Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role

A 29-year-old lady was referred to us with a rare complication of scoliosis correction surgery. She had two of the screws migrated and penetrated the descending thoracic aorta. She came to theater to have the screws removed and the aorta repaired endovascularly. The successful intervention needed a...

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Main Author: Ahmed Elrefaey
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:https://journals.lww.com/10.4103/sja.sja_369_24
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author Ahmed Elrefaey
author_facet Ahmed Elrefaey
author_sort Ahmed Elrefaey
collection DOAJ
description A 29-year-old lady was referred to us with a rare complication of scoliosis correction surgery. She had two of the screws migrated and penetrated the descending thoracic aorta. She came to theater to have the screws removed and the aorta repaired endovascularly. The successful intervention needed a multidisciplinary team planning, coordinated work, and communication between the four involved teams: anesthesia, vascular surgery, interventional radiology, and spine surgery. There was a lot of anesthetic challenges that were new to us because of the rarity of that complication. In addition, it was another situation where the trans-esophageal echocardiography was found very useful and affected the decision making by visualizing the screws inside the aorta. The outcome was successful, and the patient was discharged home safely, hence, we would like to share our experience in managing this difficult case to help others who might find themselves in a similar situation.
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institution Kabale University
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publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-a9ac1a88a6844462a4c6cf5410e4b9302025-02-06T07:24:16ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-01-0119111812110.4103/sja.sja_369_24Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE roleAhmed ElrefaeyA 29-year-old lady was referred to us with a rare complication of scoliosis correction surgery. She had two of the screws migrated and penetrated the descending thoracic aorta. She came to theater to have the screws removed and the aorta repaired endovascularly. The successful intervention needed a multidisciplinary team planning, coordinated work, and communication between the four involved teams: anesthesia, vascular surgery, interventional radiology, and spine surgery. There was a lot of anesthetic challenges that were new to us because of the rarity of that complication. In addition, it was another situation where the trans-esophageal echocardiography was found very useful and affected the decision making by visualizing the screws inside the aorta. The outcome was successful, and the patient was discharged home safely, hence, we would like to share our experience in managing this difficult case to help others who might find themselves in a similar situation.https://journals.lww.com/10.4103/sja.sja_369_24aortic injurycomplications of posterior instrumental fusionscoliosistee
spellingShingle Ahmed Elrefaey
Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
Saudi Journal of Anaesthesia
aortic injury
complications of posterior instrumental fusion
scoliosis
tee
title Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
title_full Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
title_fullStr Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
title_full_unstemmed Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
title_short Iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery. The anesthetic management and TEE role
title_sort iatrogenic descending thoracic aorta perforation by pedicle screws as a delayed complication of scoliosis correction surgery the anesthetic management and tee role
topic aortic injury
complications of posterior instrumental fusion
scoliosis
tee
url https://journals.lww.com/10.4103/sja.sja_369_24
work_keys_str_mv AT ahmedelrefaey iatrogenicdescendingthoracicaortaperforationbypediclescrewsasadelayedcomplicationofscoliosiscorrectionsurgerytheanestheticmanagementandteerole