Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2009
ReviewCan a mini-bypass circuit improve perfusion in cardiac surgery compared to conventional cardiopulmonary bypass?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the 'mini-bypass technique' can give a reduction in complications after cardiac surgery compared to the conventional cardiopulmonary bypass circuit. Altogether 144 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. ⋯ Six studies find significantly reduced inflammatory markers, and 5 measure superior myocardial protection. There are several anecdotal references to a 'learning curve' with this technique but no significant morbidity with complications arising from this were found. Mini-bypass seems to be a promising technique with many documented benefits in studies reporting as many as 1000 patients undergoing this technique.
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Interact Cardiovasc Thorac Surg · Apr 2009
Case ReportsSwyer-James-MacLeod syndrome; repeated chest drainages in a patient misdiagnosed with pneumothorax.
Swyer-James-MacLeod Syndrome (SJMS) occurs as a result of childhood bronchiolitis obliterans. Typically, this disorder is diagnosed in childhood after evaluations for recurrent respiratory infections. ⋯ Here, we are presenting a 22-year-old female patient who was diagnosed with SJMS who was initially misdiagnosed with a pneumothorax and treated by multiple chest tube drainages. This case highlights the significance of taking a careful history, the application of computed tomography and scintigraphy in confirming the diagnosis of SJMS and in eliminating other diseases.