Aortic and mitral valve replacement in children or adults with small valvular annulus.

Two methods are described for enlarging the aortic and mitral valvular annuli. The first method is aortoventriculoplasty, the results of which are reported here in 7 patients with small aortic annulus and in 4 cases with stenotic aortic valvular prosthesis inserted previously. The second method is developed for enlargement of the mitral ring to insert larger mitral valvular prosthesis.

Enlargement of mitral valvular ring. New technique for double valve replacement in children or adults with small mitral anulus.

The technical difficulty of inserting a sufficiently large prosthesis in a small mitral ring has been overcome by a new technique based on the principle of complete division of the valvular ring and its unrestricted enlargment by reconstruction of the prosthetic valve. Th technique entails division of the aortic valvular ring into and through the mitral anulus and the left atrial wall. It provides wide exposure for easy double mitral and aortic valve replacement, which is performed with large prosthetic valves that are supported in part by the patch reconstruction of the incised structures.

Simultaneous dopamine and sodium nitroprusside therapy following open heart surgery.

Twenty post-open heart surgery patients with low output syndrome were given dopamine, sodium nitroprusside (SNP) alone and in combination. Dopamine alone (3--4 mcg/Kg/min) caused an increase of cardiac output (CO) from 3.2 to 4.

Aortoventriculoplasty for tunnel subaortic stenosis and other obstructions of the left ventricular outflow tract. Clinical and hemodynamic results.

A new therapeutic concept of enlarging the outflow tracts of both ventricles with a patch and inserting an aortic prosthesis has been developed for the treatment of tunnel subaortic stenosis. This operation has been applied clinically since June 1974 on several types of obstruction in the outflow tract of the left ventricle. Twenty-one operations have been performed on 20 patients under the age of 18 years, with an overall mortality of 24% and no late deaths.

[Fresh autologus blood transfusion during open heart surgery (author's transl)].

Hemodynamic parameters were measured in 80 unselected patients prior to cardiopulmonary bypass for a variety of a operative procedures. Isovolemic blood withdrawel up to 24.7 ml/kg or 10 gms% and 30% hematocrit during sternotomy using ACD blood storage containers was carried out prior to bypass.