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Tracheal injury detected immediately after median sternotomy by inexperienced surgeons: two case reports.
Takeshita, Jun; Nishiyama, Kei; Fukumoto, Atsushi; Ohira, Suguru; Beppu, Satoru; Sasahashi, Nozomu; Shime, Nobuaki.
Afiliación
  • Takeshita J; Department of Intensive Care Medicine, Osaka Prefectural Hospital Organization, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan. t-k-s-t@koto.kpu-m.ac.jp.
  • Nishiyama K; Department of Emergency and Critical Care Medicine, National Hospital Organization, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.
  • Fukumoto A; Department of Cardiovascular Surgery, Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan.
  • Ohira S; Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University Hospital, 1025 Walnut Street, Philadelphia, PA, 19107, USA.
  • Beppu S; Department of Emergency and Critical Care Medicine, National Hospital Organization, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.
  • Sasahashi N; Department of Emergency and Critical Care Medicine, National Hospital Organization, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.
  • Shime N; Department of Emergency and Critical Care Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
J Med Case Rep ; 12(1): 49, 2018 Feb 27.
Article en En | MEDLINE | ID: mdl-29482594
BACKGROUND: Although median sternotomy is standard during cardiac surgery, the procedure is associated with a risk of injury to mediastinal organs. Here, we discuss two cases of tracheal injury following median sternotomy during cardiac surgery. CASE PRESENTATION: Ventilation failure occurred in a 78-year-old Japanese man and a 71-year-old Japanese man after median sternotomy, and tracheal injury was identified. The sites of injury were directly repaired and covered with mediastinal fat tissue, following which ventilation was successful. The burn-like deposits observed at the site of tracheal injury and on the removed endotracheal tube support the notion that the injuries in our patients were caused by electrocautery prior to median sternotomy. In one case, short sternotracheal distance may have contributed to tracheal injury during post-sternal manipulation. In both cases, the relative inexperience of both surgeons also supports the suspected cause of injury. CONCLUSIONS: Tracheal injury represents a potential complication following median sternotomy, especially when performed by inexperienced surgeons or in cases of short sternotracheal distance. Anesthesiologists should consider this rare yet potentially lethal complication.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tráquea / Enfermedades de la Tráquea / Esternotomía Tipo de estudio: Prognostic_studies Límite: Aged / Humans / Male Idioma: En Revista: J Med Case Rep Año: 2018 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tráquea / Enfermedades de la Tráquea / Esternotomía Tipo de estudio: Prognostic_studies Límite: Aged / Humans / Male Idioma: En Revista: J Med Case Rep Año: 2018 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido