J Cardiovasc Surg
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Randomized Controlled Trial Comparative Study Clinical Trial
PTFE versus human umbilical vein in above knee femoro-popliteal bypass. Early results of a randomized clinical trial.
The results of a prospective randomized clinical trial comparing PTFE and HUV grafts in above knee femoro-popliteal reconstruction are presented. A total of 93 limbs were randomized, three patients died in the early postoperative period, leaving 90 (45 PTFE and 45 HUV bypasses) to be analysed. ⋯ From one year postoperatively onwards these results are statistically and significantly different. When an above knee femoro-popliteal reconstruction is performed and autologous vein is not available or purposely not used, HUV gives better results than PTFE and is the graft of choice.
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Comparative Study
Clear prime for infant cardiopulmonary bypass: a miniaturized circuit.
The extracorporeal circuit used clinically to perform cardiopulmonary bypass (CPB) in small infants is relatively large requiring blood to prime the circuit to reduce hemodilution. To study the merits of clear prime also in infants, we did experiments in rabbits with two extracorporeal circuits: one employing traditional venous gravity drainage (priming volume 330 ml) and the other employing vacuum drainage (priming volume 90 ml). ⋯ We demonstrated that the clear priming solution in the second circuit eliminates the hemodynamic deterioration caused by blood prime in the first circuit. Studying the effect of various modes of regulation, we showed that automatic control of CPB based on venous return is similar to autoregulation of the heart according to Starling's law, and maintains not only normal hemodynamics, but also an optimal microcirculation.