scholarly journals Intracardiac thrombus formation and thromboembolic events in children with cardiomyopathies: A single‐center case series

2020 ◽  
Vol 8 (9) ◽  
pp. 1693-1697
Author(s):  
Abdulrahman Bendahmash ◽  
Saeed Almanie ◽  
Abdullah Alwadai
2019 ◽  
Vol 14 (6) ◽  
pp. 1032-1036
Author(s):  
Varun Aggarwal ◽  
Kristen Sexson‐Tejtal ◽  
Wilson Lam ◽  
Santiago O. Valdes ◽  
Caridad M. de la Uz ◽  
...  

2021 ◽  
Vol 10 (15) ◽  
pp. 3212
Author(s):  
Fabiana Lucà ◽  
Simona Giubilato ◽  
Stefania Angela Di Fusco ◽  
Laura Piccioni ◽  
Carmelo Massimiliano Rao ◽  
...  

The therapeutic dilemma between rhythm and rate control in the management of atrial fibrillation (AF) is still unresolved and electrical or pharmacological cardioversion (CV) frequently represents a useful strategy. The most recent guidelines recommend anticoagulation according to individual thromboembolic risk. Vitamin K antagonists (VKAs) have been routinely used to prevent thromboembolic events. Non-vitamin K antagonist oral anticoagulants (NOACs) represent a significant advance due to their more predictable therapeutic effect and more favorable hemorrhagic risk profile. In hemodynamically unstable patients, an emergency electrical cardioversion (ECV) must be performed. In this situation, intravenous heparin or low molecular weight heparin (LMWH) should be administered before CV. In patients with AF occurring within less than 48 h, synchronized direct ECV should be the elective procedure, as it restores sinus rhythm quicker and more successfully than pharmacological cardioversion (PCV) and is associated with shorter length of hospitalization. Patients with acute onset AF were traditionally considered at lower risk of thromboembolic events due to the shorter time for atrial thrombus formation. In patients with hemodynamic stability and AF for more than 48 h, an ECV should be planned after at least 3 weeks of anticoagulation therapy. Alternatively, transesophageal echocardiography (TEE) to rule out left atrial appendage thrombus (LAAT) should be performed, followed by ECV and anticoagulation for at least 4 weeks. Theoretically, the standardized use of TEE before CV allows a better stratification of thromboembolic risk, although data available to date are not univocal.


Mycoses ◽  
2021 ◽  
Vol 64 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Eelco F. J. Meijer ◽  
Anton S. M. Dofferhoff ◽  
Oscar Hoiting ◽  
Jacques F. Meis

Author(s):  
K Talboom ◽  
I Vogel ◽  
R D Blok ◽  
S X Roodbeen ◽  
C Y Ponsioen ◽  
...  

Abstract In this single center case series with nine percent primary diversion, 86 of 94 patients alive and with complete follow-up at one year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. Meaning: Highly selective fecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared all disadvantages of a diverting stoma. In this single-centre case series, with a primary diversion rate of 9 per cent, 86 of 94 patients who were alive and had complete follow-up at 1 year had a functioning anastomosis. Seventy-five of the initial 99 patients never had a stoma. The results indicate that, with highly selective faecal diversion in combination with proactive leakage management, low anastomoses can be preserved safely, and the majority of patients will be spared the disadvantages of a diverting stoma.


2021 ◽  
pp. 102568
Author(s):  
Fatehi Elzein ◽  
Eid Alsufyani ◽  
Yahya Al Hebaishi ◽  
Mohammed Mosaad ◽  
Moayad Alqurashi ◽  
...  

2021 ◽  
Author(s):  
Christopher A. Heid ◽  
Raghav Chandra ◽  
Charles Liu ◽  
Jessica Pruszynski ◽  
Mitri K. Khoury ◽  
...  

Hernia ◽  
2021 ◽  
Author(s):  
P. U. Oppelt ◽  
I. Askevold ◽  
R. Hörbelt ◽  
F. C. Roller ◽  
W. Padberg ◽  
...  

Abstract Purpose Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature. Methods Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome. Results Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair. Conclusion Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.


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