RESUMEN
The results of radical correction of interatrial septum defects and heart diseases associated with it were analyzed after treatment of 502 patients at the age from 5 to 48 years. In most cases (58.4%) the patients were adults. The isolated defect of the interatrial septum was diagnosed in 377 patients. Correction of the defect was performed in 82 patients (16.3%) under mild hypothermia and 420 patients (83.6%) were operated upon under conditions of artificial circulation. General lethality was 7.7%.
Asunto(s)
Cardiopatías Congénitas/cirugía , Defectos del Tabique Interatrial/cirugía , Enfermedades de las Válvulas Cardíacas/cirugía , Adolescente , Adulto , Niño , Preescolar , Circulación Extracorporea , Femenino , Cardiopatías Congénitas/complicaciones , Defectos del Tabique Interatrial/complicaciones , Enfermedades de las Válvulas Cardíacas/complicaciones , Humanos , Hipertermia Inducida , Masculino , Persona de Mediana Edad , Arteria Pulmonar/anomalías , Válvula Pulmonar/cirugía , Venas Pulmonares/anomalías , Trilogía de Fallot/complicaciones , Trilogía de Fallot/cirugíaRESUMEN
The authors' impeller pump as a left ventricular or biventricular assist device was evaluated in animal experiments and clinical trial. Three calves survived over 6 weeks in left ventricular assist experiments and neither blood damage nor organ dysfunction of the animals was detected. In clinical trial, the pump supported both the greater and lesser circulation of a 6-year-old child with trilogy of Fallot and low output syndrome after open heart surgery. In 43 hours the pump worked properly. The pump weighing 240 g can perform either in pulsatile or in nonpulsatile mode. In pulsatile pumping, the impeller changes its rotating speed periodically by introducing a square wave form voltage into the motor coil.
Asunto(s)
Corazón Auxiliar , Animales , Bovinos , Niño , Ensayos Clínicos como Asunto , Diseño de Equipo , Falla de Equipo , Humanos , Masculino , Trilogía de Fallot/cirugíaRESUMEN
From 1984 to 1989 corrective operation circulation was performed under extracorporeal in 42 adults with trilogy of Fallot (6.2% of total intracardial operations under direct vision in patients with congenital heart disease in our hospital). The obstruction was relieved by resection of the hypertrophial and sclerotic muscle trabeculae of the Rt. ventricular outflow tract and pulmonary valvotomy and patching with a piece of artificial blood vessel lined internally by auto-pericardium so that a bougie (more than 1.6cm) could be passed through. The Rt. ventricular pressure was reduced satisfactorily (PRV/PLV < 0.75). There was one operative death.
Asunto(s)
Trilogía de Fallot/cirugía , Adolescente , Adulto , Procedimientos Quirúrgicos Cardíacos/métodos , Femenino , Hemostasis Quirúrgica , Humanos , Masculino , Cuidados PosoperatoriosRESUMEN
Two hundred and thirty-four patients with trilogy of Fallot including 102 cases of severe type were operated in our hospital in the last 15 years. Right ventricular outflow patching was done in 117 cases, Devega tricuspid annuloplasty in 7 cases. Total operative mortality rate was 2.6%. The pathological anatomy and the surgical treatment of the severe type cases were discussed.
Asunto(s)
Trilogía de Fallot/cirugía , Adolescente , Adulto , Procedimientos Quirúrgicos Cardíacos/métodos , Niño , Preescolar , Femenino , Humanos , MasculinoAsunto(s)
Calcinosis/cirugía , Prótesis Valvulares Cardíacas , Estenosis de la Válvula Pulmonar/cirugía , Trilogía de Fallot/cirugía , Adulto , Calcinosis/complicaciones , Humanos , Masculino , Válvula Pulmonar/cirugía , Estenosis de la Válvula Pulmonar/etiología , Técnicas de Sutura , Trilogía de Fallot/complicacionesRESUMEN
Data on postponed closure of the sternum in 3 patients who were operated on with extracorporeal circulation are discussed. Various clinical and technical aspects of the applied method are considered. On the basis of their personal experience and the literature data, the authors discuss the causes of the development of acute heart dilatation in operations with extracorporeal circulation and, with due regard for this, substantiate the indications for the use of the method. Postponed closure of the sternum is a promising method of treatment of critical hemodynamic disorders which occur at the stage of closure of the sternotomy and are characterized by the picture of cardiac tamponade.
Asunto(s)
Taponamiento Cardíaco/cirugía , Endocarditis Bacteriana/cirugía , Esternón/cirugía , Trilogía de Fallot/cirugía , Taponamiento Cardíaco/etiología , Niño , Circulación Extracorporea , Humanos , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/cirugía , Masculino , Persona de Mediana Edad , Técnicas de Sutura , Factores de TiempoRESUMEN
Biopsies taken from the myocardium of 5 patients with Morbus Fallot and from 1 patient with ventricle septum defect were investigated with a combination of morphometric, biochemical and histophotometric techniques in order to study the cardioprotective effect of cold Kirsch's solution. At the final phase of cardioplegia the cardiomyocytes reveal the following alterations: The volume densities of mitochondria, of their degenerated areas and that of cytoplasmic vacuoles show a significant increase whereas that of myofilaments decreases. Cristae and matrix mitochondriales, however, show only moderate alterations without statistical significance. Biochemically the total ATP-concentration and creatine phosphate (CP)-concentration were more or less diminished, in most of the cases the activity of the myosin ATPase was increased, that of the creatine phosphate kinase (CPK) diminished. Compared with the biochemical estimations of the ATPase activity, its histophotometric estimations yielded corresponding results in 2 of 4 cases. In general our findings confirm the cardioprotective effect of Kirsch's solution. The combination of methods used gives more reliable results than one technique alone.
Asunto(s)
Soluciones Cardiopléjicas/farmacología , Paro Cardíaco Inducido/métodos , Cardiopatías Congénitas/cirugía , Miocardio/ultraestructura , Adenosina Trifosfatasas/metabolismo , Adulto , Niño , Creatina Quinasa/metabolismo , Femenino , Defectos del Tabique Interventricular/cirugía , Humanos , Masculino , Miocardio/enzimología , Tetralogía de Fallot/cirugía , Trilogía de Fallot/cirugíaAsunto(s)
Defectos del Tabique Interatrial/cirugía , Hipotermia Inducida , Cardiopatía Reumática/cirugía , Trilogía de Fallot/cirugía , Vena Cava Superior/anomalías , Adulto , Válvula Aórtica/cirugía , Femenino , Enfermedades de las Válvulas Cardíacas/cirugía , Humanos , Válvula Mitral/cirugía , Vena Cava Superior/cirugíaAsunto(s)
Procedimientos Quirúrgicos Cardíacos , Vasos Coronarios/cirugía , Adolescente , Factores de Edad , Aneurisma de la Aorta/cirugía , Procedimientos Quirúrgicos Cardíacos/métodos , Niño , Preescolar , Urgencias Médicas , Femenino , Prótesis Valvulares Cardíacas , Humanos , Lactante , Masculino , Trilogía de Fallot/cirugíaRESUMEN
The advent of heart-surgery in obstetrics has been determinant, in as much as it has improved therapeutic treatment and above all it has resulted in achievement which were impossible 30 years ago. The concepts already put forward by the school of cardio-obstetric surgery of Turin on haemodynamics in pregnancy and childbirth as biologic risk factors for the patient with a bad heart continue to be upheld. The results of Actis Dato Group's in cardiac surgery are reported. Almost all types of congenital and acquired cardiopathies in their relationships to pregnancy are described. 1750 Pregnancy cases in 997 heart diseased women are analised. The cooperation with the obstetrical team is stressed.
Asunto(s)
Cardiopatías/cirugía , Complicaciones Cardiovasculares del Embarazo/cirugía , Adolescente , Adulto , Coartación Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/cirugía , Conducto Arterioso Permeable/cirugía , Complejo de Eisenmenger/cirugía , Femenino , Bloqueo Cardíaco/terapia , Defectos del Tabique Interatrial/cirugía , Prótesis Valvulares Cardíacas , Humanos , Recién Nacido , Persona de Mediana Edad , Insuficiencia de la Válvula Mitral/cirugía , Estenosis de la Válvula Mitral/cirugía , Marcapaso Artificial , Pericarditis Constrictiva/cirugía , Embarazo , Arteria Pulmonar/anomalías , Estenosis de la Válvula Pulmonar/cirugía , Tetralogía de Fallot/cirugía , Trilogía de Fallot/cirugíaAsunto(s)
Defectos del Tabique Interatrial/cirugía , Válvulas Cardíacas/cirugía , Complicaciones Posoperatorias/diagnóstico , Insuficiencia de la Válvula Pulmonar/diagnóstico , Estenosis de la Válvula Pulmonar/diagnóstico , Trilogía de Fallot/cirugía , Niño , Preescolar , Estudios de Evaluación como Asunto , Hemodinámica , Humanos , Lactante , Factores de TiempoRESUMEN
The series presented consists of 25 babies (18 of which were neonates), seen between 1972 and 1974. The anatomical and angiographic study revealed 5 anatomical types, according to whether the pulmonary orifice was patent or atretic, and according to the size of cavity of the right ventricle, which may be normal or reduced (perhaps almost totally). The diagnostic clinical features and findings on angiography are recalled. The operative procedure in all 25 cases was pulmonary valvotomy carried out with a brief normothermic period of cirulatory arrest. The technique is described briefly. The results, which vary widely with the anatomical type, were as follows: out of the 25 operated cases there were 12 deaths during or immediately after surgery. The figures are none-the-less encouraging, given the grave natural history of this condition in the baby. The best results were seen in cases in which there was a right ventricular cavity of normal or at least acceptable size. The maximum postoperative follow-up period was 3 years. Most of these children have a persistant pulmonary stenosis and hypertrophic right ventricle, and require a second operation in early infancy.