The Thoracic and cardiovascular surgeon
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Sarcoidosis is a systemic disease which affects many organs, including the heart. Cardiac sarcoidosis has a reported incidence of about 25 % and carries a poor prognosis. It can occur in the form of conduction abnormalities, pericardial and valvular heart disease, congestive heart failure, arrhythmias and sudden cardiac death. ⋯ Corticosteroids have been the cornerstone of treatment of cardiac sarcoidosis, but other immunosuppressives have also been used, along with standard heart failure therapy, antiarrhythmic medications, pacemakers and implantable defibrillators. Cardiac transplantation is an option for patients who do not respond to medical treatment. We briefly review the current armamentarium for the diagnosis and treatment of cardiac sarcoidosis.
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Chylothorax remains an uncommon but challenging clinical problem. Thoracic duct ligation is the treatment of choice for postsurgical patients. However, the optimal treatment for traumatic patients is unclear. We wanted to examine the outcomes of patients with high output or recurrent chylothorax who were treated by surgical means. ⋯ Thoracic duct ligation is the treatment of choice for high output or recurrent chylothorax with a 96 % success rate. Surgical pleurodesis is effective in some cases and may be an option for marginal patients.
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Thorac Cardiovasc Surg · Jun 2009
Case ReportsA unusual case of right lung and right atrio-inferiocaval injury caused by stabbing.
Penetrating thoracic injuries can damage more than one intrathoracic structure and frequently require urgent surgical intervention due to life-threatening consequences. These injuries demand extreme awareness and emergency measures. ⋯ The patient was treated by immediate surgical repair under partial cardiopulmonary bypass and discharged successfully. This case emphasizes the fact that right chest paravertebral penetrating injuries may require cardiopulmonary bypass, although this zone has less risk for cardiac injury.