The effect of oxygen tension and mechanical stress on the outcome of fresh autogenous tissue implants in the canine blood stream.

Fresh autogenous collagenous tissue grafts were implanted in the lumen of the aorta, vena cava, pulmonary artery and vein of thirty dogs. Grafts were studied at varying periods postimplantation. Grafts in the latter three situations were vascularized and absorbed early and were replaced by host fibrous tissue; whereas grafts in the aorta remained unabsorbed because of lack of vascularization.

Surgical treatment of pulmonary atresia with intact ventricular septum.

Fifty-nine children with pulmonary atresia and intact ventricular septum underwent various forms of surgical treatment at the Hospital for Sick Children, Toronto, during 1950 to mid 1975. Twenty-three patients had pulmonary valvotomy, 15 direct, 2 indirect, and 6 both direct valvotomy and infundibulectomy. All died, 19 early and 4 late.

Tricuspid atresia: results of treatment in 160 children.

Experience in managing 160 patients with tricuspid atresia is reviewed. The majority of these children require operative treatment in the 1st year of life. Clinical management of this rather complex anomaly is simplified by classifying each child according to total pulmonary blood flow.

Surgical management of congenital cardiovascular anomalies with the use of profound hypothermia and circulatory arrest. Analysis of 180 consecutive cases.

An initial series of 180 patients subjected to definitive repair of cardiac malformations during infancy is presented. The operations were performed with profound hypothermia and circulatory stasis. Statistics relating to the entire series of patients are presented and discussed, after which the results among eleven individual groups of patients categorized by type of cardiovascular lesion are analyzed.

Hemodynamic studies in children four to ten years after the Mustard operation for transposition of the great arteries.

Fourteen patients have been studied hemodynamically 4-10 years (mean 5.5 years) after the Mustard operation for transposition of the great arteries. Investigation was directed principally at 1) the detection of baffle obstruction by catheterization of the pulmonary veins (PV) and venae cavae and recording of simultaneous right ventricular (RV) and pulmonary capillary wedge pressures (PCW); 2) the detection of intra-atrial baffle leaks by dye curves and selective angiography; 3) the assessment of RV and LV function by calculating peak VCE (dp/dt/28p) from high fidelity recordings in 11 patients.

Cerebral hemorrhage following heart surgery.

The authors report a study of the problem of intracranial hemorrhage in 16 children following cardiac surgery, four studied clinically, and 12 by postmortem pathological review. Eleven children sustained subdural hematomas of varying sizes, one had a massive extradural clot, and four had intracerebral clots. The pre-, intra-, and postoperative data of these 16 patients are presented, but the specific factors causing the intracranial hemorrhage remain unexplained.

Palliation of tricuspid atresia. Potts-Smith, Glenn, and Blalock-Taussig shunts.

Aortopulmonary (Potts-Smith), subclavian-pulmonary (Blalock-Taussig), and cavopulmonary (Glenn) shunts are the commonly performed operations for palliation of tricuspid atresia. A total of 104 patients with tricuspid atresia have undergone these procedures, either alone or in combination over a 28-year-period at the Hospital for Sick Children, Toronto. Operative risk is high in the first six months of life (44%), reasonable after six months of age (7.

Survival after systemic to pulmonary arterial shunts in infants less than 30 days old with obstructive lesions of the right heart chambers.

Ninety-seven infants less than 30 days old with obstructive lesions of the right heart chambers underwent palliative surgery from 1950 through 1972. The diagnosis was made at cardiac catheterization and confirmed at operation or subsequent autopsy. Because of unavailability of complete preoperative studies and sufficient blood gas data, 36 patients presenting between 1950 and 1965 (Group I) were analyzed for surgical risk only.