Heart, lung & circulation
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Heart, lung & circulation · Apr 2006
Case ReportsLarge retrosternal goitre: a diagnostic and management dilemma.
A substernal goitre is of clinical significance because its growth between the sternum anteriorly and vertebral bodies posteriorly leads to impingement on the surrounding structures and compressive symptoms. The incidence of substernal goitre is documented to vary between .02 and .5%. ⋯ This condition is important because it presents a diagnostic dilemma as its size and compressive symptoms mimic malignant disease, and an operative dilemma for the approach to its management. We present one of the largest reported retrosternal goitre cases in the literature.
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Heart, lung & circulation · Apr 2006
Case ReportsIntraaortic balloon pump insertion through the subclavian artery. Subclavian artery insertion of IABP.
The intraaortic balloon pump (IABP) is frequently used in the management of cardiac failure in the setting of myocardial infarction or as a bridge for coronary revascularisation surgery. The IABP is usually inserted through the femoral artery. Occasionally severe aorto-iliac occlusive disease prevents the retrograde passage of the balloon, in which case an anterograde route, usually through the ascending aorta is used. We describe four patients in whom an IABP was placed through the subclavian artery by the joint efforts of cardiologists and vascular surgeons.
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Heart, lung & circulation · Apr 2006
Routine histological analysis of resected lung tissue in primary spontaneous pneumothorax -- is it justified?
Surgical management of spontaneous primary pneumothorax consists of pleurectomy together with resection of blebs or bullae. We analysed the utility of routine histological examination of these resected specimens. A consecutive series of 64 resected specimens were reviewed, of which 43 (67%) showed the presence of bullae or blebs. ⋯ Examination of the lung parenchyma revealed inflammation in 34 (53%) cases. In all 64 cases, the histological results did not result in a change in medical therapy. Although resected lung specimens from patients with primary spontaneous pneumothorax show diversity in their histological characteristics, we would question the utility of routine pathological analysis of resected lung specimens in primary spontaneous pneumothorax.