RESUMO
Lung volume reduction operation is an important therapeutic option in patients with advanced emphysema. We report a case of spontaneous rupture of the right diaphragm after a video-assisted thoracoscopic surgical procedure for emphysema. The pathophysiology of this complication is also discussed, along with practical points for perioperative management of emphysematous patients.
Assuntos
Hérnia Diafragmática/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Enfisema Pulmonar/cirurgia , Cirurgia Torácica Vídeoassistida , Diagnóstico Diferencial , Feminino , Hérnia Diafragmática/cirurgia , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Radiografia , Reoperação , Ruptura EspontâneaRESUMO
A method of performing redo cardiac operations using port-access technology and total circulatory arrest is described. The technique was useful in 2 cases requiring re-intervention within 4 months of the primary procedure. The indications were repair of an infected ventricular aneurysm and recurrence of a postinfarction ventricular septal defect. Dense mediastinal adhesions were avoided by approaching the site of pathology directly via a left anterior thoracotomy.