ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Four patients are described in whom combined aortic stenosis and regurgitation was evident on examination. In each of them obstruction to left ventricular outflow was shown to be due to congenital subaortic stenosis, and aortic regurgitation resulted from the sequelae of bacterial endocarditis. The presence of this unusual combination of congenital and acquired malformations was suggested by certain clinical findings, and results of the preoperative hemodynamic and angiographic studies that established the diagnosis are presented.In three patients the subaortic membrane was resected, and aortic regurgitation was corrected by reconstruction or replacement of the aortic valve. All of the patients evidenced striking clinical improvement after operation, confirmed by the results of postoperative hemodynamic assessments. A fourth patient died before operation; the pathologic findings are presented in detail.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

A group of 108 consecutive patients with moderate-to-severe pulmonic stenosis and intact ventricular septum, operated upon by means of a pump oxygenator between the years of 1957 and 1961, has been presented.The total mortality of the series was 2.77 per cent, and an additional 1.8 per cent were left with residual neurologic complications.Fifty per cent of the patients showed an excellent result as indicated by normal electrocardiograms or right ventricular pressure below 65 mm. Hg by cardiac catheterization. An additional 26 per cent had good resultsas indicated by the absence of symptoms, normal x-rays, mild electrocardiographic changes, and in three instances, slight right ventricular hypertension.Ten per cent had unsatisfactory results based on significant residual abnormalities in the electrocardiograms, x-rays, or postoperative catheterization data.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The clinical presentation and operative results have been assessed of a series of patients with coarctation over the age of 40, and have been compared with a larger group of all ages.Long-standing hypertension increased markedly the incidence of symptoms due to left ventricular strain and cerebral hypertension. There was little increase in symptoms due to poor peripheral blood flow and no case of subacute bacterial endarteritis.The preoperative systolic blood pressures, when related to the normal for the age and sex of the patient, were higher and the diastolic pressures lower than an average group but signs of left ventricular strain were more common.At operation the aortic narrowing was found to be of usual severity. Grafts were necessary because of poor anastomotic tissue rather than long narrow segments as in the larger group. The operative mortality was doubled in the elderly, due entirely to hemorrhage from friable aortas. Morbidity was increased as a result of pulmonary and pleural complications.Postoperative blood pressures were almost exactly comparable with those of the over-all group when related to normal for age and sex. Symptoms were usually relieved but there was relatively slight radiologic or electrocardiographic change. The operative mortality and morbidity are acceptable in view of the risks of inaction and the satisfactory results of operation in the survivors.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

A method is described for measuring plasma levels of cardiac glycosides, utilizing their inhibitory effect on the rubidium-86 uptake of human red cells. As little as 0.05 m&mgr;g. of digoxin/ml. of plasma produces detectable inhibition, but due to the variable effect of other substances in human plasma the practical limit of the method is 1.0 m&mgr;g./ml., about 20 times as sensitive as the duck embryo heart or the C14-labeled technics.Patients on digitalis leaf were found to have much higher circulating levels than patients on digoxin (average value 7.5 m&mgr;g./ ml. of digoxin equivalent for digitalis leaf, 0.05 m&mgr;g./ml. for digoxin). Patients toxic on digoxin averaged 6 m&mgr;g./ml.Of patients not taking digitalis, 7 per cent had significant levels of digitalis-like substances in their plasma; these were mostly individuals with metastatic carcinoma, severe fluid and electrolyte disturbances, or heart failure. No drug (other than cardiac glycosides) gave consistent high levels by this test.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The cardiovascular response to angiographic contrast medium was studied in 28 patients undergoing diagnostic angiocardiography under anesthesia. A transient phase of hypotension and tachycardia similar to that described by other authors was noted. Cardiac output was increased initially by 50 per cent and returned to the base line in 20 minutes. Peripheral blood flow increased by 100 per cent, apparently due to the direct effect of the hyperosmotic solution on the vascular smooth muscle. Hemodilution, maximal 2 to 4 minutes after injection of contrast medium, suggested a transient increase in circulating blood volume. Increased ventricular filling pressures, which were thought to be due to hypervolemia, were associated with increased left ventricular stroke work.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID