Cardiogenic shock (CS) causes significant morbidity and mortality and such patients can deteriorate rapidly. Temporary left ventricular assist devices (LVADs) are a promising approach to manage these patients. The following is a case series in which patients stabilized with a temporary LVAD for CS improvement were analyzed retrospectively. Between June 2011 and January 2014, 15 patients received temporary devices through an axillary approach (mean age: 53 ± 15, 93% male). Mean survival time was 317.8 ± 359.5 days (range: 6–936 days). During support there were no major bleeding events, infectious complications at the axillary access site, upper extremity edema, or emboli. The most of the patients recovered from CS (93%) were mobilized (67%) and were extubated (73%) while on temporary device support. Median times to extubation, intensive care unit discharge, and discontinuation of inotropic medications were: 1.63, 18, and 15 days, respectively. Four patients recovered to no device support and five received a long-term LVAD, all of whom remain alive. Therefore, implantation of a temporary LVAD through an axillary approach is a promising therapy for improving outcomes in patients needing mechanical circulatory support as a bridge to recovery or a definitive LVAD.
INTRODUCTIONWe report a case of a retained foreign body in the right atrium and the review of the literature discussing several cases where the poor attention and management of medical staff has led to worsening consequences to patient's health.PRESENTATION OF CASEIn our case the mass demonstrated on MRI scan turned out to be an inflammatory process and organized clotted blood built around a broken piece of a plastic cannula protruding out of the right atrium. This caused debilitating pleuritic pain to the patient on presentation.DISCUSSIONThe cause of this iatrogenic retained piece of cannula may well be from the patients prior diagnostic investigations.CONCLUSIONAlgorithm managed indications for surgical removal of such foreign bodies in symptomatic patients lead to better patient's outcomes and decreases the chances of infection, embolization, or erosions within the heart. Keeping this in view, we managed our patient with success.
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