Anesthetic management “Abdominal Aortic Aneurysm” in the well-known case with Wolff-Parkinson-White syndrome

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Sogol Asgari ◽  
◽  
Arash Tafrishinejed ◽  
Faranak Behnaz ◽  
◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Anesthetic Management ◽  
Careful Monitoring ◽  
White Syndrome ◽  
Abdominal Aortic ◽  
Balanced Anesthesia ◽  
Life Threatening ◽  
History Of ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is an electrophysiological disorder of the heart caused by pre-stimulation of an abnormal lateral pathway that can be asymptomatic or may be accompanied by palpitations or shortness of breath. We reported a case of a 66-yearold man with a history of Wolff-Parkinson syndrome who was transferred to the operating room for simultaneous nephrectomy due to RCC and abdominal aortic aneurysm. Managing the anesthesia of these patients is challenging because they are prone to life-threatening tachyarrhythmias. Observance of all necessary precautions to prevent tachyarrhythmias, balanced anesthesia, careful monitoring and preparation with the necessary drugs and equipment to treat any complication, is the cornerstone of a positive surgical outcome. Keywords: Wolff Parkinson white syndrome; abdominal aortic aneurysm; electrophysiological disorder; anesthetic management.

scholarly journals Anesthetic Management of a Patient with Wolff-Parkinson-White Syndrome for Laparoscopic Cholecystectomy: A Case Report

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Kiran Kumar KC ◽  
Sundar Hyoju ◽  
Pawan Kumar Raya
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Incidental Finding ◽  
Anesthetic Management ◽  
Accessory Pathway ◽  
Exertional Dyspnea ◽  
White Syndrome ◽  
Balanced Anesthesia ◽  
Life Threatening ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome, an electrophysiological disorder of heart caused by preexcitation of an abnormal accessory pathway,can either be asymptomatic or may present with palpitation or exertional dyspnea. We report a case of an asymptomatic 45-year-old male with incidental finding of Wolff-Parkinson-White syndrome posted for laparoscopic cholecystectomy under general anesthesia. The anesthetic management of these patients is challenging as they are prone to develop life-threatening tachyarrhythmia. Taking all the necessary precautions to prevent tachyarrhythmia, balanced anesthesia, rigorous monitoring and preparedness with necessary drugs and equipment to treat any complications is the cornerstone for positiveoutcome.  

Successful Endovascular Repair of a Leaking Abdominal Aortic Aneurysm under Local Anesthesia

Swiss Surgery ◽  
2001 ◽  
Vol 7 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Lachat ◽  
Pfammatter ◽  
Bernard ◽  
Jaggy ◽  
Vogt ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Ct Scan ◽  
Local Anesthesia ◽  
Endovascular Repair ◽  
Anesthetic Management ◽  
High Risk Patient ◽  
Invasive Technique ◽  
Chronic Obstructive ◽  
Abdominal Aortic

Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. Patient and methods: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24mm x 12mm x 153mm) was implanted under local anesthesia. Results: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. Discussion: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

scholarly journals Rolipram Prevents the Formation of Abdominal Aortic Aneurysm (AAA) in Mice: PDE4B as a Target in AAA

Antioxidants ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 460
Author(s):  
Saray Varona ◽  
Lídia Puertas ◽  
María Galán ◽  
Mar Orriols ◽  
Laia Cañes ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Inflammatory Cells ◽  
Progressive Increase ◽  
Phosphodiesterase 4 ◽  
Inflammatory Conditions ◽  
Abdominal Aortic ◽  
Threatening Condition ◽  
Life Threatening ◽  
Effective Therapeutic Strategy

Abdominal aortic aneurysm (AAA) is a common life-threatening condition characterized by exacerbated inflammation and the generation of reactive oxygen species. Pharmacological treatments to slow AAA progression or to prevent its rupture remain a challenge. Targeting phosphodiesterase 4 (PDE4) has been verified as an effective therapeutic strategy for an array of inflammatory conditions; however, no studies have assessed yet PDE4 in AAA. Here, we used angiotensin II (AngII)-infused apolipoprotein E deficient mice to study the involvement of the PDE4 subfamily in aneurysmal disease. PDE4B but not PDE4D was upregulated in inflammatory cells from both experimental and human AAA. The administration of the PDE4 selective inhibitor rolipram (3 mg/kg/day) to AngII-challenged mice (1000 ng/kg bodyweight/min) protected against AAA formation, limiting the progressive increase in the aortic diameter without affecting the blood pressure. The drug strongly attenuated the rise in vascular oxidative stress (superoxide anion) induced by AngII, and decreased the expression of inflammatory markers, as well as the recruitment of macrophages (MAC3+), lymphocytes (CD3+), and neutrophils (ELANE+) into the vessel wall. Rolipram also normalized the vascular MMP2 expression and MMP activity, preserving the elastin integrity and improving the vascular remodelling. These results point to PDE4B as a new therapeutic target for AAA.

ASCENDING AORTIC ANEURYSM – A CASE REPORT

2020 ◽  
Vol 1 (3) ◽  
pp. 54-55
Author(s):  
Prathap Kumar. J.
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Leg Pain ◽  
Ultrasound Screening ◽  
Ascending Aortic Aneurysm ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.

Wolff-Parkinson-White Syndrome

1992 ◽  
Vol 3 (1) ◽  
pp. 180-189 ◽  
Author(s):  
Joanne Hughes Morscher
Keyword(s):  
Sudden Cardiac Arrest ◽  
Cardiac Conduction ◽  
Treatment Modalities ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Diagnostic Modalities ◽  
Supraventricular Tachycardias ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a cardiac conduction disorder that presents with potentially life-threatening consequences. Wolff-Parkinson-White syndrome-induced dysrhythmias account for 20% of all supraventricular tachycardias that occur in the general population. Clinical presentations range from no symptoms to a sudden cardiac arrest. The risk of sudden death is always present with WPW syndrome, and it is the motivating force in the evaluation and treatment of this syndrome. Current diagnostic modalities are accurate in identifying patients with WPW syndrome, but lack the sensitivity to predict sudden cardiac death. This article reviews the history of WPW syndrome, as well as its general characteristics, diagnostic criteria, treatment modalities, and nursing implications

scholarly journals Isolated right testicular pain for six days: an unusual presentation of occult abdominal aortic aneurysm leak

2011 ◽  
Vol 93 (4) ◽  
pp. e1-e2 ◽  
Author(s):  
Rachael O Forsythe ◽  
Victoria Lavin ◽  
Simon CA Fraser ◽  
Alan McNeill
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Case Reports ◽  
Haemodynamic Instability ◽  
Older Patient ◽  
Testicular Pain ◽  
Lower Back ◽  
Abdominal Aortic ◽  
History Of ◽  
The Right

Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain; however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. On examination, a painless AAA was detected. The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.

Life-Threatening Upper Gastrointestinal Bleeding Secondary to Aortoenteric Fistula

2008 ◽  
Vol 2 ◽  
pp. CCRPM.S376
Author(s):  
Tasbirul Islam ◽  
George Hines ◽  
Douglas S. Katz ◽  
William Purtil ◽  
Francis Castiller
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Gastrointestinal Bleeding ◽  
Surgical Repair ◽  
Upper Gastrointestinal Bleeding ◽  
Aortoduodenal Fistula ◽  
Open Surgical Repair ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Upper Gastrointestinal

We present a patient with gastrointestinal bleeding secondary to an aortoduodenal fistula. The patient had undergone an open surgical repair of an abdominal aortic aneurysm five years prior to admission.

Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair

1984 ◽  
Vol 01 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Patrick J. O'Hara ◽  
Gregory P. Borkowski ◽  
Norman R. Hertzer ◽  
Peter B. O'Donovan ◽  
Susan L. Brigham ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Natural History ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
History Of ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Aortoduodenal Fistula After Endovascular Abdominal Aortic Aneurysm Repair

2020 ◽  
Vol 54 (5) ◽  
pp. 445-448
Author(s):  
Akihiro Hosaka ◽  
Masaru Nemoto ◽  
Manabu Motoki ◽  
Atsushi Akai ◽  
Masaaki Kato
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Primary Repair ◽  
Recurrent Infection ◽  
Abdominal Aortic Aneurysm Repair ◽  
Duodenal Wall ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Aneurysm Repair

Aortoduodenal fistula after endovascular treatment of abdominal aortic aneurysm is a very rare but life-threatening complication. Herein, we describe 4 cases of aortoduodenal fistula diagnosed at 15 to 78 months after the index aortic intervention, all successfully treated by surgery. All patients underwent primary repair of the duodenal wall, creation of tube duodenostomy, stent graft removal, and in situ reconstruction using a rifampicin-soaked prosthesis. Patients received prolonged antibiotic treatment for at least 2 months postoperatively, and all were free of recurrent infection at follow-up. Prompt and appropriate surgical intervention is required to effectively manage this condition.

Identification of Persistent Aortocaval Fistula Using Ultrasonography in the Outpatient Setting: A Case Report

2020 ◽  
Vol 44 (3) ◽  
pp. 150-153
Author(s):  
Richard A. Meena ◽  
Melissa N. Warren ◽  
Thomas E. Reeve ◽  
Olamide Alabi
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Surgical Repair ◽  
Outpatient Setting ◽  
Aortocaval Fistula ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Aortocaval fistula (ACF) is a rare and life-threatening complication associated with rupture of an abdominal aortic aneurysm (rAAA). Early detection and management of ACF’s during surgical repair of rAAAs is recommended to reduce the risk of future aneurysm-related complications, including mortality. There is a paucity of current literature on the natural history of ACFs postendovascular exclusion. We present a case study describing the detection of a persistent ACF by duplex ultrasonography (DU) postendovascular aortic repair (EVAR).

Sign in / Sign up

Export Citation Format

Share Document