J Cardiovasc Surg
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Eight of twenty-six subjects undergoing cardiotomy had a diagnosable psychiatric syndrome after surgery. No difference between psychiatric and non-psychiatric cases was noted with respect to demographic data, pre-operative medical psychiatric history, anesthesia time, serial laboratory studies, or environment. Post-operative psychiatric cases, however, did have significantly higher exposure to psychoactive drugs during the pre- and post-operative period.
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Fifteen consecutive patients with stab wounds of the heart are reviewed. The left ventricle was stabbed in six patients and right ventricle in four. Sinus tachycardia was present in 54% and hypotension in 67% of cases. ⋯ There was only one death of a patient who arrived with no blood pressure or heart sounds. An average follow-up of 20 months revealed long-term sequela of an asymptomatic ventricular aneurysm in one patient. Our unusually gratifying results support the approach of emergency thoracotomy in patients with penetrating cardiac trauma.
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Biography Historical Article
Prof. Edmondo Malan 22 March 1910-25 January 1978.
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A dissecting aneurysm of the ascending and transverse aorta with heart failure due to sudden severe arotic valve insufficiency in a 47-year-old man has been treated successfully. Vasodilator therapy was done preoperatively, and then hemodynamics was improved markedly. A selective perfusion technique by using separate pumps at pre-determined flow-rates with hypothermia was utilized. The replacement of both the aortic valve and the ascending and transverse aorta involving brachiocephalic artery with a prosthetic valve and expanded polytetra-fluoroethylene coated woven Dacron grafts was performed.
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Case Reports
Anomalous origin of the left coronary artery from the pulmonary artery. Surgical repair of an unusual form.
The authors present a case of a 24-year-old woman with anomalous left coronary artery originating from the pulmonary artery. Surgical correction was performed by the direct transposition of the anomalous left coronary artery from the pulmonary artery to the ascending aorta, without interposed graft. ⋯ In the present case the left coronary artery originated from the right posterior sinus of the pulmonary artery. The patient is doing well 23 months after operation.