The Annals of thoracic surgery
-
The Damus-Kaye-Stansel operation is useful in the management of complex congenital heart defects. We reviewed our experience with 23 patients who underwent a Damus-Kaye-Stansel procedure. The anastomotic technique was individualized depending on the anatomy. ⋯ Four patients underwent late revision of the Damus-Kaye-Stansel connection. All survivors are asymptomatic. We conclude that the Damus-Kaye-Stansel connection provides excellent midterm results when the proximal anastomosis is adapted to the anatomy of the patient.
-
Video-assisted thoracoscopic technique was evaluated in 28 patients who underwent operation for massive pericardial effusion. Excellent results were obtained using this newly developed approach for inspection of all pericardial surfaces as well as pleural and pulmonary disorders. No perioperative or postoperative complications ensued. ⋯ From our experience, video-assisted thoracoscopy was a safe and effective procedure, especially for those patients with combined pericardial effusion and abnormal pulmonary or pleural pathology in whom subxiphoid pericardial window was not clearly diagnostic at the time of operation. It was effective also in the situation with recurrent or loculated pericardial effusion which allowed localization and drainage of it. We believe that the use of videothoracoscopy to visualize the whole pericardial and pleural cavity will continue to be of great benefit to patients with combined pericardial and pleural/lung diseases.
-
Comment Letter Case Reports
Percutaneous cardiopulmonary bypass for hypothermic cardiac arrest.
-
A woman pregnant for 21 weeks underwent an emergency operation because of an aortic arch aneurysm that had ruptured into her left lung. Cardiopulmonary bypass and deep hypothermia were used and she needed 37 minutes of circulatory arrest at a core temperature of 19 degrees C. Both the mother and fetus survived, and a normal baby was delivered by cesarean section at the 39th week of gestation.
-
Comparative Study
Transesophageal echocardiographic measurements of cardiac output in cardiac surgical patients.
Transesophageal echocardiography is becoming increasingly popular as a method of intraoperative monitoring because it can be performed continuously, does not transgress the sterile operative field, and provides data with regard to valve function, ventricular volumes, and contractility. Recently it was suggested that it can be used to measure cardiac output; however, controversy remains regarding its accuracy. ⋯ Cardiac outputs measured by thermodilution correlated well (r = 0.95) with transesophageal Doppler values derived from pulmonary artery flow velocity, with a mean difference of 0.12 +/- 0.45 L.min-1 and narrow limits of agreement of from -0.78 to +1.02 L.min-1. Based on our findings, transesophageal Doppler echocardiographic determination of cardiac output using pulmonary artery flow measurements can provide accurate hemodynamic data in patients undergoing cardiac operations.