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Awake Cardiopulmonary Bypass to Prevent Hemodynamic Collapse and Loss of Airway in a Severely Symptomatic Patient With a Mediastinal Mass  Sameh M. Said,

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Presentation on theme: "Awake Cardiopulmonary Bypass to Prevent Hemodynamic Collapse and Loss of Airway in a Severely Symptomatic Patient With a Mediastinal Mass  Sameh M. Said,"— Presentation transcript:

1 Awake Cardiopulmonary Bypass to Prevent Hemodynamic Collapse and Loss of Airway in a Severely Symptomatic Patient With a Mediastinal Mass  Sameh M. Said, MD, Brian J. Telesz, MD, George Makdisi, MD, Fernando J. Quevedo, MD, Rakesh M. Suri, MD, PhD, Mark S. Allen, MD, William J. Mauermann, MD  The Annals of Thoracic Surgery  Volume 98, Issue 4, Pages e87-e90 (October 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Preoperative computed tomography scan: (A) An axial cut shows a large anterior mediastinal mass with marked compression of the trachea and main stem bronchi (white arrow), and (B) a coronal cut shows the marked compression, displacement of the heart, and complete obstruction of the superior vena cava (white arrowhead). The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Preoperative transthoracic echocardiography: (A) A parasternal short-axis view shows a large anterior mediastinal mass (note the anechoic characteristics due to its fluid content) with marked compression of the heart (white arrows), and (B) a parasternal long-axis view shows a large pericardial effusion (**), a severely compressed right ventricle (RV), and a severely compressed ascending aorta (Asc Ao). (LV = left ventricle.) The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Intraoperative fiberoptic bronchoscopy shows nearly complete obliteration of the trachea, with touching anterior and posterior walls. The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Intraoperative photographs show (A) the large mediastinal mass; (B) a partial anterior pericardiectomy was done en block with the mass resection. The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Intraoperative bronchoscopy after resection of the mass shows complete resolution of the tracheal compression. The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Intraoperative photographs show the anterior mediastinal mass (A) front and (B) back after complete resection. The pathologic analysis confirmed the presence of mature cystic teratoma. The Annals of Thoracic Surgery  , e87-e90DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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