Comparison Between Effect of Head Positions on the Placement of Catheter in the Internal Jugular Vein

The position of the head of the patient play an important role in the ease and success of Right Internal Jugular Vein (RIJV) cannulation using external landmark-guided technique. Sixty patients undergoing open heart surgery for both acquired and congenital heart diseases were studied in three groups-neutral head position, head rotated to 20 degree and head rotated to 30 degree to the left for RIJV cannulation. The overall success rate irrespective of number of attempts and head positions in this study was 93.3%. Complications were a bit higher than in other studies. Available literature did not compare between different degree of position of head rotation. This study compared between these groups in terms of number of attempts required for RIJV cannulation, but no significant difference was found between or within the groups (P>0.05). From this study it can be proposed that, some degree of rotation (upto 20 degree) may be allowed to make landmark prominent but extreme degree of rotation which result in more number of attempts and complications is not desired. Journal of BSA, Vol. 20, No. 2, July 2007 p.56-60

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The fourth thoracic vertebra as a radiographic landmark for the depth of right internal jugular vein catheterisation in infants: A retrospective study

10.21203/rs.3.rs-86730/v1 ◽

2020 ◽

Author(s):

Guoliang Liu ◽

Jianmin Zhang ◽

Fang Wang ◽

Heqi Liu

Keyword(s):

Internal Jugular Vein ◽

Chest Radiograph ◽

Congenital Heart ◽

Heart Surgery ◽

Jugular Vein ◽

Congenital Heart Surgery ◽

Thoracic Vertebra ◽

Chest Radiographs ◽

Significant Difference ◽

Vertebral Bodies

Abstract Backgroundː The carina is considered a reliable marker for the depth of right internal jugular vein catheterisation in infants. However, the carina is not always visible on chest radiographs, whereas vertebral bodies usually are. We performed a retrospective analysis of routine post-procedural chest radiographs of infants who had undergone congenital heart surgery and required central venous catheterisation. We evaluated the possibility of using vertebral bodies as radiographic landmarks for the identification of the depth of right internal jugular vein catheterisation.Methodsː In total, 108 infants (aged 1–12 months) who underwent congenital heart surgery from the 1st of January, 2019, to the 30th of June, 2019, were included. We analysed the post-operative chest radiographs of those who underwent right internal jugular vein catheterisation and assessed the visibility of the carina and vertebral bodies, as well as their positional relationship.Resultsː In total, 95 children were enrolled; in 61 (64%) cases, the carina was visible on the chest radiograph, whereas in 34 (36%) cases, it was not visible. In all 95 (100%) cases, the vertebral bodies were clearly visible. There was a significant difference between the rate of visibility of the carina and vertebral bodies (P=0.01 P<0.05). The carina was located at the third thoracic vertebra in one case (2%) and at the fourth thoracic vertebra in 60 cases (98%). There was a significant difference in the position of the carina (P=0.01, P<0.05).Conclusionsː Most fourth thoracic vertebrae were at the same level as the carina on chest radiographs. The fourth thoracic vertebra, therefore, has potential as a radiographic landmark for the depth of right internal jugular vein catheterisation in infants when the position of the carina is not visible on the chest radiograph.

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Central Venous Access: The Effects of Approach, Position, and Head Rotation on Internal Jugular Vein Cross-Sectional Area

Anesthesia & Analgesia ◽

10.1097/00000539-200212000-00010 ◽

2002 ◽

Vol 95 (6) ◽

pp. 1519-1524 ◽

Cited By ~ 29

Author(s):

Thomas Suarez ◽

Jeffrey P. Baerwald ◽

Chadd Kraus

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Central Venous Access ◽

Head Rotation ◽

Venous Access ◽

Cross Sectional Area ◽

Sectional Area ◽

Central Venous ◽

Cross Sectional

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Treatment of cyanotic heart diseases in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh04s1009j ◽

2004 ◽

Vol 132 (suppl. 1) ◽

pp. 9-13

Author(s):

Ida Jovanovic ◽

Vojislav Parezanovic ◽

Slobodan Ilic ◽

Djordje Hercog ◽

Milan Vucicevic ◽

...

Keyword(s):

Heart Disease ◽

Mortality Rate ◽

Surgical Procedures ◽

Heart Surgery ◽

Heart Diseases ◽

Arterial Switch Operation ◽

Open Heart Surgery ◽

Age Groups ◽

Mortality Rates ◽

Cyanotic Heart Disease

Cyanotic heart diseases are relatively rare, but they are severe and heterogeneous congenital heart diseases, which require complex surgery. Development of different advanced surgical procedures, such as arterial switch operation (ASO), Fontan and its modifications, Norwood etc. operations, as well as better perioperative care significantly improved survival rate and quality of life of these children. The study group included 308 children treated for cyanotic heart disease in Yugoslavia, in the period January 2000 to July 2004. Some of them (239, 77.6%) were treated at the University Children?s Hospital in Belgrade, and others (69, 22.4%) in different institutions abroad. The age of the operated patients varied between 1 day and 19 years (median 12 months). The patients (pts) were divided into four groups, according to the disease and type of the operation. In the whole group of 308 patients treated due to cyanotic heart disease, there were 232 (75.3%) cases with open heart surgery and 76 (24.7%) with closed procedures. The mortality rate was significantly different between disease/operation groups, and age groups. Average mortality rates differed from 11.8% for palliative procedures to 12.5% for complete corrections. Mortality rate and achieved surgical results in treatment of chil?dren with cyanotic heart diseases were significantly worse than those published by leading cardiac surgery centers in the world. However, there is a clear tendency in introducing new surgical procedures, lowering the age at which the operation is done and decreasing the mortality rates.

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Case report: Diagnosis and emergency surgery on a young patient with extensive aortic dissection without any risk factors

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02216-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masoud Shafiee ◽

Mohsen Shafiee ◽

Noorollah Tahery ◽

Omid Azadbakht ◽

Zeinab Nassari ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Aortic Dissection ◽

Heart Surgery ◽

Heart Diseases ◽

Open Heart Surgery ◽

Rare Condition ◽

Underlying Disease ◽

Case Presentation ◽

History Of

Abstract Background Type A aortic dissection is a very dangerous, fatal, and emergency condition for surgery. Acute aortic dissection is a rare condition, such that many patients will not survive without reconstructive surgery. Case presentation We present a case 24-year-old male who came with symptoms of shortness of breath and cough. The patient underwent ECG, chest radiology, and ultrasound, where the patient was found to have right pleural effusion while his ECG was normal. In the history taken from the patient, he had no underlying disease, no history of heart diseases in his family. For a better diagnosis, ETT and aortic CT angiography was performed on the patient which confirmed the evidence of dissection. Immediately after the diagnosis, necessary arrangements were made for open heart surgery and the patient was prepared for surgery. The patient was admitted in the cardiac surgery ICU for 5 days and his medication was carefully administered. After the conditions were stabilized, the patient was transferred to the post-cardiac surgery ICU ward. The patient was discharged from the hospital one week after the surgery and returned to the office as an OPD one week after his discharge. Conclusion Various risk factors can play a role in creating aortic dissection. Therefore, it is necessary to pay attention to patients’ history for achieving a quick and definitive diagnosis. Therefore, to control the complications of placing the cannula as well as the duration of the surgery, it is very important to reduce the duration of pumping on the patient and to be very careful during the cannula placement.

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Open heart surgery in Nigerian children the need for international and regional collaboration: the Balyesa and Enugu experience

Journal of Cardiology and Cardiovascular Medicine ◽

10.29328/journal.jccm.1001117 ◽

2021 ◽

Vol 6 (2) ◽

pp. 044-047

Author(s):

FA Ujunwa ◽

AS Ujuanbi ◽

JM Chinawa ◽

D Alagoa ◽

B Onwubere

Keyword(s):

Success Rate ◽

Congenital Heart ◽

Heart Surgery ◽

Heart Diseases ◽

Heart Defects ◽

Open Heart Surgery ◽

Case Fatality ◽

Open Heart ◽

Cardiac Intervention ◽

Regional Collaboration

Background: Children with congenital heart diseases (CHD) often require palliative or definitive surgical heart interventions to restore cardiopulmonary function. Lack of early cardiac intervention contributes to large numbers of potentially preventable deaths and sufferings among children with such conditions. Objectives: The aim of this study is to highlight our experience and the importance of international and regional collaboration in open heart surgery among children with CHD and capacity building of home cardiac teams in Bayelsa and Enugu States. Materials and Methods: In November 2016, a memorandum of understanding (MOU) was signed between the managements of FMC, Yenagoa, Bayelsa State, UNTH, Enugu and an Italian-based NGO- Pobic Open Heart International for collaboration in the area of free open-heart surgery for children with CHDs and training of home cardiac teams from both institutions either in Nigeria or in Italy. Patients for the program were recruited from Bayelsa and Enugu States with referrals from all over the country with combined screening and selection done in UNTH. Selected patients were operated on and funded free of charge by the Italian NGO. Hands-on training of the home cardiac teams and cardiac intervention was done twice yearly in Nigeria. Result: From inception of the program in November, 2016 to May, 2019 a total of 47 children (21 Males, 26 Females; Age range 6 months to 14 yrs) with various types of congenital heart defects have benefitted from the program with 41 surgeries done in UNTH & 6 in Italy (complex pathologies) at no cost to the recipients. Also, home cardiac teams from UNTH and FMC, Yenagoa have gained from on-site capacity training & retraining from the Italian cardiac team both in Nigeria & in Italy. The Success rate was 95.7% (44) and Case Fatality rate was 4.3% (2). Conclusion: There is a great efficacy in early cardiac intervention. This is with respect to a high success rate and minimal Case Fatality seen in this study. This was achieved through Regional and international collaboration.

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P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0588 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A E Moreyra ◽

Y Yang ◽

S Zinonos ◽

N M Cosgrove ◽

J Cabrera ◽

...

Keyword(s):

Constrictive Pericarditis ◽

Heart Surgery ◽

Rare Complication ◽

Open Heart Surgery ◽

Controlled Study ◽

Robert Wood Johnson Foundation ◽

Open Heart ◽

Significant Difference ◽

Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

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Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz123 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Masahiko Asami ◽

Thomas Pilgrim ◽

Stephan Windecker ◽

Fabien Praz

Keyword(s):

Mitral Valve ◽

Heart Surgery ◽

Open Heart Surgery ◽

Transoesophageal Echocardiography ◽

Paravalvular Leak ◽

Open Heart ◽

Surgical Risk ◽

Significant Difference ◽

Valve In Valve ◽

Valve Implantation

Abstract Background Concomitant structural degeneration of surgical mitral bioprostheses and paravalvular leak (PVL) is rare but potentially fatal. Data pertaining to simultaneous transcatheter mitral valve implantation (TMVI) and percutaneous PVL closure are limited, and the optimal treatment strategy remains undetermined. We report a case of simultaneous TMVI and double percutaneous PVL closure in a patient with a degenerated bioprosthetic mitral valve and associated medial and lateral PVLs. Case summary A 75-year-old woman who underwent combined aortic (Edwards Perimount Magna 19 mm) and mitral (Edwards Perimount Magna 25 mm) surgical valve replacement 6 years ago was referred for treatment of new-onset orthopnoea and severely reduced exercise capacity. Transoesophageal echocardiography revealed severe mitral stenosis and concomitant moderate to severe mitral regurgitation, originating from two PVLs located medial and lateral from the surgical bioprosthesis. Due to high surgical risk, we performed successful transseptal mitral valve-in-valve (ViV) implantation combined with the closure of two PVLs during the same procedure. Discussion Although surgery should be considered as a first-line treatment in this setting, most patients have extremely high or prohibitive surgical risk inherent to repeat open heart surgery. Mitral ViV implantation appears a reasonable treatment option for patients with failed mitral bioprostheses. Furthermore, a recent study of percutaneous PVL closure showed no significant difference in long-term all-cause mortality compared with redo open-heart surgery. Simultaneous TMVI and percutaneous PVL closure appears feasible in selected high-risk patients.

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