Texas Heart Institute journal
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The incidence of arrhythmias after acute myocardial infarction of the inferior wall varies with the affected segment and increases when there is right ventricular involvement. This paper provides a clear review of the blood supply to the conduction system and gives an anatomic explanation of that supply. We dissected 20 human hearts after anterograde and retrograde injection of latex. ⋯ The incidence of arrhythmias after acute myocardial infarction of the inferior wall is greater when the occlusion of the coronary trunk is at or near the origin. This is due to the existence of the right superior descending artery, which is given off by the right coronary trunk less than 1 cm from the origin. The arrhythmias caused by the occlusion of the circumflex artery are due to the existence of Kugel's artery, which displays a peculiar anastomotic pattern.
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Pleural effusions that are caused by congestive heart failure and refractory to medical management are rare, and the options for treating them are few and sometimes ineffective. We report here our experience, over a 2-year period, with a novel device, the Denver Biomedical PleurX pleural catheter, in treating a series of 5 patients who had chronic, refractory, heart-failure-associated pleural effusions. The PleurX catheter is a small-bore chest tube designed to remain in place for prolonged periods, through which drainage of pleural fluid can be performed easily on a daily or less frequent outpatient basis. ⋯ For 1 patient, the catheter resulted in a partially loculated pleural space, and it was removed. In 2 patients, after prolonged use, it was associated with empyema, for which it was removed. We conclude that the PleurX catheter can effectively control refractory congestive-heart-failure-associated pleural effusions temporarily, but that its prolonged use can cause significant complications, most importantly empyema.
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Biography Historical Article
At the cutting edge of the impossible: a tribute to Vladimir P. Demikhov.
Vladimir P. Demikhov (1916-1998) performed the world's first experimental intrathoracic transplantations and coronary artery bypass operation. ⋯ Ironically, his transplantation of a dog's head drew more publicity than did his pioneering thoracic surgical accomplishments, and he became an easy target for criticism. An account of Demikhov's life and work is presented herein.