The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Aug 1994
Review Case ReportsBiatrial drainage of right superior vena cava with anomalous right pulmonary venous connection.
A case of right superior vena cava draining to both atria, predominantly to the left atrium, with anomalous right pulmonary venous connection to the lower right superior vena cava is reported. The haemodynamic significance of these anomalies is discussed, and the technique of surgical repair is described. The literature on this rare but interesting clinical entity is briefly reviewed.
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Thorac Cardiovasc Surg · Aug 1994
Celite and kaolin produce differing activated clotting times during cardiopulmonary bypass under aprotinin therapy.
Since the introduction of the proteinase inhibitor aprotinin in cardiac surgery, a strong increase of the activated clotting time (ACT) during the extracorporeal circulation phase (ECC) was reported in many clinical studies, but with a lack of correlation between ACT and heparin concentration. In searching for a cause of this inconsistency we investigated different surface activators of the ACT in a clinical study. During ECC ACT was measured in parallel, using a Hemochron device and corresponding tubes (nominally 12 mg celite activator) for celite ACT, and a HemoTec device with corresponding double tubes (nominally 0.1 ml kaolin activator) for kaolin ACT. ⋯ With aprotinin alone there were no changes of the aPTT times, whereas the celite ACT times were without any correlation. Our results indicate that using kaolin instead of celite the ACT measurements under aprotinin therapy stay in the same ranges as without application of aprotinin: aprotinin has no detectable influence on kaolin-activated ACT. In our opinion, kaolin should be used as the surface activator for ACT measurements under the conditions of ECC, heparinization, and aprotinin therapy.(ABSTRACT TRUNCATED AT 250 WORDS)