RESUMO
In this report we shall describe a 34-year old woman who presented with signs and symptoms of ipsilateral subclavian steal and thoracic outlet compression syndromes. The diagnosis was confirmed by arteriography and measurement of nerve conduction velocities. Via a single approach, the first rib was resected, the left subclavian artery was ligated at its takeoff, and flow was re-established with a woven Dacron graft. Two years postoperatively, the woman has equal and full pulses and blood pressure bilaterally, good strength, and no evidence of muscle atrophy.
Assuntos
Síndrome do Roubo Subclávio/complicações , Síndrome do Desfiladeiro Torácico/complicações , Adulto , Aorta/cirurgia , Aortografia , Prótese Vascular , Feminino , Humanos , Condução Nervosa , Polietilenotereftalatos , Costelas/cirurgia , Artéria Subclávia/cirurgia , Síndrome do Roubo Subclávio/diagnóstico , Síndrome do Roubo Subclávio/cirurgia , Síndrome do Desfiladeiro Torácico/diagnóstico , Síndrome do Desfiladeiro Torácico/cirurgiaRESUMO
The cause of hypertension following satisfactory repair of coarctation of the aorta remains obscure. Most agree that significant elevation of the blood pressure after operation demands therapy. Previously the combination of trimethaphan and reserpine was utilized, but the incidence of adverse reactions was high. We recently have used the regimen of sodium nitroprusside and propranolol in six patients with gratifying results. This report reviews the problem as well as our use of nitroprusside and propranolol in managing hypertension following coarctation repair.
Assuntos
Coartação Aórtica/cirurgia , Ferricianetos/uso terapêutico , Hipertensão/tratamento farmacológico , Nitroprussiato/uso terapêutico , Propranolol/uso terapêutico , Administração Oral , Adolescente , Adulto , Prótese Vascular , Criança , Pré-Escolar , Avaliação de Medicamentos , Humanos , Hipertensão/etiologia , Infusões Parenterais , Nitroprussiato/administração & dosagem , Complicações Pós-Operatórias/tratamento farmacológico , Propranolol/administração & dosagemRESUMO
Bronchogenic cysts usually are easily recognized and treated. On occasion they can present problems in diagnosis or management. We have experienced four such cases. A two month old infant whose cyst drained transbronchially during induction of anesthesia; a nine month old infant with preoperative respiratory obstructive signs; an adult with preoperative respiratory obstruction and acute severe respiratory distress during positioning for thoracotomy; and a newborn with an opacified hemithorax associated with retained fetal pulmonary fluid. Awareness of these unusual problems with bronchogenic cysts allows for promt and accurate management and avoids delays and possible complications.