Marcel Voos Budal Arins’ Post

📌 TRUNCUS ARTERIOSUS REPAIR 🛑Basics: Truncus arteriosus (TA) can be described as a single great artery arising from the ventricular outflow tracts in the presence of a large VSD. From this common trunk emerges the aorta and pulmonary arteries. TA can be classified by how the pulmonary arteries arise from the aorta ~TA type I has a main pulmonary artery coming off of the aorta ~TA type II has right and left pulmonary arteries arising separately frean the posterior aorta but close together. ~TA type III has right and left pulmonary arteries arising separately from the aorta from different sides and per haps different levels 🛑Surgical correction: Rastelli Repair is done as the pulmonary arteries are separated from the common trunk and anastomosed to a valved conduit from the right ventricle. The VSD is patched in a way that locates the truncus arteriosus to the left of the septum, where it functions as the aorta only. 📍Bypass notes: ~weight: 4 kg ~Age: 3 months ~Oxygenator: Baby FX-05 with infant tubing ~Aortic cannula : 3 mm ~Bicaval cannulation is done using 12Fr. for SVC and 14Fr. for IVC ~CBP Time: 166 mins ~CXT Time: 129 mins ~Delnido cardioplegia is given. ~The temperature is maintained at 26 °C and perfusion pressure is maintained between 40-50mmHg ~Minimum HCT is 27-29% on bypass and 30% coming off bypass. ♦️ECHO FINDINGS: ~ Truncus arteriosus type 1, Dilated RV and RA, Intact IAS, Large VSD, pulmonary valve absent, severe pulmonary HTN #peadatriccardiacsurgery #peadatricperfusion #perfusion #cardiacperfusionist #perfusionist #globalperfusioncommunity #cardiacsurgery #amsect. #cardiovascularperfusionist #peadatricperfusionist #childrenhospital

76 years-old male patient with history of arterial hypertension and chronic atrial fibrillation. Severe intermittent claudication (Rutherford 3) of the right lower limb (walking impairment-90 meters). Angiography revealed severe stenosis of mid SFA, moderate stenosis of popliteal artery, occlusion of all BTK vessels, occlusion of dorsalis pedis and the plantar arteries were patent. Strategy: Antegrade US-guided puncture of right CFA and 6 Fr sheath placement. Failed attempt of antegrade recanalization of the tibial-peroneal trunk (TPT) with the support of a Rubicon 18 catheter and a V-18 guidewire. Retrograde US-guided puncture of the distal posterior tibial artery (PTA) and successfull crossing of the occlusion with the support of a Rubicon 18 catheter and a V-18 guidewire. Rendez-vous technique in the popliteal artery. BAT technique because of imposibillity to cross the occlusion with a 3.0 mm x 150 mm balloon from antegrade access. Angioplasty of PTA with 3.0 mm and 3.5 mm x 150 mm balloons and TPT with a 4.0 mm x 80 mm balloon. Angioplasty of SFA with a 6.0 mm x 150 mm DCB. Spasm is observed at the retrograde puncture site in the last picture of the foot (the wire is still there). #cli #clti #clifighters #limbsalvage #peripheralarterydisease #vascularnews #endovascular #medicine #hospital

Division Interventional Pulmonology Yashoda Hospitals Hyderabad POST INTUBATION TRACHEAL STENOSIS BRONCHOSCOPIC RECANALISATION & SILICON STENT PLACEMENT YouTube link: https://lnkd.in/gB4FDcDf 72 year old male, Known case of COPD, Hypertensive, Diabetic, CAD post PTCA, CVA Was On tracheostomy and decannulated 2 weeks back. Presented with history of noisy breathing and cough. CT showed tracheal stenosis. Stenosis was dilated with electrocautery cuts, CRE balloon, serial rigid tracheoscopes and 15 by 40mm silicon stent was inserted and secured with sutures. #Bronchoscopy #Interventionalpulmonology #WomeninIP

📜 Case Report: ✍🏻Bahram Kadyrov #Percutaneous #Closure of #Giant #PDA with #Ducts #Occluders in a 4-Years-Old #Child with #Low #Body #Weight Our review of the literature using #PubMed identified limited cases of percutaneous closure for PDAs of this size, highlighting the unique nature of this case. Classification of patent ductus arteriosus. In Krichenko. #Angiographically classified pdas based on the lumen of the duct at the aortic and #pulmonary ends. #Clinical #Characteristics The patient is 4 years old, and admitted to our center with progressive dyspnea, cyanosis of the #nasolabial triangle, complaints of frequent nosebleeds according to parents, and periodic acute #respiratory infections. Sat 92 %; With light physical exertion, Sat up to 88%). ECHO - END diastolic volume -LV 127 ml END sistololic volume-LV 44 ml, systolic-diastolic discharge into the pulmonary artery through PDA..... 📰 Get full-length article here: https://lnkd.in/gXt_dUCu We do accept #PPTs and #Video Articles to be publish within our Journal. You can send us your article to given email #Email: onlinescientificresearch@gmail.com

A seemingly simple intervention for Trigger Finger treatment. Pathogenesis of the trigger disease points to a fibro cartilagenous metaplasia of the tendon causing a nodule superficial to the flexor tendon. in patients who overuse the flexors, pain develops ( trigger later ) as the nodule traverses across a tight A1 pulley. Anatomically, these are 2 different structures with a normal A1 pulley getting involved only during flexion of the finger, when a distal nodule passes underneath a tight A1 pulley. Two very important points to ponder. 1. Be it by Surgical or interventional methods, which one is the treatment target? I target the nodule. 2. While performing a percutaneous steroid injection, which axis do you prefer? I prefer the long axis to target the nodule for fenestration prior to the injection. #chronicpain #triggerfinger #musculoskeletal #painmanagement #painmedicine #paineducation

It’s not yet a rule of thumb, but a new “thumb test” may be able to detect your risk for a potential aortic aneurysm, according to Medical Xpress. An aneurysm is a ballooned segment of an artery, which are the vessels that supply oxygenated blood to your body tissues. “Aneurysms may cause no problems, but if they grow larger, they can weaken, burst and bleed. This is bad enough in most arteries, but imagine if the artery involved were the biggest in your body?” Aortic aneurysms can develop slowly, often symptom-less, so that you don’t know they are evolving. This simple thumb/palm test can tell you within seconds where you stand. https://ow.ly/LyI750RQQbV #aorticaneurysm #thumbpalmtest #heart #medicaltest #thumbtest

Aorto Uni-Iliac EVAR without Fem -Fem bypass for abdominal aortic aneurysm,is it possible? A 69 year-old man who was referred due a abdominal without complaining of lower limb ischemia. He had 70 mm AAA,Smoker,COPD & past medical history of coronary angioplasty 15 years ago. Pulesless left femoral artery in physical examination & total occlusion of left common iliac artery in CT-Angiography. **Procedure:** Aorto Uni-iliac EVAR from the renal arteries to the right common iliac artery bifurcation, Without Fem -Fem bypass, Without coiling of LCIA. The patient discharged four days after operation without complaints or complications about bowel and lower extremities ischemia. In the follow up CT-Angiograohy, everything is ok. #EVAR #Fem-Fem Bypass #Aortic #Aneurysem

This patient has a history of mitral valve replacement. They developed subacute endocarditis requiring 6 weeks of IV antibiotics. A recent ECHO reveals this. What would you do in this scenario? What heart rhythm would indicate a surgical urgency/emergency? Comment below. #physicianassistant #apacvs2024 #echocardiography #mitralvalvereplacement #mitralvalve #endocarditis #cardiacsurgery #criticalcare #physicianassistantstudent #physicianassociate

Prevent and manage dehiscence using HEMIGARD devices. A 2023 multicenter study comparing use of HEMIGARD ASRD to standard closure in diabetic lower limb amputation showed: 🎯81% reduction in wound dehiscence 🎯16% to 1.8% reduction in progression to higher amputation 🎯$6,645 to $10,397/amputation gross savings of adoption of HEMIGARD ASRD for all amputations 📑 full study and economic impacts here: https://lnkd.in/gMbiCM5N Authors: Dr. Windy Cole, DPM, CWSP, FACCWS, Danielle Butto (DPM, FACFAS, CPC), Dr. David A. Sipala, DPM, FACFAS, Erik Haniuk, Anish R Kadakia, Alex McKanna, Arun Karwal

📣 Are you suffering from joint or soft tissue pain in your feet? 💔 Consider a steroid foot injection for quick and effective pain relief! 💉 Steroid injections contain synthetic hormones that suppress inflammatory cells, relieving swelling, pain, and discomfort. Unlike oral medications, they directly target the affected area, providing stronger and more effective results. 💪 Conditions that can benefit from a steroid foot injection include arthritis, neuromas, soft tissue growths, tendonitis, and plantar fasciitis. 🦶 While side effects are rare, they may include soreness, bruising, skin changes, light-headedness, or facial flushing. Our experienced podiatrists at MyFootMedic will ensure your safety and suitability for the treatment. Book your appointment now and experience the best injury treatment at our Bedford clinic! ✨ For more information, check out our website: https://lnkd.in/ee4Ef3ta #FootPainRelief #SteroidInjection #PainManagement #MyFootMedic