Biomedical subjects
Publications and source records attributed to I F Galvin.
Described is an unusual injury, arising from a motorized vehicle accident, in which a detached fractured rib from a flail chest caused lung perforation and hemopericardium. The full diagnosis was only appreciated on computed tomography. Therefore, thoracotomy averted potential disaster.
A novel type of coronary artery graft named a T-tube conduit is described. This reversed saphenous graft, coming in three different variations, is useful at long arteriotomies, at revision redo anastomoses, and when size mismatch exists between vein and artery.
Confirming the diagnosis of acute transection of the descending aorta can be problematic. Unnecessary patient movement and time delay are often associated with conventional investigations. We describe a patient in whom such an injury was clearly and quickly defined at the bedside by transesophageal echocardiography.
Reported techniques for mammary artery-coronary artery anastomosis involve instrumental damage to one or all three layers of the mammary artery during surgical connection. Described herein is an atraumatic method of suturing that achieves a precise and highly accurate anastomosis.
A 55-year-old woman undergoing triple-valve replacement was found at operation to have a well preserved and functioning University of Cape Town prosthesis that had been inserted 18 years earlier for tricuspid stenosis. Case reporting, valve reappraisal, and factual updating on another case, the world's first documented tricuspid valve replacement for Ebstein's anomaly, are presented. These two remarkable in vivo successes speak well for this historic collar stud valve.
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Dyspnoeic conditions simulating asthma are not uncommon in adult and paediatric practice. Vascular ring anomalies in particular may be misdiagnosed, resulting in unnecessary delay before corrective surgery. We report a rare case of symptomatic double aortic arch in an adult which emphasises the above points.
Apical pneumothorax due to incomplete expansion of the lung is not uncommon following thoracotomy and also occurs in some patients with recurring spontaneous pneumothorax. Standard methods of intercostal drainage may be unsatisfactory because of difficulty in placing an intercostal tube safely and accurately within the apical air space.
A case of oesophago-pericardial fistula following oesophagoscopy and dilatation is reported. This is a rare and usually fatal complication of oesophageal instrumentation. This case is of further interest as cardiac tamponade following a Niopam swallow subsequently occurred, and the patient survived emergency surgery.
A 68-year-old woman was seen with recent-onset dysphagia. Investigations suggested a large retrocardiac tumor. At thoracotomy, a highly vascular tumor was found, involving the posterior and left aspect of the pericardium with attachment to the heart. The lesion was partially removed, and histopathological analysis revealed a malignant hemangiopericytoma. To our knowledge, this tumor site and its presentation have not been reported before.
Bronchopleural fistula usually associated with chronic empyema after lung operations continues to occur in modern surgical practice. Successful treatment depends to a large extent on adequate dependent drainage of the empyema space. Tube thoracostomy, although useful initially, is unacceptable as long-term treatment. Window thoracostomy as currently performed is effective but unnecessarily extensive. We describe a simpler procedure, triangular window thoracostomy, for use as a permanent pleurocutaneous stoma or as an interim measure before definitive surgical treatment.