The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 1979
Case ReportsCongenital aortic valve anomaly. Aortic regurgitation with left coronary artery isolation.
A case is reported of aortic regurgitation resulting from a congenitally abnormal aortic valve. The left coronary cusp of the valve was small and adhered to the aortic wall, so that there was insufficient valve tissue to maintain diastolic valve competence. In addition, this rudimentary cusp completely occluded the left coronary ostium. The patient was treated successfully by valve replacement.
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J. Thorac. Cardiovasc. Surg. · Apr 1979
Myocardial depression after elective ischemic arrest. Subcellular biochemistry and prevention.
The hemodynamic and cardiac biochemical effects of global ischemic arrest during cardiopulmonary bypass (CPB) were studied in 54 animals and compared to seven animals without ischemic arrest. Ischemic arrest alone reduced the first derivative of left ventricular force of contraction (LV dF/dt) to 52 percent of control 10 minutes after resuming function and to 64 percent after 1 hour of reperfusion. Cardiac output was depressed to 52 percent of control after 10 minutes of reperfusion, and to 74 percent of control after 60 minutes of reperfusion. ⋯ The mitochondrial respiration rate after normothermic ischemic arrest was 155 natoms of oxygen per minutes versus 237 natoms for the hypothermic hyperkalemic group. Respiratory control index was 5.5 for the normothermic group versus 9.4 for the hypothermic group. It is concluded that hypothermia, whether effected by surface cooling or by hypothermic potassium infusion, allowed full recovery of hemodynamic and biochemical functions within 1 hour of reperfusion.
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J. Thorac. Cardiovasc. Surg. · Apr 1979
Case ReportsAcute hypertension: its significance in traumatic aortic rupture.
Traumatic aortic rupture is a common occurrence associated with 16 percent of deaths from automobile accidents. Through a review of current literature and two recent cases from The Milton S. Hershey Medical Center, we have attempted to elucidate a common physical finding, acute hypertension associated with blunt chest trauma, and prove its significance as a diagnostic clue to traumatic rupture of the aorta. New laboratory findings of an aortic sympathetic reflex stimulated by stretching the aortic wall in the area of the isthmus provides a physiological explanation for the cause of hypertension after aortic trauma.
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J. Thorac. Cardiovasc. Surg. · Feb 1979
Comparative StudyPharmacologic antagonism of beta-adrenergic blockade in dogs. I. Hemodynamic effects of isoproterenol, dopamine, and epinephrine in acute propranolol administration.
Hemodynamic effects of isoproterenol, dopamine, and epinephrine were studied before and after acute beta-adrenergic blockade in 16 open-chest, anesthetized mongrel dogs. Beta blockade was induced with 1 mg. per kilogram of intravenous propranolol. Cardiac output measurements were obtained by thermal dilution, and pressure recordings were obtained in the right ventricle, pulmonary artery, left atrium, left ventricle, and aorta. ⋯ Left ventricular systolic pressure with isoproterenol after propranolol was reduced when compared with effects of smaller doses prior to propranolol. These observations suggest that none of the catecholamines studied would be optimal for circulatory support in heart failure in the presence of propranolol. The present results define a pharmacologic basis for design of appropriate drug combinations for circulatory support in beta-blocked animals.