A&A practice
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We present a case of a 69-year-old man who underwent tracheobronchoplasty for tracheobronchomalacia using a single-lumen endotracheal tube and a Y-shaped bronchial blocker for airway management. Tracheobronchoplasty is performed by sewing mesh to plicate the posterior, membranous wall of the distal trachea and main bronchi through a right posterolateral thoracotomy. ⋯ Ideally, only conventional airway management tools are used. This case demonstrates that a single-lumen endotracheal tube with a bronchial blocker can be a straightforward strategy for airway management during tracheobronchoplasty.
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Case Reports
Tricuspid Valve Avulsion After Blunt Chest Wall Trauma: A Case Report for Urgent Valve Replacement.
Tricuspid valve (TV) avulsion is rare and ordinarily does not require emergent intervention. We present the case of a polytrauma patient with traumatic TV avulsion who ultimately required urgent TV replacement in the setting of hemodynamic instability. Urgent TV replacement may be warranted after careful consideration of patient risk factors and clinical context.
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We present a case of a pediatric patient who developed recurarization after a cardiac catheterization procedure. Intraoperative neuromuscular blockade was achieved with 2 doses of rocuronium, and the blockade was reversed with a bolus dose of sugammadex at the end of the procedure. While recovering in the pediatric cardiac intensive care unit, the patient developed respiratory failure and a decline in the train-of-four response. The patient fully recovered after receiving a second dose of sugammadex.
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We report a case of subcutaneous implantable cardioverter-defibrillator implantation in a morbidly obese pediatric patient with hypertrophic cardiomyopathy for the primary prevention of sudden cardiac death. During routine defibrillator threshold testing of the newly placed subcutaneous implantable cardioverter defibrillator, normal sinus rhythm could not be restored despite repeated attempts at defibrillation using the subcutaneous implantable cardioverter defibrillator and transcutaneous pads. Here, we describe the successful intraoperative resuscitation and management after failure to restore normal sinus rhythm using the newly placed subcutaneous implantable cardioverter defibrillator and repeated transcutaneous defibrillation attempts.
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Case Reports
Large Iatrogenic Tracheal Injury From Attempted Endotracheal Cuff Leak Remedy: A Case Report.
Continuous insufflation of oxygen into the pilot balloon of an endotracheal tube has been documented as a viable method to fix an incompetent endotracheal tube cuff. We present a case of a large iatrogenic tracheal injury resulting from an improvised cuff leak management device. Valuable lessons are discussed to prevent similar incidents.