The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Dec 1983
Case ReportsPulmonary arterial embolus by an unusual wandering bullet.
We report on a wandering bullet embolus to the left pulmonary artery after it had first passed from the right ventricular to the right renal vein via the inferior vena cava. Its presence in the left pulmonary artery was confirmed by pulmonary angiography. ⋯ Clinical diagnosis may present a difficult aspect in emergency practice and angiography is mandatory. The removal of foreign bodies is recommended by the majority of authors.
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Thorac Cardiovasc Surg · Feb 1983
Case ReportsPhrenic nerve pacing for the treatment of central hypoventilation syndrome - state of the art and case report.
The application of phrenic nerve pacing is an effective method of respiratory support in adults with certain forms of acquired failure of automatic ventilation. The experience with one infant suffering from congenital central hypoventilation (Ondine's syndrome) is summarized in this report. Stimulation electrodes were implanted on the thoracic portion of each phrenic nerve. ⋯ Severe upper airway obstruction, however, required tracheostomy. Bilateral simultaneous pacing has been effective now for more than 2 years providing the desired normal ventilation during sleep. The state of the art of phrenic nerve pacing is described.
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Since 1978, fibrin glue has been applied in 268 patients. The indications were: (1) sealing of woven Dacron, (2) sealing of knitted Dacron, (3) control of various bleeding sites. ⋯ In the fibrin glue group there was a significant reduction in postoperative blood loss as well as a shortening of the operation time (period of protamin administration to skin closure). From the data it can be concluded that sealing woven Dacron prostheses with fibrin glue is superior to conventional blood preclotting.
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Thorac Cardiovasc Surg · Dec 1981
Surgical aspects of typical subaortic and atypical midventricular hypertrophic obstructive cardiomyopathy (HOCM).
Hypertrophic obstructive cardiomyopathy (HOCM) is a special form of left ventricular outflow tract obstruction. Clinical experience demonstrates 2 different types of HOCM of the left ventricle: the typical subaortic or subvalvular HOCM and the atypical midventricular form of myocardial obstruction. In a series of 108 patients operated upon, 96 had typical and 12 had atypical HOCM. ⋯ Postoperative cardiological follow-up indicates the superior effect of surgery as compared to drug therapy. The late mortality for the medical group was 10% and for the postoperative group 2.5%. These facts support our recommendation for the surgical treatment of HOCM in symptomatic patients in clinical stages III and IV (NYHA).