ABSTRACT
A case of pulmonary dirofilariasis in a human being is presented in which the lesion was visible roentgenographically for eighteen months prior to resection and in which the correct etiological diagnosis was made on frozen-section examination at the time of thoracotomy. The documented geographical spread of dirofilariasis in the canine population in the United States and southern Canada suggests that pulmonary dirofilariasis in human beings may be seen with increasing frequency by thoracic surgeons. The epidemiological and pathogenetic features of this unusual disease are discussed. A serological test for dirofilariasis is now available that may allow some patients to escape thoracotomy for this self-limited disorder.
Subject(s)
Dirofilariasis/surgery , Granuloma/surgery , Lung Diseases, Parasitic/surgery , Dirofilariasis/diagnosis , Female , Granuloma/diagnosis , Humans , Lung Diseases, Parasitic/diagnosis , Middle AgedABSTRACT
Early electrode dislodgment from the ventricular apex is a major complication associated with transvenous cardiac pacing. A new lead with flexible tines proximal to the tip electrode has been developed to minimize acute dislodgment incidence. The bipolar tined lead was implanted in 79 patients. This experience was compared to 48 implants of a standard bipolar endocardial lead. Stimulation threshold, sensing, and resistance measurements from both leads were comparable. Although the cephalic vein was the preferred venous route, the jugular vein was needed more often for tined lead insertion than for standard lead insertion. The incidence of early dislodgment with the tined lead was 2.5 percent compared to 8 percent with the standard lead (no significant difference). This preliminary experience can only suggest that the addition of flexible tined leads may reduce early electrode dislodgment.
