Mark Murton

Fractured rib with penetrating cardiopulmonary injury

Described is an unusual injury, arising from a motorized vehicle accident, in which a detached fractured rib from a flail chest caused lung perforation and hemopericardium. The full diagnosis was only appreciated on computed tomography. Therefore, thoracotomy averted potential disaster.

Bilateral Anterior Compartment Syndrome After Routine Coronary Artery Bypass Surgery and Severe Hypothyroidism

Compartment syndrome is a very rare complication of coronary artery bypass grafting and previously it has only been described unilaterally. We describe the development of compartment syndrome in bilateral anterior compartments of the lower leg after vein harvest for coronary artery bypass grafting. We describe a series of predisposing factors contributing to this condition and its delayed diagnosis, including severe undiagnosed hypothyroidism. We advise a high index of suspicion in patients postvein harvest and recommend thyroid function testing for all patients who have compartment syndrome develop.

Methysergide-induced valvular heart disease: a report of 2 cases.

Methysergide is a serotonin antagonist and is used as a long-term prophylactic treatment for migraine. Although many patients experience adequate control of migraine episodes, methysergide has been reported to cause retroperitoneal and pleuropulmonary fibrosis. Cardiovascular side effects mainly in the form of valvular fibrosis have been less recognized. We report 2 cases of methysergide-related mitral valve fibrosis.

Blunt cardiac rupture in the setting of previous sternotomy.

Most cases of blunt cardiac rupture (BCR) are associated with mortality at the scene of the injury. For the fortunate 13% to 17% of patients who survive the journey to the hospital, the treatment is definitive surgical repair. In the setting of previous sternotomy, the pericardial adhesions may limit the damage and protect against cardiac tamponade. We describe a patient who sustained 2 right ventricular tears from blunt trauma in a motor vehicle accident 18 years after coronary artery bypass graft surgery. He did not demonstrate hemodynamic compromise and was successfully managed conservatively.

Infective aortitis associated with the nonpatent remnant of a ductus arteriosus

Infective aortitis is a rare condition, which occurs most commonly in association with some form of structural abnormality of the heart or vessel wall. We describe the successful excision of an infected, nonpatent remnant of the ductus arteriosus.

Papillary fibroelastoma of the mitral valve

Abstract Papillary fibroelastoma is a rare primary tumour of the heart that may arise from the mitral valve. Such a lesion was successfully excised with subsequent repair of the anterior leaflet of the mitral valve in a 30-year-old man.

Homograft valve replacement for traumatic rupture of the aortic valve

Abstract Rupture of the aortic valve is a rare complication of non-penetrating chest trauma. Only 33 cases have been reported. While clinical presentation is variable, most patients are in a stable haemodynamic condition. The most common treatment has been aortic valve replacement. Successful valvuloplasties have been reported recently. This is the first reported case of rupture of the aortic valve in which a homograft valve has been used for replacement.