Suspected Iatrogenic Paradoxical Embolization in a Cat

2005 ◽  
Vol 41 (3) ◽  
pp. 193-197 ◽  
Author(s):  
Henry W. Green ◽  
Daniel F. Hogan
Keyword(s):  
Heart Failure ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Right Atrium ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Thromboembolic Complications ◽  
History Of ◽  
Exercise Induced ◽  
The Right

A cat was evaluated for a 5-year history of progressive, episodic, exercise-induced cyanosis and panting. Diagnostic testing demonstrated tetralogy of Fallot with predominant right-to-left shunting and right-sided heart failure. Following diagnostic catheterization, the cat developed clinical signs consistent with systemic arterial thromboembolization and was euthanized. Necropsy findings included multiple thrombi within the right atrium and ventricle, and thromboemboli within the terminal aorta and right common carotid artery, a condition most consistent with iatrogenic paradoxical embolization secondary to diagnostic catheterization. Paradoxical embolization and thromboembolic complications of diagnostic catheterization are discussed.

scholarly journals A Rare Case of Pericardial Tuberculoma with Impending Tamponade in a 52-Year Old Woman: A Case Report

2021 ◽  
Author(s):  
Clement `C Kabakama ◽  
Zahra Daudi Khan ◽  
Pilly Chillo ◽  
Amos Rodger Mwakigonja
Keyword(s):  
Heart Failure ◽  
Ct Scan ◽  
Rare Case ◽  
Mediastinal Mass ◽  
Rare Complication ◽  
Clinical Signs ◽  
Extra Pulmonary Tuberculosis ◽  
History Of ◽  
Extra Pulmonary ◽  
The Right

Pericardial tuberculoma is a rare complication of tuberculous pericarditis. It may mimic a compressive mediastinal mass, often misinterpreted as a mediastinal tumour. Since, it arises from the pericardium, pericardial tuberculoma invariably compresses structures of the heart and may present with features of either-sided heart failure depending on the side of the compression. Hereby, the authors present a case of a 52-year-old woman with progressive difficulty in breathing and symptoms of right-sided heart failure as well as clinical signs of impending cardiac tamponade following a history of extra-pulmonary tuberculosis. Echocardiogram examination revealed a mass compressing the right side of the heart but was inconclusive of the mass origin. CT Scan of the chest showed a mass arising from the pericardium. The mass was later surgically excised. Histopathology confirmed pericardial tuberculosis and a diagnosis of a pericardial tuberculoma was reached. Patient’s heart failure symptoms regressed after surgery and she was discharged to continue with anti-tuberculosis regime. This report discusses the inclusion of pericardial tuberculoma in the differential diagnoses of cardiac compressing masses, particularly in tuberculosis endemic areas and emphasise on prompt CT Scan imaging when echocardiogram is inconclusive.

scholarly journals P1242 Giant right atrium aneurysm presenting as right heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F V Moniz Mendonca ◽  
J A S Sousa ◽  
J M Monteiro ◽  
M R Mraquel ◽  
M N Neto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Right Ventricle ◽  
Right Atrium ◽  
Adult Life ◽  
Right Heart Failure ◽  
Outflow Tract ◽  
Right Heart ◽  
History Of ◽  
The Right

Abstract Introduction Idiopathic aneurysmal dilatations of the right atrium are rare anomalies. It can be diagnosed at any time between foetal and adult life. This exceptional condition can be confused with other conditions that involve enlargement of right atrium. We report a clinical case of a symptomatic adult who was diagnosed with giant right atrium aneurysm. Case report An 83-year-old female presented with complaints of fatigue, paroxysmal nocturnal dyspnoea, exertional dyspnoea, orthopnoea and cough since last week. There were no history of syncope, convulsions or evidence of thromboembolism. There were a medical history of diverticulosis and atrial fibrillation (warfarin therapy). The principal findings on physical examination included holosystolic murmur at the left middle sternal border, pulmonary rales, jugular venous distension, enlarged liver and peripheral oedema. An electrocardiogram showed an atrial fibrillation with a controlled heart rate response, right axis deviation, right bundle-branch block. A chest radiography posteroanterior view showed a markedly enlarged cardiac silhouette, increased pulmonary vascular congestion, and bilateral pleural effusions. Computed tomography (CT) scan showed aneurysmal dilated right atrium communicating with right ventricle. Right ventricle (RV) and RV outflow tract were dilated with normal pulmonary arteries. Two-dimensional transthoracic echocardiography revealed aneurysmal dilated right atrium measuring 398mL/m2. The tricuspid valve was no displaced. There was severe tricuspid regurgitation and no stenosis. The right atrium was kinetic without any intracavitary thrombus. The intertrial and interventricular septa were intact. The right ventricle and outflow tract were mildly dilated with preserved systolic function. The left atrium and left ventricle were normal. The patient was admitted to the cardiology department with the diagnosis of right heart failure. Conclusion Aneurysm of right atrium is an uncommon condition. It is diagnosed as a disproportionately enlarged right atrium compared to the other cardiac chambers in the absence of other cardiac or hemodynamic abnormalities and must be distinguished from other anomalies causing structural pathology of the right atrium. Approximately, one-half of the patients have no symptoms. Others presented with arrhythmia, palpitations, chest pain, shortness of breath, and fatigue. The major rhythm abnormality is atrial fibrillation or atrial flutter. Our patient presented with symptoms of right heart failure and atrial fibrillation. The right enlargement is usually associated with tricuspid annular dilatation responsible for functional regurgitation, which can be severe in some cases. The diagnosis of right atrium malformation can be established by echocardiography, CT or magnetic resonance imaging. Literature reports various ways to manage these patients. Treatment ranges from conservative to surgical resection specially in the presence of arrhythmias. Abstract P1242 Figure. Aneurysm of right atrium

Modified Sternocleidomastoid Sparing Approach for Vertebral Artery (V1) to Common Carotid Artery Transposition: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Sarah Travers ◽  
Farhan Siddiq
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Common Carotid Artery ◽  
Artery Occlusion ◽  
Symptom Improvement ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Traditional Approaches ◽  
Neurovascular Structures

Abstract Vertebral artery (VA) V1 segment to common carotid artery (CCA) transposition is an uncommon operation with existing literature describing dissection of the sternoclavicular head of the sternocleidomastoid (SCM) muscle.1,2 We present a modified approach for transposition without cutting the SCM. Our patient is a 76-yr-old female with history of a previous cerebellar stroke. Despite taking aspirin, she presented with another stroke resulting in severe dysarthria, vertigo, and gait disturbance. Magnetic resonance imaging (MRI) demonstrated several cerebellar infarcts. Catheter angiography demonstrated bilateral vertebral artery occlusion with filling from ascending cervical branches and a dominant left VA. We planned a left V1 to CCA transposition with a modified SCM-sparing approach for which the patient provided written informed consent. She was positioned supine with neck extended and face turned to the right. Neuromonitoring was utilized. A linear incision along the anterior border of the SCM was made, stopping 1.5 cm above the clavicular head. Neurovascular structures of the carotid sheath were dissected circumferentially and mobilized medially. The longus coli muscle over the C6 lateral mass was reflected medially. The vertebral artery was dissected to expose the maximum possible length. The inferior thyroid artery was sacrificed for better exposure. VA was ligated and transected. CCA was clamped. VA to CCA bypass was performed in a standard fashion. Surgical site was closed. The patient clinically did well postoperatively with immediate symptom improvement. Our video demonstrates an SCM-sparing technique of V1 to CCA transposition, which can be a less-extensive operation compared to the traditional approaches, which require transection of SCM head.

scholarly journals Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alessandro Robaldo ◽  
Guido Carignano ◽  
Alberto Balderi ◽  
Claudio Novali
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
High Risk Patient ◽  
Carotid Bifurcation ◽  
Left Common Carotid Artery ◽  
The Right ◽  
Bovine Aortic Arch ◽  
Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

Immune-Mediated Neutropenia in a Miniature Poodle

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Benjamin Brunson
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Clinical Signs ◽  
Response To Therapy ◽  
Tertiary Referral Center ◽  
Immune Mediated ◽  
Specialized Equipment ◽  
History Of ◽  
Light Sedation ◽  
The Right

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.

scholarly journals Intrathoracic bifurcation of the right common carotid artery

2013 ◽  
Vol 2013 (jan09 1) ◽  
pp. bcr2012007554-bcr2012007554 ◽  
Author(s):  
C. K. Gomez ◽  
O. J. Arnuk
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
The Right

scholarly journals Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Acute Onset ◽  
Suppurative Otitis Media ◽  
Vein Thrombosis ◽  
Significant Incidence ◽  
Lower Lung ◽  
History Of ◽  
The Right

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.

scholarly journals Eversion carotid endarterectomy with nerve-sparing component in a case of high location of common carotid artery bifurcation

2021 ◽  
Vol 25 (3) ◽  
pp. 94
Author(s):  
I. V. Makarov ◽  
A. S. Borisenkov ◽  
I. A. Migunov
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Common Carotid Artery ◽  
Preoperative Evaluation ◽  
Cranial Nerves ◽  
Hospital Medicine ◽  
Nerve Sparing ◽  
Left Internal Carotid Artery ◽  
Brachiocephalic Trunk ◽  
The Right

<p>We performed carotid endarterectomy on a patient with 75% stenosis of the left internal carotid artery (ICA), 70% stenosis of the left common carotid artery (CCA), 60% stenosis of the right ICA and 55% stenosis of the right CCA after a transient ischaemic attack on the premises of the surgical unit of Russian Railways Hospital–Medicine (Samara), which is the clinical site for the care of surgical diseases at Samara State Medical University. During the preoperative evaluation and physical examination, we determined that the chance of high CCA bifurcation was high because the patient had a brachymorphic physique and his neck was short and broad. In fact, during the surgical exploration of the carotid triangle area, the CCA bifurcation was identified 7 ± 0.5 cm higher than the shield-like cartilage rim; thus the CCA bifurcation area crossed the stems of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves, which precluded classic carotid endarterectomy. We then decided to perform carotid endarterectomy, using the eversion method and transposing the ICA above the rami of the cranial nerves. Through this method, we minimised traction and nerve stem trauma during the process of reconstructing brachiocephalic trunk arteries, prevented morbidities involving the cranial nerves during postsurgical period, accelerated the patient’s recovery and improved the patient’s quality of life. With further patient monitoring during the early and late postoperative periods, no abnormalities of peripheral innervation occurred.</p><p>Received 26 March 2021. Revised 6 May 2021. Accepted 11 May 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors:</strong> The authors contributed equally to this article.</p>

scholarly journals Free-floating thrombus in the right common carotid artery

2009 ◽  
Vol 54 (2) ◽  
pp. 304-306 ◽  
Author(s):  
Eiji Taguchi ◽  
Kazuhiro Nishigami ◽  
Takihiro Kamio ◽  
Takashi Honda ◽  
Koichi Nakao
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Floating Thrombus ◽  
The Right

scholarly journals An unusual origin of the right subclavian artery – arteria lusoria

2014 ◽  
Vol 27 (4) ◽  
pp. 234-236
Author(s):  
Agnieszka Mocarska ◽  
Miroslaw Szylejko ◽  
Elzbieta Staroslawska ◽  
Franciszek Burdan
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Left Vertebral Artery ◽  
Anatomical Anomaly ◽  
Arteria Lusoria ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract The aortic arch usually gives off three major arterial branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The most frequently occurring developmental variations of arterial trunks origins are a joined brachiocephalic and left common carotid artery origin, the left vertebral artery branching from the aortic arch, a double aortic arch, and a change of sequence of branching arteries. The current report presents the rare asymptomatic situation of the right subclavian artery originating as the last individual branching from the aortic arch. This abnormality was accidentally discovered in a computed tomography examination of a 69-year old male patient. The examination showed that the artery went towards the neck posteriorly from the trachea. The anatomical anomaly was interpreted as being an arteria lusoria.

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