Technique for Salvage Reconstruction of Shredded Left Main Coronary Artery After Rotablator Injury.

We report the technique needed to effectively repair a left main coronary artery shredding after rotational atherectomy and destruction of the left main coronary artery. The patient had been deemed inoperable at another center because of diffuse distal coronary disease. The complication led to cardiac tamponade and hemodynamic collapse, necessitating cardiopulmonary resuscitation and salvage surgery.

Can the Left Subclavian Artery be Safely Covered During Endovascular Repair of the Descending Thoracic Aorta?

Objective: : Routine preoperative carotid-subclavian bypass or transposition is frequently recommended in patients undergoing endovascular repair of the descending thoracic aorta (DTA). We reviewed our comprehensive thoracic endografting experience with regards to coverage of the left subclavian artery (LSA) to assess whether mandatory preoperative carotid-subclavian bypass or transposition is necessary.

Methods: : Between February 2000 and November 2005, 255 patients were successfully treated with an endoluminal graft (ELG) to the DTA.

A simple technique for aortic valve replacement in patients with a patent left internal mammary artery bypass graft.

Aortic valve replacement in patients with a patent left internal mammary artery graft is often a challenge because of the difficulties with dissection of the left internal mammary artery and optimum myocardial protection. We describe a simple technique of aortic valve replacement with a beating heart and continuous coronary perfusion for this difficult group of patients.

Overdose of tetracycline for pleurodesis leading to chemical burns of the pleura.

Chemical pleurodesis using tetracycline is an accepted and commonly employed treatment of pneumothorax and pleural effusions. We describe a case of chemical burn of the pleura in a ventilated 41-year-old who came to thoracotomy after 3 days of continuous intrapleural infusion of tetracycline at another hospital. To our knowledge this has not been previously reported although other adverse effects of this procedure are documented.

Hypoglycaemia associated with a solitary fibrous tumour of the pleura.

We report the interesting case of an elderly woman who presented with hypoglycaemic episodes and weight loss. She was found to have a solitary fibrous tumour weighing more than 1.7 kg arising from the diaphragmatic pleura, which had been producing insulin-like growth factor II.