse arch and an aberrant left brachiocephalic artery, is a rare anomaly by itself. When combined with severe mitral stenosis and hypoplasia of the left ventricle, it is rarer still. We describe the diagnosis and treatment of this rare anomaly in an infant using a modification of the Norwood operation.