The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 1986
Cryoanalgesia after thoracotomy. Improvement of technique and review of 600 cases.
The efficacy of cryoanalgesia for the control of post-thoracotomy pain has led to the acceptance of the technique as a routine procedure in this unit. A study of 600 consecutive patients in whom an improved technique was used is not reported. The freezing time for each intercostal nerve in this group was reduced to one 30 second exposure instead of the two 30 second exposures previously used. ⋯ Freezing above the fifth intercostal nerve is no longer practiced in women. Modification to the probe has simplified the procedure. Pulmonary function studies and blood-gas analysis are also described.
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J. Thorac. Cardiovasc. Surg. · Aug 1986
Late results after left-sided cardiac valve replacement in children.
Selection of types of cardiac valve substitutes for children remains controversial. Between 1976 and 1984, 166 children, 15 years of age or younger, underwent aortic (N = 53) or mitral valve replacement (N = 90) or both (N = 23). Biological prostheses were used in 84 patients and mechanical prostheses in 71; both a mitral bioprosthesis and an aortic mechanical valve were used in 11 patients. ⋯ The 7 year probability rates of freedom from all valve-related complications were 43% +/- 6% in the bioprosthesis group and 86% +/- 4% in the mechanical valve group (p less than 0.001). In the aortic position, a mechanical adult-sized prosthesis can always be implanted, and satisfactory long-term results can be anticipated. In the systemic atrioventricular position, the results are less than satisfactory with either type of prosthesis; every effort should be made to preserve the natural valve of the child.