The Annals of thoracic surgery
-
Case Reports
Scimitar syndrome: cine magnetic resonance imaging demonstration of anomalous pulmonary venous drainage.
A "scimitar" shadow was found on routine chest roentgenography in an asymptomatic patient. Evaluation with cine magnetic resonance imaging demonstrated an anomalous pulmonary vein draining into the inferior vena cava below the diaphragm. The diagnosis of scimitar syndrome was confirmed and successfully repaired at operation. Cine magnetic resonance imaging may be of considerable value in the assessment of congenital pulmonary venous abnormalities and may provide an alternative to more traditional invasive diagnostic techniques in certain circumstances.
-
Progressive left chest volume loss developed in a patient with severe flail chest despite reasonable oxygenation without intubation. Because of this chest volume loss, pain, and shortness of breath, she underwent open chest wall repair using multiple metallic struts. Rapid recovery ensued, despite a perforated duodenal ulcer on postoperative day 1. Benefits of open fixation of severe flail chest are clearly demonstrated and should be considered instead of prolonged ventilation or supportive care alone for select patients.
-
Minitracheostomy is a technique to assist in the removal of airway secretions while maintaining glottic function. A flanged, reclosable cannula 4.0 mm in internal diameter is inserted through the cricothyroid membrane into the trachea. Sixty procedures were performed in 56 patients from July 1988 to June 1989. ⋯ No adverse laryngeal effects were seen. A successful result, not requiring other invasive methods to remove secretions, was obtained in 43 (72%) of the 60 procedures. Minitracheostomy is a useful adjunct for secretion removal in the hospitalized patient.
-
Comment Letter
Direct access to the paravertebral space at thoracotomy.