Persistent Fetal SVT in a COVID-19 Positive Pregnancy

Background. Rapid introduction and spread of SARS-CoV-2 have posed unique challenges in understanding the disease, role in vertical transmission, and in developing management. We present a case of a patient with COVID-19 infection and fetus with new-onset fetal SVT. Case. A 26-year-old gravida 4 para 2012 with third trimester COVID-19 infection was diagnosed with new onset fetal SVT. Successful cardioversion was achieved with flecainide. The patient was followed outpatient until induction of labor at 39 and 3/7 weeks of gestational age resulting in an uncomplicated vaginal delivery. Postpartum course was uncomplicated. Conclusion. Fetal SVT is a potential complication of maternal COVID-19 infection. The use of transplacental therapy with flecainide is an appropriate alternative to digoxin in these cases.

A Case of Migration of Pipeline Embolization Device Causing Rupture during Treatment of an Unruptured Vertebral Artery Dissecting Aneurysm

Endoluminal reconstruction of an intracranial aneurysm using flow-diverting devices, such as the pipeline embolization device (PED), is a new treatment modality with good clinical outcomes. The device was originally indicated for challenging cases, such as wide-necked large or giant aneurysms, and is gaining popularity as a reliable treatment for nearly all intracranial aneurysms. The overall complication rate of flow-diverting devices use is 17.0%, including occlusion of side-branching or perforating arteries, rerupture of the aneurysm, in-stent thrombosis, and, rarely, stent migration. We report a rare complication of the PED: delayed migration of the PED after successful stent implantation during treatment of an unruptured vertebral artery dissecting aneurysm, which resulted in rupture of the aneurysm. Further, we discuss technical steps that can be taken to prevent this potential complication.

An unusual complication after augmentation genioplasty: odontogenic infection requiring implant removal

Augmentation genioplasty is a common surgical procedure with extremely low infection rates. We present the case of a healthy middle-aged woman who experienced years of chronic infection after chin implantation due to a fractured mandibular canine root, which is exceedingly rare. Awareness of this potential complication will reduce patient morbidity.

Epicardial Radiofrequency Ablation: Who, When, and How?

In the past decades, it has been known that reentry circuits for ventricular tachycardia or focal triggers of premature ventricular complexes are not limited to the subendocardial myocardium. Rather, intramural or subepicardial substrates may also give rise to ventricular tachycardia, particularly in those with non-ischemic cardiomyopathy. Besides, some of the idiopathic ventricular tachycardia might be originated from epicardial foci. Percutaneous epicardial mapping and ablation have been successfully introduced to treat this sub-epicardiac ventricular tachycardia. Herein, this chapter reviews the indications for epicardial ablation and the identification of epicardial ventricular tachycardia by disease entity, electrocardiography and imaging modalities. This chapter also described the optimal technique for epicardial access and the potential complication.

Asymmetrical erythematous rash secondary to subcutaneous emphysema

Subcutaneous emphysema is a frequent post-operative complication. Although many cardiorespiratory complications associated with subcutaneous emphysema has been described, skin rashes have not been described as a complication. We present a case of asymmetrical erythematous skin rash secondary to subcutaneous emphysema. To the best of our knowledge this association has not been reported before. It is important to recognise cutaneous changes such as skin rash as a potential complication of subcutaneous emphysema and avoid inappropriate management and prolonged hospital stay. complication.

Hernia formation after single-stage umbilical vein marsupialization in three foals diagnosed with omphalophlebitis.

Omphalophlebitis in foals is treated with complete resection of the affected umbilical remnants. When total resection cannot be accomplished, umbilical vein marsupialization can be implemented with minimally reported complications. This case series highlights hernia formation as a potential complication following one-stage umbilical vein marsupialization.

Periprosthetic Osteolysis in Cervical Total Disc Arthroplasty: A Single Institutional Experience

ABSTRACT BACKGROUND Cervical disc arthroplasty (CDA) affords an excellent alternative to cervical fusion for the treatment of symptomatic patients with degenerative disc disease. As more surgeons perform CDAs, an understanding of the complications associated with this technique is crucial. Periprosthetic osteolysis (PO) is a rare potential complication associated with CDA. OBJECTIVE To highlight potential complications associated with CDA. METHODS A retrospective chart review of patients who underwent CDA at our institution was performed. Patient outcomes and relevant clinical and radiographical data were analyzed in addition to associated complications. Explanted devices were subjected to macroscopic and microscopic analyses. RESULTS A total of 88 patients were included: 68 patients underwent 1-level CDA and 20 patients had 2-level CDA. Implants used in this series included Mobi-C (Zimmer Biomet), Prestige LP (Medtronic), Secure C (Globus), Advent (Orthofix), and ProDisc C (DePuy). One patient demonstrated symptoms of myeloradiculopathy that correlated with radiographical periprosthetic osteolysis and required surgical intervention in the form of disc explantation, corpectomy, and cervical instrumented fusion. Device retrieval analysis demonstrated evidence of elevated oxidation levels and increased wear in the presence of high concentrations of metal ions and debris in the surrounding tissue. The tissue did not exhibit any immune response, infection, or acute inflammation. CONCLUSION PO is a potential complication of CDA that occurs irrespective of the type of implant used. We describe its occurrence and management and highlight the importance of being aware of this understated phenomenon.