In rare circumstances, a diaphragmatic defect may allow for herniation of intra-abdominal contents into the pericardial space. These occurrences are exceedingly rare and may be due to trauma or congenital defects of the septum transversum or as the result of surgical procedures. We describe a 73-year-old female who presented with cardiac and abdominal symptoms one month after undergoing a subxiphoid pericardioperitoneal window for treatment and evaluation of a symptomatic pericardial effusion.

No abstract

No abstract

We describe the successful use of a new 15-mL EXCOR pump in 2 children whose requirements fell between the ideal fill and flow characteristics of the existing pumps. In children with a body surface area ranging from 0.33 to 0.55m 2 and weight ranging from 7 to 12 kg, the 15-mL chamber complements the EXCOR infant range. It can achieve a CI of 2.7 to 3.3 L/min/m 2 at pump rates of 60 to 120 beats/min. Restrictive and noncompaction cardiomyopathies are rare but contribute disproportionately to mortality in children with cardiomyopathy. 2,3,5 Conventional VAD cannulation of the noncompliant LV often results in insufficient drainage, with concomitant poor pump performance, and residual LA hypertension, with subsequent pulmonary congestion. In these patients, the LA/LV disproportion with preservation of systolic function makes LA cannulation an attractive option, perhaps with less risk of ventricular thrombus formation than in dilated cardiomyopathies. Optimal pump sizing could aid an uninterrupted drainage, and these patients could benefit most from the versatility offered by the additional chamber size.

Prostatic abscess is a rarely described condition and is commonly caused by gram-negative organisms such as enterobacteria. However, as the prevalence of methicillin resistant Staphylococcus aureus (MRSA) increases in the community, unusual infections due to this organism have been recently published. In this report, we describe a patient with diabetes mellitus type 2, who presents with diabetic ketoacidosis—later found to be due to a prostatic abscess from which MRSA was cultured.