摘要:

AbstractA giant aneurysm in the right sinus of Valsalva compressed the right coronary artery and caused angina pectoris in a 44‐year‐old man. Surgical correction consisted of obliterating the orifice of the aneurysm with a Dacron patch and relocating the right coronary artery. Postoperative angiography demonstrated excellent results. Pathological study demonstrated the absence of normal elastic fibers in the media of the aneur

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00592.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe distal anastomosis constructed during repair of an aortic dissection is prone to bleeding, reentry, and neodissection. To protect the hemostasis, a modification of Borst's elephant trunk procedure has been devised. This “mini‐trunk” protects the anastomosis with an internal buttress using the crease of an infolded graft and with a short flap of graft everted into the distal lumen preventing access of the blood stream to this newly constructed suture

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00593.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis report describes the technique of integrated myocardial management, which combines the advantages of various cardioprotective strategies to compensate for their individual shortcomings. This approach coordinates the myocardial protective techniques with the continuity of the operation so that the surgical procedure is never interrupted. This method (1) provides unimpaired vision, (2) avoids unnecessary ischemia and cardioplegic overdose, (3) allows aortic clamping as soon as cardiopulmonary bypass is started, (4) permits aortic un‐clamping and discontinuation of bypass shortly after the technical procedure is completed, (5) minimizes the duration of ischemia and cardiopulmonary bypass, and (6) maximizes the positive attributes of the strategies available currently. The background for this myocardial management method, which combines antegrade/retrograde delivery, warm/cold blood cardioplegia, intermittent/continuous perfusion, blood/blood cardioplegia, and avoidance of cardioplegic overdose, hemodilution, and tangential aortic clamping, is discussed. The preliminary results in 1474 patients from four centers where surgeons participated in the infrastructure of this method are presented. This has led to our adoption of this approach in all adult cardiac operation

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00594.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Book reviewed in this article:Aubert AE, Ector H, Stroobandt R:Cardiac Pacing and Electrophysiology.DordrechtChin A:Noninvasive Imaging of Congenital Heart Disease.Armonk, NYKazmers A:Cardiac Risk Assessment Before Vascular Surgery.Armonk NYBunt TJ:Vascular Graft Infections.Armonk, NY

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00595.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00596.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00597.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00662.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAlthough substantial advances have been made in the management of cardiovascular disease, it remains the leading cause of death on the United States and many other countries, due to the impact of aging and other changes in patient demographics. Since cardiovascular complications are usually associated with stress, it is not surprising that perioperative complications (cardiac death, myocardial infarction, heart failure) occur in at least 10% of patients undergoing coronary artery bypass graft surgery, with such complications consuming an additional $2 billion annually in health care resources. In addition, the limitations of the newly mandated cost‐saving methods have and will continue to have an impact upon the delivery of health care to cardiovascular patients. However, research and clinical studies in this area hold the promise of appropriate and cost‐effective therapeutic approac

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00663.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractIschemic preconditioning is one of the most powerful means to reduce myocardial ischemic cell death in the experimental laboratory. Data are now emerging suggesting that ischemic preconditioning also can occur in the human heart. Studies performed on human myocardial biopsies, angioplasty studies, clinical studies assessing acute tolerance to angina, and some studies evaluating the effect of angina prior to myocardial infarction, lend support to the concept that the human heart can be preconditioned. The ultimate objective is to develop preconditioning‐mimetic agents that can be administered prophylactically prior to the time of cardiopulmonary bypass surgery or administered to hearts that have been harvested for transplant in order to better preserve the ischemically jeopardized myocyt

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00664.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThere has been an upsurge of research on myocardial preconditioning because of its potential clinical application in areas such as cardiology, cardiac surgery, and transplantation. From a broad biological standpoint, a conceptual framework may help in both promoting understanding and suggesting future research paths. The living organism's tendency toward developing evolutionarily advantageous strategies has led to a fight or flight response, for which the authors consider preconditioning a component. Added to preconditioning, the production of stress proteins and altered myocardial states (especially that of “hibernating myocardium”) can be seen as a series of biological strategies developed and maintained during evolution. An increased understanding of the mechanisms involved in the body's self‐defense strategies should lead to better approaches, those in which we can help the cells, including those comprising the myocardium, to preserve thems

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1995.tb00665.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY