No abstract available.
Adrenocorticotropic Hormone* ; Cortisone* ; Epinephrine*

We studied the angiographic findings in 65 patients wtih congenital pulmonary atresia, ages 4 days to 14 years(mean 3.3 yrs), form 1981 to 1986 at Severance Hospital Yonsei University. 1. 6 had pulmonary atresia with anintact interventricular septum, 38 had it with cardiac anomaly Renodynamically simulating TOF, and 21 associatedwith more complicated cardiac anomalies. 2. In the group with an intact ventricular septum, 5 showed confluentintrapericardial pulmonary artery, all segmental pulmonary arteries connceted to intrapericardial pulmoanryartery. 3. In the group simulating TOF, aorta arose from RV with or without overriding in 35. In 27 patients withconfluent intrapericardial pulmonary artery, 23 had more than 10 segmental pulmoanry arteries connceted tointrapericardial artery and 5 had severely hypoplastic hilar pulmonary arteries. In 11 with nonconfluentintrapericardial pulmonary artery, 4 had more than 10 segmental pulmonary arteries connected to central pulmonaryartery and 9 had severely hypoplastic hilar pulmonary arteries. 4. In the group associated with more complicatedcardiac anomaly, included 8 patients with atrioventricular discordance, 7 with univentricular heart and 6 withtricuspid atresia. In 17 patients with confluent intrapericardial artery, 16 had more than 10 segmental pulmoanryarteries conncected to intrapeircardial artery, one showed severe hypoplasia of hilar pulmonary arteries. Inanother 4 with nonconfluence, no one showed more than 10 segmental arteries conncted to intraperdicardial or hilarpulmonary artery.
Aorta ; Arteries ; Heart ; Humans ; Pulmonary Artery ; Pulmonary Atresia ; Ventricular Septum

A hypothermic, low flow perfusion, using 5% dextrose in water as the priming fluid in the pump-oxygenator, was carried out to observe oxygen consumption, blood pH changes, and CO2 tension during the bypass period. A low oxygen consumption which was approximately one third of the preperfusion value, was observed during the total by-pass period. This is believed to be due to the effect of low flow rates employed, hypothermia and low CO2 tension observed in these animals. The pH of the arterial blood and the partition of the total CO2 remained within a fairly normal range. There was a marked reduction in CO2 tension during the bypass period. Its harmful effect on the oxyhemoglobin dissociation curve and cerebral circulation was discussed. The hemodilution attendant to the use of 5% dextrose in water as the priming fluid is considered insignificant.
Animals ; Dogs ; Glucose/*adverse effects ; *Heart-Lung Machine ; *Hypothermia, Induced ; Plasma Substitutes/*adverse effects

Open heart surgery under cardiopulmonary bypass which is combined with moderate hypothermia and 5% dextrose priming offers several advantages over the conventional methods; i.e., simplification of the machine, economy in operation, elimination of the need for a large amount of heparinized blood, avoidance of hemaological complications and utilization of the unit as a standby method. The results of open heart operations with this method in our initial 10 cases were comparable to other methods. None of the complications and the mortality were directly attributable to the oxygenator itself.

No abstract available.
Constriction, Pathologic*

A method for one-lung anesthesia in which a 14 Fogarty emboiectomy catheter is used to occlude a main bronchus is described. The method is quick, simple, effective and reliable. It eliminates most of the problems which occurs with the standard technique of using a double-lumen cuffed endotracheal tube. During one-lung mannual ventilation, anesthesia was maintained with ketamine I.V. infusion and pancuronium. Before and after one-lung anesthesia, halothane-nitrous oxide-oxygen and pancuronium were used. No significant problems regarding blood pressure, pulse rate, EKG and arterial blood gases were encountered in 3 lung cancer cases who had a pneumonectomy, a lung biopay and a left lower lobectomy.
Anesthesia* ; Blood Pressure ; Bronchi ; Catheters* ; Electrocardiography ; Gases ; Heart Rate ; Ketamine ; Lung ; Lung Neoplasms ; Pancuronium ; Pneumonectomy ; Ventilation

No abstract available.

Clinical problem occuring in the early post operative period after cardiopulmonary bypass may ne related to the altered function of capillary bed which was affected by activation of complement system. This is so called post perfusion syndrome. We selected 20 patients with confirmed congenital heart disease by cariac catheterization. We studied the changes in the C3 , immunolglobulins, total protein, and WBC count while performing open heart surgery. The results were as followed. 1. C3 level was lowest during cardiopulmonary bypass and returned to the normal level after 8 days. 2. Each immunoglobulin level decreased just after cardiopulmonary bypass, especially the IgG level, and immunoglobulins slowly returned to the normal range after 8 days. 3. Serum total protein level and electrophoretic fractions were comperatively reduced as much as immunoglobulin levels. 4. WBC count was lower just before cardiopulmonary bypass than baseline.
Capillaries ; Cardiopulmonary Bypass* ; Catheterization ; Catheters ; Complement System Proteins* ; Heart Defects, Congenital ; Humans ; Immunoglobulin G ; Immunoglobulins ; Oxygenators ; Perfusion ; Reference Values ; Thoracic Surgery

No abstract available.
Angioplasty, Balloon, Coronary* ; Emergencies*

Surgical revascularization is very effective for the relief of chest pain, improvement of exercise tolerance and ventricular performance in certain ischemic heart diseases. Bypass graft angiography and native coronary angiography after coronary artery bypass graft(CABG) were required for the evaluation of graft patency, progression of the native coronary artery disease and to predict the prognosis of the patients after CABG. The cases included in this study involved 15 patients who underwent selective bypass graft angiography among 102 CABG cases. Thirty eight sites were bypassed by saphenous vein and two sites by internal mammary artery. The results were as follows: 1) The overall patency rate of the saphenous vein bypass graft was 76.3% and the two sites of the internal mammary artery bypass graft were both patent. 2) The patency rate of direct anastomosis was 86.2% and of sequential anastomosis, 44.4%. 3) In eight patients who underwent native coronary angiography, five patients showed progression of grafted coronary artery disease. Among them, two patients had accompanying progression of coronary artery disease in non-grafted vessels. 4) Follow up treadmill test performed in six patients showed improvement of exercise tolerance in all patients. 5) There was some increase in the ejection fraction of the left ventricle after CABG in six patients who received follow up left ventriculography.
Angiography* ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mammary Arteries ; Myocardial Ischemia ; Prognosis ; Saphenous Vein ; Transplants*