ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Endocarditis was encountered on an aortic homograft valve in 14 of 539 patients, giving a total incidence of 2.6%. It was an early postoperative complication in five patients (0.9%), and only one of these survived. Four hundred and six hospital survivors were followed for periods up to 76 mo. Nine of these patients (2.2%) developed infection of the homograft valve 11 to 66 mo postoperatively and four survived. Late endocarditis occurred more commonly in patients with a history of endocarditis prior to operation (P=0.005). In only one of the nine patients with late endocarditis was the infection related to a peripheral leak around the graft. Most patients with late endocarditis rapidly developed severe homograft valve incompetence, which was the cause of death in four of the nine. Six patients were reoperated on and three of these survived.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

A palpable dicrotic pulse was observed in 18 patients after open heart operation, usually after prosthetic replacement for aortic regurgitation (14 of 18 patients). Two patients had a ventricular septal defect, one had aortic stenosis, and one, mitral insufficiency. The ages of the patients ranged from 9 to 63 years, but the dicrotic pulse was more prominent and persisted longer in younger patients. The dicrotic pulse usually appeared within 48 hours of operation, persisted 1 to 60 days and was always in a brachiocephalic distribution. Determinants of the dicrotic pulse include the stroke volume, the duration of systole, the distensibility of the arterial system, the peripheral reflection coefficient, and the systemic blood pressure. Impaired cardiac function with a low cardiac output was probably the most significant factor in the occurrence of a dicrotic pulse in this series of patients.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Alterations in body composition are present in patients with heart disease and congestive heart failure, and additional changes occur acutely after corrective surgery. The reversibility and time course of reversion to normal body composition have not been demonstrated. Nine patients were studied preoperatively and 2 to 4 weeks and 6 to 12 mo postoperatively. Measurements were made, using the isotope-dilution technic, of the volumes of total body water, extracellular water, plasma, and red cells, and of the amounts of total exchangeable sodium and potassium. Values were derived for body fat, indices of body cell mass, and the intracellular and extracellular distribution of water and potassium. Significant changes (P< 0.05) occurring 2 to 4 weeks after operation were increased in total body water (8.2%), intracellular water (15.0%), exchangeable sodium (7.1%), and intracellular potassium content (7.7%), and decrease in body weight (4.6%) and body fat (21.6%); 6 to 12 mo postoperatively there was increase in exchangeable potassium (6.8%), body weight (7.8%), and decrease in exchangeable sodium (16.1%), extracellular fluid (7.8%), plasma (8.0%), and the ratio of exchangeable sodium to exchangeable potassium (23.6%). Late postoperative values were similar to predicted normal values and indicate that postoperative recovery from valvular replacement in these patients is accompanied by resolution of most of the body compositional abnormalities of heart failure.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Twenty-four patients over 35 years of age with a secundum atrial septal defect (ASD) had a clinical and hemodynamic assessment prior to surgical closure and a follow-up assessment an average of 6 years afterward. All were initially in functional class III or IV. Twenty-three patients had a moderate to large left-to-right shunt. Five had elevated pulmonary vascular resistance (PVR); all had moderate to severe pulmonary hypertension. Left ventricular dysfunction (LVD) was found in 17.Following surgical closure, 22 patients showed sustained clinical improvement and were in class I or II. The mean pulmonary artery pressure fell to normal or mildly elevated values in 21. The PVR was now elevated in 14 patients, suggesting continued progression of obliterative pulmonary vascular disease. Three had small residual shunts. LVD, however, persisted after operation, which may reflect underlying myocardial pathology unrelated to the ASD.Operative closure of ASD, therefore, is recommended for disabled patients over 35, even if they have moderate pulmonary hypertension or congestive heart failure.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Operative correction of a Taussig-Bing malformation was successfully accomplished in a 23-mo-old boy, weighing 6.8 kg. Associated coarctation of the aorta and reversed patent ductus arteriosus were corrected in a preliminary operation. The patient's management was complicated by severe preoperative thrombocytopenia which responded to multiple phlebotomies. Surgical repair of the Taussig-Bing malformation consisted in patching the ventricular septal defect to create physiologically complete transposition of great vessels. Then a Mustard procedure was done.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The duration of the systolic phases of the cardiac cycle in 390 normal children was determined from high-speed simultaneous recordings of the electrocardiogram, phonocardiogram, apexcardiogram, and carotid pulse. Data were obtained on children 1 mo to 13 years of age and analyzed to define the independent effects of aging and heart rate on the systolic intervals. Electromechanical systole (Q-II) was found to prolong with increasing age in children with the same heart rate. Pre-ejection period was also prolonged in older children and occupied an increased percentage of total systole. The interval from onset of contraction to first sound varied inversely with heart rate and was independent of age. Electromechanical delay and isometric contraction time were directly related to age and independent of rate. Ejection time varied directly with age and inversely with heart rate but occupied a smaller percentage of systole in older children. Alterations in systolic phase duration occurring with maturation reflect the normal functional adaptation of the developing heart. Measurement of these phases can provide useful information relative to cardiac function in children.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This report describes in detail the materials and methods used in the authors' laboratory for percutaneous insertion of catheters and for manipulation of catheters with guide wires in infants and children. A simple thin-walled spinal needle is used to enter femoral vessels initially. Catheter insertion is effected thereafter with the sequential uses of a guide wire, a dilator, and an end-hole catheter. Insertion of two or three catheters into a single vessel may be accomplished. In infants weighing less than 20 pounds, dilation of the vascular puncture wound may be accomplished in stages. Guide wires of different configurations are used for catheter manipulation into various cardiac structures including some which are relatively inaccessible. Guide wires are also used for catheter exchange. Angiograms of high quality may be obtained safely.

ISSN:0009-7322    

出版商:OVID    

年代:1970

数据来源: OVID