Central Aortic Cannula Disruption Following Left Atrial Myxoma Excision.

Central aortic cannulation is used to give oxygenated blood to the patient through a heart-lung machine. Central aortic cannula disruption during cardiopulmonary bypass (CPB) is a rare complication. This could result in aortic dissection, extensive tears, bleeding, posterior aortic wall injury, oesophageal trauma, and cardiac arrest. We are reporting a central aortic cannula disruption during a left atrium (LA) myxoma excision in which the metal tip part of the cannula detached from its body, resulting in massive blood loss. The intraoperative blood salvage technique was used to maintain hemodynamics during surgery. Pre-procedural visual inspection of all cardiac consumables, including cannula, should be performed to eliminate this complication. All surgical team members should be observant to avoid such complications.

Evaluation of the Efficacy of a Digital Chest Drainage System in Traumatic Pneumothorax.

INTRODUCTION: Pneumothorax is the major complication in patients with chest trauma. Thoracic injury is a major cause of trauma-related deaths, with up to half of these patients developing pneumothorax. The initial primary management of pneumothorax is intercostal chest drainage (ICD). Chest drainage systems are used to resolve pleural air leakage (PAL), lymphatic or exudative effusion, blood accumulation after chest surgery or trauma, and other disease conditions such as pneumothorax. This study evaluates the efficacy of a digital chest drainage system (Thopaz+, Medela AG, Baar, Switzerland) in patients with pneumothorax following chest trauma and analyzes the satisfaction score by patients. METHOD: A hospital-based cross-sectional study was conducted in a tertiary care centre at the Department of Cardiovascular and Thoracic Surgery (CTVS). All patients with a diagnosis of traumatic pneumothorax/hemopneumothorax from January 2021 to June 2022, aged more than 15 years, were enrolled for the study. A total of 102 patients required chest drainage systems and were selected for the study. We analysed demographic data, clinical profiles, and routine investigations with chest X-rays and computed tomography (CT) scans. All patients were connected with digital drainage devices and monitored for air leaks and other complications. Patient satisfaction was evaluated by a purposefully developed survey questionnaire. RESULTS: Most of our study subjects were male (84.3%) and the mean age was 42.38±15.75 years. The total duration of chest tube, post-operative air leak and duration of hospital stay were noted. The mean chest tube duration was 4.39±1.18 days. Twelve patients were found to have air leaks with digital drainage devices. The mean duration of hospital stay was 5.75±1.49 days. All subjects were provided with a survey questionnaire to assess their response to digital drainage devices. We found that patients were comfortable and had positive responses for the Thopaz+ device. CONCLUSION: We found that Thopaz+ digital drainage system is useful in reducing chest tube duration and hospital stay. It also helps in the early resolution of air leaks and minimises complications. Most of our patients showed a positive attitude. With regard to Thopaz+ digital device, our study concludes that Thopaz+ should be considered for patients who need chest tube drain for pneumothorax.

Extrapleural Intrathoracic Hydatid Cyst: A Rare Cause of Upper Limb Neuropathic Pain.

Human echinococcosis is a common zoonotic disease. Due to favourable climatic conditions, India contributes to the majority of the burden of cystic echinococcosis (CE) in the world. The lung is the most commonly affected organ in the body, after the liver. Common symptoms of pulmonary hydatid cyst (PHC) include cough, chest pain, expectoration, and hemoptysis. This case report is a rare presentation of hydatid disease of the thoracic cavity with complaints of upper limb neuropathic pain. Radiological investigation showed an extrapleural thoracic cyst compressing the brachial plexus, and serological findings confirmed the diagnosis of a hydatid cyst. The patient was taken up for cyst excision as it is the treatment of choice along with adjuvant chemotherapy.

Transthoracic Migration of a Foreign Body into the Diaphragm from the Gunshot Injury and Its Management in a Child: A Case Report.

Intrapleural foreign bodies (FB) are rare and uncommon, while diaphragmatic FB secondary to gunshot injury in a child is still rarer. We now describe a 9-year-old male with a history of self-inflicted accidental air gun injury on the right side of the midline of the sternum with transthoracic migration of FB-lead bullet-measuring 1cm x1.4cm into the diaphragm managed initially with intercostal tube drainage for right hemopneumothorax at the different center underwent thoracoscopy followed by minithoracotomy and retrieval under C-arm guidance that has not been reported in the literature.