The Annals of thoracic surgery
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The pathogenesis, pathology, clinical presentation, diagnosis and management of tracheo-bronchial injuries secondary to nonpenetrating thoracic trauma are discussed.
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A new microporous, expanded polytetrafluoroethylene arterial prosthesis was evaluated in dogs. The material appears to produce an adequate prosthesis for aortopulmonary anastomosis in animals and can conduct a high rate of blood flow. ⋯ Thus far all patients are well, growing, and have a loud shunt murmur. The desirable features of this type of anastomosis are presented.
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Case Reports
Bullet emboli to the pulmonary artery: a report of 2 patients and review of the literature.
Bullet embolization to the pulmonary artery is a rare event. The purpose of this study is to report our experience with 2 patients and to review the 15 patients reported in the literature, with special emphasis on a rather peculiar complication that has occurred in 4 of the 9 patients who underwent bullet embolectomy: dislodgment of the missile during the surgical procedure and migration to the down-side lung, for which a second thoracotomy was required in 3 of those patients. ⋯ This review suggests that operative removal of a bullet in the pulmonary artery is necessary. The operation is safe and uncomplicated if precautions are taken to prevent the missile from migrating during manipulation of the lung.
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Case Reports
Spontaneous closure of a traumatic ventricular septal defect following a penetrating injury.
A ventricular septal defect acquired from a penetrating injury to the membranous septum closed spontaneously, as documented by repeat cardiac catheterization. The patient was asymptomatic from the time the lesion was discovered until the present. ⋯ Cardiac catheterization is mandatory to confirm the diagnosis, measure the magnitude of the shunt, and rule out associated intracardiac injuries. We believe the lesion should be closed on an elective basis, regardless of the absence of symptoms, if after a reasonable time there is no evidence that the ventricular septal defect is closing and a significant shunt is demonstrated.