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Ann Thorac Surg 2000;69:1668-1669
© 2000 The Society of Thoracic Surgeons

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Discussion

Discussion

DR NORMAN J. SNOW (Chicago, IL): Dr Urschel, what do you mean exactly by prompt removal of the first rib after the thrombolysis? Are you talking about hours, days, or a week?

DR. URSCHEL: "Prompt" is a relative term. What we generally do is give them 24 to 48 hours trial of thrombolysis; after 48 hours it is probably not going to open up. You may get a partial opening during that time. We then simply schedule them for surgery the next day. If thrombolysis finishes up in the evening, we operate on them the next morning. We usually leave them on heparin if we do that. If we operate on them in the afternoon, we don’t use heparin.

DR MARK J. KRASNA (Baltimore, MD): Dr Urschel, we are indebted to you in understanding the Paget-Schroetter-Urschel syndrome better than anybody else; you have taught us about it over the years. I must say that ever since I first heard you give a lecture on this topic I keep going back to my thoracic . . . [Full Text of this Article]

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