| Echocardiographic diagnosis of right ventricular inflow compression associated with pectus excavatum during spinal fusion in prone position. | |
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MedLine Citation:
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PMID: 19489950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Pectus excavatum is commonly viewed as a benign condition. Associated alterations in hemodynamics are rare. We present an unusual case of right ventricular inflow obstruction and hemodynamic compromise as a consequence of pectus excavatum encountered during surgical intervention. CASE: a 15-year-old male with pectus excavatum and thoracolumbar scoliosis developed severe hypotension after induction of general anesthesia and placement in the prone position for elective spinal fusion. A transesophageal echocardiogram revealed anterior compression of the right heart by the sternum with peak and mean right ventricular inflow gradients of 7 and 4 mm Hg, respectively. The gradient resolved with supine positioning and was reproduced with direct compression of the sternum. CONCLUSIONS: Although pectus excavatum is generally a benign condition, the cardiologist should be aware of the potential for serious hemodynamic compromise related to positioning in these patients. |
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Authors:
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James M Galas; Mary E van der Velde; S Devi Chiravuri; Frances Farley; David Parra; Gregory J Ensing |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Congenital heart disease Volume: 4 ISSN: 1747-0803 ISO Abbreviation: Congenit Heart Dis Publication Date: 2009 May-Jun |
Date Detail:
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Created Date: 2009-06-03 Completed Date: 2009-10-02 Revised Date: 2011-05-05 |
Medline Journal Info:
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Nlm Unique ID: 101256510 Medline TA: Congenit Heart Dis Country: United States |
Other Details:
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Languages: eng Pagination: 193-5 Citation Subset: IM |
Affiliation:
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Pediatrics Cardiology, University of Michigan Health System, MI, USA. jgalas@med.umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Echocardiography, Doppler, Color* Echocardiography, Transesophageal* Funnel Chest / complications, physiopathology, surgery* Hemodynamics Humans Hypotension / etiology, physiopathology, ultrasonography* Lumbar Vertebrae Male Prone Position* Scoliosis / complications Spinal Fusion* Sternum / ultrasonography Supine Position* Thoracic Vertebrae Treatment Outcome Ventricular Outflow Obstruction / etiology, physiopathology, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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