PubMed · 5694326
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A B Jenson, H L Fred. 1968-03-11. Toothpick pleurisy.. https://pubmed.ncbi.nlm.nih.gov/5694326/
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The purpose of this study was to prove the feasibility of 3D reconstructions of the diaphragm during the respiratory cycle using EPI sequences (EPI acquisition, 270 ms/image, on a healthy subject breathing spontaneously and at 0.1 Hz). Continuously recorded respiratory signal allowed for retrospective synchronization with respiratory phases for reconstruction of successive diaphragm surfaces using a specifically designed software. Displacements, area and volume changes of the diaphragm were quantified. Our measurements were comparable with the data in the literature. Reconstructed surfaces allowed in vivo diaphragm dynamic evaluation in terms of displacements, area and volume variations. EPI has adequate spatial and temporal resolution for studying diaphragm dynamics during natural breathing.
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OBJECTIVE: To study the in-hospital evolution of patients with the infradiaphragmatic and mixed types of total anomalous pulmonary venous drainage (TAPVD), who underwent surgical therapy. METHODS: Of the 65 patients diagnosed with isolated TAPVD and operated on from December 1993 to March 2002, 7 (10.8%) patients with the mixed and infradiaphragmatic forms were retrospectively selected. Their ages ranged from 5 days to 19 months (mean of 7 months), 5 (71.4%) were males, and their clinical diagnosis was established with 2-dimensional echocardiography. Four (57.1%) patients had the mixed form, which was intrinsic obstructive in 1 patient, with mild stenosis of the left inferior vein. The remaining 3 (42.9%) patients had the obstructive infradiaphragmatic form, extrinsic at the level of the diaphragm. All surgeries were performed through median sternotomy with hypothermic extracorporeal circulation, and total circulatory arrest was required in 2 patients. RESULTS: In-hospital death occurred in 1 patient with infradiaphragmatic TAPVD with connection of the inferior vertical vein with the portal vein. The cause of death was related to multisystem organ failure. In 4 (57.1%) patients, the postoperative period was characterized by the presence of low cardiac output and pulmonary hypertension. CONCLUSION: The result of the surgical correction of this anomaly is associated with acceptable morbidity and mortality, depending on early referral and surgery, without progression of the pulmonary vascular hypertension findings.