The aorto‐left ventricular tunnel from a fetal perspective: original case series and literature review

Abstract Background Cytomegalovirus (CMV) reactivation after placing left ventricular assist device (LVAD) is not a well-known entity with few cases reported in the literature. Here, we are presenting three cases of CMV reactivation after placing LVAD. A literature review of all reported cases in the literature was done. Case summary Three cases of advanced heart failure with reduced ejection fraction (Stage D9) had placed (LVAD) at the American University of Beirut Medical Center, a tertiary care centre in Lebanon. Within the first 2 weeks after LVAD implantation, the three patients spiked a high-grade fever for which sepsis workup was done, and antibiotics were initiated. Despite the escalating antibiotic regimens, the three patients had a persistent high-grade fever. The negative cultures and the continuous fever prompted an investigation for other causes of fever. Therefore, CMV polymerase chain reaction in blood was performed and revealed high titres. Patients received a full course of treatment with ganciclovir. The fever and the CMV titres declined after completing the antiviral therapy with better clinical outcomes. This raises the concern of CMV reactivation in LVAD patients. Discussion This case series and literature review highlight the epidemiology, incidence, and management of CMV reactivation among LVAD patients. Awareness about this clinical entity should be raised, especially with the increase of LVAD surgeries.

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Long-term outcomes following thrombectomy for acute ischemic stroke in patients with a left ventricular assist device: a case series and literature review

Acta Neurochirurgica ◽

10.1007/s00701-018-3635-4 ◽

2018 ◽

Vol 160 (9) ◽

pp. 1729-1735 ◽

Cited By ~ 4

Author(s):

Bikei Ryu ◽

Tatsuya Ishikawa ◽

Koji Yamaguchi ◽

Go Matsuoka ◽

Seiichiro Eguchi ◽

...

Keyword(s):

Ischemic Stroke ◽

Literature Review ◽

Left Ventricular Assist Device ◽

Case Series ◽

Left Ventricular ◽

Long Term Outcomes ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist

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A case series of sodium glucose co-transporter-2 inhibitor (SGLT-2i) related diabetic ketoacidosis and literature review of the possible pathophysiology

Endocrine Abstracts ◽

10.1530/endoabs.44.p75 ◽

2016 ◽

Author(s):

Jawad Bashir ◽

Steve Bain ◽

Irfan Khan ◽

Tamar Saeed

Keyword(s):

Literature Review ◽

Diabetic Ketoacidosis ◽

Case Series

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Infrapopliteal Arterial Pseudoaneurysm Development Secondary to Blunt Trauma: Case Series and Literature Review

Vascular and Endovascular Surgery ◽

10.1177/1538574420907184 ◽

2020 ◽

Vol 54 (4) ◽

pp. 367-374

Author(s):

Matthew T. Chrencik ◽

Brian Caraballo ◽

John Yokemick ◽

Peter J. Pappas ◽

Brajesh K. Lal ◽

...

Keyword(s):

Literature Review ◽

Blunt Trauma ◽

Case Series ◽

Duplex Ultrasound ◽

Endovascular Coiling ◽

Skeletal Trauma ◽

Delay In Diagnosis ◽

Tibial Arteries ◽

Pulsatile Mass ◽

Orthopedic Injuries

Objectives: Infrapopliteal arterial pseudoaneurysms (IAP) following blunt trauma with associated orthopedic injuries are uncommon, often present in a delayed fashion, and encompass a diagnostic and therapeutic dilemma. Herein, we present a series of IAPs that were diagnosed following blunt trauma and their management. Methods: Case series consisting of 3 patients and a review of the international literature. Results: Our case series included 3 patients presenting with IAPs following blunt trauma with associated orthopedic injuries. They were all identified in a delayed manner (>3 weeks) after the orthopedic injuries were treated. All patients presented with pain and a pulsatile mass while one concurrently had neurologic deficits. The pseudoaneurysms were diagnosed by duplex ultrasound and confirmed by angiography to be originating from the tibioperoneal trunk, anterior tibial, and posterior tibial arteries respectively. Two patients were treated with surgical excision. Of these, one required an arterial bypass procedure while the other underwent direct ligation only. The third patient was treated by endovascular coiling. A literature review from 1950 to the present found 51 reported cases of IAP resulting from blunt trauma. Ninety percent of trauma-related infrapopliteal injuries occurred in men with a mean delay in diagnosis of 5.6 months (median 1.8 months) after injury. Since 1950, management has shifted from primarily ligation to incorporating minimally invasive endovascular techniques when appropriate. Conclusions: Infrapopliteal artery pseudoaneurysms are rare following blunt skeletal trauma. A delay in diagnosis often occurs and can result in major morbidity and extensive surgical intervention. We recommend a high index of suspicion and a thorough vascular examination in patients with lower extremity skeletal trauma to help identify and treat these injuries early and effectively.

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