The Journal of thoracic and cardiovascular surgery
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Because of increasing interest in the application of the Blalock-Taussig shunt in smaller infants, we reviewed the course of 18 infants aged 6 months or less who underwent this procedure. The mortality rate in 4 infants under 2 weeks of age was 50 per cent and that in those 2 weeks to 6 months of age, 28 per cent. The patency rate was 70 per cent. Because of late problems with the Waterston shunt and a comparable mortality rate, the Blalock-Taussig procedure is recommended for all infants, except perhaps those under 2 weeks of age.
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J. Thorac. Cardiovasc. Surg. · Aug 1975
A study of the electroencephalogram during surgery with deep hypothermia and circulatory arrest in infants.
Seveteen infants (2 1/2 to 28 months old) were continuously monitored by six-channel electroencephalography (EEG) during the entire surgical procedure of open-heart repair. They were subjected to surface hypothermia supplemented by cold extracorporeal circulation (ECC) down to an average esophageal temperature of 21 degrees C., to cardiac arrest of 40 minutes average (range 19 to 62 minutes), and to ECC rewarming. Survival time of the EEG was correlated to esophageal temperature at the time of arrest. ⋯ Reappearance latency was well correlated with the duration of arrest. Potential normalization was oberved in 13 infants, but true normalization was observed in only 2 infants during the 90 to 120 minute period after ECC. By judging the EEG and by comparing this series with two previous series of moderate and deeper hypothermia in older patients, we concluded that the immediate tolerance of the brain to deep hypothermia and circulatory arrest seems no different in infants and in older patients.
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J. Thorac. Cardiovasc. Surg. · Jul 1975
Isolated replacement of the aortic valve with the Starr-Edwards prosthesis. A 9 year review.
A 9 year review of patients who underwent replacement of the aortic valve with the Starr-Edwards prosthesis indicates that the operative mortality rate for aortic valve replacement continues to decline. Thromboembolic complications have been markedly lessened in newer model valves. ⋯ The large majority of patients who survive surgery can expect to be rehabilitated to a highly functional existence, with longevity not unlike that of the general population. The Starr-Edwards prosthesis is a very satisfactory prosthesis for replacement of the aortic valve.
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This report presents a 15 year review of the surgical treatment of 9 patients with congenital mitral stenosis seen at the Columbus Children's Hospital. The over-all mortality rate was 45 per cent. ⋯ The mitral valve should be explored with the use of cardiopulmonary bypass and the anatomic type of the valve determined. Type I valves will often respond to open valvulotomy, whereas Type II and III valves must be replaced.
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J. Thorac. Cardiovasc. Surg. · Jun 1975
Spotaneous rupture of an intercostal artery in a patient with neurofibromatosis and scoliosis.
A case is reported of spontaneous rupture of an intercostal artery at its origin from the aorta in a patient with neurofibromatosis and scoliosis. The possible role played by each of these conditions in the pathogenesis of the spontaneous rupture is discussed. Comment is made on the unusual radiologic appearances of extrapleural hemorrhage.