ABSTRACT
This report describes a case of metastatic breast carcinoma in a 62-year-old woman with cardiac tamponade and pleural effusion. Pericardiocentesis followed by ADM (10 mg) instillation successfully controlled cardiac tamponade. After local treatment CAF systemic chemotherapy was performed without serious complications. A long survival time of 50 months was observed. This result suggests that in this case pericardiocentesis with ADM instillation was life saving and that systemic chemotherapy prolonged life.
Subject(s)
Breast Neoplasms/complications , Cardiac Tamponade/therapy , Doxorubicin/administration & dosage , Pleural Effusion/therapy , Breast Neoplasms/pathology , Cardiac Tamponade/etiology , Combined Modality Therapy , Drainage/methods , Female , Heart Neoplasms/secondary , Humans , Injections, Intralesional , Middle Aged , Pleural Effusion/etiology , Pleural Neoplasms/secondary , PrognosisSubject(s)
Heart Septal Defects, Atrial/diagnosis , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Electrocardiography , Female , Humans , Infant , Male , VectorcardiographySubject(s)
Cardiac Surgical Procedures , Cardiopulmonary Bypass , Hypothermia, Induced/methods , Child , Child, Preschool , Humans , InfantSubject(s)
Chylothorax/surgery , Postoperative Complications/surgery , Adult , Child, Preschool , Chylothorax/etiology , Drainage , Female , HumansSubject(s)
Chyle , Pericardium/surgery , Adult , Heart Diseases/surgery , Humans , Ligation , Male , Thoracic Duct/surgeryABSTRACT
The effects of vasodilator therapy upon organ blood flow, beta-glucuronidase activity in plasma and pulmonary surfactant were evaluated before and during cardiopulmonary bypass. Alpha adrenergic blockade with phenoxybenzamine increased the organ blood flow in the heart, brain, stomach, small intestine, large intestine, and liver, whereas it decreased the organ blood flow in the kidney, spleen, and lung. These changes were extremely similar to those observed at hemorrhagic shock. With 2 mg/kg of POB the organ blood flow tended to approach to control levels. The increase of beta-glucuronidase activity at hemorrhagic shock was considerably inhibited after intravenous drip of 2 mg/kg of phenoxybenzamine. We examined the changes of pulmonary surfactant biochemically. Pulmonary surfactant was decreased in endotoxin shock and similar changes were observed in cardiopulmonary bypass when perfusion time was extended to 3 hours. The decrease of pulmonary surfactant after bypass was inhibited by application of POB. From these results, we supposed that the circulatory dynamics during cardiopulmonary bypass might be similar to that of shock and the application of POB in cardiopulmonary bypass might be useful. We applied POB clinically and had good results.
