European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1994
Comparative StudyComparison of single- and multi-dose crystalloid cardioplegia to protect the immature myocardium.
The primary objective of this study was to compare the protective effects of single-dose and multi-dose St. Thomas' Hospital cardioplegic solution number 1 in the ischemic and reperfused neonatal rabbit heart. In addition, the effect of including bicarbonate (a component of St. ⋯ At the end of the reperfusion period, the hearts were freeze clamped and taken for metabolic analysis. With multi-dose cardioplegia (without bicarbonate) the postischemic recovery of cardiac output was 67.0 +/- 6.5% and with single-dose the value was 39.3 +/- 10.0% (NS). The same pattern of postischemic recovery (that varied between 30% and 60%) for aortic flow, stroke volume and stroke work was observed with both multi-dose and single-dose infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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Eur J Cardiothorac Surg · Jan 1994
Major pulmonary resection by video assisted mini-thoracotomy. Initial experience in 35 patients.
Video-assisted thoracic surgery is emerging as a viable approach to increasingly complex intrathoracic therapeutic procedures. From February to July 1993, 35 patients (25 male, 10 female; mean age = 60 years, range: 17-74) underwent a major pulmonary resection using a video-assisted technique: lobectomy (n = 30) or pneumonectomy (n = 5). Pathology disclosed bronchogenic carcinomas (n = 26), metastases (n = 3), and miscellaneous disorders (n = 6). ⋯ The mean hospital stay was 11 days (SD: +/- 3). All the patients experienced minor postoperative chest pain. We conclude that video-assisted lung resections are technically feasible without an increased risk.
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Eur J Cardiothorac Surg · Jan 1994
Case ReportsCardiac tamponade secondary to intrapericardial rupture of a hepatic amoebic abscess.
We report the case of a patient who underwent an emergency subxiphoid pericardiectomy with evacuation of 1700 cc of anchovy sauce-like fluid. On pericardial inspection a fistulous communication was seen with a cavity in the left hepatic lobe. ⋯ The hepatic cavity and pericardium were drained: bacteriological investigation of the fluid yielded entamoeba histolytica and chloroquine was administered. Apart from the rarity of the observation in western countries, we discuss surgical approaches in cases of unknown purulent pericardial effusions, stressing the possibility of achieving a good surgical result even with a minor surgical procedure such as subxiphoid pericardiectomy and drainage.
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Eur J Cardiothorac Surg · Jan 1994
Comparative StudyInfluence of systemic hypothermia on systolic and diastolic functional recovery after continuous warm antegrade blood cardioplegia.
Experimental observations in our laboratory indicate that myocardial recovery is similar following warm or cold antegrade blood cardioplegia when the core temperature is maintained at 37 degrees C. To determine the effects of hypothermia on myocardial recovery, 15 adult mongrel dogs were randomized to normothermic or hypothermic bypass (28 degrees C) during 60 min of continuous warm antegrade blood cardioplegia. The hypothermic group was rewarmed after releasing the aortic cross-clamp and bypass was discontinued at 30 min in both groups. ⋯ Myocardial ultrastructure was preserved after normothermic bypass. In contrast, cellular oedema and mild ultrastructural changes were evident after systemic hypothermia. We therefore conclude that the use of systemic hypothermia during bypass is associated with lower core temperatures during early recovery which results in impaired functional recovery.
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Eur J Cardiothorac Surg · Jan 1994
Case ReportsStent-angioplasty of an anastomotic stenosis of the pulmonary artery after lung transplantation.
Anastomotic stenosis of the pulmonary artery after lung transplantation is a rare complication, which commonly necessitates surgical correction. Transesophageal Doppler sonography and pulmonary arteriogram are standard diagnostic means for visualization of venous and arterial anastomoses. Balloon dilatation combined with implantation of a vascular endoprosthesis was successfully used for treatment of severe anastomotic stenosis of the pulmonary artery after lung transplantation.