The Annals of thoracic surgery
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Iatrogenic esophageal perforation after endoscopy or surgery can be a devastating event. Traditional therapy has most often consisted of operative repair of the esophagus. This investigation summarizes our experiences treating iatrogenic intrathoracic perforations of the esophagus using an occlusive removable esophageal stent. ⋯ Endoluminal esophageal stent placement is an effective method for the treatment of acute, iatrogenic perforations of the intrathoracic esophagus. These stents result in rapid leak occlusion, provide the opportunity for early oral nutrition, may significantly reduce hospital length of stay, are removable, and avoid the potential morbidity of operative repair.
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The aortic valve reimplantation technique leads to excellent clinical outcome in patients with aortic valve incompetence and aneurysms of the ascending aorta. This technique is now applied for aneurysms of ascending aorta, aortic dissection type A, and even dilatation of pulmonary autograft after the Ross operation. We report a case of aortic root dilatation late after a Mustard operation for transposition of the great arteries that was successfully managed by valve-sparing aortic root reimplantation.
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Thoracoscopic talc pleurodesis is a therapeutic option for recurrent pleural effusion. ⋯ Patients with pleural effusion due to malignant disease gain from early pleurodesis. The most favorable outcome after talc pleurodesis was seen in women whose lungs were fully expandable, in patients whose Karnofsky index exceeded 60%, in patients whose body mass index was greater than 25 kg/m2, and in patients with benign disease.