| Complications of reperfusion in acute aortic artery occlusion following saddle embolization originating from an atrial myxoma. | |
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MedLine Citation:
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PMID: 15586530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 58-year-old man presented to the hospital with an 8-hour history of acute-onset bilateral lower limb ischemia. A large saddle embolus had occluded the aorta and could not be removed by balloon endarterectomy through the femoral arteries. Successful open aortic and femoral thromboembolectomy followed by extensive fasciotomies was accompanied by severe reperfusion injury. Life-threatening hyperkalemia was associated with three episodes of intraoperative ventricular fibrillation and ventricular tachycardia requiring cardiac massage and defibrillation. A dextrose-insulin-bicarbonate infusion was required to correct the hyperkalemia. Rhabdomyolysis developed at 24 hours, causing marked myoglobinuria and acute renal failure, which required hemofiltration. Histology of the recovered embolus confirmed an atrial myxoma, and when the patient had fully recovered, open cardiac surgery was carried out to resect the tiny stump of residual myxoma. Rhabdomyolysis associated with a myxomatous saddle embolus has not been previously reported. This case highlights the need for pre- and perioperative measures to be taken to overcome hyperkalemia and acute renal failure when revascularizing acute, massive, prolonged ischemia of the lower body. |
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Authors:
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Tahir Ali; J Castro; C R Young; K G Burnand |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Vascular Volume: 12 ISSN: 1708-5381 ISO Abbreviation: Vascular Publication Date: 2004 May-Jun |
Date Detail:
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Created Date: 2004-12-09 Completed Date: 2005-03-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101196722 Medline TA: Vascular Country: Canada |
Other Details:
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Languages: eng Pagination: 202-5 Citation Subset: IM |
Affiliation:
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Academic Department of Surgery, St Thomas' Hospital, London, UK. tahir.ali@kcl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aortic Diseases / etiology, surgery* Arterial Occlusive Diseases / etiology, surgery* Heart Atria Heart Neoplasms / complications* Humans Kidney Failure, Acute / etiology Male Middle Aged Myxoma / complications* Reperfusion / adverse effects* Reperfusion Injury / etiology Thromboembolism / complications Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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