The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 1982
Case ReportsTraumatic avulsion of the innominate and left carotid arteries: successful repair.
Traumatic rupture of the aorta or the arch vessels is a rare and frequently fatal injury. This lesion should be considered in all cases of severe chest trauma. Early aortography is essential for accurate diagnosis. ⋯ Cerebral circulation was maintained during the operation with a heparin-coated shunt from the ascending aorta to the right common carotid artery. Reconstruction was accomplished by inserting a bifurcated Dacron prosthesis from the aorta to the innominate and left carotid arteries. The use of a heparin-bonded shunt maintained cerebral perfusion, and greatly simplified the operation and avoided the risk of extracorporeal circulation and systemic anticoagulation in a patient with multiple trauma.
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J. Thorac. Cardiovasc. Surg. · Sep 1982
Case ReportsUrgent myocardial revascularization for dissection of the left main coronary artery: a complication of coronary angiography.
Acute subintimal dissection of the left main coronary artery (LMCA) is a rare but devastating complication of selective coronary angiography. The compromise of the coronary blood flow to an extensive area of myocardium becomes clinically evident in most patients shortly after the injury. Three patients who had catheter-induced LMCA dissection were successfully managed with aorta-coronary artery bypass. We recommend that urgent myocardial revascularization using standard techniques should be carried out in all patients following this injury.
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J. Thorac. Cardiovasc. Surg. · Sep 1982
Comparative StudyMechanical circulatory support via the left ventricular vent: the concept of left ventricular copulsation.
Left ventricular copulsation was evaluated as a means of circulatory support in an experimental canine cardiogenic shock preparation. Copulsation was effected by a commercially available pulsatile assist device which was attached to an apical left ventricular vent cannula. ⋯ The improvement in these variables was significantly greater during left ventricular copulsation than during IABP (p less than 0.05). The method is simple, uses equipment that is readily available, and is potentially a powerful intermediate circulatory support modality between IABP and more complex techniques.