Case Report
Anesthetic Management of a Patient with Saber-Sheath Trachea
Ying Wan
,
Xin Wang*
Issue:
Volume 8, Issue 3, September 2024
Pages:
83-86
Received:
6 August 2024
Accepted:
14 August 2024
Published:
20 August 2024
Abstract: Saber-sheath trachea is a deformation of the trachea characterized by a tracheal index of less than 0.67, commonly found in patients with chronic obstructive pulmonary disease (COPD). This condition can lead to symptoms such as shortness of breath, coughing, and recurrent respiratory infections, which may necessitate surgical intervention. We present the case of a 72-year-old male with a left upper pulmonary lobe tumor scheduled for thoracoscopic lobectomy. The patient exhibited severe emphysema and had a tracheal index of 0.28, indicating a significantly narrowed intrathoracic trachea. Preoperative assessments revealed stable vital signs and low risk for perioperative complications, allowing for standard noninvasive monitoring during the procedure. Anesthesia was induced while maintaining spontaneous breathing using inhalation anesthetics. A left-sided double-lumen endotracheal tube was successfully placed for lung isolation. Throughout the surgery, airway pressures remained below 20 cm H2O, and the patient tolerated ventilation well. Following the procedure, fiberoptic bronchoscopy confirmed the absence of airway complications. The patient experienced a smooth recovery, was discharged after 6 days, and reported feeling well at the 3-month follow-up. This case underscores the importance of careful anesthetic management in patients with saber-sheath trachea undergoing thoracic surgery.
Abstract: Saber-sheath trachea is a deformation of the trachea characterized by a tracheal index of less than 0.67, commonly found in patients with chronic obstructive pulmonary disease (COPD). This condition can lead to symptoms such as shortness of breath, coughing, and recurrent respiratory infections, which may necessitate surgical intervention. We prese...
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Case Report
Aneurysm of the Anterior Mitral Valve Complicating Infectious Mitro-Aortic Endocarditis in a Biscuspid Aortic Valve: About a Case
Issue:
Volume 8, Issue 3, September 2024
Pages:
87-91
Received:
11 July 2024
Accepted:
14 August 2024
Published:
30 August 2024
Abstract: Mitral valve aneurysm is a rare condition usually associated with aortic valve endocarditis. The mechanism, poorly understood, generally includes a regurgitant infectious flow originating from the aortic valve, direct contact with vegetation and direct propagation, through adjacent structures, such as the mitro-aortic intervalvular fibrous body. This report details the case of a 56-year-old patient followed for severe bicuspid aortic insufficiency of the aortic valve for 4 months and admitted to heart failure due to infectious endocarditis with a fatal outcome. Physical examination revealed aortic and mitral insufficiency syndrome and congestive heart failure. Transthoracic echocardiography revealed type 1 L-R bicuspid heart disease and leaking polyvalvulopathy with severe eccentric aortic and severe mitral regurgitation. The aortic and mitral valves were the seat of the vegetations. The mitral valve was the seat on its atrial side of a contained aneurysmal sac with thrombosed hyperechogenicity. Blood cultures were positive for streptococci and probabilistic dual antibiotic therapy was started. The patient was unable to benefit from surgical treatment. However, the patient died following complications such as ischemic stroke and septic shock. A necropsy was not done.
Abstract: Mitral valve aneurysm is a rare condition usually associated with aortic valve endocarditis. The mechanism, poorly understood, generally includes a regurgitant infectious flow originating from the aortic valve, direct contact with vegetation and direct propagation, through adjacent structures, such as the mitro-aortic intervalvular fibrous body. Th...
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