A surgical approach to chronic aortomyoplasty in the goat model.

The left latissimus dorsi skeletal muscle of seven male goats was prepared and applied circumferentially to the descending aorta just below the subclavian artery. Stimulation of the neural pedicle of the latissimus dorsi was performed in an attempt to convert it to a fatigue-resistant cardiac-like muscle. Timing of the stimulus was in diastole.

Determinants of outcome in lesions of the thoracic aorta in patients with multiorgan system trauma.

Of all patients presenting at our level 1 trauma center with multiorgan system injuries, 33 have been identified with acute lesions of the thoracic aorta. Mean severity injury score was 24 +/- 3. Four patients underwent resuscitative thoracotomy upon arrival in the emergency department.

Continuous venous oximetry for hemodynamic and oxygen transport stability post cardiac surgery.

Under the diagnostic-related group (DRG) reimbursement system, hospitals are looking to decrease costs related to unnecessary laboratory measurements. To assess the efficacy of continuous SvO2 as the only means to monitor the balance of the oxygen transport of the stable postoperative cardiac patient in the ICU, we studied 26 adult patients undergoing cardiac surgery with an uneventful postoperative course. All subjects had an Opticath fiberoptic PA catheter inserted for 29.

Multichamber gunshot wounds of the heart. The utility of transesophageal echocardiography.

A patient had a gunshot wound to the heart involving three cardiac chambers. Conventional echocardiography failed to identify the intracardiac injuries. The utility of transesophageal echocardiography in a patient with cardiac trauma is described.

Ventricular free-wall rupture after myocardial infarction. Treatment and outcome.

Ventricular free-wall rupture remains one of the leading causes of death after myocardial infarction (MI). With increased abilities for diagnosis and resuscitation techniques, surgical correction of free-wall myocardial defects resulting from ischemia and necrosis may become a simple modality of treatment, resulting in improvement of the survival rate. We are reporting our experience with four patients with ventricular free-wall rupture after MI, with emphasis on clinical presentation, diagnosis, and surgical management.

Silicone pouch for protection of automatic implantable cardioverter-defibrillator leads.

Automatic implantable cardioverter-defibrillator has become routine treatment for recurrent, drug-resistant ventricular tachycardia. Although there is documentation regarding clinical experience and device performance, there is little information on how to avoid complications related to the retrieval of sensing and defibrillation leads from the subcutaneous space. We are reporting our experience with a silicone pouch for protection of automatic implantable cardioverter-defibrillator leads that allows immediate and simple retrieval of the leads in case an automatic implantable cardioverter-defibrillator generator is needed.

Platelet-rich plasma reduces postoperative blood loss after cardiopulmonary bypass.

To study the effect of plasma sequestration and reinfusion of platelet-rich plasma on blood loss after cardiopulmonary bypass, 18 patients undergoing heart operations were randomly selected either to have collected or not to have collected approximately 250 ml of platelet-rich plasma before initiating cardiopulmonary bypass with the use of the Haemonetics Plasma Saving System (Haemonetics Corporation, Braintree, Mass.). All patients had standardized anesthesia and cardiopulmonary bypass.

Heparinless extracorporeal bypass for treatment of hypothermia.

In an attempt to assess the changes occurring to the coagulation profile during internal active core rewarming with partial cardiopulmonary bypass (CPB) without heparin anticoagulation, five pigs were anesthetized, and a model for severe to moderate hypothermia was created. Femoral-femoral bypass with Bio-Pump, heat exchanger, and a membrane oxygenator were used during the rewarming for 64.8 +/- 8.