Cardiac trauma.

Fifty years ago, nearly all significant cardiac injuries were fatal, many were untreatable, and most undiagnosed until the autopsy suite. In the last 20 years, however, dramatic improvements in prehospital trauma management, new diagnostic modalities, and the availability of cardiac surgery in many hospitals have rendered treatable most cardiac injuries. Knowledge of various types of cardiac injuries, the methods available to facilitate rapid diagnosis, and familiarity with techniques for surgical repair are no longer an academic exercise but a life-saving necessity.

Does the Centers for Disease Control's NNIS system risk index stratify patients undergoing cardiothoracic operations by their risk of surgical-site infection?

Background: In 1991, the Centers for Disease Control and Prevention devised the National Nosocomial Infection Surveillance (NNIS) System risk index to stratify populations of surgical patients by the risk of acquiring surgical-site infections (SSIs).

Objective: To determine whether the NNIS risk index adequately stratifies a population of cardiothoracic surgery patients by the risk of developing SSI.

Design: Case-control study.

Multiple left-sided cardiac lesions in one of Noonan's original patients.

We describe a complex case of obstruction of the left ventricular outflow tract in one of Dr. Noonan's original patients. Intraoperative findings revealed pathology at the valvar, subvalvar and supravalvar positions.

Age-related effects of St Thomas' Hospital cardioplegic solution on isolated cardiomyocyte cell volume.

Objectives: We tested the hypothesis that neonatal cells are more sensitive to cardioplegia-induced cell swelling than more mature cells and spontaneous swelling in the absence of ischemia can be prevented by cardioplegia with a physiologic KCl product.

Methods: Cell volumes of isolated ventricular myocytes from neonatal (3-5 days), intermediate (10-13 days), and adult (>6 weeks) rabbits were measured by digital video microscopy. After equilibration in 37 degrees C physiologic solution, cells were suprafused with 37 degrees C or 9 degrees C St Thomas' Hospital solution (standard or low Cl(-)) or 9 degrees C physiologic solution followed by reperfusion with 37 degrees C physiologic solution.