Cor triatriatum is a rare congenital cardiac anomaly. Majority of the cases present in the childhood with an incidence of 0.4%. However, we report a case of cor triatrium sinister with ostium secundum atrial septal defect (ASD) in a 39-year-old female. The intraoperative 3D transesophageal echocardiography (TEE) offers an advantage over 2D TEE in visualizing the interatrial septum and the attachments of the fibromuscular accessory membrane in the left atrium (LA), which could help in surgical decision-making in this patient.
Transcatheter valve implantation in patients with aortic stenosis has evolved as an acceptable alternative to surgical aortic valve replacement in a subset of patients at excessively high risk from surgery. The structural valve degeneration (SVD) is a known phenomenon in catheter-based valves too, which was hitherto seen with surgical bioprosthetic valves. Echocardiography plays a pivotal role not only in early detection but also in the management of SVD of Transcatheter valves. The goal of this report is to agglomerate our experience of an unusual case of SVD of a catheter-based valve implanted inside the bioprosthetic aortic and mitral valve apparatus and its management with aortic and mitral valve replacement with mechanical valve prosthesis.
The anesthetic management of a patient with Necrotising Fascitis involving chest wall & neck is presented. Necrotising Fascitis causes necrosis and gas formation in the fascial planes. The edema, compressing the chest wall associated with respiratory distress and neck tissue caused deviation of the trachea. Thorough pre-op evaluation including IDL, CT chest neck was done. Anesthesia was induced with Inj. Ketamine induction 1.5 mg/kg and after confirmation of ventilation Inj. Scoline was given. DL scopy followed by bougie guided intubation was done. Post-op. patient was electively kept on ventilator support.
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