Severe intravascular hemolysis following mitral valve repair.

We report two cases of severe intravascular hemolysis (IVH) following mitral valve repair using a Cosgrove-Edwards ring. In both cases, the degree of mitral regurgitation (MR) seen postoperatively worsened significantly compared to intraoperative transesophageal echocardiogram. Both patients required reoperation with mitral valve replacement with immediate resolution of the hemolysis.

Ventricular cross stimulation using a pacing system analyzer.

Cross stimulation refers to the situation in which a pacing lead positioned in one cardiac chambers results in stimulation of another chamber. We report three cases of ventricular cross stimulation observed at the time of pacing system implantation. The cross stimulation occurred through bipolar atrial and ventricular leads connected in bipolar configuration to a dual chamber pacing systems analyzer.

Short-duration, high-dose urokinase infusion for recanalization of occluded saphenous aortocoronary bypass grafts.

Thrombolytic recanalization of arterial bypass grafts has been pursued aggressively in the peripheral circulation but not in the coronary circulation. In an attempt to apply peripheral transcatheter thrombolytic techniques to the coronary circulation, nine patients with 10 occluded saphenous aortocoronary bypass grafts underwent recanalization procedures using a short-duration, high-dose urokinase infusion. Urokinase was infused at the occluded graft orifice at a rate of 600 units/min.

Emery-Dreifuss muscular dystrophy with autosomal dominant transmission.

A woman with early-onset, slowly progressive, humeroperoneal muscle weakness had marked restriction of neck flexion with contracture at the elbows. She developed exertional dyspnea at age 25, atrial fibrillation with slow ventricular rate was discovered, and a cardiac pacemaker was implanted. Her father had a similar disorder.

Clinical angiographic regression of atherosclerosis after partial ileal bypass.

Clinical documentation of atherosclerotic plaque regression has been difficult to obtain. This is a report of a patient with severe and early atherosclerotic cardiovascular disease with regression of at least three major atherosclerotic lesions demonstrated by coronary arteriography 10 years after partial ileal bypass operation. The patient's total plasma cholesterol was reduced over these 10 years, ranging from 40% to 23%, from the preoperative level of 757 mg/dl.

Changes in ventilation and perfusion in anesthetized dogs following lobar lavage with saline solution.

The therapeutic application of endobronchial lavage has been inhibited by concern regarding alterations in the exchange of gases, particularly hypoxemia, and by the technical complexity of the procedure. Using a cuffed fiberoptic bronchoscope with which lavage could be restricted to one lobe, we studied the sequence of alterations in the exchange of gases after lavage and the attendant disturbances in ventilation and perfusion in ten mongrel dogs following lobar lavage with 1,850 ml of physiologic saline solution. Sequential scintiphotographs of ventilation and perfusion and sequential measurements of arterial blood gas levels were obtained.