Pulmonary Embolism in a Critically Ill Infant with Univentricular Parallel Circulation (original) (raw)

Acute Pulmonary Embolism in a Neonate: Precipitation During Cardiac Catheterization and Successful Treatment

Pediatric Cardiology, 1998

This report illustrates the rare occurrence of a pulmonary embolus in a neonate during cardiac catheterization. The patient was a term newborn who underwent repair of obstructed infradiaphragmatic total anomalous pulmonary venous connection. Postoperative risk factors for pulmonary embolism included severe pulmonary hypertension unresponsive to nitric oxide therapy, an indwelling venous catheter, and young age. Successful management was achieved by initial mechanical fragmentation with streptokinase infusion and monitoring by serial lung perfusion scans.

Venous Air Embolism Leading to Cardiac Arrest in an Infant with Cyanotic Congenital Heart Disease

Case Reports in Anesthesiology, 2012

Gas emboli, including venous and arterial, are a rare but important complication of pediatric cardiac surgery. They have the potential to have devastating consequences and require prompt recognition and treatment. We present a case of gas embolism occurring in the immediate postoperative period in an infant with cyanotic congenital heart disease after palliative cardiac surgery resulting in cardiopulmonary arrest. The embolism was diagnosed by visualization of air within the vessel creating an airlock and occluding pulmonary blood flow.

Intrapulmonary Sequestration in a 2-month-old Baby Treated Successfully by a Combination of Embolization and Surgical Resection

The Journal of Pediatric Research, 2019

Intralobar pulmonary sequestration is a rare congenital malformation, usually diagnosed later in childhood or adolescence. We report a case who presented with tachypnea and was diagnosed at 2 months of age. Pulmonary sequestration is usually managed by embolization or surgical resection. Recently, preoperative embolization of aberrant arteries to minimize the risk of serious intraoperative hemorrhage has also been described. Our case was successfully treated with embolization followed by a thoracoscopic resection.

Pulmonary Embolism in Children: A Case Series

Indian Journal of Critical Care Medicine, 2020

Background: Pulmonary embolism (PE) is a life-threatening event with a mortality of ~10%. It is relatively uncommon in children and literature regarding the condition is sparse. In adults, the classical clinical presentation is with pleuritic chest pain, hemoptysis, and dyspnea, whereas in children, the presentation is often nonspecific. Materials and methods: Clinical features, risk factors, and outcome of children with PE presenting to our unit between December, 19 and March, 2020 were recorded. Results: Four children [mean age: 10 (6-16) years, 3 females], all presenting with tachycardia and dyspnea were diagnosed with PE. Different risk factors such as deep vein thrombosis, nephrotic syndrome, softtissue infection, and infective endocarditis (IE) were identified in all patients. One child died while others responded to anticoagulation. Conclusion: We aim to highlight the importance of timely recognition of PE in children with known risk factors for the same. Early recognition and timely treatment of PE are critical to save lives.

Clinical features and outcome of pulmonary embolism in children

British Journal of Haematology, 2008

Pulmonary embolism (PE) is not an uncommon occurrence in adulthood but is a rare event in children. Paediatric registry data has reported the annual incidence of childhood PE as 0AE86 per 10 000 hospital admissions (Andrew et al, 1994) and 0AE14-0AE9 per 100 000 children (Van Ommen et al, 2001; Stein et al, 2004). PE is characteristically seen in children with serious underlying medical disorders and its incidence is likely to rise with the increasingly successful treatment of previously fatal conditions, such as congenital cardiac malformations, prematurity and malignancy. There is also an association with the use of central venous catheters (Massicotte et al, 1998) that are often relied upon for the administration of drugs, parenteral nutrition and chemotherapy. The masking of symptoms by those of underlying disease states, accompanied by a low index of suspicion in the physician, has resulted in under-diagnosis of PE in the paediatric setting as evidenced by the incidence of up to 4AE2% seen in autopsy studies (Buck et al, 1981). Failure to diagnose and treat PE promptly can have serious consequences. Mortality rates of PE in childhood are reported to be around 10% (Andrew et al, 1994; Van Ommen et al, 2001). Morbidity in the form of symptomatic thromboembolic pulmonary hypertension is seen in 3AE8% of adults at 2 years (Pengo et al, 2004). The long-term implications of PE in childhood are currently unknown. Due to the small numbers of evaluable patients, approaches to diagnostic imaging and treatment in childhood PE have mostly been extrapolated from the results of adult studies. The duration of anticoagulant therapy and the role of thrombolytic agents are not well defined (Van Ommen & Peters, 2006). This retrospective study is the largest descriptive cohort of children presenting to a single centre with PE. In describing the clinical features, this study will lead to a better understanding

Transcatheter Palliation of a Young Infant With Obstructed Supracardiac Total Anomalous Pulmonary Venous Connection

Cureus

Obstructed total anomalous pulmonary venous connection is a life-threatening pediatric cardiac emergency. Infants usually present in critical condition with marked respiratory distress, severe metabolic acidosis, and central cyanosis. Urgent cardiac surgical intervention, despite its high risk, is necessary in order to save the life of the patient. A two-month-old female infant presented to our tertiary care hospital with dense cyanosis and metabolic acidosis. She required mechanical ventilation, but her oxygen saturation did not improve. Her 2D transthoracic echocardiography revealed obstructed supracardiac total anomalous pulmonary venous connection with adequate interatrial communication and severe pulmonary hypertension. After discussion with the family and pediatric cardiac surgical team, it was decided to offer her transcatheter relief of obstructive ascending channel. She underwent successful balloon angioplasty of stenosed levoatrial cardinal vein (vertical vein) with remarkable improvement in blood flow and vessel caliber. She was extubated and her oxygen saturation rose from the high seventies to low eighties immediately after the procedure. She is scheduled for cardiac surgical repair within the next few days. Transcatheter angioplasty is a workable option in stabilizing very sick young infants with obstructed total anomalous pulmonary venous connection, especially supracardiac ones.