David R. Craddock

Malignant fibrous histiocytoma associated with a Dacron vascular prosthesis

A case of malignant fibrous histiocytoma associated with a Dacron vascular prosthesis is presented. To our knowledge, only four such tumors have been previously recorded in the English-language literature despite extensive use of vascular prosthetic grafts over the last 30 years.

Cardiac involvement in a case of acute lymphoblastic leukemia

We present an extremely rare case of an immunocompromised patient with a T-cell acute lymphocytic leukemia relapse presenting as a right atrial tumor. Problems in diagnosis, vulnerability due to previous immunosuppression and bone marrow transplant, and successful surgical excision are highlighted. Cardiac involvement with hematologic neoplasms should be taken with more than academic interest, as it may be amenable to treatment.

Chylothorax: An unusual complication following coronary artery bypass grafting using the left internal mammary artery

Abstract Development of a massive left-sided chylothorax following coronary artery grafting in a 56-year-old man is presented because of its rarity. Management with chest-tube drainage and dietary restrictions of fat with parenteral nutrition were used to treat the patient. Pleural fluid analysis for chyle in presence of massive pleural effusion was the key to early diagnosis and treatment to prevent increased morbidity and mortality. From 1985 to 1997 at this hospital, this complication occurred in 1 out of 18,978 patients who underwent coronary artery bypass graft surgery; in 6,232 patients, the left internal mammary artery was used.

Venous Cannula Obstruction by Embolus during Cardiopulmonary Bypass

During a routine mitral valve repair with coronary revascularization in a 65-year-old man, venous return was suddenly interrupted. The venous cannula was rapidly removed, revealing a large thrombus obstructing its lumen. Prompt recognition of the problem and replacement of the venous cannula resulted in uneventful recovery of the patient.

Rupture of Left Atrial Appendage and Pericardium Due to Blunt Trauma

A 37-year-old woman sustained a ruptured pericardium and two lacerations of the left atrial appendage in an automobile accident. Simple suture repair of the atrial appendage was achieved after clamping the base of the left atrium to control the bleeding.