A 28-day-old child presented with recurrent cardiac tamponade. Diagnostic tests revealed an intrapericardial tumour but was not conclusive as to the aetiology. The tumour was successfully resected.
A 28-day-old child presented with recurrent cardiac tamponade. Diagnostic tests revealed an intrapericardial tumour but was not conclusive as to the aetiology. The tumour was successfully resected.
The introduction of video technology and endoscopic stapling devices has made video-controlled thoracoscopic lung biopsy (VTLB) a realistic alternative to open lung biopsy (OLB). We have compared the diagnostic value of tissue obtained in 12 patients having elective VTLB with 19 patients who had elective OLB. Patients in the 2 groups were similar in preoperative respiratory status and indication for biopsy. The mean operative time for VTLB was 68 min, and 60 min for OLB. There were no serious complications or deaths. The average size of specimens was 23 cm3 for VTLB and 8.1 cm3 for OLB. Despite the differences in mean size, pathology results were similar, showing a specific diagnosis in 6 of 12 patients having VTLB and 11 of 19 patients having OLB. The patients were discharged, on average, 3 days after VTLB and 7.2 days after OLB (p=0.0002). Tissue obtained at VTLB was equal in diagnostic value to OLB. The reduction in hospital stay and surgical trauma makes VTLB the procedure of choice for diagnostic lung biopsy.
Cardioscopic surgery is proposed in conjunction with cardiopulmonary bypass and cardioplegic arrest, both achieved with peripheral cannulation. Early studies suggest that cardioscopic surgery is possible.
We describe a technique of treating the saphenous vein with a new vasodilator solution during harvesting for coronary bypass grafting. In a previous study, glyceryl trinitrate (GTN) and verapamil caused full relaxation of the vein. When used in combination, these agents caused a rapid onset (due to GTN) and long duration of action (due to verapamil). We routinely apply this solution to the inside and the outside of the saphenous vein during harvesting to provide a relaxed venous conduit for coronary bypass grafting.
A cleft was found in the cardiac apex in a three-year-old boy undergoing surgery for an atrial septal defect. Such clefts are seen in some whales and have been reported rarely in man. Our patient also had a deep cleft in the right atrioventricular region, persistent left superior vena cava, and a long intrapericardial course of the right pulmonary veins.
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