Scandinavian journal of thoracic and cardiovascular surgery
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Scand J Thorac Cardiovasc Surg · Jan 1984
Congenital chylothorax: management by ligature of the thoracic duct.
Congenital chylothorax in a male infant persisted for 10 weeks despite repeated thoracocenteses and dietary regimens which included total parenteral nutrition for 37 days and a peroral semielementary diet with medium-chain triglyceride content for 19 days. Thoracotomy disclosed a small leak in the thoracic duct. The duct was ligated above and below the leak, as attempted repair was unsuccessful. There was no recurrence of pleural effusion after the operation and no distal lymphoedema was observed.
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Scand J Thorac Cardiovasc Surg · Jan 1984
Case ReportsBronchial rupture caused by blunt chest trauma.
Tracheobronchial rupture is a rare and serious complication of blunt chest trauma. The cause is often a traffic accident and the rupture may be associated with other, fatal injuries. Three cases were treated at our clinic in the period 1970-1982. ⋯ The early clinical picture may vary, depending on the site and extent of the injury, from only minimal mediastinal emphysema to severe dyspnea with extensive subcutaneous and mediastinal emphysema or persistent pneumothorax. The correct diagnosis was confirmed in all three of the described cases by bronchoscopy, which was performed in the late course because of respiratory difficulties and roentgenographic evidence of pulmonary complications. Since early surgical repair is essential for a good functional result, the possibility of tracheobronchial rupture must be kept in mind in any case of severe thoracic trauma.
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Scand J Thorac Cardiovasc Surg · Jan 1984
The value of activated coagulation time in monitoring heparin therapy during extracorporeal circulation.
The anticoagulant effect of heparin was studied in 20 patients undergoing aortocoronary bypass surgery. The protamine dose necessary to reverse heparin after extracorporeal circulation (ECC) was assessed in ten patients from individual heparin dose-response curves (HDR group). The other ten patients received protamine according to a routine protocol (control group). ⋯ The postoperative bleeding was not related to the levels of heparin or coagulation parameters after heparin reversal. The concentrations of fibrinogen and AT-III showed variations dependent on the changes in haematocrit. A number of factors other than heparin that influence ACT are discussed.