Abstract
Cardiac wound bed drainage is achieved via large-bore plastic tube(s), which are typically removed within 48 hours, to lower risk of arrhythmia and tissue damage. While standard tube removal is simple and rapid, tubes inadvertently sutured to the chest wall are removed through a complex surgical procedure. Herein, we describe a novel tube extraction procedure, using an endoscopic scissor under bronchoscopic guidance. Tube extraction was achieved in all three presented cases, and patient recovery and wound healing periods were similar to those standard removal of nonsutured tubes. This report demonstrates the safety and convenience of the proposed method as a feasible alternative to invasive chest tube extraction.
Highlights
One or more large-bore plastic tubes are usually introduced to the pericardial space after open cardiac procedures, to facilitate wound bed drainage of blood, fluid and air that accumulates in either the mediastinum or the pleural space and to prevent tamponade and pneumothorax
In order to prevent the need to open the surgical site, we present a novel endoscopic method for chest tube extraction, requiring a bronchoscope and endoscopic scissors
A third patient presented a mediastinal tube trapped within the two sternum edges, as identified by the bronchoscope
Summary
One or more large-bore plastic tubes are usually introduced to the pericardial space after open cardiac procedures, to facilitate wound bed drainage of blood, fluid and air that accumulates in either the mediastinum or the pleural space and to prevent tamponade and pneumothorax. Use of these large, stiff tubes is painful and may result in hypoventilation, atelectasis, and heightened use of analgesic agents. A third patient presented a mediastinal tube trapped within the two sternum edges, as identified by the bronchoscope In this case, the procedure was performed with the addition of delicate sedation and application of extra tension while extracting the tube [2,3].
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