The Journal of thoracic and cardiovascular surgery
-
A method is presented for the endoscopic intubation of malignant tumors of the trachea and main bronchi with a Souttar tube. This is appropriate when urgent relief of respiratory obstruction is necessary and when the tumor is unsuitable for resection. ⋯ The method failed in one patient. There were no operative deaths.
-
J. Thorac. Cardiovasc. Surg. · Nov 1980
Massive air embolism during cardiopulmonary bypass. Causes, prevention, and management.
Massive air embolism during cardiopulmonary bypass is a frightening complication requiring immediate response and carrying strong medicolegal implications. From July, 1971, to July, 1979, there were eight instances of massive air embolism during 3,620 cardiopulmonary bypass operations. Five such accidents from other institutions are included in this report. ⋯ Cerebral injury which resolved within a 2 month period occurred in three patients. The remainder had no neurologic sequelae. Nonfatal cerebral air injury may be associated with prolonged convalescence yet complete recovery, as compared to embolism from debris or clot, which offers a poorer prognosis.
-
J. Thorac. Cardiovasc. Surg. · Nov 1980
Case ReportsLeft atrial--left ventricular conduit for relief of congenital mitral stenosis in infancy.
Severe congenital mitral stenosis in the infant poses a difficult problem. We present the case history of an infant in whom a left atrial--left ventricular apical conduit was used to bypass a severely hypoplastic mitral valve. Associated coarctation of the aorta, patent ductus arteriosus, and ventricular septal defect were corrected at the same time. This method of circumventing the mitral valve offers a new approach to the relief of congenital mitral hypoplasia in small infants.
-
J. Thorac. Cardiovasc. Surg. · Nov 1980
Early and late results of total correction of tetralogy of Fallot.
Two hundred and nine patients underwent total repair of tetralogy of Fallot without congenital pulmonary atresia from 1971 to 1979. The age of the patients ranged from 22 months to 27 years (mean 6.8 years). Previous palliative shunts were present in 130 patients (62.2%). ⋯ Pulmonary valvular insufficiency was well tolerated postoperatively in the absence of distal pulmonary artery obstruction. This experience supports a policy of aggressive relief of the right ventricular outflow tract obstruction including liberal use of transannular patching and, when indicated, extensive reconstruction of the pulmonary artery branches. We also recommend a two-stage treatment program for symptomatic infants with unfavorable anatomy consisting of initial Blalock-Taussig shunt followed by total repair at about 3 years of age.