This is a case of 77-year old male who was diagnosed with Hypertensive Cardiovascular Disease (HCVD), Chronic Kidney Disease and Adenocarcinonam of the prostrate. He was also diagnosed earlier this year with Coronary Artery Disease – 3-vessel disease and underwent coronary artery bypass graft in June 2010. He is also hemodialysis three times a week.
He was admitted for planned pleurodesis due to diagnosed pleural effusion of about 600-700 cc of fluid on each side of the pleural space, however patient was undecided. Since then, patient has gradual development of dyspnea or difficulty breathing.
His dypnea was relieved by thoracentesis. The surgeon then suggested for bilateral thoracoscopy for the evaluation of the pleural cavity and possible biopsy of questionable and doubtful fluids and talc pudrage. The talc pudrage of the pleural cavity is the administration of a talc to promote adhesion of tissues so as to prevent accumulation of fluid. During pleuroscopy talc is insufflated through the lumen of the mediastinoscope. Up to 2 gr of purified talc is sprinkled under vision over the entire pleural surface.
Source: www.ncbi.nlm.nih.gov
The procedure was successful and the patient was discharged 2 days after the chest tubes were removed. There were no complaints about dyspnea and he can tolerate room air. He will just come back as an out-patient for his hemodialysis.