A free-floating tumor thrombus in the left atrium is an unusual metastasis of non-small cell lung cancer. Surgical resection of free-floating tumor thrombus prior to adjuvant therapy relieves cardiac symptoms such as exertional dyspnea, and prevents life-threatening complications including systemic embolization, mitral obstruction, or sudden death.
As a consequence of the progress in the development of endovascular techniques, hybrid treatment is becoming a more popular option for the treatment of coarctation accompanied by cardiac diseases. Two-stage procedures and extra-anatomical bypass might be alternative techniques if endovascular procedures are contraindicated or failing.
Preoperative vein mapping for harvesting SVGs is an effective method in reducing wound site complications, hospital stay, and hospital costs and in increasing patient comfort and satisfaction.
Purpose: In the treatment of the postsurgical pericardial effusions via pericardiocentesis, determination of the puncture site might be difficult. Contrast echocardiography may not be efficient due to surgical artefacts and pulmonary problems and therefore may lead to inaccurate evaluation. Alternative imaging methods might be helpful to perform the pericardiocentesis with decreased complications.
Methods: We retrospectively analyzed the patients who had undergone pericardiocentesis in our department from January 2008 through April 2018. The procedure was performed in slightly semi-seated position with the guidance of the echocardiography and fluoroscopy. Following the catheterization, percutaneous drainage was performed.
Results: There were 63 patients needed intervention due to pericardial effusion. 67% of the patients were using warfarin and the next patients were using acetyl salicylic acid and/or clopidogrel. All effusions were in the posterolateral localization. The mean volume of aspirated pericardial fluid was 404 ± 173 mL (150–980 mL). Control echocardiograms showed that almost all fluid was drained in all patients and there were no procedural or follow-up complications.
Conclusion: In the treatment of postoperative pericardial effusion, fluoroscopy is an alternative method to locate the catheter accurately in challenging situations following cardiac surgery. Thus, procedural risk minimizes and drainage of pericardial fluid is performed safely.
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