Kyobu geka. The Japanese journal of thoracic surgery
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Randomized Controlled Trial Clinical Trial
[A clinical evaluation of the Hepcon/HMS: a new device of monitoring hemostasis management during cardiopulmonary bypass].
The "Hepcon/HMS", a small, protable console which can instantaneously measure residual whole blood heparin concentration and automatically compute the necessary dose of additional heparin during extracorporeal circulation and also compute the required dose of protamine to reverse the effect of residual heparin. ⋯ By using "Hepcon/HMS", smaller amount of protamine to reverse residual heparin was achieved without no hemostatic derangement nor increase in the amount of postoperative bleeding, irrespective of the fact that the greater amount of heparin was administered during extracorporeal circulation as compared with the conventional anticoagulation protocol. It may help prevent the undesirable side effects of administering excessive amount of protamine, including depression of myocardial function, platelet dysfunction, anaphylactic reaction and catastrophic circulatory collapse.
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Case Reports
[Appropriate early open heart palliation of univentricular atrioventricular connection with subaortic stenosis].
Long-term conventional pulmonary artery banding deteriorates ventricular function in patients who have univentricular atrioventricular connection with subaortic obstruction. Protection of the pulmonary vascular bed and early relief of subaortic stenosis is essential to improve the outcome after Fontan operation. From January 1995 through January 1996, three infants underwent open heart palliation because of univentricular atrioventricular connection with subaortic stenosis. ⋯ It is difficult to adjust appropriate blood flow through a Blalock-Taussing shunt and a surgically isolated pulmonary artery is capable of inducing pulmonary distortion after Damus-Norwoood type operation. Whereas natural regulation of the pulmonary arterial blood flow by a restrictive ventricular outflow tract is come up after a palliative arterial switch operation. Palliative arterial switch operation is an useful alternative open heart palliation for neonates and early infants who had univentricular atrioventricular connection with subaortic stenosis.