Thursday, May 1, 2014

Cath Lab II

This is a continuation from Monday's case (scroll down to review).

The patient is taken emergently to the cath lab where a procedure is performed. The post-procedure chest X-ray is shown above. The patient is extubated after the procedure and brought to the PACU. The PACU nurse pages you because the patient is not moving his legs.

Challenge: What happened?

Image shown under Creative Commons Attribution Share-Alike License.


Jimmy said...

Is this a Left atrial appendage occlusion device for atrial fib?? maybe it's involving the Vagus nerve??

Craig Chen said...

good thoughts - i haven't seen what the atrial appendage occlusion device looks like on CXR. this is a TEVAR stent graft
Cath Lab II

The patient underwent a thoracic endovascular aneurysm repair (TEVAR), the percutaneous placement of a stent graft in the descending thoracic or thoracoabdominal aorta. This procedure has a 3-11% risk of spinal cord ischemia leading to paraplegia.

Source: UpToDate, Wikipedia.