Zeitschrift für Kardiologie
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Comparative Study
[Hemodynamics after mitral valve replacement with Starr-Edwards, Björk-Shiley and Lillehei-Kaster protheses (author's transl)].
After mitral valve replacement hemodynamic abnormalities persist. These abnormalities were studied 1 year postoperatively. In 50 randomized patients; 15 with Starr-Edwards (SEM), 15 with Lillehei-Kaster (LKM) and 20 with Björk-Shiley (BSM) prostheses at rest and during exercise. ⋯ However, there is an important pressure gradient caused by the small internal diameter. Lillehei-Kaster pivoting disc valves reach surprisingly small functional valve areas. This may be caused by an incomplete opening of the disc.
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In 565 patients with acute myocardial infarction admitted to a coronary care unit within 12 hours of the onset of symptoms, serum potassium level was determined on admission. The incidence of dysrhythmias occurring during the first 12 hours was referred to the initial serum potassium level. Hypopotassemia (less than or equal to 3.5 mmol/l) was seen in 9.2% and associated with a significantly higher incidence of ventricular arrhythmias in 33% as compared to 18% in the control group. ⋯ Hyperpotassemia (less than or equal to 5.1 mmol/l) was found in 6% with a higher incidence of second and third degree AV block and left-bundle branch block. This group was much more prone to severe haemodynamic complications and therefore had a bad prognosis with a high clinic mortality of 53%. There was no relation between supraventricular arrhythmias, sinuatrial bradyarrhythmias and intraventricular block other than left bundle branch block to serum potassium level.
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The natural history of 162 children with transposition of the great arteries is referred, whose first heart catheterization fell between 1967 and June 1975. In 149 of them balloon atrial septostomy (BAS) was performed, with a mean increase in arterial oxygen saturation of 21 %. In 11 cases BAS was repeated after inadequate first BAS, but again without success. ⋯ These values include the mortality of palliative operations which were necessary to bridge over the time until "corrective" operations could be performed. The operative mortality of Mustard operations was 10% for the simple TGA and 16% for all TGA cases operated on. On the basis of the mortality values of the BAS, of atrioseptectomy (Blalock-Hanlon) and of the Mustard procedure the proceeding after BAS and the indication for operations is thoroughly discussed.