Rotura de pared libre de ventrículo izquierdo tras infarto agudo de miocardio. A propósito de un caso

La rotura de la pared libre del ventrículo izquierdo es una rara complicación del infarto agudo de miocardio que ocurre habitualmente entre el 1º y 5º día postinfarto. Presentamos un nuevo caso de rotura cardiaca tratado con éxito mediante cirugía sin circulación extracorpórea. Consideramos que los departamentos de cirugía general y torácica de hospitales sin cirugía cardiaca, podrían asumir este tipo de intervención para evitar las consecuencias nefastas deun largo traslado intercentros.Palabras clave: infarto agudo de miocardio, rotura cardiaca, circulación extracorpórea

Rotura de pared libre de ventrículo izquierdo tras infarto agudo de miocardio. A propósito de un caso

La rotura de la pared libre del ventrículo izquierdo es una rara complicación del infarto agudo de miocardio que ocurre habitualmente entre el 1º y 5º día postinfarto. Presentamos un nuevo caso de rotura cardiaca tratado con éxito mediante cirugía sin circulación extracorpórea. Consideramos que los departamentos de cirugía general y torácica de hospitales sin cirugía cardiaca, podrían asumir este tipo de intervención para evitar las consecuencias nefastas deun largo traslado intercentros.Palabras clave: infarto agudo de miocardio, rotura cardiaca, circulación extracorpórea

Sedation with Propofol plus Paracetamol in External Cephalic Version: An Observational Study

Although the influence of neuraxial anesthesia or sedation with remifentanil in external cephalic version (ECV) is widely known, ECV results using propofol have not been previously analyzed. This study aimed to evaluate ECV outcomes when propofol was used. An observational analysis of ECV was performed between 1 January 2018 and 31 December 2020. ECV was accomplished with tocolysis and propofol. One hundred and thirty-one pregnant women were recruited. The propofol mean dose was 156.1 mg (SD 6.1). A cephalic presentation was achieved in 61.1% (80/131) of the pregnant women. In total, 56.7% (38/67) of pregnant women with cephalic presentation at labor had a spontaneous delivery, 26.9% (18/67) had an operative delivery, and an intrapartum urgent cesarean section was performed in 16.4% (11/67). In total, 46 pregnant women (35.9%) were scheduled for an elective cesarean section due to non-cephalic presentation. The emergency cesarean section rate during the following 24 h was 10.7% (14/131). A major ECV complication arose in 15 cases (11.5%). ECV outcomes when propofol was used seems to be similar to those with other anesthetic adjunct, so sedation with propofol could be an adequate option for ECV. More studies are needed to compare its effectiveness with neuraxial techniques