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J Thorac Cardiovasc Surg 2006;132:187-189
© 2006 The American Association for Thoracic Surgery

Brief Communication

Dual-layer sandwich mesh repair in the treatment of major diaphragmatic eventration in an adult

Dipartimento di Chirurgia "Pietro Valdoni," Università degli Studi di Roma "La Sapienza," Rome, Italy

Received for publication January 18, 2006; accepted for publication February 13, 2006.

^_* Address for reprints: Angelo Di Giorgio, MD, Università degli Studi di Roma "La Sapienza," Dipartimento di Chirurgia "Pietro Valdoni," Policlinico Umberto I, Via Lancisi 2-00161, Roma, Italy. (Email: angelo.digiorgio@uniroma1.it).

The first 20% of the full text of this article appears below.

Total eventration of a hemidiaphragm is a rare anomaly in adults. This condition could be subsequent to primary or acquired phrenic nerve palsy, but often it presents as a pure degenerative muscular disease without evident signs of denervation. Surgical repair is indicated only in cases of progressive exertional dyspnea, recurrent respiratory infections, or both. Routine surgical techniques counted are plication or incision, followed by double-breast suturing performed through a low posterolateral thoracotomy or minimally invasive access. We report a case of left major eventration in a 58-year-old woman in which the vanishing of most of the diaphragmatic tissue represented an extreme condition incompatible with the performance of a standard procedure.

Clinical Summary

A 58-year-old, female heavy smoker was admitted to our department for a 6-month history of progressive exertional dyspnea and left-sided chest pain. Ten years previously, the patient had a blunt chest trauma caused by a road accident without particular complications and with complete recovery after 5 days of hospitalization. Clinical examination revealed auscultatory bruising over the lower anterolateral quadrants of the left hemithorax; other clinical signs were absent, and laboratory parameters were within normal ranges. A standard radiograph of the chest showed a high displacement . . . [Full Text of this Article]

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