Surgical Repair of Scimitar Syndrome

Scimitar syndrome (SS) is a form of partial anomalous pulmonary venous drainage that is dramatically visible on plain chest radiography (CXR). In these individuals, the entire venous drainage from the right lung enters a single anomalous large vein that descends to the inferior vena cava. This descending vein is visible on CXR as a curvilinear density along the right heart border and resembles the curved Turkish sword that gives the condition its name. SS forms part of the large spectrum of associated conditions known as venolobar syndrome. These include right lung hypoplasia or sequestered segments of right lung, congenital heart disease and various others. We report, along with our other five cases, a special case of a young woman who presented incidentally, with a murmur, at 16 years of age. Full investigation including angiography showed a large atrial septal defect (ASD) with right heart dilation and SS. She underwent surgical correction with uneventful and complete correction by baffling of the scimitar vein from its entry into the inferior vena to the left atrium through the enlarged ASD.

Chylopericardium after Cardiac Surgery

Chylopericardium after intra-thoracic surgery is rare. Its incidence is reported to be between 0.22% and 0.5%[1, 2] following paediatric cardiac surgery, but is not quantified following cardiac surgery in the adult population. A delay in diagnosis can lead to serious consequences with tamponade and death[3]. Chronic lymph leak can also lead to immunosuppresion, hypoproteinemia and malnutrition[3]. The majority of published literatures on this condition after cardiac surgery are in children. There are few reports of chylopericardium in adults following coronary artery bypass grafting and valvular surgery[4–6], and these advocate treatment with either total parental nutrition or surgical intervention. We report on the case of chylopericardium after a trial. Septal defect surgical closure in an adult patient treated successfully by oral dietary manipulation.

Giant Thymolipoma – A Rare Benign Tumour of the Thymus Gland

Thymolipoma is a rare benign tumour of mediastinum. It is often asymptomatic but can enlarge significantly prior to the diagnosis. It consists of thymic and fatty tissue surrounded by a capsule. A 23-year-old man sought medical attention for respiratory distress since 10 years progressively increasing in severity. Computed tomography findings were suggestive of a space occupying lesion in the anterior mediastinum with extension into hemi-thorax on either side. The tumour was surgically resected by median sternotomy. The tumour measured ∼21x25x10 cm and weighed 2800 gm. Histopathological examination revealed thymolipoma.