Teeth infection may “shunt” through Fontan in high-altitude conditions

The Fontan surgery involves the creation a conduit between the inferior vena cava and the right pulmonary artery. This conduit has a small fenestration that shunts the blood from right to left in case the pulmonary blood flow is limited; namely, if the pulmonary vascular resistance is increased then...

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Detalles Bibliográficos
Autor Principal: Mestra Durango, Camilo Fidel
Otros Autores: Ronderos, Miguel
Formato: Trabajo de grado (Bachelor Thesis)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2018
Materias:
Acceso en línea:http://repository.urosario.edu.co/handle/10336/14291
id ir-10336-14291
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic Fontan
Abceso cerebral
Altitud
Procedimiento de Fontan
Venas Cavas
spellingShingle Fontan
Abceso cerebral
Altitud
Procedimiento de Fontan
Venas Cavas
Mestra Durango, Camilo Fidel
Teeth infection may “shunt” through Fontan in high-altitude conditions
description The Fontan surgery involves the creation a conduit between the inferior vena cava and the right pulmonary artery. This conduit has a small fenestration that shunts the blood from right to left in case the pulmonary blood flow is limited; namely, if the pulmonary vascular resistance is increased then the shunt is increased. Thus bacteria may bypass the pulmonary circulation and easily get access to the systemic circulation (bacteremia). We report the case of a patient that underwent Fontan surgery in 2010 and remained in a highaltitude city for 7 years, during this time he was asymptomatic until 2017 when he developed a brain abscess due to Streptococcus gordonii, a pathogen of dental plaque. Since high-altitude may raise pulmonary vascular resistance in response to reduction in the partial pressure of oxygen, we conclude that the long-term outcome of increased altitude on Fontan hemodynamics can lead to the shunt of teeth flora and lead to severe infections.
author2 Ronderos, Miguel
author_facet Ronderos, Miguel
Mestra Durango, Camilo Fidel
format Trabajo de grado (Bachelor Thesis)
author Mestra Durango, Camilo Fidel
author_sort Mestra Durango, Camilo Fidel
title Teeth infection may “shunt” through Fontan in high-altitude conditions
title_short Teeth infection may “shunt” through Fontan in high-altitude conditions
title_full Teeth infection may “shunt” through Fontan in high-altitude conditions
title_fullStr Teeth infection may “shunt” through Fontan in high-altitude conditions
title_full_unstemmed Teeth infection may “shunt” through Fontan in high-altitude conditions
title_sort teeth infection may “shunt” through fontan in high-altitude conditions
publisher Universidad del Rosario
publishDate 2018
url http://repository.urosario.edu.co/handle/10336/14291
_version_ 1645141927376453632
spelling ir-10336-142912019-09-19T12:37:54Z Teeth infection may “shunt” through Fontan in high-altitude conditions Brain abscess due to dental infection in Fontan Surgery Mestra Durango, Camilo Fidel Ronderos, Miguel Fontan Abceso cerebral Altitud Procedimiento de Fontan Venas Cavas The Fontan surgery involves the creation a conduit between the inferior vena cava and the right pulmonary artery. This conduit has a small fenestration that shunts the blood from right to left in case the pulmonary blood flow is limited; namely, if the pulmonary vascular resistance is increased then the shunt is increased. Thus bacteria may bypass the pulmonary circulation and easily get access to the systemic circulation (bacteremia). We report the case of a patient that underwent Fontan surgery in 2010 and remained in a highaltitude city for 7 years, during this time he was asymptomatic until 2017 when he developed a brain abscess due to Streptococcus gordonii, a pathogen of dental plaque. Since high-altitude may raise pulmonary vascular resistance in response to reduction in the partial pressure of oxygen, we conclude that the long-term outcome of increased altitude on Fontan hemodynamics can lead to the shunt of teeth flora and lead to severe infections. 2019-08-01 06:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2019-04-23 2018-02-02 2018-02-06T20:10:54Z info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion http://repository.urosario.edu.co/handle/10336/14291 spa info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Especialización en Cardiología Pediátrica Facultad de Medicina instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR D’Udekem Y, Iyengar AJ, Cochrane AD, Grigg LE, Ramsay JM, Wheaton GR, et al. The Fontan procedure: Contemporary techniques have improved long-term outcomes. Circulation. 2007;116(11 SUPPL. 1). Day RW, Orsmond GS, Sturtevant JE, Hawkins JA, Doty DB, McGough EC. Early and intermediate results of the Fontan procedure at moderately high altitude. Ann Thorac Surg [Internet]. The Society of Thoracic Surgeons; 1994;57(1):170–6. Available from: http://dx.doi.org/10.1016/0003- 4975(94)90388-3 Johnson JT, Lindsay I, Day RW, Van Dorn CS, Hoffman J, Everitt MD, et al. Living at altitude adversely affects survival among patients with a fontan procedure. J Am Coll Cardiol [Internet]. Elsevier Inc.; 2013;61(12):1283–9. Available from: http://dx.doi.org/10.1016/j.jacc.2013.01.008 Lemler MS. Fenestration Improves Clinical Outcome of the Fontan Procedure: A Prospective, Randomized Study. Circulation [Internet]. 2002;105(2):207–12. Available from: http://circ.ahajournals.org/content/105/2/207.long Mehrotra A, Khanna P, Kumar S, Abraham G. Renal abscess after the Fontan procedure: a case report. J Med Case Rep [Internet]. 2011;5:50. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi? artid=3048475&tool=pmcentrez&rendertype=abstract Patel K, Clifford DB. Bacterial Brain Abscess. The Neurohospitalist [Internet]. 2014;4(4):196–204. Available from: http://journals.sagepub.com/doi/10.1177/1941874414540684 Doern CD, Burnham CAD. It’s not easy being green: The viridans group streptococci, with a focus on pediatric clinical manifestations. J Clin Microbiol. 2010;48(11):3829–35. Zheng W, Tan MF, Old LA, Paterson IC, Jakubovics NS, Choo SW. Distinct Biological Potential of Streptococcus gordonii and Streptococcus sanguinis Revealed by Comparative Genome Analysis. Sci Rep [Internet]. Springer US; 2017;7(1):2949. Available from: http://www.nature.com/articles/s41598- 017-02399-4 Lakshmi V, Bhushanam V, Kumar A, Solanki R, Subramanian S. Brain abscess due to Streptococcus oralis in an immunocompetent patient. Indian J Med Microbiol [Internet]. 2014;32(2):179. Available from: http://www.ijmm.org/text.asp?2014/32/2/179/129817 Lockhart PB, Brennan MT, Sasser HC, Philip C, Paster BJ, Bahrani-mougeot FK. NIH Public Access. 2009;117(24):3118–25. Vidal JE, Tuon FF. Brain abscess due to viridans streptococci in a severely immunosuppressed HIVinfected patient. Int J STD AIDS. 2009;20:654–6. McRae ME. Long-term Issues After the Fontan Procedure. AACN Adv Crit Care [Internet]. 2013;24(3):264–82. Available from: http://acc.aacnjournals.org/cgi/doi/10.1097/NCI.0b013e31829744c7
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