In Reply.—Thank you very much for sending us the letter from Pecero and Martinez commenting on our article published in the September 1989 issue of the Archives.1
First of all, we would like to comment briefly on the two cases presented by Pecero and Martinez.
The death of the first patient has been attributed to general anesthesia, which would have caused compression of the right ventricular outflow tract. Unfortunately, their data do not supply enough evidence to support their statement that a "severe hemodynamic compromise" might be encountered in those patients with anterior mediastinal mass compressing the right ventricular outflow tract. (Continued on p 2213.) (Continued from p 2212.)
Moreover, we cannot agree with their operational conclusion that "RVOT obstruction and/or PS allows us to select the patient at severe vital risk" and that it "proscribes general anesthesia for aggressive pathological diagnostic approach."
In fact, the main issues