The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 1982
The third manpower study of thoracic surgery: 1980 report of the Ad Hoc Committee on Manpower of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons.
An ad hoc committee was appointed by The Society of Thoracic Surgeons (STS) in 1977 in order to determine the available manpower and workload of thoracic surgeons in 1976. This committee conducted a survey of the professional activities and geographic location of all known surgeons certified by the American Board of Thoracic Surgery (ABTS) at that time. A summary of this study indicated the available and projected thoracic surgery manpower. ⋯ The material was sent to the Academic Computer Services at George Washington University Medical Center for tabulation and data processing. This report summarizes the results of this survey. It also compares these data with those obtained in the 1976 study and, based on this information, attempts to project the thoracic surgery manpower needs in the next decade by using several hypothetical models.
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J. Thorac. Cardiovasc. Surg. · Oct 1982
Cardiac operation during active infective endocarditis: results of aortic, mitral, and double valve replacement in 94 patients.
Cardiac valve replacement was performed in 94 patients (95 operations) in the presence of active infective endocarditis. Most of the patients were extremely ill. The operation was performed as an emergency or semiemergency lifesaving procedure in 88% of them, and more than half received little or no antibiotic treatment prior to the operation. ⋯ In seven of the eight deaths, the cause of death was probably not related to the timing of the original operation. We recommend early valve replacement for patients with infective endocarditis. We believe that early operation reduces mortality, prevents emboli, and is associated with excellent long-term results.
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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.