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Year : 2010  |  Volume : 13  |  Issue : 1  |  Page : 70
Right subpleural position of the ascending aorta: A pitfall for the cardio-thoracic surgeon


Department of Cardio-thoracic Surgery, University Hospital, Patras School of Medicine, Patras, Greece

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Date of Web Publication11-Jan-2010
 

How to cite this article:
Baikoussis NG, Apostolakis EE, Koletsis EN, Dougenis D. Right subpleural position of the ascending aorta: A pitfall for the cardio-thoracic surgeon. Ann Card Anaesth 2010;13:70

How to cite this URL:
Baikoussis NG, Apostolakis EE, Koletsis EN, Dougenis D. Right subpleural position of the ascending aorta: A pitfall for the cardio-thoracic surgeon. Ann Card Anaesth [serial online] 2010 [cited 2020 Aug 4];13:70. Available from: http://www.annals.in/text.asp?2010/13/1/70/58840


We would like to present a case that illustrates a potential "pitfall"/catastrophe if thoracocentesis was performed based on X-ray alone without the CT of the chest. An 85-year-old female presented with dyspnoea and chest X-ray [Figure 1], revealed features of "pleural effusion" on the right side, suggesting a thoracocentesis and chest tube placement. However, there was a severe tracheal deviation, but the etiology was not known. According to the bibliography, reasons for sever tracheal deviation could be diffuse fibrous, [1] goiter, [2] unilateral emphysema, recurrent pneumonia, etc. [3],[4] CT of chest [Figure 2], showed severe shift of mediastinum to right with ascending aorta just under the lateral thoracic cavity.

 
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1.Teirstein AT, Morgenthau AS. "End-stage" pulmonary fibrosis in sarcoidosis. Mt Sinai J Med 2009;76:30-6.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Escudero A, Moret E, Rengel A, Sariñena MT. Tracheal deviation caused by a goiter. Rev Esp Anestesiol Reanim 2007;54:509-11.   Back to cited text no. 2      
3.Patel N, Bishay A, Bakry M, George L, Saleh A. Dyspnea with slow-growing mass of the left hemithorax. Chest 2007;131:904-8.   Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Banker MC, Sambol J, Raina S. Management of an ascending aortic aneurysm with coronary artery disease and tracheal compression from a substernal goiter. J Card Surg 2005;20:177-9  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  

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Correspondence Address:
Nikolaos G Baikoussis
Cardiothoracic Surgeon, Kolokotroni 4, Ovria, 26500 Patras
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.58840

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