The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 1979
Pulmonary artery banding in infants with complete atrioventricular canal.
Management of symptomatic atrioventricular canal (AVC) in infancy may be difficult. Between July, 1969, and September, 1977, 31 infants with complete AVC presented in congestive heart failure (CHF) to the University of Minnesota Hospitals. Fifteen of these patients have responded to medical management and have been followed as outpatients. ⋯ Each of the remaining six patients, who have been followed for 9 months to 9 years, had minimal mitral insufficiency and a large ventricular shunt. The three patients dying after banding had significant mitral insufficiency. We believe that pulmonary artery banding is an effective palliative procedure for infants with complete AVC and CHF who have large ventricular shunts and minimal mitral insufficiency.
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J. Thorac. Cardiovasc. Surg. · May 1979
Case ReportsIntraoperative hemodialysis during cardiopulmonary bypass in chronic renal failure.
This report describes the features and the course of a patient on maintenance hemodialysis in whom infective endocarditis of the aortic valve ensued. The subsequent development of intractable congestive heart failure necessitated aortic valve replacement. Use of intraoperative hemodialysis, facilitating the intraoperative and postoperative management of the patient, is described. Following valve replacement the patient did well with no evidence of congestive heart failure.
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J. Thorac. Cardiovasc. Surg. · May 1979
Case ReportsRunaway pump head: new cause of gas embolism during cardiopulmonary bypass.
Massive gas embolism was narrowly avoided during a recent case of cardiopulmonary bypass for aortic valve replacement. Cause of the mishap was an arterial pump head that had rapidly accelerated spontaneously, emptying the oxygenator of blood within seconds. No gas entered the patient's vascular system, but a period of circulatory arrest was required in order to purge the extracorporeal circuit of gas and to re-establish blood flow. Only an instantaneous response by the perfusionist prevented massive gas embolism.
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A 59-year-old man underwent resection of aneurysm of the descending thoracic aorta with graft replacement. A postoperative chylothorax was managed by nonsurgical means and subsided. ⋯ This was found to be a chylous pseudocyst. Management of chylothorax and the details of this unique case are described.