Clinical significance of perioperative Q-wave myocardial infarction: the Emory Angioplasty versus Surgery Trial.

Objective: The primary end point of the Emory Angioplasty versus Surgery Trial was a composite of three events: death, Q-wave infarction, and a new large defect on 3-year postoperative thallium scan. This study examines the clinical significance of Q-wave infarction in the surgical cohort (194 patients) of the Emory trial.

Methods: Twenty patients (10.

Third-time coronary artery bypass operations: surgical strategy and results.

Background: Increasingly, patients are returning for a second, third, and even fourth coronary artery bypass graft (CABG) procedure.

Methods: This report reviews the in-hospital and long-term outcomes for 102 patients undergoing a third or fourth CABG at Emory University from December 1977 to April 1994.

Results: The mean interval from the first to second CABG was 5.

Prevention of postoperative pericardial adhesions with a hyaluronic acid coating solution. Experimental safety and efficacy studies.

Postoperative pericardial adhesions complicate reoperative cardiac procedures. Topical application of solutions containing hyaluronic acid have been shown to reduce adhesions after abdominal and orthopedic surgery. The mechanism by which hyaluronic acid solutions prevent adhesion formation is unknown but may be due to a cytoprotective effect on mesothelial surfaces, which would limit intraoperative injury.

Acute effects of massive transfusion of a bovine hemoglobin blood substitute in a canine model of hemorrhagic shock.

The capability of stroma-free hemoglobin solutions to act as a plasma expander with oxygen and carbon dioxide transport properties has encouraged the idea of their possible use in settings of massive blood loss. Using a canine hemorrhagic shock model (systolic arterial pressure < or = 50 torr for 60 min), we evaluated the efficacy of an ultra-pure stroma-free bovine hemoglobin solution (PBHg) as a resuscitation fluid in hypovolemic and acidotic animals, using homologous blood (PRBC) and 10% human serum albumin (HSA) as control solutions. Following volume replacement, dogs were studied for 2 h under anesthesia and for 4 h subsequently while awake.

Ultra-pure polymerized bovine hemoglobin blood substitute: effects on the coronary circulation.

The effects of stroma-free hemoglobin (SFHgb) on the coronary circulation remain unclear. An intact canine model utilizing intracoronary adenosine to abolish the confounding effect of autoregulation was used to study maximal myocardial oxygen delivery during progressive hemodilution with polymerized bovine SFHgb. The circumflex coronary artery was instrumented with a flow probe, hydraulic constrictor, and proximal and distal catheters for adenosine infusion and distal pressure measurement, respectively.