Circulatory function of patients with operatively closed ventricular septal defect and preoperative pulmonary arterial hypertension was evaluated in 11 asymptomatic subjects at rest and during intense treadmill exercise three to 15 years after operation. The pulmonary-to-systemic resistance ratio was normal or mildly to moderately elevated preoperatively. Postoperative mean pulmonary arterial p...

In order to evaluate the reliability and sensitivity of echocardiograms for detecting and quantitating pericardial effusion, 41 patients had echocardiograms on the day prior to cardiac operation. A fluid trap was used to aspirate the pericardium at operation. Thirty-nine of 41 patients had echocardiograms of diagnostic quality. In 25 patients, the echocardiogram was negative for pericardial eff...

OBJECTIVE Donor shortage and improved medical treatment of heart failure increase the prevalence of patients with extreme right ventricular failure and ascites to heart transplantation. The clinical outcome of heart transplantation in these patients has rarely been reported. Here, we sought to evaluate the clinical outcome of heart transplantation in patients with extreme right ventricular fail...

BACKGROUND Transesophageal echocardiography (TEE) is often performed during cardiac operations. The need to repeat TEE to exclude left atrial or left atrial appendage thrombus before direct current cardioversion (DCCV) in patients with a recent intraoperative TEE showing no thrombus is unclear. We sought to determine the incidence of and risk factors for new thrombus in patients undergoing TEE-...

Gastrointestinal (GI) complications occurring after cardiac surgery are considered as “second line” complications due to their scarcity. Cardiac surgeons, ICU staff and nursing personnel are usually aware and suspicious of cardiac-related mishappenings after heart surgery; however they often tend to underestimate potentially lethal manifestations involving the gastrointestinal track, or organs ...

T HE internist frequently is called upon by his surgical colleagues for an opinion concerning the risk of anesthesia and of a surgical procedure in a patient who has organic heart disease. A request of this kind carries with it a number of implied questions, among the most important of which are: 1. Does the cardiac abnormality increase the risk of the contemplated procedure? 2. Will the anesth...

T HE internist frequently is called upon by his surgical colleagues for an opinion concerning the risk of anesthesia and of a surgical procedure in a patient who has organic heart disease. A request of this kind carries with it a number of implied questions, among the most important of which are: 1. Does the cardiac abnormality increase the risk of the contemplated procedure? 2. Will the anesth...

background : we report experimental myocardial infarction by occluding coronary arteries in ovine models. methods: twelve ewes were included in the study. after the chest was opened by left lateral thoracotomy incision, the second diagonal branch of the left anterior descending coronary artery was ligated at a point approximately 40% distant from its base. prophylactic antiarrhythmics were admi...

postoperative vasoplegic syndrome (vs) is characterized by low systemic vascular resistance, normal or elevated cardiac output, and poor response to volume expansion. the incidence of vs after cardiac surgery requiring cardiopulmonary bypass is about 20%. sometimes, vs becomes refractory and initial treatments do not work, rendering treatment a great challenge. in this study, we describe a youn...

OBJECTIVES The Ross procedure is the aortic valve-replacement procedure of choice in children. Nonetheless, late autograft re-operation for dilatation and/or valve regurgitation is of concern. We examined whether preoperative haemodynamic manifestation (e.g., stenosis, regurgitation and mixed aortic valve disease) affected late re-operation risk. METHODS Medical records of 227 children who un...