The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 1975
Isolated replacement of the aortic valve with the Starr-Edwards prosthesis. A 9 year review.
A 9 year review of patients who underwent replacement of the aortic valve with the Starr-Edwards prosthesis indicates that the operative mortality rate for aortic valve replacement continues to decline. Thromboembolic complications have been markedly lessened in newer model valves. ⋯ The large majority of patients who survive surgery can expect to be rehabilitated to a highly functional existence, with longevity not unlike that of the general population. The Starr-Edwards prosthesis is a very satisfactory prosthesis for replacement of the aortic valve.
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This report presents a 15 year review of the surgical treatment of 9 patients with congenital mitral stenosis seen at the Columbus Children's Hospital. The over-all mortality rate was 45 per cent. ⋯ The mitral valve should be explored with the use of cardiopulmonary bypass and the anatomic type of the valve determined. Type I valves will often respond to open valvulotomy, whereas Type II and III valves must be replaced.
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J. Thorac. Cardiovasc. Surg. · Jun 1975
Spotaneous rupture of an intercostal artery in a patient with neurofibromatosis and scoliosis.
A case is reported of spontaneous rupture of an intercostal artery at its origin from the aorta in a patient with neurofibromatosis and scoliosis. The possible role played by each of these conditions in the pathogenesis of the spontaneous rupture is discussed. Comment is made on the unusual radiologic appearances of extrapleural hemorrhage.
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J. Thorac. Cardiovasc. Surg. · May 1975
Case ReportsFatal air embolism during thoracotomy for gunshot injury to the lung. Report of a case.
Fatal coronary air embolism occurred during thoracotomy in a patient with a gunshot wound involving the hilum of the right lung. Embolism was observed during a second period of failure of heart action. Evidently, air entered the pulmonary veins from the bronchus, which was receiving positive-pressure ventilation. The literature contains reports of only 3 similar cases, but we suspect that air embolism may be responsible for death and morbidity in additional cases in which accidental or iatrogenic lung trauma has produced a pathway between the bronchial tree and the pulmonary veins.
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In this report, we shall describe the instantaneous electronic monitoring of the fetal heart rate at 24 weeks' gestation. The mother was undergoing resection of coarctation of the aorta. Because the fetal heart rate reflects by physiological and pharmacologic events, monitoring this rate enabled the anesthesiologists and surgeons to make therapeutic intervention sooner and on a more rational basis.