A lower-lobe-seeking pulmonary artery catheter.

The Grollman pulmonary artery catheter was modified by turning the pigtail downward to facilitate lower lobar catheterization with the femoral approach. The advantage of this tip configuration was obvious in the 30 cases in which it was attempted. The superiority of this catheter in traversing the tricuspid valve and in entering the right or left pulmonary artery with equal ease was also noted.

Percutaneous angioscopy. Work in progress.

The cardiovascular applications of flexible fiber-optic technology are imminent because of recent advances in miniaturization. In the work described here, angioscopy, or vascular endoscopy, was performed in the cadaveric aorta and in the systemic and pulmonary circulations of the canine model and selected human patients. Subsequent to our development of percutaneous techniques, clinical trials have ranged from lower-extremity venoscopy to aortic-root arterioscopy. Angioscopy could be clinically useful because of relative or absolute contraindications to iodinated contrast material. The ability to see in color and three dimensions may afford some other advantages to angioscopy over conventional angiography.

Demonstration of pleural tube track tubularity.

The inflammatory reaction that is caused by the placement of a tube in the pleural space persists after tube removal and may be observed on chest roentgenograms. One radiological presentation of this reaction is a lucent stripe, which represents localized iatrogenic pneumothorax in the track of the tube. The possibility that this stripe may represent a tubular track is not generally appreciated. We report two instances in which the three-dimensional tubular nature of the tracks is demonstrated. Failure to correlate such a stripe with roentgenograms showing the previous placement of the chest tube at the site of a track may lead to confusion and potentially serious misinterpretation.

Dilated pulmonary venous confluence presenting as a mass in mitral stenosis.

Pulmonary varices are rare venous anomalies which typically present as masses. Since they are usually clinically insignificant, varices must be diagnostically distinguished from parenchymal tumors and mediastinal adenopathy so one may adhere to a conservative medical approach. This report reviews the literature and illustrates a convergence of varices that presented as a larger sized mass than previously described by others.

Multicentric fibroepithelial ureteral polyp.

A case of a fibroepithelial ureteral polyp consisting of numerous separate ureteral growths is presented, and the preoperative diagnostic criteria are discussed. The latter are crucial in raising the suspicion of a benign process and thereby encouraging a conservative operative approach.