Which device was inserted here? | Figure 1

jurijk

Colorectal Surgery

Which device was inserted here?

More about this case

Resolved

Why you should join Figure 1

• Share your knowledge with our global community of healthcare professionals

• Get help from experts in your field

• Learn from our library of real-world cases and quizzes

Case Discussions

Heterogeneity is the rule with bicuspid aortic valves, so optimal surgical solutions vary by patient. Our experts share experience-based guidance for managing various presentations of bicuspid aortic valve and aortopathy:

If the valve is the primary indication for surgery (i.e., severe aortic stenosis and/or severe regurgitation):

1. Replace the aorta if >45 mm in diameter.
2. Replace the root too if it is >5 cm and AVR is being done. If the native valve is being retained, it needs to be stabilized, so the diameter threshold should be lowered to >45 mm.
3. Sometimes thresholds need to be lowered further, depending on the quality of tissue or for a small patient, such as an individual with Turner syndrome or other syndromic connective tissue disorder.

If the aorta is the primary indication for surgery:

4. Operate if the aorta is >5 cm in diameter or the cross-sectional area-to-height ratio is >10 cm2/m.
5. Consider sparing the valve if it looks healthy, but address the root if >45 mm.
6. Selectively lower thresholds.
7. In some cases, parts of the arch should be resected because this may be curative.

65 y/o M redo-Aortic valve replacement s/p improperly sized TAVR. Image shows previously implanted aortic valve with open leaflets prior to explanation.

Mitral valve of a 50-yr-old patient. Can you identify the pathology here?

#Echocardiography #cardiology #heart #Cardiovascular-disorders #cardio

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.

He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?